Superior vena cava syndrome (SVCS) in cancer patients often requires prolonged vascular access. This study evaluates tunneled femoral inserted central catheter (TFICC) outcomes in adult oncology patients with SVCS. A prospective cohort study of 89 SVCS patients receiving TFICCs at Sun Yat-sen Univesity Cancer Center between March and June 2022. Primary outcomes included complication rates, including dislodgement, occlusion, abnormal blood reflux, skin injury, thrombosis, unplanned removal. Logistic regression was performed to identify risk factors for these complications. Among 89 patients, 47.2
Germline BRCA1/2 pathogenic or likely pathogenic variants (PVs) are well-established genetic risk factors for breast cancer. However, most previous studies focused on Western populations, leaving a gap in the characterization of Asian cohorts. Therefore, we conducted a retrospective analysis across three hospitals in Northwest China, aiming to elucidate the clinical implications of BRCA PVs in this understudied population. This multi-center, retrospective cohort analysis investigated the influence of BRCA PV status on the response to neoadjuvant chemotherapy (NAC) and prognosis. We enrolled 1009 stage I-III breast cancer patients who underwent germline BRCA1/2 testing and received at least four cycles of a standard NAC regimen between January 1, 2017, and August 31, 2025. The primary endpoint was pathological complete response (pCR), and the secondary endpoint was event-free survival (EFS). Of the 1009 patients, 62 (6.1
Ubiquitination and liquid-liquid phase separation has been reported to be closely related to the development and occurrence of tumors, but its role in multiple myeloma (MM) remains unexplored. For the first time, based on ubiquitination and liquid-liquid phase separation prognosis related genes (ULLPSRGs), consistent clustering analysis and prognostic difference analysis were conducted, and a prognostic model was constructed through multivariate Cox regression. The model was validated on an independent dataset. Simultaneously conduct immune infiltration analysis, enrichment analysis and drug sensitivity evaluation. Then, the potential therapeutic targets of MM were confirmed through cell experiments. We have identified for the first time four ULLPSRGs associated with MM prognosis. Consensus cluster analysis based on four ULLPSRGs revealed that the two identified clusters had prognostic differences. A prognostic model was constructed based on ULLPSRGs and validated in an independent dataset. The signature is an independent risk factor for MM patients and significantly correlates with clinical factors, the signature was associated with the tumor microenvironment. Cell experiments have confirmed that inhibiting the expression of UBA1 can inhibit the cycle progression of MM cells and promote apoptosis. Our signature can provide clinicians with prognostic predictions and help guide the treatment of patients with MM.
IgG4-positive Hashimoto’s thyroiditis (IgG4-HT) is an aggressive HT subtype that may be misdiagnosed as primary thyroid lymphoma (PTL) due to overlapping clinical and imaging features. This study aimed to evaluate the utility of ultrasound for non-invasive differentiation between IgG4-HT and PTL. Data from 13 IgG4-HT and 19 PTL patients (all pathology-proven) were retrospectively collected. Clinical characteristics, laboratory findings, and sonographic features were compared between the two groups. IgG4-HT patients were younger than PTL patients (40.31 ± 11.38 vs. 69.00 ± 10.25 years, P < 0.001). No significant differences in sex distribution, compressive symptoms, or thyroid function were found. On ultrasound, PTL showed larger anterior-posterior thyroid diameters (left lobe: 3.00 ± 1.29 cm vs. 1.65 ± 0.32 cm, P < 0.001; right lobe: 3.19 ± 1.24 cm vs. 1.62 ± 0.44 cm, P < 0.001), more frequent linear hyperechoic areas (89.5
Pancreatic cancer (PC) is a highly lethal malignancy, and its growing global burden remains closely linked to diagnosis at advanced stages. Understanding the range of factors that have been investigated in relation to pancreatic cancer risk can help clarify where evidence is most consistent and where important gaps remain for prevention and future research. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and the Joanna Briggs Institute methodology. PubMed/MEDLINE, Scopus, Web of Science, ProQuest, and ScienceDirect were searched from database inception to 13 July 2026. Observational studies investigating factors associated with pancreatic cancer risk were included. Two reviewers independently screened studies, extracted data, appraised methodological quality using the Critical Appraisal Skills Programme (CASP) checklists, and synthesized the evidence using thematic analysis. A total of 130 studies published between 2001 and 2026 were included. Sixteen major themes of factors associated with pancreatic cancer risk were identified. Substance use was the most frequently investigated theme, followed by metabolic disorders, body weight and composition, dietary habits, and pancreatic conditions. Smoking, diabetes mellitus, chronic pancreatitis, obesity-related measures, increasing age, and family history of pancreatic cancer were the factors most frequently reported across the included studies. The evidence also covered hepatobiliary and kidney disorders, systemic and oral health conditions, chronic inflammation, infectious agents, environmental exposures, demographic characteristics, genetic factors, socioeconomic and psychosocial factors, and medication-related exposures, although these areas were investigated less often. The evidence identified in this review was concentrated around several established risk factors, particularly smoking, diabetes mellitus, chronic pancreatitis, obesity-related measures, increasing age, and family history of pancreatic cancer. At the same time, the literature extends beyond these commonly studied factors to a broader set of clinical, behavioral, environmental, genetic, and social exposures, for which the available evidence is less extensive and often heterogeneous. These findings indicate that important areas of pancreatic cancer risk remain insufficiently characterized. Future prospective studies with standardized and clearly defined exposure assessment are needed to address these gaps and support more reliable pancreatic cancer risk stratification.
