In addition to diet quality, which influences the risk of colorectal cancer (CRC), temporal eating patterns, such as meal frequency, duration, regularity, and timing, may also play an important role. Recent studies have suggest that these eating patterns can influence CRC risk; however, dietary guidelines predominantly emphasise modifying the intake of specific food items to reduce risk and promote overall health. Additionally, comprehensive studies examining the relationship between temporal eating patterns and CRC risk are lacking. This review aimed to synthesise the available evidence on how temporal eating patterns may affect CRC risk and mortality. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic literature review was conducted using databases such as Medline, Scopus, Web of Science, CINAHL, and ProQuest, ultimately including 20 relevant articles.

Higher eating frequency, particularly when involving unhealthy foods, along with skipping breakfast and increased snacking may elevate CRC risk. Furthermore, a short interval between the last meal and bedtime has been associated with an increased risk of CRC and related mortality. The findings suggest that a short interval between the last meal and bedtime may increase CRC risk, potentially through mechanisms such as circadian rhythm disruption, oxidative stress, and inflammation. In addtion, higher meal frequency, particularly when coupled with an unhealthy diet, appears to further elevate the risk. Future research should employ standardised definitions and detailed assessment of 24-hour eating patterns to better elucidate their relationship with CRC outcomes.

HyperArc™ (HA) automates both planning and delivery of single-isocenter VMAT radiosurgery (SRS) and was designed for complex multi-metastasis cases. The clinical effectiveness of treating benign intracranial tumors (BIT) with HA is unknown. We collected data on treatment planning, delivery, and clinical outcomes of BIT managed with SRS since HA deployment.

Patients received SRS using HA from 2017 to 2021 at a single institution. Prescription dose was normalized to ≥ 99% of gross tumor volume without additional expansion. Treatments were delivered on Varian Edge linear accelerator with 10MV flattening-filter free beam at up to 2400 MU/min with high-definition multi-leaf collimator. Post-treatment imaging, toxicities, and outcomes were assessed.

198 BIT targets (min = 0.1 cc, max = 58.9 cc) were treated. A large variety (n = 8) of BIT were treated with the most common pathologies being meningiomas (130), pituitary adenomas (30), and acoustic schwannomas (23). Nearly half (45.1%) were treated in a single fraction (12-22 Gy) versus 54.9% with fractionated SRS (24-35 Gy). Mean RTOG CI and Paddick GI were 1.12 and 3.31, respectively. A majority (74%) were treated with 3 arcs with mean treatments lasting 10.5 min. Mean FU was 2.6 years. 20 of 198 (10.1%) tumors progressed with mean time to failure being 2.1 years. Tumor progression occurred in 10.1%, mostly in recurent WHO II meningiomas. Of those that progressed, 19 were meningiomas with 17 being WHO grade 2 with prior surgery. Grade 3 + CNS toxicity was reported in 4.3% of patients, with 98.9 and 99.5% hearing and visual preservation, respectively.

Without any planning target volume expansion, HA efficiently delivers high-quality plans with sharp dose fall-off for a wide variety of BITs. Early clinical outcomes and toxicity are consistent with historical controls.

Thymectomy is a well-established treatment in anti-AChR generalized myasthenia gravis (gMG) patients aged 18-50 years. However, the MGTX trial failed to prove an additional benefit of thymectomy in late-onset MG (LOMG) patients and studies conducted so far have shown controversial results. The primary aim of this study was to assess the safety and effectiveness of thymectomy in LOMG patients compared to medical therapy alone.

This was an observational retrospective case-control study of LOMG patients followed at the MG Clinic of Pisa University Hospital from 1996 to 2024. Inclusion criteria were: diagnosis of non-thymomatous gMG with anti-AChR antibodies; age at onset ≥ 50 years, and minimum follow-up of 12 months. The cumulative incidence of disease remission between the thymectomy and the conservative group was compared with Kaplan-Meier analysis with log-rank test and the Cox regression model was used to estimate the effect of thymectomy on achieving remission after adjustment for confounding variables.

Among our population of 127 LOMG patients, 87 patients underwent thymectomy, while 40 patients received medical treatment only. When evaluating neurological outcomes at the last follow-up, the thymectomy group had a 3.25-fold (HR = 3.25, 95% CI 1.31-8.1) increased probability of achieving disease remission than the conservative group, after adjustment for confounding variables.

Our findings suggest that thymectomy may be a feasible and potentially beneficial therapeutic option in this MG subgroup, possibly increasing the likelihood of disease remission without ongoing immunosuppressive therapy.

