Background: Intestinal cancer (IC) is among the most common cancers worldwide in both sexes. It is the third most common cancer and the second leading cause of cancer-related death globally. At the national level, IC is also highly prevalent, accounting for 49.8% of all digestive cancers, and it is the second leading cause of cancer-related death. In addition, dietary factors are critical to both the prevention and development of this cancer type; certain foods are markedly protective, whereas others confer a high risk. Objectives: The purpose of this study is to develop an intelligent system to optimize the risk of IC using a traditional Moroccan nutritional database, thereby enabling users to make personalized decisions. Methods: The database comprised 1 135 patients, of whom 493 had IC and 642 were control patients, with data on socioeconomic status, clinical history, lifestyle, behavior, and diet. It was complemented by a dietary table of traditional Moroccan dishes, together with the macronutrient composition of their respective constituents. The proposed model is based on a Transformer architecture, and SHAP (Shapley Additive exPlanations) values are used to identify risk and protective factors for personalized recommendations for the prevention of IC. Results: The Transformer model achieved an AUC (area under the receiver operating characteristic curve) of 0.984, an accuracy of 95.3%, a recall of 94.6%, a precision of 94.6%, and an F1-score of 94.7%. These values exceeded those previously reported in the literature, supporting the relevance of the proposed method. Conclusions: This study demonstrated the relevance of integrating dietary practices with contemporary predictive models of IC and the potential to develop tailored dietary guidance. This work contributes to efforts to provide effective and adaptable solutions within the Moroccan context.
Context: Despite the gradual increase in scientific attention to cancer information avoidance, a comprehensive review of its evolution, conceptual dimensions, theoretical foundations, and determinants over the past three decades has not yet been conducted. This study aimed to analyze research on cancer information avoidance to delineate the current state of the field, identify knowledge gaps, and guide future research directions. Evidence Acquisition: The present study employed a mixed-methods approach, combining a scoping review and bibliometric analysis. Data were extracted from articles indexed in the Scopus, PubMed, and Web of Science databases. Based on the inclusion and exclusion criteria, 28 studies were selected and analyzed using scoping review methods and the Biblioshiny software. Results: The results indicated that studies on cancer information avoidance have shown an upward trend over the past three decades. Research has primarily focused on information avoidance among patients and women. The literature review revealed that the determinants of cancer information avoidance include sociodemographic factors, individual (cognitive and affective) factors, and social and situational (cultural, informational, disease-related, and health system-related) factors. Furthermore, the review of theories and models indicated that most studies have drawn on theories such as Cognitive Dissonance, Uncertainty Management, and the Extended Parallel Process Model, whereas a specific conceptual model for cancer information avoidance has yet to be developed. Discussion: This study provides a comprehensive overview of the conceptual framework and research landscape of cancer information avoidance and emphasizes the need to develop indigenous and interdisciplinary models to enable a deeper understanding of this phenomenon.
Background: Albumin and the albumin-to-globulin ratio (AGR) are established prognostic markers in multiple myeloma (MM); however, the prognostic value of baseline serum total protein in patients with MM undergoing autologous stem cell transplantation (ASCT) remains unclear. Objectives:This study investigated the prognostic significance of baseline total protein for progression-free survival (PFS) in patients with MM undergoing autologous stem cell transplantation (ASCT). Methods: Twenty-one consecutive patients with MM who underwent ASCT between 2023 and 2025 at the Stem Cell Transplant Research Center of Taleghani Hospital were included. Survival outcomes were evaluated using Kaplan-Meier estimates stratified by baseline total protein levels and Cox proportional hazards models. Patients were followed for a median of 19 months (range, 10.5 - 32 months). Results: Higher baseline total protein was significantly associated with inferior PFS (HR, 2.10; 95% CI, 1.08 - 4.08; P = 0.028). Patients with total protein > 9 g/dL had significantly shorter PFS and 12-month PFS than those with total protein <= 9 g/dL (log-rank test; P = 0.008 and P = 0.029, respectively). A trend toward inferior OS was observed (log-rank test; P = 0.052). Elevated total protein was strongly correlated with M-protein and globulin levels and was associated with lower hemoglobin levels and a higher erythrocyte sedimentation rate (ESR). Conclusions: Higher baseline total protein is associated with inferior PFS in patients with MM undergoing ASCT. Given its simplicity and universal availability, it may serve as a cost-effective and accessible prognostic marker at the time of diagnosis. Larger prospective studies are needed to validate its independent prognostic value.