Achieving early diagnosis of esophageal squamous cell carcinoma (ESCC) is crucial for reducing the disease burden. This study aims to identify potential serum protein biomarkers associated with the early diagnosis of ESCC in two independent populations and further develop diagnostic models. This case-control study identified and verified ESCC-shared biomarkers in two independent populations from Taixing and Jinan (China). Utilize differential analysis and functional enrichment analysis, combined with bulk RNA-seq and single-cell RNA-seq data, were used to validate the diagnostic proteins at the tissue and cellular levels. Multiple machine learning algorithms were employed to screen core diagnostic proteins and develop models for ESCC diagnosis. Indicators such as area under the curve (AUC) were used to evaluate the models’ predictive capabilities for ESCC diagnosis. Lastly, survival data were employed to further expand the ability of genes encoding core diagnostic proteins to predict the prognosis of ESCC patients. Differential analysis validated across two independent populations revealed 13 proteins with diagnostic value for ESCC, with most proteins showing consistent expression patterns in mRNA and single-cell RNA compared to serum samples. The diagnostic model, developed using the gradient-boosted decision tree algorithm based on the variables retained after Lasso regression (CDKN1A, ADAMTS15, KLK13, RSPO3, ANXA1, MetAP2), demonstrated best discriminative effects, calibration, and clinical utility in both the derivation dataset [AUC = 0.932, 95
Due to a lack of efficient screening methods or trustworthy biomarkers with high sensitivity and specificity, ovarian cancer (OC) is a quarrelsome disease with a high death rate. Investigators believe that circulating tumor cell-free DNA (cfDNA) can provide crucial clues concerning both primary and metastatic OCs. Our goal was to identify the potential of circulating cfDNA as a non-invasive biomarker for ovarian cancer. This case‒control prospective study was carried out on 150 participants, of whom 50 patients were confirmed to have ovarian cancer, 50 patients had benign ovarian lesions, and 50 participants were controls. For OC patients, medical, laboratory, and imaging evaluations together with survival analysis were performed. Quantification of cfDNA was done by real-time PCR. A distinct difference in the mean cfDNA was observed in the malignant group (11.84 ng/mL) compared to the benign (3.90 ng/mL) and control (0.23 ng/mL) groups. ROC curve analysis revealed that cfDNA had the highest value as a strong discriminatory marker for prediction of ovarian cancer in suspected cases and prediction of late stage and is a reasonable predictor of mortality (AUC 0.934, p < 0.001, 95
Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS–HIPEC) using cisplatin is an established treatment for selected patients with peritoneal malignancies, but acute kidney injury (AKI) remains a common and clinically significant complication. Perioperative nephroprotection is therefore an integral component of cisplatin-based HIPEC protocols. Sodium thiosulfate is widely used in this setting and has demonstrated effectiveness in reducing postoperative renal toxicity. Cilastatin, a drug with a long-standing clinical safety record, has shown consistent nephroprotective effects in experimental models and emerging clinical studies, and may offer an alternative strategy for renal protection during HIPEC. However, comparative randomized evidence between these two approaches is currently lacking. This study is a prospective, randomized, double-blind, non-inferiority clinical trial conducted at a high-volume tertiary referral center. Adult patients undergoing CRS followed by cisplatin-based HIPEC are randomized in a 1:1 ratio to receive either intravenous cilastatin or sodium thiosulfate administered according to standardized nephroprotection regimens. Randomization and drug preparation are managed by the hospital pharmacy to ensure allocation concealment and blinding of participants, clinicians, and outcome assessors. The primary outcome is the incidence of AKI within the first 7 postoperative days, defined according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. Secondary outcomes include cisplatin pharmacokinetics and its concentration in tumor nodules after HIPEC, perioperative adverse events, the evolution of renal dysfunction up to postoperative day 14 in patients who develop AKI, and exploratory analyses of urinary biomarkers of renal injury. A total sample size of 90 patients provides 80
Abstract Background This study examined the associations of estimated glucose disposal rate (eGDR), a surrogate of insulin sensitivity, and the insulin resistance indices TG/HDL-C and TyG with gastrointestinal (GI) cancer mortality in the UK Biobank. Methods We included 369,447 participants without cancer at baseline and recorded 4,305 GI cancer-related deaths over a mean follow-up of 13.5 years. Fine-Gray models assessed associations of eGDR, TG/HDL-C, and TyG with GI cancer mortality. Results Higher eGDR was associated with lower pooled GI cancer mortality (sHR, 0.67; 95% CI, 0.61–0.74; P < 0.001); associations with EC, ESCC, CRC, LC, and PC mortality remained significant after false discovery rate (FDR) correction. TyG, but not TG/HDL-C, remained associated with pooled GI cancer mortality, and both markers remained associated with LC mortality. Subgroup analyses were exploratory. Conclusions Higher eGDR was associated with lower pooled and several site-specific GI cancer mortality outcomes, whereas TG/HDL-C and TyG associations were modest and site-specific. These findings do not establish clinical utility.
