The aim of this study was to evaluate the prognostic performance of the revised 2023 International Federation of Gynecology and Obstetrics staging system for endometrial cancer compared with the 2009 system, with a particular focus on its ability to discriminate between intermediate- and advanced-stage disease.

This retrospective cohort study included 400 patients who underwent surgical treatment for endometrial cancer at a tertiary referral center between 2008 and 2018. Patients were reclassified according to both the International Federation of Gynecology and Obstetrics 2009 and 2023 criteria. Clinicopathological variables and survival outcomes were compared across staging systems. Kaplan-Meier curves with log-rank testing and Cox proportional hazards models were used to assess disease-free survival and overall survival. Harrell's concordance index and the Akaike Information Criterion were calculated to compare prognostic discrimination between staging systems.

International Federation of Gynecology and Obstetrics 2023 system demonstrated superior prognostic performance with significantly improved concordance index values for both disease-free survival (C-index 0.681 vs. 0.647, p=0.041) and overall survival (C-index 0.709 vs. 0.672, p=0.037). Five-year disease-free survival rates under International Federation of Gynecology and Obstetrics 2023 were 87.1, 75.9, and 52.3% for Stages I, II, and III-IV respectively, compared with 86.2, 71.8, and 52.3% under International Federation of Gynecology and Obstetrics 2009. Five-year overall survival rates showed similar improvement in Stage II discrimination (92.1, 79.2, and 58.7% for International Federation of Gynecology and Obstetrics 2023 vs. 91.3, 76.5, and 58.7% for International Federation of Gynecology and Obstetrics 2009).

The 2023 International Federation of Gynecology and Obstetrics staging system provides improved prognostic discrimination compared with the 2009 classification, particularly in delineating intermediate- from advanced-stage endometrial cancer. By incorporating adverse histopathological parameters and allowing integration of molecular classifiers, the revised system enables more accurate risk stratification and individualized treatment planning.

This study compared the clinical characteristics of catheter-related thrombosis (CRT) associated with internal jugular and subclavian vein-implanted ports.

This retrospective study enrolled patients who were newly implanted with a vascular access port between January and December 2022. Relevant patient and clinical information, including demographic data, catheter details, and CRT results, were mainly obtained from the hospital's electronic medical record database. Follow-up was conducted until the time of the patient's first occurrence of thrombus at the infusion port or the last vascular color Doppler ultrasound available for patients without thrombus up to the study deadline (December 2024).

Among 647 patients who underwent B-ultrasound examinations due to different reasons, such as discomfort symptoms, catheter dysfunction, and pre-extubation thrombus screening, 277 patients (42.8%) experienced CRT, and the median time to thrombosis was 14 (12, 16) months. It was most frequently located at the entrance of the catheterized vein (36.6%). Breast cancer and internal jugular vein catheterization were risk factors for CRT. After pairwise comparisons, there was a significant difference in the median time (4 [2, 7] vs 5 [3, 10] months) between the early onset thrombus (hypoechoic), and older thrombi (hyperechoic signal) (adjusted P = .021).

For cancer patients who undergo ultrasound examinations for various reasons, the risk of CRT is relatively high. More attention should be paid to patients with breast cancer and with internal jugular vein implantation around 14 months after catheterization.

Adjuvant pembrolizumab improves disease-free and overall survival among patients with resected clear-cell renal-cell carcinoma. The hypoxia-inducible factor 2α inhibitor belzutifan has activity in advanced disease. Adjuvant pembrolizumab with belzutifan may further improve outcomes in patients with clear-cell renal-cell carcinoma at increased risk for recurrence.

In this phase 3, double-blind trial, we randomly assigned participants in a 1:1 ratio to receive intravenous pembrolizumab at a dose of 400 mg every 6 weeks (≤9 doses) and either daily oral belzutifan at a dose of 120 mg (pembrolizumab-belzutifan) or placebo (pembrolizumab-placebo) for up to 1 year. The primary end point was disease-free survival as assessed by the investigator; secondary end points included overall survival and safety.

A total of 921 participants were assigned to receive pembrolizumab-belzutifan and 920 were assigned to receive pembrolizumab-placebo. The median time from randomization to the data-cutoff date (August 23, 2025) was 28.4 months (range, 15.0 to 40.1). Disease-free survival was significantly higher with pembrolizumab-belzutifan than with pembrolizumab-placebo (hazard ratio for disease recurrence or death, 0.72; 95% confidence interval [CI], 0.59 to 0.87; two-sided P<0.001); the estimated 24-month disease-free survival was 80.7% and 73.7%, respectively. At this interim analysis with 29% of the final-analysis events observed, overall survival did not differ significantly between the groups (hazard ratio for death, 0.78; 95% CI, 0.51 to 1.19; two-sided P = 0.24); the estimated 24-month overall survival was 96.2% with pembrolizumab-belzutifan and 95.7% with pembrolizumab-placebo. Adverse events of grade 3 or higher occurred in 52.1% of the participants who received pembrolizumab-belzutifan and in 30.2% of those who received pembrolizumab-placebo.