Context: The intersection of menopause and breast cancer often impairs patients' quality of life due to the accompanying physical and psychological burdens. This study examined the efficacy of mindfulness and cognitive-behavioral therapy (CBT) on menopausal breast cancer patients' physical and psychological symptoms. Objectives: To evaluate the efficacy of mindfulness and CBT interventions in reducing physical and psychological symptoms in menopausal women with breast cancer. Data Sources: This PROSPERO-registered meta-analysis (CRD42021275803) was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Clinical trials published up to January 31, 2025, were identified through systematic searches of PubMed, Web of Science, Scopus, and the Cochrane Library. Study Selection: Eight studies, with sample sizes ranging from 21 to 255, were assessed using the quality assessment checklist and the Cochrane risk of bias tool. Results: A random-effects meta-analysis of eight studies (sample sizes ranging from 21 to 225 participants) demonstrated significant improvements in vasomotor symptoms — specifically hot flashes and night sweats — following mindfulness-based and CBT interventions [standardized mean difference (SMD) = 0.961; 95% CI: 0.662 - 1.260; P < 0.001]. Significant reductions were also observed in anxiety (SMD = 0.332; 95% CI: 0.146 - 0.517; P < 0.001) and depression (SMD = 0.766; 95% CI: 0.199 - 1.332; P = 0.008), along with improvements in sleep quality (SMD = 1.008; 95% CI: 0.411 - 1.602; P = 0.001). Due to the limited number of eligible studies, pooled analyses were conducted combining mindfulness and CBT interventions, without separate subgroup estimation. Conclusions: Mindfulness and CBT interventions can notably mitigate physical symptoms and mental health issues in menopausal patients with breast cancer, potentially ameliorating the side effects of pharmacological treatments.
Introduction: Nicotine addiction is one of the most prevalent forms of addiction, particularly among young people, and its prevalence has increased significantly. High levels of nicotine and carcinogens in smokeless tobacco are among the most important risk factors for developing premalignant lesions and head and neck cancers. Case Presentation: Over a 1-year period, dental examinations were conducted in 4000 patients referred to the Department of Oral and Maxillofacial Medicine, School of Dentistry, Yazd, Iran. Among these patients, 45 reported a history of smokeless tobacco use; 31 were male and 14 were female. Seventeen patients (11 males and 6 females) aged 24 to 80 years had oral mucosal lesions. Only 6 patients presented with oral lesions as their chief complaint, whereas lesions in 9 patients were identified incidentally. Conclusions: These findings suggest a strong clinical association between smokeless tobacco use, known as SNUS in Iran, and the occurrence of precancerous and malignant lesions.
Background: Cancer patients undergoing chemotherapy often experience multiple treatment related adverse effects. Although chemotherapy improves survival outcomes, it is frequently accompanied by side effects that substantially impair quality of life. Sleep disturbances are among the most common problems, yet they remain underrecognized in routine clinical practice. Poor sleep quality may worsen fatigue, reduce treatunent adherence, and negatively affect overall well-being. In Vietnam, evidence on sleep quality among cancer patients receiving chemotherapy remains limited. Objectives: The objective of this study is to identify factors associated with poor sleep quality among cancer patients undergoing chemotherapy in Vietnam. Methods: A cross sectional study was conducted among 432 cancer patients receiving chemotherapy using convenience sampling. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), which includes 19 items across 7 components and evaluates sleep quality over the previous month; a global PSQI score of > 5 indicated poor sleep quality. Data were analyzed using the Chi square test or Fisher's exact test, followed by multivariable Poisson regression with robust variance estimation to identify factors associated with poor sleep quality. Results: A total of 432 cancer patients were included, with a median age of 59 years (IQR: 47.5-66; range: 18-85 years). Females accounted for 55.3% of the study population. The median PSQ! score was 5.0 (IQR: 4.0-8.5), and 49.8% of patients were classified as having poor sleep quality. In the adjusted model, poor sleep quality was associated with other comorbidities, cancer stage III-IV, fatigue, peripheral neuropathy, diarrhea, and sleep medication use, whereas university/postgraduate education and chemotherapy cycle Ts were associated with a lower prevalence of poor sleep quality. Conclusions: Nearly half of the patients had poor sleep quality as measured by the PSQI. Poor sleep quality was associated with several demographic and clinical factors, including educational level, other comorbidities, chemotherapy cycle, cancer stage, fatigue, peripheral neuropathy, diarrhea, and sleep medication use. These findings help fill an important evidence gap and support early screening and supportive sleep care for patients undergoing chemotherapy.