While several countries reported an impact of the coronavirus disease (COVID-19) pandemic on cancer incidence in 2020, little is known about trends in the following years. This study examined changes in cancer incidence in Baden-Württemberg between 2015 and 2023.

Data from the Baden-Württemberg Cancer Registry were used to calculate age-standardized and age-specific incidence rates for all cancers combined and for colorectal, lung, prostate, and breast cancer. Incidence rates for 2020 to 2023 were compared with those from a pre-pandemic reference period (2017-2019) and with expected rates based on modeled trends between 2015 and 2019 using standardized incidence ratios (SIRs).

Among men, the age-standardized overall cancer incidence declined significantly from 734.0 per 100,000 in 2019 to 672.9-681.7 during 2020-2023. In women, incidence declined from 542.2 in 2019 to 504.3-524.4, with statistically significant reductions in 2022 and 2023. Compared to 2017-2019 levels, 14,214 fewer cases (-5.5%) were diagnosed in 2020-2023; relative to model-based expectations, 19,525 fewer cases (-7.6%) were reported. Site-specific analyses showed significantly lower colorectal cancer incidence in both sexes from 2020 onwards (SIRs: 0.81-0.90). For men, part of this decline may reflect a pre-existing downward trend. No significant deviations were found for lung and prostate cancer. Female breast cancer incidence was significantly lower only in 2020 (SIR: 0.93).

Cancer incidence in Baden-Württemberg remained consistently below pre-pandemic and expected levels from 2020 through 2023. Further research is warranted to disentangle potential contributing factors, including post-pandemic effects, competing mortality risks, and migration-related population changes.

The emergence of artificial intelligence (AI) has greatly promoted the development of the field of medical image analysis, but the potential benefits of AI-assisted colonoscopy and diagnosis (CADe/CADx) for the detection rate of colorectal adenomas and the histological diagnosis of polyps are still controversial and unknown.

We conducted a search on PubMed, Web of Science, Embase, and Cochrane, and the last search time was August 2024. We collected adenoma detection rate (ADR), polyp detection rate (PDR), and sessile serrated lesion detection rate (SSL). Paired analysis and network meta-analysis (NMA) were performed using R Studio. StataSE15.0 software was used for statistical analysis to calculate the sensitivity and specificity of CADx and conventional colonoscopy.

We included a total of 64 studies, including 52 RCT studies and 12 clinical studies, with a total of 50,834 patients undergoing colonoscopy. The results showed that different adjuvant interventions had significant differences in the detection rate of adenoma compared with routine colonoscopy ADR [RR = 1.20, 95% CI (1.14, 1.26), P < 0.001], and the results were statistically significant. Among different CADe models and advanced optical imaging techniques, ENDOANGEL model-assisted colonoscopy is the most effective method for detecting colorectal adenomas and polyps (97.8%), and Endocuff-AI model-assisted colonoscopy is the most effective method for detecting sessile serrated lesions (94.4%). In the performance study of endoscopists with or without CADX-assisted diagnosis, the optical diagnostic sensitivity of colorectal adenomas was (88% VS 86%), specificity (78% VS 77%), and AUC area (91% VS 89%), and the study results showed no significant differences.

ENDOANGEL model-assisted colonoscopy shows the best efficacy on both ADR and PDR, Endocuff-AI model-assisted colonoscopy shows the best performance on SSL, and compared with optical evaluation without CADx, real-time polyp assessment using CADx did not significantly increase the diagnostic sensitivity of neoplastic polyps during colonoscopy.

Cancer-related fatigue is a common and significant symptom experienced by patients with cancer and survivors across all age groups, profoundly impacting their quality of life. Adolescents and young adults often encounter substantial academic, career, and personal demands, which pose unique challenges in managing this symptom and may have a more profound overall impact on their lives. While digital health interventions show considerable promise in managing cancer-related fatigue, few reviews have specifically addressed their use among adolescents and young adults.

This scoping review aimed to identify and assess the types and effectiveness of digital health interventions in managing cancer-related fatigue among adolescents and young adults.

A comprehensive literature search was conducted using the keywords "digital health," "adolescent," "young adult," "fatigue," and "neoplasms" across 6 databases: PubMed, CINAHL, PsycINFO, Embase, Cochrane Library, and Web of Science. The search included English-language publications from the inception of each database to August 2024. Two researchers independently screened the studies based on predetermined inclusion and exclusion criteria.