Treatment with pembrolizumab-belzutifan led to significantly higher disease-free survival, with a greater risk of grade 3 or higher toxic effects, than treatment with pembrolizumab monotherapy after nephrectomy in participants with clear-cell renal-cell carcinoma at increased risk for recurrence. (Funded by Merck Sharp and Dohme, a subsidiary of Merck [Rahway, NJ]; LITESPARK-022 ClinicalTrials.gov number, NCT05239728.).

Anemia is a common and debilitating complication in cancer patients, affecting prognosis, quality of life, and treatment response. The burden of anemia may be higher in resource-limited settings due to nutritional deficiencies and limited healthcare access. However, data on anemia among newly diagnosed cancer patients in Ethiopia remain scarce. This study was aimed to determine the magnitude and predictors of anemia in newly diagnosed adult solid cancer patients in Hawassa, Ethiopia.

A cross-sectional study was conducted among randomly selected 405 newly diagnosed adult solid cancer patients at selected public health facilities in Hawassa City, Ethiopia, from June 2021 to October 2021. Data were collected using structured face-to-face interviews and from medical records. Data were entered into EpiData version 3.1 and exported to SPSS version 26 for analysis. Descriptive statistics were computed for all variables. Binary logistic regression was performed to determine the independent effects of potential explanatory variables on the presence of anemia. Adjusted Odds ratios with 95% confidence intervals were calculated. Statistical significance was set at p-value < 0.05.

The prevalence of anemia was 26.4% (95% CI: 22.1-30.7%), with normocytic anemia (56.1%) being the most common morphological type. Multivariable analysis identified a history of bleeding (AOR = 3.46, 95% CI: 1.94-6.16), advanced cancer stage (AOR = 2.01, 95% CI: 1.20-3.34), and underweight BMI (AOR = 2.14, 95% CI: 1.28-3.55) were significantly associated with anemia. Conversely, higher educational attainment (diploma and above) was protective (AOR = 0.35, 95% CI: 0.13-0.93).

Anemia affects over one-quarter of newly diagnosed solid cancer patients in Hawassa, with advanced-stage disease, bleeding history, and decreasing body mass index as significant risk factors. These findings highlight the need for routine anemia screening at diagnosis, nutritional interventions, and early bleeding management in oncology settings.

The National Health Interview Survey (NHIS), a nationwide in-person and telephone survey of the civilian non-institutionalized population, is used to measure progress towards Healthy People objectives on cancer screening. Survey reports have been compared to medical record data to assess validity of these questions; however, few studies have assessed reliability, or response consistency over time. We assessed the test-retest reliability of questions on cervical, colorectal, breast and lung cancer screening from the 2021 and 2022 NHIS.

We surveyed 1,770 adults ages 18 + years with and without prior screening for breast, cervical, colorectal, and lung cancer from four U.S. health systems (three in Washington state and one in Michigan) to examine validity of the NHIS questions. Among people who completed the validity survey, we randomized individuals to receive an additional survey one month later (N = 944) and three months later (N = 822). We calculated Cohen's Kappa, Gwet's AC1, and simple concordance to assess reliability.

Among our study sample, 535 (56.7% of those assigned) to one month follow-up and 537 (65.0%) assigned to three month follow-up completed the reliability survey. Among these, 36 (6.6%) and 94 (17.6%) of those assigned to one and three month follow-up respectively were excluded from reliability analyses because they had additional screening tests after completing the validity survey. Cohen's Kappa showed strong-to-moderate reliability for being up to date with mammography screening: 0.83 at one month and 0.78 at three months; reliability for other screening tests was considerably lower: 0.61 and 0.60 for cervical, 0.57 and 0.62 for colorectal, and 0.72 and 0.58 for lung and one and three months, respectively.

We found strong-to-moderate reliability of responses recalling breast cancer screening at one and three months following an initial survey. Reliability may not be a major threat to self-reported cancer screening behavior.

Enfortumab vedotin plus pembrolizumab (EV/P) recently emerged as the preferred first-line treatment regimen for metastatic urothelial carcinoma (mUC), but evidence outside trial settings is relatively limited.