Background: Cervical cancer remains a major global health concern, particularly in developing countries. Perineural invasion (PNI) is a well-established adverse prognostic indicator in several cancers; however, its prognostic significance in cervical cancer has been reported inconsistently. Objectives: This study aimed to determine the prevalence of PNI in cervical cancer, investigate its associations with clinicopathological characteristics, and evaluate its impact on patient survival. We hypothesized that PNI is associated with more aggressive tumor characteristics and poorer survival outcomes. Methods: This retrospective cohort study included a consecutive series of 33 patients with cervical cancer who underwent abdominal radical hysterectomy at Shahid Sadoughi Hospital, Yazd, between 2012 and 2023. Patients were included if they underwent primary surgical treatment and had complete medical records. Adjuvant chemotherapy was administered postoperatively in selected cases according to clinical indications. Patients who had received neoadjuvant therapy or had incomplete data were excluded. When pathology slides or paraffin blocks were unavailable, PNI status could not be evaluated; however, the remaining variables were analyzed in these cases. Clinical and pathological data, including age, tumor stage and size, depth of stromal invasion, lymph node involvement, lymphovascular space invasion (LVSI), parametrial involvement, margin status, tumor histological type, treatment method, and PNI status, were reviewed. Survival data were obtained through follow-up. Statistical analyses included descriptive statistics, chi-square tests, t tests, and Kaplan-Meier survival curves. Results: Perineural invasion was detected in 32% of evaluable cases (8/25) and was significantly associated with deep stromal invasion (P = 0.04) and positive surgical margins (P = 0.03). No significant correlations were observed with tumor size, lymph node status, LVSI, parametrial involvement, treatment type, or other clinicopathologic variables. Most patients presented with early-stage disease (66.7% stage IBi), and nonkeratinized squamous cell carcinoma (SCC) was the predominant subtype (48.5%). Survival analysis was limited by low mortality (2 deaths) and showed no significant difference by PNI status (P = 0.51). Conclusions: Perineural invasion is present in a substantial proportion of cervical cancer cases and is associated with aggressive tumor characteristics. Although survival data are limited, PNI is indicative of a poorer prognosis. Routine assessment of PNI is recommended to improve risk stratification and guide therapy. Larger studies are needed to clarify its prognostic and therapeutic significance.
Background and Objectives: Cancer-related pain presents in a broad range of patients who suffer from cancer. Although there have been significant improvements in the clinical management of cancer patients, the known therapeutic approaches to this challenge are still inefficient. Methods: In this study, we reported 5 cases of advanced metastatic cancer, all of whom engaged in home recovery strategies applying electrostatic therapy devices. Results: The application of electrostatic therapy is an appropriate method for metastatic cancer patients, leading to a reduction in the need for painkillers and opioid-related drugs. Conclusions: Regarding the increase in cancer incidence, this simple, safe, and non-pharmacologic method can address the high load on the medical care system. Furthermore, home therapies were deployed in the absence of the capability to deliver non-emergency and non-life-threatening care during pandemic social distancing.
