Background/Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. This study evaluates the predictive value of Carcinoembryonic Antigen (CEA) in identifying CRC recurrence following surgical resection. Methods: This retrospective study was realized in the Oncology Institute in Cluj-Napoca and included 88 patients diagnosed with CRC. Clinical, demographic, and tumor-specific data were collected, including TNM staging, tumor histology. CEA levels were recorded before surgery. Receiver Operating Characteristic (ROC) analysis was performed to determine the diagnostic accuracy of CEA in predicting tumor relapse, and the sensitivity and specificity of various CEA cut-off values were assessed. Results: Most patients presented with advanced-stage tumors (T3/T4, 80.6%). CEA levels were significantly higher in patients with lymphatic and perineural invasion and in those with metastases (mean CEA: 45.0 ng/mL for M1 vs. 13.2 ng/mL for M0, p = 0.032). ROC analysis revealed an area under the curve (AUC) of 0.877 (95% CI: 0.763-0.949). A CEA cut-off value of 11.73 ng/mL yielded 100% sensitivity and 74.5% specificity for detecting recurrence; Conclusions: CEA is a valuable non-invasive biomarker for predicting CRC relapse, with high sensitivity and acceptable specificity. Regular CEA monitoring post-surgery can facilitate early detection of recurrence, improving prognosis.

Background: Night shift work has been classified as a probable carcinogen due to its disruption of circadian rhythms. However, whether night shift work can increase the risk of ovarian cancer remains unclear. Herein, we investigated this association using a systematic review and meta-analysis. Methods: We systematically searched several databases until June 2025 for relevant studies. Effect estimates were extracted and pooled using a random-effects model to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity across studies was assessed using the I² statistic, and publication bias was assessed using Egger's regression test and funnel plot asymmetry. Results: Seven studies (eight cohorts) involving >2.5 million women were included. Overall, night shift work was not significantly associated with ovarian cancer (OR = 1.13; 95% CI: 0.96, 1.32; I² = 49%). However, significant associations were observed in case-control studies (OR = 1.36; 95% CI: 1.12, 1.66; I² = 0.8%) and in high-quality studies (OR = 1.17; 95% CI: 1.00, 1.37; I² = 52%). Sensitivity analyses suggested that exposure misclassification in some cohort studies attenuated risk estimates. No publication bias was detected (z = -0.63, p = 0.53). Conclusions: While the overall findings did not demonstrate a statistically significant association, evidence from case-control studies that collected detailed information about night shift work suggests an increased ovarian cancer risk in night shift workers. Future large-scale prospective studies with detailed exposure assessments are warranted to confirm these findings.

Background: Despite evidence discouraging contralateral prophylactic mastectomy (CPM) in average-risk patients, its use is increasing globally. While well-studied in Western settings, little is known about the factors influencing CPM decisions in the Middle East and North Africa (MENA) region. This study explores clinical, psychosocial, and communication-related factors associated with CPM choices among women with early-stage breast cancer. Methods: We conducted a retrospective study of 253 early-stage breast cancer patients who underwent mastectomy, with or without CPM, at the American University of Beirut Medical Center. Clinical and demographic data were extracted from medical records, and decision-making factors were assessed through tailored patient questionnaires. Associations were analyzed using chi-square tests and multivariable logistic regression. Results: Of the 253 women included in the study, 37 underwent CPM, while 216 had unilateral mastectomy (UM). Compared to the UM group, women who chose CPM were more likely to have a college education (96.9% vs. 57.6%, p < 0.001), be employed (69.7% vs. 41.3%, p = 0.002), and report a family history of breast cancer (55.6% vs. 30.2%, p = 0.003). Immediate reconstruction was significantly more common among CPM patients (67.6% vs. 16.4%, p < 0.001), and the 30-day rehospitalization rate was also higher (16.2% vs. 6.1%, p = 0.031). Women in the CPM group were more likely to prioritize extending life (84.6% vs. 56.7%, p = 0.007) and achieving peace of mind (80.8% vs. 49.3%, p = 0.003). Although all CPM patients cited risk reduction as a primary motivator, only 46.2% believed they had a lower recurrence risk than their peers (vs. 20% of UM patients, p < 0.001). Decisions to undergo UM were more frequently influenced by physicians' recommendations (95.3% vs. 53.8%, p < 0.001), whereas CPM decisions appeared to be more patient-driven. Additionally, CPM patients reported more negative expectations and higher dissatisfaction with pain (57.7% vs. 32.0%, p = 0.012) and reconstructive outcomes (54.5% vs. 27.5%, p = 0.035). Conclusions: In this first study from the MENA region exploring CPM decision-making, choices were largely driven by personal preferences rather than clinical risk. These findings highlight the need for improved risk communication, shared decision-making, and broader integration of genetic counseling in surgical planning.

