To evaluate the role of preoperative ultrasound biomicroscopy (UBM) in diagnosing invasive ocular surface squamous neoplasia (OSSN).

This retrospective single institution-based study included surgical cases of OSSN, in which UBM was performed preoperatively. The UBM characteristics of OSSN and signs of invasion were studied. The preoperative UBM imaging findings were correlated with the postoperative histopathological examination (HPE). The performance of UBM was studied in predicting invasive OSSN, considering HPE as the gold standard.

Fifteen patients were included in the study, with an average age of 61 ± 12.8 years and an 80% male preponderance (n = 12). A clear plane between the lesion and the sclera was considered as episcleral or 'non-invasive,' and disruption of this interface was interpreted as 'invasive OSSN.' Compared to postoperative HPE, UBM interpretation predicted invasive OSSN with an accuracy of 73.3%, a sensitivity of 71.4%, and 100% specificity.

UBM is a useful adjunctive tool for assessing the invasion, lesion height, and depth of invasion in OSSN. On correlating with HPE, UBM showed a good performance in preoperative detection of invasive OSSN.

Eyelid sebaceous gland carcinoma (SGC) is a rare and aggressive malignancy of the eyelids. Dysregulated cholesterol metabolism has been found to be involved in pathogenesis of various cancers including glioblastoma, breast, prostate, and pancreatic cancer. The role of cholesterol metabolism in SGC and its molecular characterization remains unexplored. This study evaluates the clinical significance of the expression of a key enzyme involved in cholesterol metabolism, acyl-CoA cholesterol acyltransferase 1 (ACAT1) in eyelid SGC.

A cohort of 50 eyelid SGC cases diagnosed over a period of 12 years were selected. Cholesterol quantification, immunohistochemistry (IHC), and real-time PCR to determine the protein and mRNA expression of ACAT were performed.

Increased concentration of total cholesterol, free cholesterol, and cholesteryl esters was observed in SGC tumor tissues. Overexpression of ACAT1 at protein and mRNA levels was observed in 66% of the eyelid SGC patients. Significant association of high ACAT1 mRNA expression was observed in patients with lymph node metastasis ( P = 0.03) and advanced (III/IV) tumor stage ( P = 0.02). SGC patients with a high ACAT immunoexpression also had reduced disease-free survival.

Overexpression of ACAT1 is a frequent event in the pathogenesis of eyelid SGC and is associated with high risk clinicopathological features. It could serve as a reliable poor prognostic biomarker.

To assess the diagnostic efficacy of the 18 MHz Color Doppler ultrasound (CDU) probe (L8-18i) in distinguishing benign and malignant preorbital masses and compare its performance with the 11 MHz probe (L3-12).

A retrospective study analyzed ultrasound data from 17 patients (7 male, 10 female; age 5-80 years) with preorbital masses between May 2021 and April 2024. Patients underwent imaging with both probes, assessing mass size, internal echo characteristics, and blood flow parameters. Results were compared with postoperative pathology using Wilcoxon signed-rank and Mann-Whitney U tests.

Mass locations included the upper eyelid (4), lower eyelid (10), inner canthus (1), brow (1), and conjunctiva (1). Anteroposterior diameters measured by both probes showed no significant difference ( P = 0.320), nor did internal echo characteristics ( P = 0.891). However, blood flow signals differed significantly ( P = 0.014). Pathology revealed benign lesions (chronic inflammation, nevi, cysts, hemangiomas) and malignant tumors (sebaceous gland carcinoma, basal cell carcinoma, squamous cell carcinoma). The L8-18i probe detected significant differences in peak systolic and end-diastolic velocities between benign and malignant masses ( P = 0.048), while the L3-12 probe did not.

The 18 MHz CDU probe demonstrated superior visualization of mass structure and blood flow, improving differentiation between benign and malignant lesions. It enhanced clarity in detecting hemorrhage, necrosis, and septation, offering higher sensitivity and accuracy than the 11 MHz probe, aligning more closely with pathological findings.

Insomnia affects 30%-60% of cancer survivors, with around 20% meeting criteria for insomnia disorder. Cognitive behavioral therapy for insomnia (CBTi) is the first-line treatment, but access is limited by cost and therapist availability, prompting exploration of alternative delivery modes, including digital interventions.

To systematically review and conduct a network meta-analysis (NMA) of the efficacy of different CBTi delivery methods for managing insomnia in cancer survivors.

The PubMed, Embase, CINAHL and Cochrane Library were searched for relevant articles published before September 25, 2025. Only randomized controlled trials of adult cancer patients evaluating the effects of any CBTi delivery mode on subjective sleep outcomes were included. Primary outcome was insomnia severity index (ISI) score; secondary outcomes included sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency (SE). A frequentist random-effects NMA was conducted.

