Lung cancer patients frequently experience a reduced quality of life and psychological distress during treatment. Traditional Chinese Medicine (TCM) nursing shows promise, but substantial heterogeneity in the evidence base limits clinical interpretation.

A comprehensive literature search identified 15 randomized controlled trials (RCTs) involving 1,135 participants. A meta-analysis was conducted using RevMan 5.4 and Stata 17. Following the Donabedian framework, data were categorized into structure, process, and outcome dimensions to explore sources of heterogeneity.

In the primary analysis, TCM nursing significantly improved all outcomes. For the Karnofsky Performance Status (KPS) score, the primary random-effects analysis showed a significant improvement (MD = 7.18, 95%CI 4.29-10.08). The sensitivity analysis excluding one outlier yielded a consistent effect (MD = 8.71, 95%CI 6.49-10.92). For the Self-Rating Depression Scale (SDS) score, the primary analysis showed a significant reduction (MD = -5.94, 95%CI -6.96 to -4.92). The sensitivity analysis excluding one outlier confirmed the robustness of these results (MD = -5.74, 95%CI -6.39 to -5.09). For the remaining outcomes with low heterogeneity, primary fixed-effects analysis revealed that TCM nursing significantly reduced Self-Rating Anxiety Scale (SAS) scores (MD = -4.65, 95%CI -5.28 to -4.03) and Visual Analog Scale (VAS) pain scores (MD = -1.46, 95%CI -1.56 to -1.36). Additionally, TCM nursing lowered the incidence of gastrointestinal reactions (RR = 0.19, 95%CI 0.06-0.58) and improved nursing compliance (RR = 1.24, 95%CI 1.10-1.39) (all p < 0.01). The subgroup analysis confirmed that comprehensive TCM care was more effective than emotion regulation alone for treating depression (p = 0.01). Intervention timing was suggested as a potential hypothesis-generating source of heterogeneity via sensitivity analysis. Structural factors (staff training, equipment, and qualifications) were critically underreported across all studies included in the analysis.

TCM nursing significantly improves multidimensional outcomes for lung cancer patients. The Donabedian model effectively identifies sources of process-related heterogeneity and highlights critical structural reporting gaps that require attention in future research.

PROSPERO, ID https://www.crd.york.ac.uk/PROSPERO/view/CRD420261339100.

Sequential conditioning allogeneic hematopoietic stem cell transplantation (allo-HSCT) regimens might offer improved disease control in high-risk myeloid patients. But concerns remain regarding toxicity, infection risk and delayed immune reconstitution (IR), particularly in older and HLA-haploidentical transplant recipients. To address these concerns, we comprehensively compared safety, feasibility and clinical outcome across HLA-matched related (MRD), matched unrelated (MUD) and haploidentical donor (Haplo) HSCT and longitudinally characterize IR patterns and their associations with post-transplant outcomes.

We conducted a retrospective matched-pair analysis comparing MRD-, matched MUD- and Haplo-HSCT in elderly patients matched for (1) disease activity: p = 1.0; (2) disease status: p = 1.0; (3) modified disease risk index (DRI): p = 0.9; (4) hematopoietic cell transplantation comorbidity index (HCT-CI): p = 0.92; and (5) age: p = 0.95. Outcomes included disease-free (DFS) and overall survival (OS), relapse, non-relapse mortality (NRM), graft-versus-host disease (GvHD), toxicity, infections, and donor-specific IR dynamics and their impact on clinical outcomes.

With a median follow-up of more than 9 years, no significant differences were observed in long-term disease control and survival among the three groups (5-y DFS/OS: MRD = 41%/41%, MUD = 56%/63%, Haplo = 58%/58%; p = 0.52/0.55). Cumulative incidences (CI) of 5-y-NRM and 1-y moderate and severe chronic GvHD (cGvHD) rates were comparable among the three groups (NRM/cGvHD: MRD = 19%/13%, MUD = 29%/6%, Haplo = 18%/19%; p = 0.3/0.57). Overall immune cell recovery after one year was comparable among groups, though early recovery of CD3+ T and NK cells was delayed after Haplo-HSCT. Subgroup analysis revealed that higher early CD4+ T and lower B cell counts were associated with increased CI of acute GvHD III-IV° (p = 0.04/0.03). Additionally, NK recovery at one year was associated with improved DFS and OS as well as lower relapse incidence.

