To identify the potential subgroups of demoralization in ovarian cancer patients and explore the influencing factors associated with different potential subgroups.

This multicenter cross-sectional study recruited 309 ovarian cancer patients using convenience sampling from five tertiary hospitals in Lanzhou City, Gansu Province, China, between June 2024 and February 2025. Participants were assessed using a sociodemographic and disease-related questionnaire, the Demoralization Scale Mandarin Version (DS-MV), the Chinese version of the Memorial Symptom Assessment Scale (MSAS-Ch), the Patient Health Questionnaire (PHQ-9), the Medical Coping Modes Questionnaire (MCMQ), and the Perceived Social Support Scale (PSSS). Latent profile analysis (LPA) was employed to explore potential subgroups of demoralization among ovarian cancer patients. Univariate analyses and multivariate logistic regression analyses were conducted to analyze influencing factors associated with different potential subgroups.

The average demoralization score among ovarian cancer patients was 35.61 ± 8.51. Demoralization of ovarian cancer patients was divided into three classes: the critical demoralization-stable group (57%), the moderate demoralization-helplessness group (30.7%), and the high demoralization-distress group (12.3%). Multivariate logistic regression analysis revealed that the number of chemotherapy sessions, symptom burden, coping styles, and social support were the influencing factors for the potential profile of demoralization in ovarian cancer patients (P < 0.05).

The demoralization in ovarian cancer patients exhibits heterogeneity. Healthcare professionals should prioritize identifying high-risk subgroups and develop targeted clinical symptom management strategies to prevent or alleviate demoralization.

Nonoperative management (NOM) in blunt pancreatic injury (BPI) is frequently complicated by pseudocyst formation and pancreatic atrophy. To address these complications, we have utilized a pancreatic stent via endoscopic retrograde cholangiopancreatography (ERCP) for children with PDI since 2019.

We present our experience with ERCP-based NOM for PDI and provide a literature review of stent therapy in pediatric PDI.

Ten children with BPI treated between January 2007 and December 2025 were classified according to the 2024 American Association for the Surgery of Trauma pancreatic injury grades: IB (n = 3), IIA (n = 3), IIIA (n = 2), and IIIB (n = 2). Pancreatic stents were placed in two IIIA cases and one IIIB case. The IIIB case subsequently underwent transpapillary pseudocyst drainage (TPPD) due to a pseudocyst infection.

NOM was successful in all low-grade injuries (< II) without complications. One IIIB patient treated without stenting developed a pseudocyst requiring cyst-gastrostomy; 1-year follow-up demonstrated severe pancreatic atrophy. In the two IIIA stent cases, the duct injury was successfully bridged: one patient had no pseudocyst formation, and the other developed a pseudocyst that resolved spontaneously; both showed preserved pancreatic parenchyma. The IIIB patient treated with TPPD experienced rapid cyst resolution; 1-year imaging revealed approximately 50% distal pancreatic atrophy.

TPPD should be considered for symptomatic pseudocysts, even after stent placement. ERCP-based NOM for pediatric PDI can be performed safely, may prevent pancreatic atrophy, and represents a valuable option in the management of PDI in children.

Combination immunotherapy has shown encouraging activity across multiple solid tumors. We report the complete and consecutive cohort of patients with locally advanced oral squamous cell carcinoma (OSCC) treated at a single center within the prospective, multicenter, randomized phase 2 BelieveIT-201 trial (ASND0038), evaluating neoadjuvant intratumoral Toll-like receptor (TLR) 7/8 agonist (TransCon TLR7/8 Agonist) therapy combined with systemic immunotherapy.

Patients with non-metastatic OSCC treated within the BelieveIT-201 trial (ASND0038) between April and December 2024 were included. Neoadjuvant therapy comprised two cycles of intratumoral TransCon TLR7/8 Agonist combined with either intravenous pembrolizumab or TransCon IL-2 β/γ according to 1:1 randomization, followed by surgical resection. The trial was terminated prematurely by the sponsor for reasons unrelated to safety or efficacy, which limited the cohort to six patients. Clinical, radiographic, pathological responses, and safety were assessed. Immunohistochemical analyses of paired pre- and post-treatment tumor samples evaluated immune cell infiltration (CD3, CD8, CD68, CD163). The individual patient was the unit of analysis, and given the small number of patients all analyses are descriptive; no inferential statistical testing was performed. Progression-free survival (PFS) and overall survival (OS) are reported as absolute event counts.

