Mackay Memorial Hospital (Chinese: 馬偕紀念醫院; pinyin: Mǎjiē Jìniàn Yīyuàn), established on 26 December 1912, is one of the largest medical centers in Taiwan. It is a private Christian hospital in Zhongshan District, Taipei, Taiwan, mostly associated with George Leslie Mackay, the first modern missionary to northern Taiwan. The hospital is deeply rooted in the Presbyterian tradition and under the spiritual guidance of the Presbyterian Church in Taiwan.
Gastric cancer (GC) remains a global health burden. While international guidelines share consensus, variations exist in disputed issues. The 2025 Taiwan Consensus and Management Guidelines for Gastric Cancer had just been released. We compared the key recommendations with established international guidelines. A multidisciplinary taskforce addressed key questions and recommendations using modified Delphi method and evidence-based approaches. The comparative review aimed to elucidate similarities and differences among guidelines from Taiwan, Japan, South Korea, China, Europe, and the US. Guidelines converge on absolute endoscopic resection criteria for early GC but differ in extended indications and perioperative approaches for locally advanced disease. Heterogeneity exists in biomarker assessment protocols, cutoff thresholds, and companion diagnostics. For metastatic disease, consensus exists on anti-HER2, anti-VEGF, immunotherapy, and biomarker-driven strategies, though oligo-metastatic definitions and intraperitoneal chemotherapy indications remain controversial. Optimal GC management requires integrating global evidence with regional contexts. The comparative review addresses heterogeneity among international guidelines, which helps harmonize management strategies as therapeutic standards evolve.
Muscle loss after radiotherapy is associated with poor overall survival in patients with oral cavity cancer. In this study, we aimed to develop a machine learning model for predicting muscle loss after radiotherapy. This study included patients with oral cavity cancer who underwent surgery and post-operative radiotherapy at two tertiary centers between 2010 and 2020. Muscle loss was determined by comparing pre- and post-radiotherapy computed tomography scans. The Random Forest (RF), eXtreme Gradient Boosting (XGBoost), and Categorical Boosting (CatBoost) models were trained to predict muscle loss using clinical and toxicity features. Model performance was evaluated using the area under the curve (AUC). The SHapley Additive exPlanations (SHAP) method was used to interpret the model. Of 903 eligible patients (median age: 55 years), 572 and 331 were in the derivation and external validation cohorts, with 144 (25.2
BACKGROUND/AIM:Previous studies suggest that thyroid cancers in the isthmus are associated with more aggressive behavior and unfavorable patient outcomes compared to lobar tumors. This study aimed to characterize the molecular features of isthmus thyroid cancer. MATERIALS AND METHODS:Transcriptomic and proteomic data were retrieved from the Cancer Genome Atlas. We performed 1:2 propensity score matching based on age, sex, tumor subtype, size, extrathyroidal extension, lymph node metastasis, and stage, matching 15 papillary thyroid cancers with the BRAF V600E mutation located in the isthmus to 30 tumors in the unilateral lobar area. RESULTS:Despite balanced oncogenic drivers, BRAF-mutant isthmus tumors exhibited significantly lower BRAF-RAS scores and higher ERK output scores. Additionally, these tumors had a slightly elevated DNA methylation-based stemness index. Principal component analysis revealed distinct gene expression patterns between the two groups. Differential expression and gene set enrichment analysis indicated enrichment in extracellular matrix remodeling, cell adhesion pathways, and TGF-β signaling. Notable upregulated genes included oligoadenylate synthases, TNR, HAS3, and LIF. Hierarchical proteomic clustering highlighted increased co-expression of several oncoproteins and DNA damage response markers in isthmus tumors. CONCLUSION:BRAF-mutant papillary thyroid cancers in the isthmus display distinct molecular characteristics, including increased ERK signaling activity. These findings suggest that topographical location independently influences tumor biology and may account for the more aggressive clinical behavior of isthmus tumors at the molecular level.