Background: Optimal management of FIGO 2018 stage IB3-IIA cervical cancer remains debated. Objectives: This study compared oncological outcomes and toxicity profiles between 2 primary treatment paradigms for locally advanced disease: neoadjuvant chemotherapy followed by radical surgery (NACT_RS) and definitive chemoradiotherapy (CRT). Methods: This retrospective analysis included 81 consecutive patients with tumors >= 4 cm (FIGO stage IB3-IIA) who were treated between 2021 and 2024. Patients received either NACT_RS (n = 31) or CRT (n =50). Patient characteristics, treatment-related complications graded according to the Common Terminology Criteria for Adverse Events version 5.0, and survival outcomes were compared. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox regression. Results: The NACT_RS and CRT groups were well matched for baseline tumor size, stage, and histology. Grade >= 2 late complications were significantly more frequent in the CRT group (64.0%) than in the NACT_RS group (6.5%) (P < 0.001), driven mainly by high rates of vaginal stenosis and dyspareunia. Notably, the 12 surgical patients who required adjuvant radiotherapy also had a lower rate of late complications (16.7%) than the definitive CRT group. Three-year PFS was significantly better in the NACT_RS arm (96%) than in the CRT arm (74%) (P = 0.013). Similarly, 3-year disease-specific OS was 100% for NACT_RS and 81% for CRT (P = 0.011). In multivariate analysis, CRT was associated with an 8.2-fold higher risk of recurrence than NACT_RS (1-112 = 8.16; 95% CI, 1.07-6236; P= 0.043). Conclusions: In this cohort of patients with locally advanced cervical cancer, NACT_RS was associated with superior survival outcomes and substantially lower rates of long-term morbidity compared with definitive CRT. NACT_RS appears to be a viable and potentially superior strategy for downstaging larger tumors to achieve excellent oncologic outcomes while minimizing the substantial late toxicities associated with pelvic radiotherapy.
Background: Accurate cumulative dose assessment is essential in patients with rectal cancer undergoing fractionated high-dose-rate (HDR) brachytherapy, particularly when the external beam radiation therapy (EBRT) dose is incorporated. Objectives: This study aimed to evaluate the dosimetric impact of deformable image registration (DIR) on cumulative dose assessment in patients with rectal cancer undergoing fractionated high-dose-rate (HDR) brachytherapy. Methods: In this retrospective cohort study, 12 patients with locally advanced rectal cancer were treated with EBRT (50.4 Gy in 28 fractions) followed by HDR brachytherapy (4 fractions of 6-7 Gy). DIR-based dose accumulation was performed across all brachytherapy fractions using MIM software, with conversion to the equivalent dose in 2 Gy fractions (EQD2) and voxel-wise summation. The EBRT dose distribution was rigidly registered to the final brachytherapy computed tomography (CT) scan to calculate the total dose. Dose-volume parameters, including D90 for the clinical target volume (CTV) and D2cc, Dicc, and D0.lcc for organs at risk (OARs), were compared between DIR-based and conventional dose summation. Registration quality was evaluated using the Dice similarity coefficient (DSC). Results: DIR resulted in significant reductions in cumulative OAR doses compared with simple summation, including rectum D2cc (-2.5 +/- 1.2 Gy, P <0.01) and bladder D2cc (-1.9 +/- 1.0 Gy, P = 0.02), as well as a modest increase in target coverage (CTV D90: +1.3 +/- 1.1 Gy, P = 0.03). The median D90 improvement after DIR-based re-optimization was 1.77 Gy EQD2. DIR quality was acceptable for most structures (DSC > 0.80), although it was lower for the CTV (0.73) owing to its irregular shape and sensitivity to motion. Conclusions: DIR improves the accuracy of cumulative dose assessment in rectal cancer radiotherapy and may facilitate safer dose escalation and improved organ sparing. Integrating DIR into adaptive brachytherapy workflows offers a promising strategy for personalized treatment in anatomically variable pelvic regions.
