To systematically characterize the global research landscape, collaborative networks, knowledge structure, thematic evolution, and emerging research trends in robotic thyroid and neck surgery, with particular emphasis on technological innovation, platform development, and remote-access surgical approaches. This study aims to provide an objective overview of research evolution and knowledge structures rather than evaluate the clinical superiority of specific robotic platforms. The Web of Science Core Collection was used as the data source to retrieve literature published up to July 6, 2026, related to thyroid tumors, thyroidectomy, neck lymph node dissection, robot-assisted surgery, robotic thyroid surgery, remote-access approaches, technological innovation, and representative robotic platforms. Retrieved records were manually screened according to predefined inclusion and exclusion criteria, and bibliographic information was further standardized before bibliometric analysis to improve data consistency and reproducibility. After screening by document type and language, a total of 280 English-language articles and reviews were included. CiteSpace and VOSviewer were used to analyze countries/regions, institutions, authors, journals, co-cited references, co-cited authors, keyword co-occurrence, clustering, timelines, time zones, citation bursts, and thematic evolution. The annual number of publications gradually increased from 2009, entered a sustained growth phase after 2014, and peaked in 2023. Among the included records, 236 were articles and 44 were reviews. At the country/region level, South Korea, the United States, and China were the leading contributors. At the institutional level, Seoul National University, Seoul National University Hospital, Korea University, Yonsei University, and its affiliated health system formed the core research cluster. In terms of authors, Kim HY, Chai YJ, Chung WY, Kang SW, Dionigi G, and Tae K showed high productivity and academic influence. The knowledge base was mainly centered on gasless transaxillary robotic thyroidectomy, bilateral axillo-breast approach robotic thyroidectomy, transoral vestibular approach, safety of remote-access surgery, surgical completeness, and protection of the recurrent laryngeal nerve and parathyroid glands. Keyword burst analysis showed that early hotspots included "axillary approach," "scarless," "breast approach," and "neck surgery"; mid-term research shifted toward "surgical completeness," "retroauricular approach," and "transoral thyroidectomy"; and recent frontiers have focused on "robotic surgical procedures," "postoperative pain," "radical neck dissection," and "recurrent laryngeal nerve." Research on robotic thyroid and neck surgery has evolved from early exploration of remote-access feasibility toward comprehensive evaluation of oncological safety, functional preservation, technological innovation, and clinical translation. Bibliometric evidence suggests that current research attention has gradually shifted toward intelligent surgical assistance, recurrent laryngeal nerve preservation, patient-centered outcomes, and comparative evaluation of different robotic approaches. Future investigations may benefit from multicenter prospective studies, standardized outcome assessment, inter-platform comparison, and AI-assisted surgical technologies.

DNA methylation profiling identifies clinically relevant subgroups of non-functioning pituitary adenomas (NFPAs), but requires tumour tissue and is unavailable preoperatively. We investigated whether reported outcome-associated methylation-defined NFPA phenotypes are associated with preoperative MRI radiomic features.

We performed a single-centre retrospective radiogenomic analysis nested within a previously published, outcome-characterised NFPA methylation cohort. Seventy-four patients with preoperative gadolinium-enhanced T1-weighted MRI were included. Tumours were automatically segmented using a fine-tuned U-Net. The primary analysis tested binary discrimination between the outcome-associated low-risk (k1/k2) and high-risk (k3/k4/k5) methylation strata using a prespecified L1-penalised logistic-regression model with leakage-controlled repeated stratified cross-validation, 0.632 + bootstrap optimism correction, and 1000-shuffle whole-pipeline permutation testing.

Seven radiomic features were false-discovery-rate significant and four survived Bonferroni correction, predominantly LoG-filtered first-order intensity features. The prespecified model separated high-risk from low-risk tumours with balanced accuracy 0.69 (95% CI, 0.58-0.80), AUC 0.73 (0.61-0.84), 0.632 + AUC 0.71, and permutation p = 0.001. The SF1-restricted analysis remained significant (balanced accuracy 0.73, AUC 0.70, p = 0.008), whereas k3-focused analyses were not significant. Clinical sex-lineage models classified at chance.

Preoperative MRI radiomics was associated, at the group level, with a composite methylation-defined risk label previously associated with postoperative regrowth in the same source cohort. The study was clinically outcome-anchored, but the classifier did not use individual regrowth or progression-free survival as its endpoint and should not be interpreted as an independently validated prognostic model. Pooling k3, k4, and k5 does not establish a shared imaging phenotype of aggressiveness. External outcome-linked validation is required before clinical implementation.