Breast cancer progression is influenced not only by tumor-intrinsic alterations but also by interactions within the tumor immune microenvironment (TIME). We aimed to identify genetically regulated susceptibility genes associated with immune-related cellular states in breast cancer. We first performed a transcriptome-wide association study (TWAS) using FinnGen summary statistics to identify candidate genetically regulated genes associated with breast cancer susceptibility. Their transcriptional activity was subsequently mapped onto the GSE176078 single-cell atlas using AUCell, UCell, and AddModuleScore. Because B cells consistently showed the highest enrichment, we further applied hdWGCNA to characterize co-expression modules associated with the high TWAS score (HTS) state. We then integrated LASSO, Random Forest, Boruta, and XGBoost analyses to prioritize candidate hub genes. The prognostic and immunological relevance of ELF1 was further evaluated in GSE96058 (n = 3,273) and METABRIC (n = 2,509). Functional validation was further performed using ELF1-modulated B-cell models, including Raji and GM12878 cells, together with direct co-culture assays with MDA-MB-231 breast cancer cells. TWAS analysis identified 65 candidate genetically regulated genes, and their activity appeared to be preferentially enriched in B cells. hdWGCNA further linked HTS-associated modules to RNA splicing and B-cell activation pathways. Among the candidate genes, ELF1 was the only candidate feature consistently prioritized across all four machine learning algorithms. Low ELF1 expression was associated with inferior overall survival in the GSE96058 cohort, while a consistent survival trend was observed in the METABRIC cohort. ELF1 expression positively correlated with naive B-cell infiltration but showed negative correlations with plasma cells and M0/M1 macrophages. Functional experiments demonstrated that ELF1 modulation affected B-cell proliferation, activation marker expression, RNA splicing-related molecules, and altered the proliferative and invasive behaviors of breast cancer cells in direct co-culture systems. By integrating TWAS, single-cell transcriptomics, machine learning, and preliminary experimental validation, we identified ELF1 as a B-cell-associated prognostic biomarker in breast cancer. These findings suggest that ELF1 may represent a molecular link between genetically regulated expression patterns and B-cell-related immune states within the tumor microenvironment.