Sequential therapy is safe and feasible in elderly patients with high-risk or active disease across all three transplant platforms. The observed associations between IR and clinical outcomes highlight the relevance of immune monitoring for anticipating post-transplant complications and guiding individualized prophylactic and therapeutic strategies. Prospective studies are needed to further investigate these findings and define the underlying mechanisms.

To evaluate whether women who have undergone cancer chemotherapy or radiotherapy achieve assisted reproductive technology (ART) outcomes comparable to those of non-cancer patients with equivalent ovarian reserve, and to explore the association between ART outcomes and the interval after chemotherapy or radiotherapy.

Retrospective cohort study.

32 cancer survivors who had received chemotherapy or radiotherapy and 160 matched control women had similar ovarian functions without malignancy.

Number of oocytes retrieved, embryo development, cumulative pregnancy rate and cumulative live birth rate.

This study performed inverse probability of treatment weighting (IPTW) to minimize potential confounding factors. After IPTW adjustment, the baseline characteristics were well balanced between the survivor and control groups. In the weighted regression analysis, the survivors exhibited a lower number of MII oocytes (β=-3.06 95%CI [-5.568, -0.555], P = 0.02), and a reduced high-quality embryo rate (β=-0.25 95%CI [-0.375, -0.128], P < 0.001). However, in the FET cycle, there was no difference in cumulative pregnancy rate and cumulative live birth rate and abortion rate. Besides, there was no strong relationship between the interval after chemo or radio therapy and ART outcomes.

This study demonstrated that when women with a history of chemotherapy or radiotherapy had similar ovarian function with women who had not experienced cancer still exhibited reduced number of MII oocyte and lower high-quality embryo rate and there was no difference in FET outcomes between survivor and control group. We also found no significant difference in different treat-to- IVF/ICSI interval in FET cycle outcomes.

Understanding the demographics, tumor characteristics, mutations, and immune scores in colorectal cancer (CRC) patients may aid in tailoring treatment and predicting survival.

This retrospective cohort study assessed clinical parameters, immune scores, and their relationship with survival in patients with CRC.

The study included 74 patients, mean age 53.7 years, mostly male (53.3%) and aged 41-70 (77.3%). Common comorbidities included cardiovascular diseases (29.3%) and hypertension (21.3%). Adenocarcinoma accounts for 74% of CRC cases, with 73% of CRCs affecting the colon. KRAS mutations and Microsatellite instability-High (MSI-H)/deficient mismatch repair (dMMR) were found in 1.3% and 16% of patients, respectively. Stage IV (77.3%) and liver metastases (52.7%) were prevalent. Immune score was influenced by cancer stage (p = 0.04) and metastasis (p=0.05). The immune score was not associated with survival (p = 0.181). Patients with comorbidities had lower one- (p = 0.027) and two-year survival rates (p = 0.037) survival rates. Cardiovascular comorbidities negatively impacted one-year survival (p = 0.047) and two-year survival (p = 0.037). The mean survival time was shorter for males (2.047±0.288 vs. 2.781±0.195 years, p = 0.041), patients with comorbidities (1.772±0.371 vs. 2.702±0.188 years, p = 0.017), and cardiovascular comorbidities (1.558±0.316 vs. 2.685±0.207 years, p = 0.038). Comorbidities (unadjusted hazard ratio [HR] 2.948, p = 0.023) and cardiovascular comorbidities (unadjusted HR 2.695, p = 0.046) were initially associated with survival but lost significance after adjusting for confounding variables.

This study provides insights into CRC patient demographics and their interplay with the immune score and survival.

To identify and characterize cognitive trajectories over 3 years in men with prostate cancer (PCa) and their associated sociodemographic, clinical, and treatment-related factors.

This study included 454 men with PCa from the NEON-PC cohort. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), before treatment and at 1- and 3-year follow-ups. Probable cognitive impairment (PCI) was defined using age- and education-adjusted cut-offs. Model-based clustering and clinical interpretability were used to identify cognitive trajectories. Adjusted odds ratios (aORs) were estimated using multinomial logistic regression.