Six patients were treated (median age 63 years; median follow-up 81 weeks). Three patients achieved a major clinical response, two showed partial response, and one had progressive disease. Pathologic evaluation revealed one complete response, one major response, and four non-responses. All patients underwent surgery; postoperative morbidity was substantial, with at least one grade III adverse event in every patient and one postoperative death. All three patients with a major clinical response developed sterile tumor-associated pseudoabscesses in spatial proximity to the injection site. Immunohistochemical analyses revealed remodeling of the tumor immune microenvironment, including increased T-cell infiltration, most pronounced in the tumor center. Within the first year, two of six patients experienced a progression-free survival event (n = 1 progressive disease, n = 1 death). After surgery none of the patients showed disease recurrence.

Neoadjuvant intratumoral TransCon TLR7/8 Agonist-based combination immunotherapy was feasible in this small prospective cohort of patients with locally advanced OSCC and was accompanied by consistent remodeling of the tumor immune microenvironment. Because of the limited number of patients and the premature termination of the parent trial, no conclusions on efficacy or on comparative tolerability can be drawn.

To evaluate the cost-effectiveness of elranatamab versus physician's choice of treatment (PCT) for patients with triple class exposed multiple myeloma in Japan.

A cost-effectiveness analysis was conducted comparing elranatamab with PCT using a partitioned survival model with three health states from the Japanese public healthcare payer perspective. A weekly cycle length and a 25-year lifetime horizon were applied, with costs and health outcomes discounted at 2% annually in accordance with Japanese HTA guidelines. Clinical inputs for elranatamab were derived from the phase 2 MagnetisMM-3 trial. Comparative effectiveness versus PCT was estimated using an unanchored matching-adjusted indirect comparison (MAIC) with the prospective real-world LocoMMotion study. Utility values were calculated by applying the Japanese value set to EQ-5D-5L data collected in MagnetisMM-3. Scenario analyses were performed using MAIC-based comparisons versus teclistamab and idecabtagene vicleucel (ide-cel).

In the base-case analysis, elranatamab increased quality-adjusted life-years (QALYs) compared with PCT (2.59 vs 0.82) at a higher total cost (JPY 36,901,695 (USD 246,570) vs 30,899,696 (USD 206,466)), resulting in an incremental cost of JPY 6,001,999 (USD 40,104) and an incremental QALY gain of 1.77. The incremental cost-effectiveness ratio (ICER) was JPY 3,394,966 (USD 22,684) per QALY, remaining within cost-effectiveness thresholds in Japan. Sensitivity analyses demonstrated the robustness of the base-case results. In scenario analyses, elranatamab was dominant versus teclistamab and ide-cel.

Limitations include reliance on the clinical opinion of a single hematology expert for Japanese clinical practice patterns, extrapolation beyond observed trial follow-up, and inherent constraints of MAIC due to the lack of head-to-head trials.

From the healthcare payer perspective, elranatamab was cost-effective versus PCT in the base case and scenario analyses, with ICERs consistently below commonly accepted thresholds in Japan; contingent on the unanchored MAIC and long-term extrapolation, this should be interpreted with caution.

Research in exercise oncology has consistently provided evidence supporting the integration of exercise into all phases of cancer care. However, less is known about how this can be implemented across different patient populations and healthcare settings. This study aims to generate knowledge about the equitable implementation of digitally supported physical rehabilitation during and after systemic cancer treatment through feasibility testing in 5 South Baltic countries. Methodology. This study is part of the gAMBeRh project (Advanced Modeling of Baltic E-cancer caRe) and is an international, multicenter, prospective study with a hybrid implementation-effectiveness design. It includes 2 single-arm feasibility trials, each aiming to enroll 30 patients undergoing systemic treatment and 30 patients who have completed systemic treatment or are receiving long-term or life-prolonging treatment at each participating site, for a total of 300 adult cancer patients. All tumor groups are eligible, and participants must be .18 years of age. We will use the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to structure data collection and reporting. Additionally, Group Concept Mapping will be used to evaluate determinants of participation among patients and determinants of intervention delivery among healthcare professionals (HCPs). Enrollment began in September 2024 and is expected to be completed by December 2026. Discussion. While digital solutions have the potential to overcome barriers to integrating exercise into oncology care, inequitable implementation may inadvertently exacerbate disparities in cancer rehabilitation if these innovations remain inaccessible to patients with fewer resources. By evaluating reach, effectiveness, adoption, implementation, and maintenance, as well as the determinants of participation among patients and HCPs, this study will contribute to the evidence base on the implementation of digitally supported physical rehabilitation in cancer care.