Neoadjuvant chemotherapy, a cornerstone of early-stage triple-negative breast cancer (TNBC) treatment, has limited efficacy and is often accompanied by substantial toxicity. As a promising chemotherapy-free alternative, the combination of immune checkpoint inhibitors and anti-angiogenic agents provides the potential to enhance antitumor efficacy by remodeling the tumor microenvironment while reducing treatment-related adverse events (TRAEs). This study aimed to assess the clinical value and feasibility of neoadjuvant camrelizumab plus apatinib in patients with early-stage TNBC.

This study enrolled stage II-III TNBC patients with baseline tumor-infiltrating lymphocytes (TILs) > 10%. Participants received 8 cycles of neoadjuvant treatment, consisting of intravenous camrelizumab 200 mg every 21 days (or 3 mg/kg for patients weighing < 50 kg), combined with oral apatinib 250 mg daily. The primary endpoint was pathological complete response (pCR) rate; secondary endpoints included objective response rate (ORR), disease-free survival (DFS), overall survival, and safety.

Between December 2022 and March 2024, 25 patients were screened, 14 were recruited and treated, 13 were evaluable for efficacy, and 11 subsequently underwent surgery. The results showed a pCR rate of 27.3% (3/11), an ORR of 46.2% (6/13), and a 24-month DFS rate of 90.9%. TRAEs were predominantly of grade 1-2, with grade ≥ 3 events occurring in 28.6% patients. Exploratory transcriptomic analysis identified differences in genes related to extracellular matrix remodeling and immune regulation.

Camrelizumab plus apatinib demonstrated manageable toxicity and preliminary antitumor activity, supporting further investigation of this chemotherapy-free strategy in early-stage TNBC patients with enriched TILs.

NCT05556200 (Registration Date: September 27, 2022).

We aimed to evaluate the effectiveness of pelvic floor muscle training (PFMT), with or without adjunctive biofeedback or electrical stimulation, in improving erectile function (EF) in men who have undergone radical prostatectomy (RP) for prostate cancer, by examining randomized controlled trials (RCTs).

PubMed, Scopus and Web of Science databases were systematically searched. Eligible studies were RCTs examining PFMT for post-RP erectile dysfunction (ED) according to predefined inclusion and exclusion criteria. The protocol was registered in PROSPERO (CRD420251162740).

Twelve RCTs were included in the final analysis. PFMT-related effects on EF were inconsistent: four RCTs reported statistically significant EF benefits, one multimodal survivorship trial showed a favorable surgery-subgroup sexual-domain signal, and seven found no significant between-group EF difference. Across trials with extractable mean IIEF/IIEF-5 endpoint data, between-group differences ranged from - 0.97 to + 2.18 points, with a maximum change-score advantage of + 4.3 points. Selected favorable findings included higher 12-month potency rate after biofeedback-assisted PFMT (47.1% vs. 12.5%) and higher 15-month IIEF-EF scores after supervised PFMT initiated at 12 months for persistent ED (11.1 ± 8.8 vs. 9.3 ± 7.1; p = 0.025). Evidence quality was limited by substantial clinical and methodological heterogeneity and risk-of-bias concerns.

PFMT may improve EF through enhancing the structural support for erections and the hemodynamic erectile response after RP. Men who prefer a holistic approach may benefit from PFMT as part of a multimodal rehabilitation program. Further research to clarify the role of PFMT in EF recovery after RP is needed.

Rash is a frequently observed adverse effect of gemcitabine (GEM) plus nanoparticle albumin-bound paclitaxel (nab-PTX) therapy for pancreatic cancer. However, the clinical characteristics of this reaction remain poorly understood. In this study, we aimed to identify factors associated with the development of rash during GEM plus nab-PTX therapy for pancreatic cancer in a real-world setting.

Patients with pancreatic cancer receiving GEM plus nab-PTX (n = 313) were retrospectively evaluated. The primary endpoint was to identify factors associated with all-grade rash during the first cycle. The secondary endpoint was the change in eosinophil levels from baseline to the nearest assessment time point after rash development in patients who developed symptoms.