Four cognitive trajectories were identified: (1) consistently high (highest scores throughout follow-up); (2) moderate-stable (stable intermediate scores); (3) moderate-downward (intermediate baseline scores and declining over the follow-up); and (4) consistently low (lowest baseline scores). PCI prevalence increased over time in the moderate-downward trajectory (8.1%-33.3%, p < 0.001) and remained high in the consistently low trajectory (29.8%-32.6%, p = 0.537). Compared with the consistently high trajectory, age (≥ 75 vs. ≤ 65: OR = 4.00; 95% CI: 1.61-9.93), education (≥ 10 vs. ≤ 4 years: aOR = 0.02; 95% CI: 0.01-0.06), and depressive symptoms (per one-point increase in the Hospital Anxiety and Depression Scale: aOR = 1.12; 95% CI: 1.01-1.24) were associated with the consistently low trajectory. Androgen deprivation therapy (ADT) was associated with the moderate-downward trajectory (aOR = 2.33; 95% CI: 1.01-5.36).

Four distinct cognitive trajectories were identified among men with PCa over 3 years, with worse trajectories associated with sociodemographic, psychological distress, and treatment-related factors.

Transarterial chemoembolization (TACE) is the standard treatment for patients with early-stage hepatocellular carcinoma (HCC), and post-embolization syndrome frequently occurs after the procedure. Although multiple studies have investigated risk factors for PES in HCC patients after TACE, their findings remain inconsistent and controversial. This systematic review aims to synthesize current evidence and identify risk factors associated with PES in HCC patients undergoing TACE.

This study follows a registered protocol for a systematic review and meta-analysis. We will include randomized and non-randomized trials, prospective or retrospective cohort studies, and predictive model development articles that report risk factors for post-embolization syndrome (PES) after transarterial chemoembolization (TACE) in patients with liver cancer. The primary outcome is the risk factors for post-embolization syndrome. A comprehensive literature search will be conducted from database inception across PubMed, MEDLINE, EMBASE, Web of Science, Scopus, CINAHL Plus, OpenGrey, the Cochrane Library, Google Scholar, and the China National Knowledge Infrastructure (CNKI). Two researchers will independently screen titles, abstracts, and full texts. Risk of bias will be assessed using validated tools. Where studies have similar sample characteristics, assessment methods, research design type and corresponding outcomes, we will pool the results and apply various types of meta-analyses such as mean difference, standard mean difference, or Cox regression for continuous outcomes and risk ratio measurement or logistic regression for categorical outcomes depicted in odds ratios and 95% confidence intervals (CIs). Meta-regression will be used to analyze heterogeneity if necessary.

This systematic review and meta-analysis will integrate evidence from both randomized and non-randomized studies, providing an updated and comprehensive synthesis of risk factors for PES after TACE in HCC patients. This study will also explore some factors that may explain the possible differences among different studies. The research results will be published in a peer-reviewed journal.

PROSPERO CRD420251218746.

Sunitinib resistance contributes to poor outcomes in advanced renal cell carcinoma (RCC). This study investigated the anti-metastatic effects and underlying mechanisms of melatonin in sunitinib-resistant (SR)-RCC. Melatonin significantly inhibited the migration and invasion of A498-SR and Caki-1-SR cells. SR-RCC cells exhibited elevated CTSD expression, impaired endoplasmic reticulum (ER) stress signaling with reduced GRP78 and IRE1α, and enhanced p38 MAPK activation, all of which were reversed by melatonin. Silencing p38 MAPK further potentiated the inhibitory effects of melatonin on cell migration and invasion. Mechanistically, CTSD expression was regulated through both GRP78/p38 MAPK-mediated ER stress. In vivo, melatonin markedly reduced lung metastasis of Caki-1-SR cells without causing significant toxicity to major organs. Collectively, these findings demonstrate that melatonin inhibited the metastatic potential of SR-RCC by decreasing CTSD expression, restoring ER stress response, and decreasing p38 MAPK expression, supporting its potential as an anti-metastatic therapeutic agent for SR-RCC.

An intraductal tubulopapillary neoplasm (ITPN) is a rare pancreatic tumor characterized by scant mucin production. Even when associated with an invasive carcinoma component, its prognosis is generally considered more favorable than that of conventional pancreatic ductal adenocarcinoma. However, its pathogenesis and optimal treatment strategy remain unclear. Herein, we report a case of a synchronous multifocal ITPN treated with total pancreatectomy.