Findings from the AMBeR eRehab study will inform future efforts to digitize cancer rehabilitation while ensuring that inequities are not reproduced.

Esophageal adenocarcinoma is associated with poor survival despite advances in systemic therapy. Readily available serum biomarkers may improve risk stratification; however, their combined role in biomarker-guided treatment decisions remains insufficiently investigated.

To evaluate the prognostic significance of combined baseline carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels and explore their utility for biomarker-based risk stratification in patients with esophageal adenocarcinoma receiving systemic chemotherapy.

This retrospective real-world cohort study included 38 patients with histologically confirmed esophageal adenocarcinoma who received systemic chemotherapy at a tertiary referral center between January 2016 and December 2021. Patients were classified into three exploratory biomarker-defined risk groups according to baseline serum CEA and CA19-9 levels. Overall survival was evaluated using Kaplan-Meier analysis and Cox proportional hazards regression, while treatment outcomes were explored across biomarker-defined groups and chemotherapy regimens.

Elevated baseline CEA and CA19-9 levels were associated with shorter overall survival. Patients with simultaneous elevation of both biomarkers demonstrated the poorest survival outcomes (multivariable hazard ratio = 2.22). Differences in survival were observed across chemotherapy regimen groups within biomarker-defined categories; however, these comparisons were exploratory and may have been influenced by treatment-selection bias and unmeasured clinical factors. Patients with distal or gastroesophageal junction adenocarcinoma showed more favorable outcomes than those with cervical or thoracic tuxzmors.

Combined assessment of baseline CEA and CA19-9 may provide a practical and inexpensive approach for biological risk stratification in esophageal adenocarcinoma. However, these findings do not establish that the biomarkers can guide chemotherapy selection. Prospective multicenter studies with independent validation are required to determine their prognostic and predictive value before biomarker-guided treatment selection can be recommended in routine clinical practice.

Patients with lung adenocarcinoma (LUAD) receiving radiotherapy represent an important but underexplored clinical subgroup. These patients often undergo concomitant pharmacologic treatments, yet the prognostic impact and underlying determinants of such combined regimens remain poorly understood.

This retrospective observational study aimed to develop and validate a radiotherapy-specific machine learning prognostic model for LUAD and to compare survival across concomitant pharmacologic regimens.

In this retrospective observational study, using genomic and clinical data from TCGA, a radiotherapy-specific prognostic model for LUAD was developed and validated through ten machine learning algorithms. Survival analyses were conducted across distinct concomitant pharmacologic strategies, followed by functional enrichment to elucidate molecular mechanisms underlying differential outcomes.

Demonstrating robust prognostic abilities, the model efficiently sorted patients into high- and low-risk categories. Both treatment type and risk score independently predicted overall survival, with significant interaction effects. Low-risk patients receiving targeted or combination therapy-mainly erlotinib, gefitinib, or bevacizumab-exhibited substantially improved survival compared with those receiving conventional chemotherapy. Enrichment of "Exogenous peptide presentation," "MHC class II assembly," "Peptide-MHC II assembly," and "Symbiotic interaction" pathways indicated immune modulation and host-tumor crosstalk as key mediators of treatment efficacy.

This study establishes a radiotherapy-specific prognostic model for lung adenocarcinoma, demonstrating distinct molecular and therapeutic heterogeneity and highlighting the superior survival benefit of targeted combination therapy in low-risk patients.

Selected high-risk appendiceal neoplasms with tumour perforation or T4 disease may be considered for risk-reducing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), even without overt radiological peritoneal disease. Since 2012, our centre has offered laparoscopic CRS-HIPEC, and a robotic approach was recently introduced to enhance visualisation, dexterity, and precision while minimising surgical trauma. This study evaluates the feasibility, safety, and early outcomes of risk-reducing robotic CRS-HIPEC (RCRS-HIPEC) in selected patients with high-risk appendiceal neoplasms without radiological peritoneal disease.

This retrospective single-centre case series was conducted at a national referral centre for peritoneal surface malignancy. Eight patients underwent standardised RCRS-HIPEC. The cohort included low-grade appendiceal mucinous neoplasm ( n = 3), goblet cell carcinoma ( n = 4), and appendiceal adenocarcinoma ( n = 1). The standardised operative approach included omentectomy, falciform excision, umbilicectomy, and cholecystectomy or salpingo-oophorectomy where indicated, followed by closed HIPEC. Outcomes assessed included operative time, blood loss, complications, length of stay, histopathology, patient-reported recovery, and preliminary resource utilisation.

