This study aims to identify independent risk factors for tumor recurrence and postoperative complications in platinum-resistant ovarian cancer patients undergoing cytoreductive surgery.

This study retrospectively included 96 patients with platinum-resistant ovarian cancer who underwent cytoreductive surgery between January 2020 and December 2022. Of these, 76 patients were in the recurrence group, and 20 patients were in the non-recurrence group. Among them, 84 patients developed postoperative complications and 12 did not. Recurrence was defined as disease progression evidenced by radiological findings according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1, or tumor recurrence confirmed by histopathology. Complications within 30 days were graded using the Clavien-Dindo system (grade ≥II). Collected clinicopathological variables included surgical duration, peritoneal cancer index (PCI), surgical complexity score (SCS), and postoperative cancer antigen 125 (CA125), the latter measured after two cycles of adjuvant chemotherapy to assess recurrence. Variables with p < 0.05 in univariate analysis were included in a multivariate logistic regression model to identify independent risk factors. Receiver operating characteristic (ROC) curve analysis was used to assess the discriminative power of the identified predictors.

Recurrence was significantly associated with longer surgical duration, elevated postoperative CA125, increased PCI, fewer chemotherapy cycles, and suboptimal cytoreductive surgery (all p < 0.05). Multivariate analysis identified surgical duration (odds ratio (OR) = 2.076), postoperative CA125 (OR = 1.193), and PCI (OR = 1.247) as independent risk factors for recurrence. Exploratory ROC analysis suggested moderate discriminative ability of the combined factors (area under the curve (AUC): 0.84), although no model validation was performed. Surgical duration, CA125, and PCI each demonstrated moderate predictive values, with AUCs of 0.77, 0.66, and 0.67, respectively. Complications were independently associated with elevated postoperative CA125; however, the complication model demonstrated only modest discriminative ability (AUC = 0.71). These results should be interpreted as exploratory.

Prolonged surgical duration, elevated postoperative CA125 levels, and higher PCI scores were independently associated with recurrence in patients with platinum-resistant ovarian cancer, while elevated postoperative CA125 levels were also associated with postoperative complications. These factors demonstrated moderate discriminative ability and may serve as potential markers for postoperative risk stratification. However, these findings are exploratory in nature and require external validation.

Gastric cancer (GC) remains a significant concern worldwide, with a very high incidence in Japan, South Korea, and China. Early diagnosis of GC is important for reducing its mortality; to achieve this, screening of individuals at a high risk for developing GC should include frequent esophagogastroduodenoscopy. Currently, various population-based GC screening strategies are being implemented in South Korea, Japan, and the Matsu region of Taiwan. Many studies have suggested that serum pepsinogens (sPGs) can be used as GC biomarkers in South Korea, China, Europe, and other countries; indeed, Japan first included the sPG test in GC screening prior to 1990. However, while the role of sPGs (particularly type 1) as a marker of atrophic gastritis is well known, studies on the association between sPG levels and GC have mainly focused on the association with intestinal-type GC. Recent studies have demonstrated that sPGII is associated with severe inflammation and proliferation. Specifically, high sPGII levels and Helicobacter pylori positivity are associated with an increased risk of early diffuse-type GC, particularly in young females. In this review, the physiology of sPGs and the usefulness of sPG levels in the detection of intestinal- or diffuse-type GC are discussed in terms of sex and age.

To compare functional and oncological outcomes among the novel anterior approach, the Retzius-sparing approach, and the conventional anterior approach for robot-assisted radical prostatectomy.

This retrospective cohort study included 585 patients who underwent robot-assisted radical prostatectomy between September 2017 and August 2022 at Jichi Medical University Saitama Medical Center. Among them, 173, 109, and 303 patients underwent the novel anterior approach, the Retzius - sparing approach, and the conventional anterior approach, respectively. Urinary continence recovery was evaluated as the primary endpoint, while postoperative inguinal hernia incidence and oncological outcomes, including surgical margins and biochemical recurrence-free survival, were assessed as secondary endpoints and compared using Kaplan-Meier methods.

Patient characteristics did not differ across groups except for surgeon's experience and follow-up duration. Both the Retzius-sparing approach and the novel anterior approach were associated with earlier recovery of complete continence (HR = 3.10, 95% CI 2.26-4.26; HR = 1.60, 95% CI 1.25-2.04) and a lower incidence of inguinal hernia (HR = 0.34, 95% CI 0.19-0.62; HR = 0.23, 95% CI 0.13-0.42) compared with the conventional anterior approach. Biochemical recurrence-free survival did not differ significantly among the three approaches, despite the higher rate of positive surgical margins in the Retzius-sparing approach.