A total of 2965 articles were retrieved during the initial search, of which 10 (0.34%) satisfied the inclusion criteria of this review. The 10 included studies comprised 5 (50%) randomized controlled trials, 2 (20%) quasi-experimental studies, 2 (20%) mixed methods studies, and 1 (10%) cohort study. On the basis of the functions and forms of digital health interventions, the interventions included in this review were categorized into the following 5 types: dynamic health monitoring and feedback, automated online guidance and feedback, live remote coaching and instruction, gamified interventions, and robot-assisted interventions. Multiple studies (7/10, 70%) demonstrated that digital health interventions are effective in reducing cancer-related fatigue in adolescents and young adults and show potential in improving physical function and emotional well-being in this population.

Digital health interventions overcome the time and spatial limitations of traditional treatments and provide holistic support across physical, psychological, and social domains. They hold significant potential to alleviate cancer-related fatigue in adolescents and young adults. Future research should integrate various fatigue measurement scales and conduct large-scale studies and long-term follow-ups to capture a more comprehensive range of fatigue experiences, validate these findings, and enhance the effectiveness of digital health interventions.

Kidney cancer remains a significant challenge in oncology, with accurate prognostic assessment being crucial for postoperative management. While radiomics has shown promise in cancer prognosis, there is limited research on comprehensive models that effectively integrate radiomic features with clinical parameters for kidney cancer survival prediction.

This study aimed to develop and validate a comprehensive computed tomography (CT) radiomics-based nomogram for predicting overall survival in postoperative patients with kidney cancer by integrating radiomic features with clinical parameters.

Radiomic features were extracted from regions of interest in CT images of 207 postoperative patients with kidney cancer. The eigenvalue data of all radiomic features were processed using z score standardization and the R software package GLMNet. We integrated survival time, survival status, and radiomic features and screened these features using the least absolute shrinkage and selection operator-Cox regression method. We conducted 10-fold cross-validation to obtain an optimal model of 5 radiomic features. Multivariate Cox regression hazard models were established to analyze patients' overall survival. The predictive ability of the nomogram (receiver operating characteristic curve and calibration curve) was evaluated using bootstrap resampling validation. Patients were divided into high- and low-risk groups based on the radiomic risk score cutoff value, and the Kaplan-Meier method was conducted to identify established models' forecasting ability. Five radiomic features were screened for predictive model construction.

This retrospective analysis was conducted from April 2024 to July 2024 using data from The Cancer Imaging Archive public database. The final cohort included 207 patients (3 excluded from the initial 210) who underwent nephrectomy for kidney cancer. The median follow-up time was 33 (IQR 11-47) months. The receiver operating characteristic curve and area under the curve showed that the predictive model performed well. The calibration curve of nomogram and radiomic features in the cohort study set indicated an overall net benefit. Kaplan-Meier curves indicated that overall survival time was dramatically shorter in the high-risk group.

Our radiomics nomogram successfully integrates CT-derived radiomic features with clinical variables for kidney cancer survival prediction, demonstrating good prognostic capability and offering a noninvasive, quantitative tool for personalized postoperative management and clinical decision-making.

Linac-based SRS provides a highly precise noninvasive treatment option for intracranial lesions. DCA and VMAT are commonly used Linac-based techniques. There are no standardized guidelines for technique selection, particularly considering the geometric properties of the lesions. We thus sought to compare DCA and VMAT to define a workflow for clinical decision-making. This study introduces Q_asym, a novel parameter quantifying lesion asymmetry, and compares the dosimetric performance of DCA and VMAT.

Between 2018 and 2021, a total of 89 brain metastases from 24 patients with lesion volumes up to 4.3 cm³ were included. VMAT and DCA plans were created for each lesion with identical field parameters, resulting in a total of 178 evaluable plans. The parameters included the CI, DSI, and MUs. Various approaches for quantifying asymmetry were explored and their impact on CI and DSI was investigated. Additionally, we introduced the novel Q_asym index, designed to quantify lesion asymmetry.

VMAT resulted in lower CI values, especially for volumes exceeding 2 cm³. With a prescription dose of 20 Gy, DSI_90% values were comparable between VMAT and DCA for < 2 cm³, while VMAT achieved lower values for larger volumes. VMAT showed higher DSI_50% and DSI_25% values for < 2 cm³, which reversed for larger volumes. V_2Gy values were similar for both techniques for < 2 cm³ but were lower for VMAT in larger volumes. Q_asym significantly correlated with CI (p < 0.01). Analysis of ΔCI% and ΔDSI% revealed that VMAT outperformed DCA for lesions > 2 cm³ and smaller volumes with a Q_asym > 1.2. DCA required significantly fewer MUs (p < 0.01).