Invasive non-mucinous lung adenocarcinoma (INMA) is biologically heterogeneous, with histological patterns defining distinct subtypes; however, the significance of non-predominant components is not fully characterized. We investigated the associations of micropapillary/solid (MP/S) and lepidic (Lep) components with clinicopathological features, molecular profiles, and perioperative circulating tumor DNA (ctDNA) dynamics in a Chinese cohort. We retrospectively analyzed 73 INMA patients with definitive histological subtyping and next-generation sequencing data. Tumors were assessed for MP/S and Lep components irrespective of predominance. Histologic patterns were correlated with clinicopathological variables, genomic alterations, and individualized tumor-informed ctDNA detection. The cohort was predominantly early-stage, with 71.2
Cancer of unknown primary (CUP) is defined by the presence of metastatic disease without an identified primary tumor despite comprehensive diagnostics. The absence of a known primary tumor creates substantial diagnostic uncertainty for patients and caregivers, and precludes site-specific, evidence-based treatments. Fibroblast activation protein inhibitor (FAPI) PET tracers have recently gained attention as promising alternatives to [18F]fluoro-2-deoxy-d-glucose ([18F]FDG), as they selectively target cancer-associated fibroblasts within the tumor microenvironment and demonstrate low physiological uptake in normal tissues. This favorable biodistribution yields high tumor-to-background contrast, potentially overcoming the limitations of [¹⁸F]FDG and enhancing diagnostic performance in patients with CUP. This investigator-initiated, patient advocacy supported, multicenter, prospective clinical trial evaluates the diagnostic performance of the novel radiotracer [¹⁸F]F-FAPI for primary tumor detection in patients with CUP. Fifty patients (aged ≥ 18 year) diagnosed with CUP after a standard diagnostic work-up, including [18F]FDG PET-CT, will be recruited in six medical centers throughout the Netherlands. Participation in the study involves a single [¹⁸F]F-FAPI PET-CT scan. Images will be centrally interpreted by two independent nuclear medicine physicians or nuclear radiologists, with a consensus report and recommendations provided to the treating physician. A central Truth Panel of multidisciplinary experts will review all pseudonymized clinical data collected up to six months after the [¹⁸F]F-FAPI PET-CT, including whole genome sequencing, pathology, and additional imaging, to assess the clinical impact and added diagnostic value of [¹⁸F]F-FAPI PET-CT. Patient recruitment commenced in July 2024. The study will be completed after the six-month follow-up of the last enrolled participant has been completed. This study aims to determine the utility of [¹⁸F]F-FAPI PET-CT in identifying the primary tumor in CUP patients with inconclusive results from conventional diagnostics, including [¹⁸F]FDG PET-CT. We hypothesize that [¹⁸F]F-FAPI PET-CT will identify the primary tumor in at least 15
Advances in precision oncology and cancer therapies have improved survival for Canadians with advanced cancer, resulting in a growing population living long-term while receiving ongoing treatment. However, little is known about their supportive care needs or how they differ from those treated with curative intent, limiting the relevance of existing resources. As such, this study aimed to explore the lived experiences and challenges faced by Canadians receiving ongoing treatment for advanced cancer. A qualitative study was conducted involving semi-structured virtual interviews with 22 Canadians receiving ongoing treatment for advanced cancer. Interviews were audio-recorded, transcribed verbatim, and analysed thematically using descriptive techniques. Two overarching themes were identified. First, participants described challenges unique to living long-term with advanced cancer, including persistent treatment-related symptoms, uncertainty about the future, and disruptions to daily routines, responsibilities, and identity. Second, participants described barriers and facilitators influencing their ability to live well with advanced cancer, including capacity for self-management and self-advocacy, support from family and friends, financial considerations, and support from healthcare providers. Participants reported difficulty navigating available resources and limited guidance from providers and felt that existing supports and resources were insufficient to address the challenges they experienced. Individuals living with advanced cancer face physical, emotional, practical, and adjustment-related challenges that are distinct from those with earlier stage cancers. Existing supports are rarely effective at addressing these challenges, leaving patients to grapple with unmet needs. Future research should include the development and adaptation of supports that are accessible and tailored to this population.
Adult-type diffuse gliomas, central nervous system (CNS) World Health Organization (WHO) grade 4 (CNS WHO grade 4), remain the most aggressive primary malignant brain tumors despite advances in multimodal treatment. We evaluated overall survival and factors associated with mortality among adults with WHO grade 4 diffuse gliomas treated at two tertiary neurosurgical referral centers in the Democratic Republic of the Congo (DRC). We conducted a multicenter retrospective cohort study including 102 adults with histologically confirmed CNS WHO grade 4 gliomas treated between January 2018 and December 2025. Demographic, clinical, surgical, pathological, treatment, and available molecular characteristics were extracted from institutional records. Overall survival was estimated using the Kaplan–Meier method. Factors associated with mortality were evaluated using multivariable Cox proportional hazards regression adjusted. Among the 102 patients included, the median age was 50.0 years (interquartile range [IQR], 41.2–57.0), and 64 (62.7