Background and Objective: Neoadjuvant chemotherapy (NAC) is widely used in the management of breast cancer (BC) andprovides an opportunity to evaluate treatment response in both the primary tumor and axillary lymph nodes (LNs).Understanding the relationship between breast tumor response and axillary clearance may inform surgical decision-makingand prognostication. Methods: In this retrospective study, patients with histologically confirmed BC who received NAC followed by definitive breastand axillary surgery at a tertiary referral center between 1987 and 1990 were included. Exclusion criteria were male sex andincomplete pathological data regarding breast tumor response, axillary LN status, or immunohistochemical profile. Chi-squaretest (chi(2)) and odds ratio (OR) with 95% confidence intervals (CI) were used for statistical analysis. Results: A total of 375 patients with BC treated with NAC were evaluated for breast tumor response and axillary LN response atdefinitive surgery. A strong association was observed between breast tumor response and axillary LN response, with patientsdemonstrating a favorable breast tumor response showing significantly higher odds of axillary clearance (OR 5.18, 95% CI 3.07 -8.75; P < 0.001). In addition, breast tumor response was significantly associated with non-luminal immunohistochemical status(OR 1.76, CI95% 1.02 - 3.03; P = 0.03), as was axillary LN response (OR 2.43, 95% CI 1.48 - 3.99; P < 0.001). Conclusions: Breast tumor response following NAC is strongly correlated with axillary LN response and is associated withtumor biology. These findings support the potential role of response-based stratification in guiding individualizedmanagement strategies for patients with BC.
Background: Breast cancer (BC), the second most prevalent cancer worldwide, poses a significant health challenge. Despite major advances in therapeutic modalities for BC, patients who undergo modified radical mastectomy face considerable risks of locoregional recurrence, ranging from 10% to 40%. Electrochemotherapy (ECT), a novel treatment modality, has demonstrated promising efficacy, particularly for skin and subcutaneous metastases, by enhancing drug penetration and minimizing systemic adverse effects. Methods: This case series was the first multicenter study in Iran to evaluate the effect of ECT on skin metastases in patients with recurrent BC following either lumpectomy or mastectomy. The study was conducted in 2 cancer referral centers from April 2023 to November 2024. Patients with BC who experienced treatment failure with skin metastasis or chest wall recurrence were included. Results: All included patients had large lesions (> 5 cm) with metastatic spread to the skin. Among the 10 cases, 2 patients achieved complete response, 3 patients developed clear skin margins and became operable for mastectomy, and 5 patients achieved local control of tumor-associated symptoms. Conclusions: These findings demonstrated an impressive overall response to ECT in skin metastases of BC and underscore its potential to improve treatment outcomes for patients experiencing recurrent disease while reducing the burden of systemic therapies.
Background: Primary bone tumors are rare but aggressive malignancies with varying prognostic outcomes. To improve treatment methods, it is crucial to understand the survival trends and demographic attributes of these patients. Objectives: This study aimed to evaluate the survival rate and associated demographic and clinical characteristics of patients diagnosed with primary bone tumors in Guilan, the north province of Iran, between 2014 and 2018. Methods: This retrospective cohort study utilized data from the provincial cancer registry. Survival analyses were performed using life table methods, Kaplan-Meier estimates, and Cox proportional hazards regression to evaluate survival outcomes and identify factors potentially predictive of prognosis. Results: The study included 166 patients, with a male-to-female ratio of 1.7:1 and a mean age of 44.75 +/- 25.55 years. The most prevalent primary bone tumor was osteosarcoma (14.5%), followed by chondrosarcoma (7.2%). The overall 5-year survival rate was 43%. Age at diagnosis had a significant effect on survival (P < 0.0 01), whereas gender was not significantly associated with survival. Conclusions: These results emphasize the importance of early diagnosis and appropriate management strategies for enhancing patient outcomes.