This study provides detailed dosimetric information on two commonly applied planning techniques for Linac-based SRS treatment for brain metastases. These findings might support decision making for optimal technique selection upon volumetric features. Q_asym provides a practical tool for these purposes.

The non-medical economic consequences of cancer on individuals and families in low- and middle-income countries, including Bangladesh, remain poorly quantified. This study measures the non-medical economic consequences of cancer survivors and their families, including sacrifices in essential family consumption, social participation and family members' schooling.

We conducted a cross-sectional survey between January and May 2022, involving 607 adult patients receiving cancer treatment at two tertiary specialised cancer hospitals in Bangladesh. Participants reported any occurrence of non-medical economic consequences: reduction in essential goods (REG) consumption, avoidance of social events (ASE) and cessation of schooling (CS) of family members. We used a multivariable logistic regression model to assess the associations between each non-medical economic consequence and clinical and socioeconomic factors. Additionally, we fitted a Poisson regression to model the count of non-medical economic consequence events as a function of disease stage and relevant covariates.

Overall, 39% of patients reported REG, 36% ASE, and 38% CS. After adjusting for co-variates, advanced cancer (stage IV) was a significant predictor of non-medical economic consequence (REG: OR = 5.58, 95% CI 0.99-31.44, p = 0.051; ASE: 11.35, 1.81-71.07, p = 0.009; SS: 101.56, 2.47-4173.90, p = 0.015) compared with early cancer (stage I). Compared with the highest-income families, patients from low- and lower-middle-income families had significantly higher odds of experiencing all outcomes (REG: OR = 7.57, 3.01-19.06, p < 0.001 and 7.23, 1.81-28.89, p = 0.005; ASE: 10.21, 3.81-27.36, p < 0.001 and 17.99, 4.26-75.96, p < 0.001; CS: 11.37, 3.23-40.00, p < 0.001 and 12.58, 1.90-83.19, p = 0.009). Employed patients were also at markedly higher risk, with substantially increased odds of REG (18.27 times), ASE (41.01 times) and CS (72.34 times) compared with non-employed patients (all p < 0.01).

Cancer treatment in Bangladesh imposes substantial and inequitable non-medical economic consequences, disproportionately affecting patients with advanced-stage cancer, lower-income families and those in active employment. Policymakers may prioritise strengthening early cancer detection programs, expanding targeted financial protection schemes and introducing workplace and educational support mechanisms to safeguard family welfare and promote more equitable outcomes during cancer treatment.

Primary gastrointestinal (GI) diffuse large B-cell lymphoma (DLBCL) is a rare malignancy. Given its rarity, the nature of the disease, particularly those originating in the colorectum, remains poorly defined.

This multicenter retrospective study analyzed the clinical characteristics and treatment outcomes of primary GI DLBCL, with a focus on colorectal cases.

A total of 104 cases of primary GI DLBCL were retrospectively collected from three institutions (2010-2024) and classified into three groups based on the lymphoma's origin.

Among 104 patients, 57.7% had gastric, 18.3% small bowel, and 24.0% colorectal DLBCL. Approximately 60% presented with limited-stage disease (Stage I-II). All patients received front-line R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), achieving a complete remission (CR) rate of 81.0%. The estimated 3-year overall survival (OS) and progression-free survival (PFS) were 91.7% and 91.9%, respectively. Outcomes varied by disease origin, with gastric DLBCL showing the most favorable prognosis and small bowel the poorest (3-year OS 93.9% vs. 69.3%).

In the colorectal subgroup (n = 25), 84.0% had disease in the ascending colon, and 70.0% had limited-stage disease. Obstructive symptoms were the most common initial presentation. The CR rate after R-CHOP was 80.0%, with estimated 3-year OS and PFS of 86.7% and 72.3%, respectively. While primary tumor resection improved local disease control, it did not confer an OS benefit. During follow-up, 13.5% of patients experienced relapse, most frequently more than 12 months after achieving CR. Relapsed or refractory primary GI DLBCL demonstrated better outcomes than conventional relapsed nodal DLBCL.

These findings confirm the efficacy of front-line R-CHOP in primary GI DLBCL and suggest that primary tumor resection may be a useful component of treatment for localized primary colorectal DLBCL.