A man in his 50s was referred to Gunma University Hospital for evaluation of pancreatic duct abnormalities after CT revealed a caliber change in the main pancreatic duct in the pancreatic body and distal pancreatic atrophy. Further evaluation demonstrated lesions associated with main pancreatic duct strictures in the pancreatic body and tail. A diagnosis of resectable pancreatic body and tail cancers was therefore established, and the patient received 2 courses of neoadjuvant chemotherapy (NAC) with gemcitabine plus S-1. Imaging after NAC revealed a new lesion in the pancreatic head. Endoscopic ultrasonography-guided fine-needle aspiration confirmed adenocarcinoma, and the patient was diagnosed with synchronous multifocal pancreatic cancers involving the pancreatic head, body, and tail. Total pancreatectomy was performed. Histopathological examination demonstrated 3 noncontiguous synchronous multifocal ITPNs, each with an independent invasive carcinoma component, in the pancreatic head, body, and tail. The postoperative course was uneventful, and the patient was discharged on POD 15. The patient required no adjuvant therapy and remained recurrence-free at 11 months postoperatively.

We describe an extremely rare case of a synchronous multifocal ITPN. The noncontiguous distribution observed in this case raises the possibility of multicentric development, although alternative mechanisms cannot be excluded. Further case accumulations and molecular analyses are required to clarify the pathogenesis of this disease and establish optimal treatment strategies.

Tumor-induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, resulting in hypophosphatemia and altered bone turnover. It is most frequently caused by phosphaturic mesenchymal tumors (PMTs), a rare and distinct group of neoplasms. Patients with TIO exhibit clinical features of osteomalacia, including bone and muscle pain, severe muscle weakness, gait disturbance, and increased susceptibility to fracture. PMTs exhibit pananatomic distribution, in soft tissue or bones, but are most commonly found in the lower extremities, followed by the head and neck. Most head and neck tumors are located in the sinus area, while jaw involvement is exceptionally rare. Diagnosis is difficult and the misdiagnosis rate is high. A case PMT occurring in the jaws are presented to highlight diagnostic features and challenges. Notably, PMTs are benign tumors and their removal results in correction of the biochemical aberrations that underly the TIO.

Granulomatous mastitis (GM) of the breast has long posed a clinical dilemma in terms of diagnosis and management. GM can range from acute to chronic inflammations, which will have treatment implications. Inflammation of the breast may clinically mimic breast carcinomas and pyogenic abscesses. Thus, in the absence of known etiology, such as trauma or breastfeeding, GM may be difficult to diagnose. Currently, the incidence of GM is 2.4 per 100,000 women and 0.37% of the total population in the US. The rarity of GM contributes to it being a poorly understood disease. It has no definite clinical features and is often confused with a neoplasm or infection clinically and radiologically.

The study aimed to describe the clinical characteristics of GM seen in the Breast Care Clinic in the Philippine General Hospital (PGH) from January 2015 to June 2019. This study would initially provide institutional data on GM that is relevant in the Philippines.

This is a retrospective observational study of patients with GM seen in the Philippine General Hospital, a national tertiary referral hospital, from January 2015 to June 2019.

A total of 43 patients with pathological findings of GM from January 1, 2015 to June 15, 2019 were recorded. Among these 43 patients, 98% were female. The median age was 38.9 ± 11.3 years old. In 60.5% (26 out of 43) of patients, the initial impression was breast malignancy. The most common clinical presentation in 69.8% (30 out of 43) of the subjects was a breast mass. In more than 50% of the patients, breast ultrasonography was the initial imaging performed. The histopathologic profile of the patients showed inflammation, of which, the greatest were that of chronic granulomatous inflammation (46.5%, n-20). Treatment options performed were tended more medical (53.5%, n-23) than surgical (16.3%, n-7).Among those who received medical treatment, the therapeutics given were antitubercular medications (34.9%, n-15) and antibiotics (16.3%, n-7), while the others had a combination of antitubercular and antibiotic regimen medications (2.3%, n-1); unknown treatment (25.6%, n-11) and none (11.6%, n-5). For patient outcomes, no mortalities were recorded during the study period. However, most patients had inconsistent follow-ups. Approximately 7%-23% of the patients who had followed up within the six months showed improvement or resolution of symptoms.

This study assessed the clinical profiles of patients with GM in a national tertiary referral hospital. Internationally, there is still no consensus on the algorithm and management of GM patients. However, the authors recommend a close follow-up every two weeks to re-evaluate patient response to the medical regimen being administered. The authors recommend a prospective study with a longer follow-up period to gain a deeper understanding of GM in Filipinos.