The novel anterior approach and the Retzius-sparing approach may offer functional advantages over the conventional anterior approach, while oncological outcomes appear comparable across groups in this retrospective cohort. These hypothesis-generating findings suggest the need for further prospective studies with longer follow-up.

Findings from our previous study showed that the combination of pyrotinib, trastuzumab, and chemotherapy represents a viable treatment strategy with an acceptable safety profile for heavily pre-treated human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC). We present here the final efficacy and safety results of our investigation.

Patients with HER2-positive MBC who previously received anti-HER2 therapies such as trastuzumab, pertuzumab, or lapatinib were treated with a combination of pyrotinib, trastuzumab, and chemotherapy. Progression-free survival (PFS), predictive factors of PFS, and safety were updated in both the intention-to-treat population (ITT) and the subgroup exhibiting brain metastases (Sub-BM). Overall survival (OS) along with its predictive factors was initially analyzed in both ITT and Sub-BM.

Forty patients were eligible for this analysis. After a median follow-up of 46.6 months, 27 deaths occurred and four patients continued treatment with pyrotinib combined with trastuzumab and chemotherapy. The median PFS was 7.5 [95% confidence interval (CI), 4.5-10.5 months] and 9.1 months (95% CI, 0.0-18.9 months) in the ITT and Sub-BM, respectively. The median OS was 32.2 (95% CI, 21.8-42.6 months) and 32.2 months (95% CI, 18.4-46.0 months) in the ITT and Sub-BM, respectively. Cox regression analyses revealed that liver or/and lung metastases were significant adverse predictive factors for PFS (p = 0.020) in the ITT. No new safety concerns were identified following 28 months of additional follow-up. Adverse events were similar to those reported at the primary analyses with respect to specificity, incidence, and severity.

Updated analyses pertaining to PFS and safety were generally aligned with data obtained from initial assessments. The OS outcomes further substantiated that the combination of pyrotinib, trastuzumab, and chemotherapy is an alternative therapeutic regimen for managing HER2-positive MBC with heavy pre-treatment in certain situations, particularly among those with non-visceral metastases.

This study investigates the correlations and risk factors of complications associated with different urinary diversion methods after radical cystectomy (RC) for bladder cancer (BC).

A retrospective analysis was conducted on 574 bc patients treated between 2012 and 2022. Complications were categorized as early or late occurrences. Multistate Cox regression and stepwise logistic regression models were employed to identify independent predictors. Heat maps were utilized to explore correlations among complications.

Patients undergoing ureterostomy were generally older, had a higher prevalence of comorbidities, and exhibited a greater propensity for late urinary tract infections (UTIs), nephrolithiasis, and anxiety/depression. Bricker conduits were linked to small-bowel obstruction and ureteroenteric strictures, while orthotopic neobladders were associated with incontinence and urinary retention. Diabetes increased risks of urolithiasis and mild bowel obstruction but decreased strictures and reflux. High pathological grade predicted strictures; low hemoglobin increased obstruction and late UTIs. Robot-assisted laparoscopy reduced early UTIs, reflux, and ostomy-related obstruction. Bowel obstruction risk was elevated in patients with higher body mass index or smoking history but was mitigated by robotic approaches. Late UTIs were strongly linked to ureterostomy and heavy smoking.

Ureterostomy raises the risk of UTIs, kidney issues, and psychological disorders, necessitating careful follow-up. Bricker conduits require monitoring for bowel complications, while orthotopic neobladders are linked to incontinence and metabolic problems, demanding careful patient selection. Advanced age, heavy smoking, T4 stage, and long hospital stays are key predictors of complications and should guide preoperative risk assessment. Robot-assisted laparoscopy lessens gastrointestinal and stoma-related events.

Germline genetic testing can identify people at high risk of hereditary cancers. Limited data exist on differences in receipt and knowledge of germline genetic testing for cancer predisposition (hereafter genetic testing for cancer).

Data from the National Center for Health Statistics Rapid Surveys System collected between January-February 2024 were analyzed to estimate prevalence of receipt, knowledge, and interest in genetic testing for cancer.

An estimated 8.4% of adults received genetic testing for cancer. Among adults who had not received genetic testing for cancer, 52.0% knew genetic tests can indicate high risk of getting cancer in the future, and 40.7% expressed interest in getting tested in the future. The most common reason for interest was knowing risk would make a difference in health care decisions (93.3%). Among adults who did not report interest in genetic testing for cancer, the most common reason for disinterest was no provider recommendation (54.2%). Differences in receipt, knowledge, and interest were observed by sociodemographic characteristics and health history.

This report provides national estimates that can inform strategies to increase genetic testing for cancer among high-risk populations, including efforts to reduce potential testing barriers.