Twenty-two trials involving 2040 participants were included. Compared with treatment as usual (TAU), digital CBTi (dCBTi) demonstrated the largest reduction in ISI scores (MD = -9.70, 95% CI = -10.80 to -8.61), followed by telephone CBTi (MD = -8.74). dCBTi also significantly improved SOL (-30.95 min), WASO (-25.62 min), TST (+31.67 min), and SE (+14.63%). Group CBTi significantly improved SOL (-11.60 min) and WASO (-22.03 min). Meta-regression analyses identified breast cancer diagnosis as a significant moderator of dCBTi effects on SOL (coefficient = 25.20, p = 0.015) and SE (coefficient = -16.17, p = 0.007). The certainty of evidence ranged from low to very low, primarily because of imprecision and network incoherence.

dCBTi demonstrated the greatest potential for improving insomnia outcomes among the evaluated CBTi delivery modalities. However, given the low certainty of evidence and the presence of network inconsistency for selected outcomes, these findings should be interpreted cautiously. High-quality head-to-head trials are needed to confirm the comparative effectiveness of different CBTi delivery modalities in oncology populations.

The study protocol was prospectively registered on PROSPERO (registration no. CRD42023429081).

This study evaluated the effect of increasing the critical value threshold for hyponatremia combined with systematic intervention on sodium regulation in patients undergoing myomectomy. A retrospective analysis was performed. Patients who underwent myomectomy and received conventional care between March 2014 and March 2019 (n=844) served as the reference group (threshold: 120 mmol/L), while those treated between March 2019 and March 2024 (n=1385) formed the observation group. In the observation group, the hyponatremia critical threshold was raised to 129 mmol/L, alongside targeted interventions including patient education, dynamic sodium monitoring, use of normal saline as the oxytocin solvent, and dietary management. The observation group showed a significantly lower overall incidence of hyponatremia compared with the reference group (21.3% vs. 25.8%, P<0.05). The reduction was more pronounced for moderate-to-severe hyponatremia, decreasing from 5.6% (0.9% severe, 4.7% moderate) to 2.2%, with no severe cases observed. Symptomatic episodes were also reduced (8/31 vs. 25/48). Acute moderate-to-severe hyponatremia occurred predominantly in patients receiving intravenous oxytocin. In conclusion, elevating the hyponatremia critical threshold combined with multidimensional intervention effectively reduces both the incidence and severity of postoperative hyponatremia following myomectomy, supporting its value in early warning and clinical management.

This study evaluated and compared the prognostic significance of three different computed tomography (CT)-based radiological indices of sarcopenia-skeletal muscle index (SMI), psoas muscle index (PMI), and three-dimensional (3D) psoas muscle volume index (PVI)-in patients with metastatic castration-sensitive prostate cancer (mCSPC).

We retrospectively reviewed 120 patients diagnosed with mCSPC (2003-2022). Baseline muscle parameters were calculated from diagnostic CT scans. Sarcopenia was defined using the Martin criteria for SMI, and optimal cut-offs derived from maximally selected rank statistics for PMI (4.08 cm²/m²) and PVI (92 cm³/m²). Associations of these indices with age, overall survival (OS), and prostate cancer-specific survival (PCSS) were evaluated.

Advancing age was significantly associated with SMI (OR: 1.05, p = 0.036) and PVI-defined sarcopenia (OR: 1.09, p < 0.001), with a non-significant trend for PMI (OR: 1.06, p = 0.069). Survival analysis revealed that sarcopenia by all three indices was significantly associated with worse OS (SMI [HR: 1.88, p = 0.032], PMI [HR: 2.19, p = 0.016], and PVI [HR: 2.07, p = 0.013]). In multivariable analyzes, SMI (HR: 1.86, p = 0.042), PMI (HR: 3.73, p < 0.001), and PVI (HR: 2.46, p = 0.006) remained independent risk factors for poorer OS. No significant impacts were observed for PCSS.

When using body physique-adjusted or mathematically optimized thresholds, all three easily and rapidly measurable radiological indices (SMI, PMI, and PVI) may serve as potential, independent prognostic indicators for OS in patients with mCSPC.

To compare surgical complications, biochemical failure, and mortality rates between open radical prostatectomy (ORP) and robot-assisted radical prostatectomy (RARP).

All men undergoing radical prostatectomy (1995-2023) at a single academic hospital were included, and preoperative factors, surgical parameters, complications, biochemical failures, and mortality were collected. Generalized linear models and cause-specific Cox regressions stratified by surgical procedure were used. Cumulative incidences of biochemical failure were estimated with the Aalen-Johansen estimator, accounting for death as a competing risk. Analyses of surgical complications were adjusted for age and lymphadenectomy, while positive surgical margins, biochemical failure, and mortality were adjusted for preoperative PSA, pathological lymph node stage, pT category, tumor percentage, ISUP score, age, and year of surgery.