Postoperative complications are common after major cancer surgeries, occurring in 25–50
SMARCA4-deficient thoracic tumor(SMARCA4-DT) is a relatively rare and highly aggressive tumors, typically associated with mutations or deletions of the SMARCA4 gene. This article aims to explore the clinical features of SMARCA4-DT patients, disease outcomes, effective prognostic indicators, and the therapeutic value of immune checkpoint inhibitors (ICIs) in advanced SMARCA4-DT patients. A total of 98 cases of SMARCA4-DTs diagnosed at Shanghai Chest Hospital from May 2019 to September 2023 were selected and collected.The clinical features of all patients were analyzed, and disease-free survival (DFS) and overall survival (OS) were assessed for those with complete surgical resection. For advanced, non-resectable patients, treatment strategies were divided into a chemotherapy group and a combination therapy group, including ICIs. A statistical analysis of progression-free survival (PFS) and OS was performed to explore the therapeutic role of ICIs in advanced patients and to identify potential predictive markers. Among the 98 patients, 60 (61.2
Head and neck squamous cell carcinoma (HNSCC) is the seventh most common cancer worldwide. Postoperative radiotherapy (PORT) ± chemotherapy improves outcomes in patients with high- and intermediate-risk pathologic features but is associated with substantial morbidity. While de-escalation strategies have been explored mainly in HPV-positive oropharyngeal cancer, prospective evidence across broader HNSCC populations is lacking. Retrospective evidence suggests that a pathology-driven, tailored PORT strategy may safely reduce treatment volumes while maintaining acceptable oncologic control. This trial prospectively evaluates the safety and efficacy of compartmentalized PORT (COMPORT) of the four most common HNSCC localizations. COMPORT is a multicenter, single-arm phase II trial with Bayesian design that will enroll 50 patients with resected oral cavity, oropharynx, larynx, and hypopharynx HNSCC and an indication for adjuvant PORT, as recommended by a multidisciplinary tumor board. Eligible patients will be treated according to a COMPORT-specific algorithm, omitting low-risk anatomical compartments. In some cases, this results in complete omission of PORT. Primary endpoint is the rate of recurrence in omitted (non-irradiated) compartments within 30 months. Secondary endpoints include loco-regional control, progression-free survival, overall survival, physician-rated toxicity (TAME score), and quality of life (MDADI, EORTC QLQ-C30 and HN43). In this trial, COMPORT will be considered successful if the probability that recurrence rates remain below 18
To evaluate the clinical significance of folate receptor alpha (FRα) expression in endometrial serous carcinoma. We retrospectively analyzed 47 patients with histopathologically confirmed endometrial serous carcinoma who underwent hysterectomy and received systemic therapy. FRα expression was assessed by immunohistochemistry and categorized as high or low based on ≥ 25
To systematically explore the effects of clinicopathological characteristics on lymph node metastasis (LNM) and long-term overall survival (OS) in cervical squamous cell carcinoma patients, and to further identify risk factors for high-level and multiple lymph node metastases. A total of 788 patients who underwent surgical treatment for cervical squamous cell carcinoma between June 2012 and March 2019 were retrospectively included. Stratified Cox proportional hazards regression models stratified by pathological grade were constructed to screen independent prognostic factors for OS and address minor proportional hazards assumption violation. Restricted cubic spline (RCS) binary logistic regression and conventional multivariable logistic regression were performed to evaluate independent predictors of overall lymph node metastasis, high-level (common iliac artery and above) lymph node metastasis, and three or more metastatic lymph nodes (gLNM3). Increased tumor volume (HR = 1.006, P = 0.007), positive lymphovascular space invasion (LVSI, HR = 1.961, P < 0.001), positive vaginal invasion (HR = 1.753, P = 0.001), and positive lymph node metastasis (HR = 2.938, P < 0.001) were confirmed as independent adverse prognostic factors for OS. No postoperative adjuvant treatment modality significantly affected patient survival. RCS logistic regression revealed a marginally significant overall association between continuous tumor volume and lymph node metastasis (global P = 0.053), with a positive linear risk trend observed within the tumor volume range of 10–35 cm³ (OR = 1.866, P = 0.040). Multivariable logistic regression identified LVSI positivity (OR = 4.276, P < 0.001), pathological grade III (OR = 1.706, P = 0.002), endogenic tumor growth pattern (OR = 2.676, P = 0.008), and mass-type gross tumor (OR = 6.455, P = 0.016) as independent risk factors for lymph node metastasis. Among patients with pelvic lymph node metastasis, tumor maximum diameter > 4 cm (OR = 2.290, P = 0.027) and positive LVSI (OR = 3.889, P < 0.001) were independent predictors of high-level lymph node metastasis. Furthermore, LVSI positivity independently increased the risk of having ≥ 3 metastatic lymph nodes (OR = 2.195, P = 0.005). Tumor volume, LVSI, vaginal invasion, and lymph node metastasis are robust independent prognostic indicators for overall survival in cervical squamous cell carcinoma patients. LVSI serves as a core risk factor that comprehensively promotes overall, high-level, and multiple lymph node metastases. Tumor volume exhibits a marginal linear predictive effect on lymph node metastasis, while adjuvant treatment shows no significant impact on patient long-term survival.