Histopathological growth patterns (HGPs) of liver metastases have been shown to possess prognostic significance. To date, only 2 studies have evaluated the reproducibility of HGP assessment. The aim of our study was to assess the interobserver reproducibility of HGP classification in liver metastases.

A retrospective, consecutive, single-center cohort study was conducted, including patients who underwent surgical resection for liver metastases at the University of Szeged between 2011 and 2023. A comprehensive database was established, incorporating basic histopathological data for each case. Histological slides were independently reviewed by 2 pathologists, 3 pathology specialist trainees, and 2 medical students with varying levels of experience in gastrointestinal pathology. Interobserver agreement was evaluated using intraclass correlation coefficients (ICC) and Fleiss' kappa.

The study included resection specimens from 205 patients, comprising 336 metastatic lesions, predominantly of gastrointestinal origin (n = 188). Excellent interobserver agreement was observed among specialist trainees (ICC = 0.911) and board-certified pathologists (ICC = 0.984). Overall agreement among all 7 evaluators was good (ICC = 0.822).

Our findings demonstrate that HGPs can be reliably assessed by individuals with at least 2 years of experience in general pathology. To our knowledge, this is the first study to include the largest number of board-certified pathologists and pathology specialist trainees in a HGP reproducibility analysis. Additionally, no comprehensive literature review on this topic has been previously conducted.

Background/Objectives: Patients with advanced ovarian cancer with a high tumor burden typically undergo neoadjuvant chemotherapy (NACT) followed by interval debulking surgery. The optimal number of NACT cycles remains undefined: although three to four cycles are considered gold-standard, in real-world practice, five or more cycles are frequently administrated. This study aims to evaluate the impact of delayed interval debulking surgery (DIDS) after ≥5 cycles of NACT on the survival rates. Methods: We conducted a retrospective analysis of women with advanced ovarian cancer that underwent surgery in the 1st Department of Obstetrics-Gynecology Clinic from 2012 to 2022. Patient characteristics, oncological, and follow-up information were collected. Results: A total of 125 patients met the inclusion criteria and were divided into two groups: Group A (77 patients) received 3-4 of NACT cycles, and Group B (48 patients) ≥5 cycles. No statistically significant difference was observed between the groups concerning age, BMI, comorbidities, Aletti score, FIGO stage, pre-operative CA-125 values, surgery duration, rate of postoperative complications, hospital stay, ICU admittance, and complete gross resection (RD = 0). However, patients undergoing DIDS experienced significantly greater intraoperative blood loss. Progression-free survival did not differ between groups (IDS: 17 vs. DIDS: 18 months, p = 0.561), whereas overall survival was significantly lower in the DIDS group (IDS: 52 vs. DIDS: 36 months, p = 0.00873). This statistical significance persisted after controlling for residual disease, but was lost after adjusting for FIGO stage. Conclusions: DIDS may be considered for advanced ovarian cancer patients with a high tumor burden, when complete gross resection (RD = 0) cannot be achieved during IDS. Further prospective randomized trials are necessary to evaluate its oncological safety and morbidity.

Stomach adenocarcinoma is a major contributor to worldwide mortality and significantly impacts life expectancy. The main objective of the current study was to identify a prognostic biomarker for stomach adenocarcinoma to advance translational medicine and improve patient outcomes.

various databases (GEPIA, UALCAN, miRNet, StarBase, and Kaplan Meier plotter) bioinformatics tools (cytoscape) and were used in this study.

Ten novel unfavorable prognosis-associated genes were identified. In addition, 41 potential miRNAs were predicted. ELAVL3-hsa-mir-29a-3p and CALCR-hsa-mir-29a-3p were identified as the two critical networks in the oncogenesis of stomach adenocarcinoma via bioinformatics analysis. Subsequently, the binding of lncRNAs to hsa-mir-29a-3p was predicted utilizing the starBase and miRNet databases. Following the execution of both expression and survival analyses for the predicted lncRNAs, it was determined that only one lncRNA, KCNQ1OT1, exhibited significant overexpression in stomach adenocarcinoma, and its elevated expression was associated with an unfavorable prognosis. Subsequently, we constructed a triple ceRNA network involving mRNA, miRNA, and lncRNA, which is associated with the prognosis of stomach adenocarcinoma.

In summary, the current study provides an extensive ceRNA network that highlights novel prognostic biomarkers for stomach adenocarcinoma.