Mean age was 65.8 years; there were 5 male and 3 female patients. Mean operative time was 6 h 19 min (±25 min), with minimal blood loss (<150 mL). No patient required epidural analgesia, parenteral nutrition, or prolonged critical care. Median time to first flatus was 3 days, and median hospital stay was 5 days. Two patients experienced Clavien-Dindo grade I morbidity, with no major complications. Histopathology demonstrated residual disease in two patients. Early electronic patient-reported outcome measures suggested favourable recovery, and preliminary Patient Level Information and Costing System data indicated potential NHS resource savings.

RCRS-HIPEC is feasible and safe in carefully selected patients with high-risk appendiceal neoplasms without radiological peritoneal disease. A standardised robotic approach may promote reproducibility, support enhanced recovery, and reduce healthcare resource use. Larger comparative studies are warranted.

IntroductionThe influence of ultrasound imaging plane on the diagnostic performance of artificial intelligence-based computer-aided diagnosis systems for thyroid nodules remains unclear. This study evaluated S-Detect in transverse and longitudinal ultrasound planes and compared four plane-based interpretation strategies.MethodsThis prospective cross-sectional study included 157 patients with 207 surgically confirmed thyroid nodules. Each nodule was independently analyzed by S-Detect in transverse (S-Detect_T) and longitudinal (S-Detect_L) planes. Four diagnostic strategies were evaluated: transverse-plane assessment, longitudinal-plane assessment, a serial strategy classifying a nodule as possibly malignant only when both planes indicated possible malignancy, and a parallel strategy classifying a nodule as possibly malignant when either plane indicated possible malignancy. Diagnostic performance, agreement, and interplane discordance were assessed.ResultsOf the 207 nodules, 140 were malignant and 67 were benign. S-Detect_L showed numerically higher sensitivity and specificity than S-Detect_T (93.6% vs 92.1% and 62.7% vs 59.7%, respectively), but neither difference was statistically significant. Transverse- and longitudinal-plane classifications agreed in 89.4% of nodules, whereas 10.6% showed interplane discordance. The parallel strategy achieved the highest sensitivity (97.9%) and negative predictive value (92.5%) but the lowest specificity (55.2%). The serial strategy achieved the highest specificity (67.2%) and the lowest false-positive rate (32.8%) but had lower sensitivity (87.9%). Compared with the serial strategy, the parallel strategy identified 14 additional malignant nodules while producing eight additional false-positive classifications. A sensitivity analysis restricted to one nodule per patient showed the same overall pattern.ConclusionsTransverse- and longitudinal-plane S-Detect assessments showed similar diagnostic performance, although interplane discordance occurred in a subset of nodules. The parallel strategy favored sensitivity, whereas the serial strategy favored specificity and fewer false-positive classifications. No imaging plane or combination rule was consistently superior across all diagnostic measures.

Until recent introduction of ceftazidime/avibactam (CAZ-AVI) to Korean hospitals in October 2023, alternative antibiotics had been used to treat carbapenem-resistant Enterobacterales (CRE) infection such as high-dose meropenem combination therapy with amikacin, tigecycline, and/or colistin. To compare the outcome of CRE bacteremia between CAZ-AVI (study group) and alternative antibiotics (comparator group) before/after the introduction of CAZ-AVI.

We retrospectively reviewed the adult patients with hematologic malignancy who had CRE bacteremia between January 2020 and July 2024.

A total of 85 patients with CRE bacteremia were analyzed including 25 with CAZ-AVI and 60 with alternative antibiotics. In a time-dependent multivariable Cox model for negative conversion of bacteremia, CAZ-AVI (hazard ratio [HR], 2.475; 95% confidence interval [CI], 1.493-4.102; P < 0.001) and Klebsiella pneumoniae carbapenemase [KPC] (HR, 0.490; 95% CI, 0.296-0.810; P = 0.005) was independently associated with rapid negative conversion. CAZ-AVI was associated with rapid negative conversion of bacteremia in the inverse probability of treatment weighting (IPTW) analysis (HR, 3.030; 95% CI, 1.818-5.263; P < 0.001). In a time-dependent multivariable Cox model, CAZ-AVI was the only independent predictor for 30-day mortality (HR, 0.295; 95% CI, 0.087-0.996; P = 0.049), although CAZ-AVI did not reach any statistical significance for 30-day mortality (HR, 0.513; 95% CI, 0.146-1.804; P = 0.298) in IPTW analysis.

CAZ-AVI showed higher rapid negative conversion for CRE bacteremia in patients with hematologic malignancy, compared to the alternative antibiotics.