To evaluate outcomes associated with first-line EV/P compared with gemcitabine plus cisplatin (G/C) in patients with mUC.

This retrospective cohort study used the TriNetX database. Adults with mUC initiating first-line EV/P or G/C between September 2007 and September 2025 were included. Cohorts were propensity score matched for comparison by demographic characteristics, comorbidities, kidney function, and location of metastatic disease.

The primary outcome was overall survival (OS). Secondary outcomes included time to next treatment (TTNT), time to hospitalization within 90 days of treatment initiation (EHA), and adverse events (AEs). Outcomes were compared using Kaplan-Meier analysis and log rank test, reporting hazard ratios (HRs) and 95% CIs.

The study included 4433 patients (1841 receiving EV/P and 2592 receiving G/C), with the EV/P group being significantly older (mean [SD] age, 70.6 [10.1] years vs 67.2 [10.6] years; P < .001) and having a higher proportion of Black patients (129 [6.7%] vs 139 [5.3%]; P = .04) and White patients (1445 [76.0%] vs 1614 [61.8%]) but a smaller proportion of Asian patients (145 [7.6%] vs 326 [12.5%]; P < .001). The EV/P group also carried a greater comorbidity burden, including higher rates of heart failure, diabetes, and obesity, while baseline characteristics were well balanced after propensity score matching. First line EV/P was associated with lower risk of death (HR, 0.70; 95% CI, 0.63-0.79), longer median OS (20 vs 11 months), lower risk of EHA (HR, 0.73; 95% CI, 0.64-0.83), and longer TTNT (median, 35 vs 10 months; HR, 0.49; 95% CI, 0.39-0.61). Receipt of EV/P at first line was associated with higher rates of rash, hyperglycemia, and hypothyroidism but fewer cytopenias and gastrointestinal toxic effects.

In this retrospective cohort study of patients with mUC, EV/P was associated with longer OS, delayed TTNT, and lower time to EHA compared with G/C. These findings support the broader adoption of EV/P as first-line therapy in routine clinical practice.

Circulating brain injury biomarker levels increase after transsphenoidal surgery for pituitary tumors. However, their relationship with long-term fatigue and cognitive outcomes remains unclear. We investigated whether postoperative changes in glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and tau are associated with fatigue and cognitive outcomes in patients with nonfunctioning pituitary adenomas (NFPAs).

This prospective cohort study included 68 patients with NFPAs undergoing endoscopic transsphenoidal surgery. Plasma GFAP, NfL, and tau were measured pre- and postoperatively using ultrasensitive assays. Fatigue was assessed using the Multidimensional Fatigue Inventory and cognitive performance with the Repeatable Battery for the Assessment of Neuropsychological Status preoperatively and at 12-months postsurgery. Clinically meaningful changes were defined as ≥ 0.5 standard deviations from baseline.

All biomarkers increased significantly after surgery, with tau peaking immediately, GFAP on day 1, and NfL on day 5 (all p < 0.01). Patients with preoperative hypothalamic compression showed greater postoperative increases in GFAP and NfL. At 12-months, fatigue improved at the group level, and cognitive performance remained stable. However, individual outcomes were heterogeneous: clinically meaningful worsening was observed for fatigue in 8/58 patients (14%) and for cognitive performance in 6/31 patients (19%). We identified no significant associations between increased postoperative biomarker levels and changes in fatigue or cognitive performance.

Endoscopic transsphenoidal surgery for NFPAs is associated with transient increases in circulating brain injury biomarkers, particularly in patients with hypothalamic compression. Our findings revealed that these elevations were not related to long-term fatigue or cognitive decline, suggesting that they may reflect short-term surgical effects without sustained functional consequences.

To characterize the clinical presentation, endocrine phenotype, and outcomes of pituitary metastasis in a contemporary tertiary-center cohort, with emphasis on clinically actionable diagnostic red flags.

We conducted a retrospective single-center case series of 14 consecutive patients diagnosed with pituitary metastasis between 2010 and 2025. Presenting manifestations, endocrine features, radiologic findings, primary tumor origin, treatment patterns, and overall survival were assessed. In patients without histopathologic confirmation, diagnosis was established using the validated clinicoradiologic model proposed by Yuzkan et al. RESULTS: Median age was 52.5 years, and 71.4% of patients were women. Hypopituitarism (64.3%), arginine vasopressin deficiency (50.0%), and visual impairment (50.0%) were frequent at presentation. One patient presented with sudden bilateral visual loss and hemodynamic instability, mimicking an apoplexy-like sellar emergency. Breast cancer was the most common primary tumor (28.6%). Serum prolactin levels, available in 11 patients, were uniformly below the range typically expected for macroprolactinoma despite large sellar masses. Histopathologic confirmation was obtained in 35.7% of cases, whereas the remainder fulfilled high-likelihood clinicoradiologic criteria. Median overall survival after pituitary metastasis diagnosis was 6.5 months, and 92.9% of patients died during follow-up.