Despite major advances in molecular diagnostics, morphological examination of blood and bone marrow remains fundamental in the evaluation of diverse malignancies. This five-case series illustrates how subtle and often overlooked morphological clues can be decisive in diagnostically challenging settings. The aim of this study is to demonstrate that morphological assessment should extend beyond isolated cytologic features to include spatial distribution of cells, functional behavior, and bone marrow microenvironmental context. The reported cases comprise: (1) bone marrow infiltration by dedifferentiated melanoma mimicking a hematologic neoplasm, with melanin-laden macrophages providing a critical clue; (2) carcinocythemia revealing metastatic melanoma, with neoplastic cells confined to smear edges; (3) an anaplastic IgA multiple myeloma with striking cytological atypia; (4) acute monoblastic leukemia with a rapidly fatal course; and (5) myelodysplastic syndrome with SF3B1 mutation, characterized by prominent erythroblastic islands and subtle dysplasia. Key findings highlight that atypical spatial localization of tumor cells, functional features such as hemophagocytosis, and microenvironmental alterations may provide decisive diagnostic information. In conclusion, a structured, contextual morphological approach remains central to the accurate diagnosis of aggressive malignancies and serves as an essential complement to immunophenotypic and molecular techniques.

Ablation technology represents a fundamental approach to the management of solid tumors, with cryoablation serving as a particularly effective modality due to its established therapeutic efficacy, minimally invasive nature, lower complication rates, and broad clinical utility. China has pioneered this field through the development of a next-generation cold and hot co-ablation system that integrates low-temperature freezing with intense thermal ablation, thereby enhancing therapeutic versatility. Its efficacy and safety profile have been rigorously validated in the context of hepatocellular carcinoma. However, compared to conventional thermal ablation techniques, such as microwave, radiofrequency, and standalone cryoablation, the factors influencing the success of combined cold and hot co-ablation therapy are significantly more complex. This complexity is further intensified when targeting liver cancers situated in anatomically challenging regions, including areas adjacent to the diaphragm, hepatic hilum, gastrointestinal tract, gallbladder, and heart. To ensure the judicious application of this advanced composite ablation technology in hepatic malignancies, a comprehensive expert consensus has been meticulously established through the collaborative efforts of experts from the Committee of Ablation Therapy in Oncology, the Chinese Anti-Cancer Association, the Expert Committee on Ablation Therapy, the Chinese Society of Clinical Oncology (CSCO), and the Committee of Tumor Ablation, the Chinese College of Interventionalists.

Neurofibromatosis type 1 is a hereditary disease with a wide variability of clinical manifestations, from the almost complete absence of typical symptoms to a multisystem lesion of the body. One of the possible clinical manifestations of this pathology is a pheochromocytoma - a tumor of the adrenal gland with the possible development of considerable cardiovascular complications. The article describes four cases of patients with pheochromocytoma as part of familial neurofibromatosis type 1, differing in clinical course from asymptomatic form to vivid paroxysmal manifestations. At the same time, the presence and degree of arterial hypertension did not correlate with the level of metanephrines and the size of the pheochromocytoma. 3 out of 4 patients have a hereditary history of neurofibromatosis type 1. In 1 out of 4 cases, simultaneous bilateral damage to the adrenal glands was noted, while the radiation characteristics of pheochromocytomas, both with computed tomography and CT/PET with 18-FDG, differed from the "classic" ones. An objective examination with the identification of "erased" signs of neurofibromatosis type 1 made it possible to establish the diagnosis of bilateral pheochromocytoma even with questionable laboratory and imaging data. Knowledge of clinical manifestations, timely diagnosis of neurofibromatosis type 1, comprehensive treatment and subsequent regular monitoring of patients, as well as examination of blood relatives can significantly improve prognosis and survival.

Pituitary adenomas (PA) are the most common lesions of hypothalamic-pituitary region. Clinical presentations of PA depend on both hormonal activity and tumor growth characteristics. Despite the fact that PA are mostly benign, they can grow invasively and mechanically affect adjacent structures. With invasive growth of PA, radical removal is difficult and associated with a higher risk of surgical complications. Pathogenesis of PA invasiveness is not fully understood. Tumor cell invasion depends on both intercellular interactions within the tumor and interaction with extracellular matrix components (ECM). Major factors that play an important role in these processes include matrix metalloproteinase (MMP) family and tissue inhibitors of matrix metalloproteinases (TIMPs). Two MMPs were mostly studied in PA - types 2 and 9. These molecules are of interest, as they participate in degradation of type IV collagen, which is a key component of the ECM in hypothalamic-pituitary region. This review discusses the general concept of PA invasiveness, the characteristics of MMPs, and research of the relationship between these molecules and PA invasiveness.