Systematic PSA-based screening for prostate cancer remains controversial due to the trade-off between reduced mortality and risk of overdiagnosis and overtreatment. Adding new tools like magnetic-resonance-imaging-targeted biopsies and genetic markers may limit the harms, but we lack definitive mortality data. While opportunistic PSA testing is widely used in Denmark, unsystematic use may potentially be harmful. Introduction of a systematic screening programme in Denmark requires careful consideration of the clinical, psychological, societal and economic impacts, and Danish politicians should thus engage in the debate to clarify these issues.

Breast cancer accounts for 14% of all cancer-related deaths among women. Women aged 50-69 years are offered biennial mammography, which reduces breast cancer-specific mortality. Simulations suggest that risk-stratified screening detects more early-stage cancers while lowering the number of unnecessary recalls, assessments and biopsies in low-risk women. This trial will investigate whether multifactorial risk-stratified screening, including polygenic score, is feasible, acceptable, cost-efficient and safe.

A minimum of 962 consenting women aged 50-67 years will be randomised 1:1 into a control group receiving standard screening or an intervention group offered screening intervals based on individual risk. Risk factor data collection, communication and follow-up will occur online using a tool co-designed with women in the target group. The primary outcome will be the proportion of low-risk women who, within 800 days of their baseline mammogram, will refrain from their legally ensured two-year mammogram interval. Secondary outcomes include quality of life, anxiety and breast cancer worry, measured at baseline and repeated three times during follow-up. In addition, health economy analyses will be conducted.

The findings will inform the development of large-scale risk-stratified screening trials.

Novo Nordisk Foundation, grant no. NNF21OC0070842. ACA is supported by Cancer Research UK grants: PPRPGM-Nov20\100002 and SEBCD3-2024/100001.

gov Identifier: NCT06060938. Registration date: 11092023.

Lung cancer is one of the common cancers globally. One of the adverse symptoms of lung cancer and its treatment is fatigue. Pharmacological interventions have not shown efficacy on cancer-related fatigue, and investigations on nonpharmacological interventions may be useful. This systematic review aims to evaluate the efficacy of nonpharmacological interventions on managing fatigue and quality of life outcomes among people undergoing treatment for lung cancer and evaluate if treatment efficacy differed between single and multimodal interventions.

Relevant literature published in MEDLINE, Scopus, Cochrane Library, CINAHL, and ProQuest from January 2003 to January 2023 was included. Included studies must have: participants over 16 years of age receiving treatment such as chemotherapy, radiotherapy, and/or surgery, cancer-related fatigue (CRF) as an outcome, and must be randomized controlled trials. Two reviewers independently extracted data from eligible articles, and data analysis was performed using R 4.1.0 software.

Total of 14 randomized controlled trials were included and categorized into four groups: physical activities, traditional Chinese medicine (TCM), education, and dietary counselling. Our extensive search did not find any multimodal studies related to CRF in patients with lung cancer. Pooled results of this systematic review found that TCM and education interventions have a significant positive impact on fatigue in patients with lung cancer. Physical activity and dietary counselling were not effective in managing fatigue. None of the reported nonpharmacological interventions in this review significantly impact QoL.

This review identified that TCM and educational programs improved CRF in patients with lung cancer. However, physical activities and dietary counselling did not show any improvements in fatigue for patients undergoing lung cancer treatment.

PROSPERO registration ID: CRD42023407326.

The increasing availability of large-scale omics data calls for robust analytical frameworks capable of handling complex gene expression datasets while offering interpretable results. Recent advances in artificial intelligence have enabled the identification of aberrant molecular patterns distinguishing disease states from healthy controls. Coupled with improvements in model interpretability, these tools now support the identification of genes potentially driving disease phenotypes. However, current approaches to gene anomaly detection often remain limited to single datasets and lack accessible graphical interfaces. We introduce E-ABIN, a general-purpose, explainable framework for anomaly detection in biological networks. E-ABIN combines classical machine learning and graph-based deep learning techniques within a unified, user-friendly platform, enabling the detection and interpretation of anomalies from gene expression or methylation-derived networks. By integrating algorithms such as support vector machines, random forests, graph autoencoders, and graph adversarial attributed networks, E-ABIN ensures high predictive accuracy while maintaining interpretability. We demonstrate the utility of E-ABIN through case studies of bladder cancer and celiac disease, where it effectively uncovers biologically relevant anomalies and offers insights into disease mechanisms. E-ABIN is freely available on the Zenodo platform at https://doi.org/10.5281/zenodo.17062501.