The incidence of all-grade rash was 20.4%, with grades 1 and 2 accounting for 18.5% and 1.9%, respectively. Multivariable logistic regression analysis identified baseline renal impairment as an independent risk factor and the regular co-administration of non-steroidal anti-inflammatory drugs (NSAIDs) as a protective factor for rash development (adjusted odds ratio [95% confidence interval]: 2.01 [1.03-3.91], P = 0.04 for renal impairment; and 0.44 [0.20-0.91], P = 0.03 for NSAID co-administration). Eosinophilia at the nearest time point after symptom onset occurred in 12.5% of patients with rash, with eosinophil levels significantly elevated from baseline, suggesting partial involvement of an immune-mediated mechanism.

Our study identified baseline renal impairment as a risk factor and regular NSAID co-administration as a protective factor against rash development during real-world GEM plus nab-PTX therapy for pancreatic cancer.

Accurate nidus access is essential for treating osteoid osteoma, but the incremental contribution of physical robotic targeting should be distinguished from imaging, definitive treatment, and the wider care pathway. We systematically reviewed peer-reviewed human reports in which a robot physically positioned or constrained an instrument used for biopsy or treatment. PubMed/MEDLINE, Embase, Web of Science Core Collection, the Cochrane Library, Wanfang Data and the China National Knowledge Infrastructure were searched from inception through August 2026, without a final language restriction. Primary outcomes were success, recurrence or retreatment, and treatment-related complications. Secondary outcomes included localization, instrument corrections, radiation, procedure time, diagnostic yield, recovery, and cost. Twelve reports contained 440 report-level treatment records, including 232 robot-assisted procedures, before assessment of probable or possible overlap. Evidence comprised seven retrospective comparisons, four uncontrolled series, and one case report. Robot-proximal findings generally favored more reproducible or conservative access, including fewer Kirschner-wire corrections, shorter localization, greater resection accuracy, or a smaller bone window. Procedure-time effects varied by comparator and workflow. In comparisons that approximately held treatment constant, clinical success, later pain, recurrence, and complications were not clearly improved. Apparent advantages over open surgery mainly reflected minimally invasive access or treatment modality rather than robotic targeting alone. Meta-analysis was not performed because clinically equivalent comparisons were not independently replicated, outcome definitions differed, and cohort overlap was probable or possible. Comparative certainty was very low. Robotic targeting may improve trajectory execution in technically demanding lesions, but superior long-term effectiveness, safety, diagnostic adequacy, robot-attributable radiation reduction, and cost-effectiveness remain unproven.

Intrauterine pathologies are common among women with infertility and may negatively impact fertility treatment outcomes if undetected.

To determine the patterns and associated clinical factors of intrauterine pathologies at hysteroscopy in women evaluated for infertility.

A retrospective cross-sectional study of 282 women with infertility was carried out at Blessed Specialist Hospital, Npor, Anambra state a private endoscopy center in Southeast Nigeria over 10 years. Clinical data and hysteroscopic findings were extracted. Statistical associations were analyzed using Chi-square tests with a significance level of P < 0.05.

The mean age of the participants was 34.8 ± 5.2 years. Uterine pathologies were confirmed hysteroscopically in 50.35% (n = 142/282) of the patients. The most frequent intrauterine pathologies identified were intrauterine adhesions (24.47%, n = 69), endometrial polyps (14.18%, n = 40), submucous myomas (12.06%, n = 34), and uterine septa (5.32%, n = 15). Regarding procedures, 22.80% (n = 57/250) of patients with complete surgical logs underwent therapeutic hysteroscopy, while 77.20% (n = 193/282) had diagnostic interventions. Bivariate analysis revealed significant statistical associations between the presence of intrauterine pathologies and both maternal age ≥35 years ( P = 0.012) and uterine enlargement ( P < 0.001).

Intrauterine pathologies affect half of the women evaluated for infertility in this cohort, with intrauterine adhesions being the most prevalent entity. Advanced maternal age and uterine enlargement are strongly associated with these anomalies. Hysteroscopy remains crucial for accurate diagnosis during fertility work-ups.