Pituitary metastasis frequently presents with combined endocrine dysfunction and neuro-ophthalmologic compromise, occasionally as an acute sellar emergency. In oncologic patients with sellar lesions, the combination of AVP-D, visual deterioration, and non-prolactinoma-range hyperprolactinemia should raise suspicion for pituitary metastasis and prompt urgent endocrine and local evaluation.

Routine follow-up of lung cancer patients involves thoracic computed tomography (CT) scans every 3-6 months for 2 years and then annually up to 5 years. With increasing numbers of survivors, risk-stratified follow-up, tailoring surveillance to recurrence risk, may reduce unnecessary scans while maintaining high-quality follow-up. This study explored healthcare professionals' (HCPs) perceived barriers and facilitators to implement risk-stratified follow-up in lung cancer care.

A qualitative study was performed, involving 14 semi-structured individual interviews with HCPs engaged in lung cancer care. Transcripts were analyzed using inductive thematic analysis, with codes subsequently organized according to the Grol and Wensing framework across six different levels: Innovation, Patient, Professional, Social context, Organization, and Economic and Political.

Barriers and facilitators were identified across all levels. HCPs generally viewed risk-stratified follow-up as a promising approach to align care with individual patient risk. Facilitators included its personalized nature, potential to reduce unnecessary imaging, and improve follow-up efficiency. However, HCPs emphasized the need for robust evidence demonstrating safety, effectiveness, and resource optimization. Patient-level barriers included varying follow-up preferences and limited health literacy, while tailored communication was seen as a facilitator. Organizational barriers such as staffing shortages and unclear role delineation were frequently mentioned. Integration into care pathways and interprofessional collaboration were identified as facilitators to address these challenges. Concerns about reduced clinical autonomy and patient safety were also expressed. Financial constraints at the economic and political level were reported to potentially hinder implementation.

HCPs are generally receptive to evidence-based risk-stratified follow-up. Successful implementation requires evidence of effectiveness, integration into care pathways, clear roles, and aligned reimbursement.

Percutaneous cryoablation (PC) has been incorporated among first-line treatment options for desmoid-type fibromatosis (DF). Loco-regional therapies, including PC, induce tissue changes that may precede measurable tumor shrinkage, thereby limiting the reliability of purely dimensional response criteria. To address this limitation, we compared response evaluation criteria in solid tumors (RECIST) 1.1 and magnetic resonance imaging (MRI)-adapted (M-)RECIST in patients with DF treated with PC.

We retrospectively identified all consecutive patients with progressing extra-abdominal DF treated with PC. Responses were assessed with RECIST 1.1 and M-RECIST, the latter relying on T2- and diffusion-weighted imaging, as well as unenhanced and contrast-enhanced T1-weighted imaging, to define residual viable tumor. Non-progression (NPR) and overall response rates (ORR) were defined as the percentage of patients without radiological progression and partial/complete responses, respectively.

Thirty-four patients (females/males, 26/8) and 37 procedures were identified. RECIST 1.1 and M-RECIST were applicable in 35 and 34 procedures, respectively. At a median follow-up of 15.7 months (interquartile range [IQR] 19.5), RECIST 1.1. Responses were: 10/35 (28.6%) partial response (PR), 22/35 (62.9%) stable disease (SD), and 3/35 (8.6%) progressive disease (PD), with ORR 28.6% and NPR 91.4%. At a median follow-up of 16.0 months (IQR 20.5), M-RECIST responses were: 15/34 (44.1%) complete response (CR), 12/34 (35.3%) PR, 4/34 (11.8%) SD, and 3/34 (8.8%) PD, with ORR 79.4% and NPR 91.2%. Overall concordance was negligible.

M-RECIST yielded higher NPR/ORR than RECIST 1.1. These findings pave the way for studies addressing whether this shift in response categorization associates with improved outcomes prediction.

This work provides supporting evidence for the implementation of residual viable disease assessment in evaluating DF responses to PC.

In patients with DF, responses to cryoablation can be characterized using purely dimensional and viability-based criteria. RECIST 1.1 and M-RECIST yielded complete agreement for PD. M-RECIST may refine response categorization below the progression threshold.