Background: Acute lymphoblastic leukemia (ALL) is driven by recurrent chromosomal translocations that serve as key diagnostic and prognostic markers. Conventional detection methods are accurate but costly and labor-intensive. SYBR Green-based real-time PCR offers a simpler, probe-free alternative. Objectives: This study aimed to develop and validate a SYBR Green-based multiplex real-time PCR assay for simultaneous detection of four major ALL translocations - ETV6-RUNX1, TCF3-PBX1, KMT2A-AF4, and BCR-ABLI - to provide an affordable diagnostic tool suitable for resource-limited settings. Methods: To concurrently identify prevalent chromosomal translocations of ALL, a SYBR Green-based real-time multiplex PCR assay was developed. The HPRT gene, characterized by a distinct melting temperature, was amplified separately and served as the internal control. Upon optimization of the multiplex protocol, its performance was validated across a cohort of 30 newly diagnosed ALL patients, with pre-established translocation-positive and translocation-negative status, and 10 healthy donors. Results: The optimized multiplex assay showed robust performance, with all five targets successfully co-amplified in a single master mix containing nine primers. Amplification efficiencies for all targets remained within the acceptable 90-110% range, with specificity verified at 100%. The assay exhibited strong reproducibility, supported by low intra-and inter-assay variation. Conclusions: Our findings confirm that the designated SYBR Green-based multiplex PCR assay is a precise and reliable alternative for the simultaneous detection of major ALL-associated translocations. This method shows promise as a costeffective, high-performance diagnostic tool. However, to firmly establish its clinical utility and reproducibility, future validation with a larger, multi-center patient cohort is warranted.
Background: This study evaluates the potential of apparent diffusion coefficient (ADC) values derived from diffusion-weighted imaging (DWI) as non-invasive imaging biomarkers for breast cancer prognosis, correlating them with lcey histopathological and molecular features. Objectives: To assess the diagnostic accuracy of (ADC values derived from diffusion-weighted MRI for predicting breast cancer prognostic factors by examining their correlation with histopathological and molecular markers, including ER/PR status, HER2 expression, Ki-67 index, tumor grade, size, and lymph node metastasis. Methods: In this prospective study, 35 consecutive patients with histologically confirmed breast cancer were recruited through the private radiology office in Tehran, Iran, between December 2017 and August 2018. All patients underwent breast MRI at Athari Imaging Center, Tehran, using a 1.5 T scanner including diffusion-weighted imaging sequences. Histopathology served as the reference standard for all imaging findings. Apparent diffusion coefficient values were measured from manually selected regions of interest and statistically analyzed for correlations with ER/PR, HER2, Ki-67, tumor grade, size, and lymph node status. No indeterminate or missing data were recorded. Receiver operating characteristic (ROC) curve analysis was used to determine diagnostic performance thresholds, and variability in diagnostic accuracy across biomarkers was assessed through AUC comparison. Results: Significantly lower ADC values were observed in tumors with lymph node metastasis (P = 0.016), high Ki-67 expression (P = 0.042), and positive ER/PR status (P = 0.031). ROC analysis demonstrated high diagnostic performance of ADC for identifying metastatic lymph nodes (AUC = 0.879), ER/PR-positive tumors (AUC = 0.864), and Ki-67-positive tumors (AUC = 0.837). No significant correlations were found between ADC and HER2 status, tumor grade, or size. Conclusions: Apparent diffusion coefficient values significantly correlate with lcey prognostic factors in breast cancer, including hormone receptor status, tumor proliferation, and lymph node involvement. These findings highlight ADC as a promising non-invasive diagnostic biomarker for early risk stratification and treatment planning. Larger multicenter studies are warranted to validate these results and support broader clinical application.
Background: Breast cancer often requires mastectomy, leading to psychological distress and reduced quality of life. Objectives: This study examined the mediating role of alexithymia, specifically its 3 dimensions, in the relationship between body image concerns and marital quality of life in post-mastectomy patients. Methods: This cross-sectional study enrolled 120 married women (aged 2050) with stage III breast cancer who had undergone mastectomy at Shohada Tajrish Hospital, Tehran, in 2024; participants completed 3 validated self-report questionnaires: The Toronto Alexithymia Scale (TAS-20), the Body Image Concern Inventory (BICI), and the Revised Dyadic Adjustment Scale (RDAS). Data were analyzed using descriptive statistics, Pearson's correlations, and path analysis in SPSS and AMOS, with ethical approval obtained and informed consent secured from all participants. Results: Body image concerns were directly associated with lower marital quality of life beta = 0.3 P = 0.003 ) and with higher alexithymia, particularly difficulty identifying feelings ( beta = 0.609 P < 0.001 ) . Only difficulty identifying feelings significantly mediated this relationship (0.240, P = 0.024 ). Notably, externally oriented thinking showed a positive direct association with marital quality of life ( beta = 0.239 , P=0.001). Conclusions: Body image concerns following mastectomy impair marital quality of life, primarily through impaired emotional identification. The unexpected positive role of externally oriented thinking suggests context dependent functions of alexithymia traits. Findings support the integration of emotion focused psychological support into surgical care pathways.