Acute graft-versus-host disease (aGvHD) remains a substantial cause of morbidity and mortality after allogeneic hematopoietic cell transplantation (allo-HCT). Limited studies explore the association between specific major histocompatibility complex (MHC) alleles and aGvHD or transplant-related mortality (TRM). After a noted clinical trend of higher TRM among a series of patients with aGvHD and MHC class I HLA- A   ∗ 01:01, we retrospectively evaluated transplant outcomes of 404 adult allo-HCT patients who underwent unmodified allografts between 03/2010 and 02/2017. HLA- A   ∗ 01:01 was expressed by 104 (25.7%) patients. In a univariate analysis, patients who underwent unmodified transplants and expressed HLA- A   ∗ 01:01 had a higher risk of TRM (HR 1.63 [95% CI: 1.05-2.53], p = 0.035). In a multivariate cause-specific Cox model, HLA- A   ∗ 01:01 was significantly associated with TRM after adjusting for grade II-IV aGvHD, conditioning regimen intensity, and age at transplant (HR 1.59 (95% CI: 1.02-2.48) p = 0.039). There were no significant differences in overall survival (OS), aGvHD, or chronic GvHD based on HLA- A   ∗ 01:01 expression. With confirmation in a larger cohort, these findings have potential implications for the selection of allograft type, conditioning regimen, and post-transplant monitoring for this high-risk population.

Breast cancer continues to be a substantial global health concern, constituting a substantial proportion of new cancers diagnosed. Breast Imaging Reporting and Data System (BI-RADS) is a standardised instrument that facilitates the appraisal of lesions in mammographic reporting. A hook wire localisation biopsy (HWLB) is frequently employed to diagnose suspicious microcalcifications or non-palpable lesions. The study aims to ascertain the probability of detecting malignancies in non-palpable breast lesions by examining the malignancy rate detected by BI-RADS classification and HWLB results.

This retrospective study utilised data from patients who underwent HWLB at a tertiary hospital from January 2016 to December 2021.

Among the 65 patients analysed, 21.5% exhibited malignant lesions, predominantly detected through routine mammogram screening. There was a statistically significant association (p=0.007) between BI-RADS classification and the malignancy status. Using BI-RADS 4A as the threshold ensures 100% sensitivity but leads to a low specificity of 13.73%, Positive Predictive Value (PPV) of 24.1% and Positive Likelihood Ratio (LR+) of 1.2. While increasing the threshold to BI-RADS 4B improves specificity to 80.4%, reducing false positives. This suggests that many BI-RADS 4A cases are actually mostly benign.

BI-RADS 4A notably exhibited a high false-positive rate, possibly due to benign lesions mimicking cancer radiologically and the operator-dependent nature of radiology. Despite these constraints, findings affirm the crucial role of hook wire localisation biopsy and BI-RADS classification in evaluating non-palpable breast lesions.

Cancer-related financial hardships are common and negatively impact cancer-related outcomes. Supporting patient-clinician cost discussions, financial navigation, and insurance literacy may help mitigate this distress. This qualitative study informed the adaptation of the "Improving Cancer Patients' Insurance Choices" (I Can PIC) tool into the "Cancer Affordability REsources" (CARE) Tool by updating content, design, and implementation processes.

Patients ≥ 18 years, diagnosed with lung, prostate, colorectal, or gynaecological cancer within 3 years, English-speaking, and treated at specified urban or rural cancer centres were included. Healthcare personnel (HP) were employed at one of these cancer centres and worked with the specified cancer types. The Consolidated Framework for Implementation Research (CFIR) and the 5As of Access in Healthcare Framework guided the development of semi-structured interview guides and codebook. Interviews were conducted virtually, transcribed professionally, coded, and analysed using rapid thematic analysis.

Twenty-two patients with cancer and 14 HP from urban and rural cancer centres participated (N = 36). We identified four themes. First, there was a mismatch of expectations around cost conversations. HP expressed concerns about potentially introducing financial-related distress and did not know specific cost information, while patients emphasised the need for cost discussions with HP. One shared, "I'm kind of… removed from the financial aspect, which is good 'cause then I can just focus on taking care of patients." In contrast, one patient said, "…It's not acceptable to just have your hands up and say I don't know… a patient needs to know." Second, preferences for timing of cost conversations varied, with a need for both immediate and subsequent conversations per patient readiness. One patient shared, "I would have loved to speak with someone about the cost, but I was more concerned about my survival…". Third, there were multiple usability considerations, including technological demands, health literacy, and the perceived relevance of the tool. Fourth, context-specific delivery is critical to ensure access.

This user-centred content, usability, and implementation focused adaptation of the CARE Tool incorporated perspectives from patients, HP, and end-users. Next steps will evaluate the CARE Tool in a clinical trial, assessing financial hardships, self-efficacy, health insurance literacy, and implementation.

This research teams includes a patient advocate and our research question, design, data collection, and interpretation of results was presented for feedback to our community advisory board, made up of patient and public research partners. We recruited patients and healthcare personnel to participate in this study. We greatly appreciate the time, perspective, and experience that our patient and community research partners and participants have contributed to this study.