BACKGROUND/AIM:A substantial proportion of patients with cancer experience clinically relevant psycho-oncological distress. In addition to clinic-based screening, mobile approaches are receiving increasing attention for standardized assessment. However, evidence in patients with musculoskeletal sarcoma remains limited. PATIENTS AND METHODS:Forty-five patients with sarcoma underwent smartphone-based distress screening using a cancer-specific questionnaire (QSC-R10) at two time points (T1 and T2). At T1, patients also completed the System Usability Scale (SUS) and additional acceptability items. RESULTS:Mean QSC-R10 scores decreased significantly from T1 to T2 (p=0.034). Patients with recurrent disease showed significantly higher distress at follow-up (p=0.012). Usability was high (SUS: 83.78±12.68), and overall acceptance was high. CONCLUSION:Smartphone-based distress screening is feasible and well accepted in patients with musculoskeletal sarcoma and may improve the identification of psycho-oncological needs through repeated, real-world assessments.
BACKGROUND/AIM:Circadian rhythms regulate DNA repair, cell-cycle control, apoptosis, pigmentation, barrier function, and immune surveillance in skin, and their disruption may increase susceptibility to ultraviolet-induced carcinogenesis. MATERIALS AND METHODS:This narrative review synthesizes mechanistic, experimental, epidemiologic, and translational studies on circadian rhythm disruption and skin neoplasms, with emphasis on melanoma and nonmelanoma skin cancer. RESULTS:Core clock genes such as CLOCK, BMAL1, PER, and CRY orchestrate daily oscillations in cutaneous physiology, including nucleotide excision repair and inflammatory signaling. Experimental studies show that ultraviolet (UV) exposure during circadian phases with low DNA repair capacity produces more persistent lesions and more tumors, while human meta-analytic evidence suggests a modest increase in melanoma risk among shift workers. Evidence for basal cell carcinoma and squamous cell carcinoma is less consistent, likely because of differences in UV exposure, occupation, and confounding by behavior. CONCLUSION:Circadian disruption is a plausible modifier of skin cancer risk, particularly for melanoma, through effects on UV DNA repair, immune surveillance, melatonin signaling, and tumor biology. Further prospective studies using objective circadian biomarkers and dermatology-specific endpoints are needed.
BACKGROUND/AIM:Kita-Kyushu Lung Cancer antigen-1 (KK-LC-1) is a cancer-testis antigen that represents a promising target for treatment with T-cell receptor (TCR) gene-engineered T cells. This study aimed to evaluate the utility of immunohistochemical detection of KK-LC-1 in resected lung adenocarcinoma specimens. PATIENTS AND METHODS:We reviewed the medical records of 110 patients who underwent curative resection for lung adenocarcinoma. The original monoclonal antibody against KK-LC-1, Kmab34B3, was evaluated in this study. Overall survival (OS) and recurrence-free survival (RFS) were compared based on KK-LC-1 positivity and epidermal growth factor receptor (EGFR) mutation. Cox regression analyses were performed to identify prognostic factors. RESULTS:Thirty-nine patients (35%) were positive for KK-LC-1. KK-LC-1 positivity was significantly associated with larger invasive tumor size, advanced pathological stage, lymphatic invasion, vascular invasion, and lymph node metastasis. No significant difference in OS was observed between KK-LC-1-positive and -negative patients (5-year OS: 79.8% vs. 94.0%, p=0.07). However, KK-LC-1-positive patients had significantly poorer RFS than KK-LC-1-negative patients (5-year RFS: 67.7% vs. 85.5%, p=0.020). In multivariate analysis, KK-LC-1 positivity was not an independent predictor of RFS (hazard ratio=1.230, p=0.63). EGFR mutation analysis was available for 89 patients, of whom 45 (50.5%) harbored EGFR mutations. In the EGFR mutation-positive subgroup, KK-LC-1-positive patients had significantly poorer OS than KK-LC-1-negative patients (5-year OS: 77.0% vs. 100%, p=0.026). RFS also tended to be poorer in KK-LC-1-positive patients, although the difference did not reach statistical significance (5-year RFS: 66.6% vs. 88.4%, p=0.055). CONCLUSION:KK-LC-1 positivity was significantly associated with pathological high-grade tumors and poor RFS in patients with lung adenocarcinoma. Moreover, KK-LC-1 may serve as a prognostic factor for lung adenocarcinoma, and KK-LC-1-positive patients may be suitable candidates for TCR reconstitution therapy.
Sun exposure is widely recognized as a major etiologic factor in cutaneous melanoma. However, melanomas also occur in skin areas unexposed to the sun, such as the palmoplantar surface. Although the risk factors and mutational processes underlying acral melanoma remain poorly understood, these tumors frequently occur at sites of increased mechanical stress on the hand and foot, suggesting that mechanical stress may contribute to the development of plantar melanoma. Furthermore, mechanical forces regulate skin homeostasis, especially during skin development, regeneration, and wound healing. In plantar acral melanoma, mechanical stress associated with weight-bearing activity has been linked to nuclear membrane instability, which may explain the frequent occurrence of plantar acral melanoma at higher mechanical stress points. In this review, we discuss the role of mechanical stress in melanoma pathogenesis and provide an overview of mechanobiological mechanisms involved in melanoma progression and aggressiveness. Insights from these investigations may guide future research and improve the management of acral melanoma.
BACKGROUND/AIM:While thermal ablation has emerged as a less invasive alternative for colorectal liver metastases (CRLM), evidence directly comparing repeat hepatectomy and ablation after prior resection remains limited. This study aimed to compare survival and short-term outcomes between the two strategies using propensity-adjusted analyses with multiple imputation. PATIENTS AND METHODS:A total of 150 patients with recurrent CRLM after initial resection who underwent repeat hepatectomy (n=94) or ablation (n=56) were retrospectively enrolled. Outcomes included overall survival (OS), local tumor progression-free survival (LTPFS), distant progression-free survival (DPFS), and perioperative outcomes. Propensity score matching (PSM) was applied, and Inverse probability of treatment weighting (IPTW) was additionally used as a sensitivity analysis. Estimates were pooled across imputed datasets. RESULTS:In pooled PSM analyses, ablation showed comparable OS to repeat hepatectomy [hazard ratio (HR)=1.330, p=0.370] and comparable DPFS (HR=1.310, p=0.299). However, ablation was associated with significantly worse LTPFS (HR=4.540, p=0.004). For short-term outcomes, ablation resulted in shorter hospital stay (4.6 versus 15.5 days, p<0.001) and lower incidence of Clavien-Dindo grade ≥IIIa complications (0% versus 19.5%, p=0.033). These findings were consistent in IPTW analyses. CONCLUSION:Repeat hepatectomy and ablation for intrahepatic recurrence after resection of colorectal metastases showed comparable OS, with a trade-off between superior local control and reduced perioperative burden. When both options are feasible, ablation may represent a reasonable alternative to repeat hepatectomy for patients prioritizing lower treatment burden.