A total of 3,477 men were included (ORP: 1,759; RARP: 1,718). RARP was associated with reduced odds of in-hospital complications (adjusted odds ratio [aOR]: 0.28, 95% confidence interval [CI]: 0.11-0.74). RARP was associated with a reduced risk of biochemical failure compared to ORP (unadjusted hazard ratio [HR]: 0.52, 95% CI: 0.29-0.93). No other outcomes or mortality rates differed significantly.

RARP was superior in terms of complications and non-inferior for oncological outcomes compared to ORP at our center. Although the only randomized trial yet, has not proven any significant improvement in long-term cancer control comparing the open versus robotic approach, RARP seems to have replaced ORP as the gold standard for surgical treatment of localized prostate cancer. However, the overall benefit of RARP in the surgical evolution remains elusive.

Leptomeningeal metastasis (LM) is a devastating complication of lung cancer. We investigated the clinical and molecular evolution of LM in the modern targeted-therapy era and factors associated with post-LM survival.

We retrospectively analyzed 201 patients with cytologically confirmed lung cancer LM diagnosed between November 2012 and May 2026. Patients were classified by LM diagnosis date (2012-2016 vs. 2017-2026). Intervals from lung cancer and Stage IV diagnosis to LM were compared using the Mann-Whitney U test. Paired primary tumor and cerebrospinal fluid (CSF) molecular profiles were assessed in 80 patients. Overall survival (OS) was evaluated using Kaplan-Meier and prespecified multivariable cox analyses.

Adenocarcinoma accounted for 93.0% of cases. The intervals from lung cancer and Stage IV diagnosis to LM were longer in the later cohort (23.7 vs. 13.8 months, p < 0.001; 17.4 vs. 10.4 months, p = 0.002). Unadjusted OS from LM diagnosis did not differ significantly between eras (9.8 vs. 11.3 months, p = 0.864). Tissue-CSF driver discordance occurred in 7/80 patients (8.75%). In multivariable analysis, later diagnostic era, smoking, and ECOG PS ≥ 2 were associated with higher mortality (adjusted HR, 1.826, p = 0.014; 1.847, p = 0.014; and 1.674, p = 0.007, respectively), whereas post-LM third-generation EGFR-TKI exposure was associated with lower mortality (adjusted HR, 0.385; p < 0.001).

The later era was associated with a longer interval to LM diagnosis but no statistically significant improvement in unadjusted post-LM OS. Adjusted associations require cautious interpretation because of residual confounding and post-baseline treatment bias. CSF profiling may provide clinically relevant information beyond primary tumor genotyping.

Our aspiration is a future with universal administration prior to exposure using simply delivered and affordable vaccines covering all high-risk human papillomavirus (HPV) types and other HPVs associated with significant morbidity. However, this scenario remains unrealized: no vaccine today covers the full range of high-risk HPV types, nor have we reached every population that needs HPV vaccination, so infection remains prevalent. The reasons are multifaceted, involving scientific, economic, sociocultural, and logistical hurdles, yet efforts are ongoing worldwide to overcome these challenges. Broad implementation of primary HPV-based screening, including self-sampling, will improve cervical cancer prevention and inform many more women of their high-risk HPV-positive status. Development of high-risk HPV-targeted therapeutics could further accelerate declines in cervical cancer by clearing prevalent infections. Progress on HPV vaccination and improvements in screening technology continue at a remarkable pace. Reduction in cervical cancer incidence is evident where vaccination and/or screening have been adopted early and widely implemented.

Screening recommendations in the United States have not been modified for women who have been vaccinated against human papillomavirus (HPV). Using 3 independent Cancer Intervention and Surveillance Modeling Network (CISNET) models (Policy1-Cervix, Harvard and STDSIM-MISCAN), we evaluated the impact of switching from 3-yearly cytology-based screening for ages 21-65 ("cytology alone") to primary-HPV-16/18 screening for ages 25-65 every 5-years ("standardized 5-yearly HPV screening"), or every 8-10 years for younger vaccinated cohorts ("tailored HPV screening"). Compared to cytology alone, switching to standardized 5-yearly HPV screening for all women would reduce total cervical cancer deaths over the period 2020-2099 by 9%-14% and total colposcopies by 15%-49%, and achieve cervical cancer elimination by 2030-2037, 4 years earlier than cytology screening alone. Compared to cytology alone, tailored HPV screening would reduce cervical cancer deaths over the period 2020-2099 by 2%-14%, colposcopies by 30%-59%, and achieve elimination by 2030-2040, 1-4-years earlier. In conclusion, primary HPV screening in all women would be associated with improved health outcomes and would reduce colposcopy referrals in the longer term compared to older, cytology approaches. Tailoring the HPV screening interval to vaccination status has potential to increase efficiencies and maintain effectiveness and elimination timing.