Context: Odontogenic tumors and cysts (AOD) have a significant prevalence in Iran and have many negative effects on patients' health. Objectives: The aim of the study is to investigate the prevalence of odontogenic cysts and tumors in Iran with a systematic review and meta-analysis method. Methods: In this meta-analysis study, which was conducted using the PRISMA checklist, all published articles (2000 - 2024) on the prevalence of AOT and oral cancers (OCs) were included in the study. The information search was conducted by two researchers specializing in oral and dental diseases (in domestic Iranian and international databases). Articles published in Iran, in which the prevalence or the number of AOT and OCs were reported, were included in the study. Systematic review studies and case reports were excluded from the study. The researchers used a checklist containing items such as the number of anatomical locations of odontogenic (Maxilla and Mandible), the number of odontogenic tumors, the number of odontogenic cysts, and the total number of patients. An analysis was done using the software CMA. Results: Result showed in 1043 articles found in the initial search, 26 articles were entered into the meta-analysis stage, and data analysis was conducted for them. The prevalence of AOD was 0.124 (CI = 0.121 - 0.126) based on the Fixed analysis model and 0.067 (CI = 0.097 - 0.046) in the random analysis model. Also, based on the Random model, the prevalence of Odontogenic cysts was equal to 0.111 (CI = 0.085 - 0.144) and the prevalence of Odontogenic tumors was equal to 0.023 [CI = 0.012 - 0.040]. Conclusions: Since the prevalence of odontogenic cysts and tumors was significant in this meta-analysis study, it is suggested to take necessary measures and screening for the prevention of AOT and OCs.
Context: Accurate diagnosis and timely treatment of pediatric bone lesions are essential, as delayed or incorrect diagnosis can result in significant morbidity. Bone infections such as osteomyelitis and primary bone sarcomas — including osteosarcoma and Ewing’s sarcoma — often present with similar clinical and radiological features, creating substantial diagnostic challenges. This narrative review synthesizes current evidence on the clinical presentation, diagnostic complexities, and multidisciplinary management strategies for differentiating between bone infections and sarcomas in pediatric patients. By offering practical guidance for healthcare providers, this review aims to enhance diagnostic accuracy, reduce the risk of misdiagnosis, and improve overall patient outcomes. Evidence Acquisition: A comprehensive literature review was conducted, focusing on the clinical features, diagnostic imaging, and biomarkers used to differentiate bone infections from sarcomas. The review also examines the role of multidisciplinary teams in managing these conditions and emphasizes the importance of early and accurate diagnosis. Pediatric bone infections and sarcomas often present with nonspecific symptoms such as pain and swelling, making differential diagnosis challenging. Diagnostic imaging modalities, including plain radiography, magnetic resonance imaging (MRI), and computed tomography (CT), are essential but may yield inconclusive results. Advanced diagnostic tools — such as immunohistochemistry, molecular genetics, and liquid biopsy — have demonstrated potential in enhancing diagnostic precision. A multidisciplinary team approach, involving sarcoma surgeons, pathologists, oncologists, and radiologists, is essential for comprehensive assessment and individualized treatment planning, ultimately contributing to improved patient outcomes. Results and Conclusions: Differentiating between bone infections and sarcomas in pediatric patients remains a significant clinical challenge due to their overlapping symptoms and radiological features. Early and accurate diagnosis, combined with a coordinated multidisciplinary treatment approach, is crucial for achieving optimal patient outcomes. Future research should focus on refining diagnostic pathways, developing novel and disease-specific biomarkers, and strengthening multidisciplinary collaboration to further enhance the precision of diagnosis and the effectiveness of treatment for pediatric bone lesions.
