Although hormone receptor-positive (HR+) invasive ductal carcinoma (IDC) is the most common breast cancer subtype, there is limited evidence describing how demographic and clinical features vary across U.S. regions. Understanding geographic disparities is essential for improving screening and treatment planning. To examine regional variations in demographic, socioeconomic status (SES), and stage-at-diagnosis characteristics among U.S. patients with HR+ IDC.

This cross-sectional study used data from the National Cancer Database (NCDB) for patients diagnosed with HR+ IDC between 2004 and 2020. Patients were categorized into 6 U.S. geographic regions: Northeast, Southeast, Midwest, Southwest, Mountain, and Pacific, based on the Commission on Cancer facility location. Descriptive and comparative analyses evaluated age, sex, race and ethnicity, insurance type, income, urban-rural residence, and American Joint Committee on Cancer stage.

Among 136,280 patients (mean age, 64.4 years; 98.8% female), racial and SES composition differed significantly across regions. Black patients comprised 19.5% of the Southeast cohort and 18.1% of the Southwest cohort, compared with 2.9% in the Mountain region. The Asian population was highest in the Pacific (13.1%). Low-income households (<$63,000) were most prevalent in the Southwest (74.7%) and Southeast (69.5%), while the Pacific region had the highest proportion of higher-income households (46.4%) and metropolitan residents (94.3%). Stage III-IV disease at diagnosis occurred most often in the Southwest (17.6%) and least in the Northeast (14.0%).

Significant variation exists in the demographic and SES profile of patients with HR+ IDC, corresponding to differences in stage at diagnosis, and BC-related overall outcomes. These disparities likely reflect inequities in screening access, SES, and healthcare infrastructure, underscoring the need for region-specific public health strategies. Targeted regional interventions and equitable screening expansion are warranted to reduce geographic disparities and improve overall BC-related outcomes.

Hand-foot syndrome (HFS) is a common adverse event associated with capecitabine. While the fibroblast growth factor receptor (FGFR) signaling pathway is involved in skin wound healing, its essential role in capecitabine-induced HFS remains unclear. We examined the association between polymorphisms in FGFR signaling pathway-related genes and capecitabine-induced HFS in patients with colorectal cancer (CRC).

This retrospective study included patients with CRC who received capecitabine and oxaliplatin. HFS was evaluated using CTCAE v5.0, up to 2 cycles. Polymorphisms were identified using whole-exome sequencing and confirmed using direct sequencing. The association between HFS and polymorphisms was analyzed using Fisher's exact test. The Bonferroni correction for multiple testing was performed to calculate the corrected p-value (Pc).

Overall, 937 polymorphisms were identified in 71 genes. Intronic FGFR2 rs2981460 C/C, and rs2981461 T/T genotypes, and haplotype II/II comprising the C and T alleles were associated with a lower HFS incidence (p=0.0161, Pc=0.113; p=0.0163, Pc=0.114; and p=0.0161, Pc=0.113, respectively). Synonymous FGFBP2 rs2286459 A/A was associated with a lower HFS frequency (p=0.0469, Pc=0.328). 3'-Untranslated region and nonsynonymous variants SPRY2 rs11911 T/G or G/G and rs504122 G/A or A/A, and homozygotes or heterozygotes of haplotype 2 comprising respective G and A alleles, were significantly associated with higher HFS incidence (p=0.0000803, Pc=0.000562; p=0.0000803, Pc=0.000562; and p=0.0000803, Pc=0.000562, respectively). A significantly higher HFS incidence was observed in patients with a combined risk genotype and diplotypes of FGFR2 any/II or any/any, FGFBP2 rs2286459 G/G or G/A, and SPRY2 2/2 or any/2 (p=0.0000314).

Variants in FGFR signaling pathway-related factors were significantly associated with capecitabine-induced HFS.

Ampulla of Vater carcinoma is a rare malignancy with limited survival after resection, and the role of adjuvant therapy remains unclear. S-1 (oral prodrug of 5-FU with modulators gimeracil and oteracil) has been adopted as an adjuvant treatment for biliary cancers in Japan, but its benefit in ampullary carcinoma is uncertain. We aimed to identify prognostic factors and evaluate the impact of adjuvant S-1 in resected ampullary carcinoma.

We retrospectively reviewed 53 patients who underwent pancreatoduodenectomy for ampullary carcinoma at a single institution (2005-2023). Clinicopathologic data and use of adjuvant S-1 were collected. Cancer-specific survival (CSS) and relapse-free survival (RFS) were estimated by the Kaplan-Meier method and compared by the log-rank test. Cox proportional hazards models identified independent prognostic factors. Outcomes with versus without adjuvant S-1 were compared within the node-positive (N+) subset of patients.

The 5-year CSS and RFS for all patients were 70.8% and 66.2%, respectively. On multivariate analysis, lymph node metastasis (N+) was the only independent predictor of worse CSS (p=0.04) and RFS (p=0.001). Among N+ patients (n=20), 5-year CSS (51.4% vs. not reached) and RFS (18.0% vs. 18.7%) were similar with adjuvant S-1 (n=11) or surgery alone (n=9) (p=0.5 and 0.4). Adjuvant S-1 did not improve survival in node-positive patients.

Lymph node status is a major prognostic factor in ampullary carcinoma. Adjuvant S-1 chemotherapy conferred no significant survival benefit for node-positive patients, underscoring the need for more effective adjuvant strategies.

This study aimed to investigate prognostic factors in pulmonary metastasectomy for colorectal cancer (CRC), considering the location of the primary tumor.

We collected information from patients who underwent pulmonary resection for CRC at two high-volume centers from January 2010 to December 2023. Using a multivariate Cox proportional hazards model, patient background factors that affected the prognosis after pulmonary metastasectomy were identified.

A total of 289 patients were included in the study. The multivariate analysis revealed the primary tumor site [hazard ratio (HR)=1.89, p=0.016], the maximum diameter of the pulmonary nodule (HR=1.76, p=0.016), and multiple metastases (HR=2.10, p<0.001) had significant prognostic impact on overall survival (OS). The multivariate analysis of disease-free survival (DFS) revealed smoking history (HR=1.58, p=0.039) and multiple metastases (HR=2.08, p<0.001) as significant prognostic factors. After 1:1 propensity score matching (PSM) of patients based on the number of metastatic tumors, two populations revealed a consistent trend with 5-year survival rates of 73.4% and 48.0% for single pulmonary and multiple metastases.

Multiple metastases significantly worsened both OS and DFS after pulmonary metastasectomy, and the similar trend was observed after PSM.

Residual disease after neoadjuvant systemic therapy (NST) is strongly associated with prognosis in breast cancer. However, currently available indices such as the Residual Cancer Burden (RCB) and Neo-Bioscore are complex and not readily applicable in daily clinical practice. This study aimed to evaluate the prognostic significance of residual tumor morphology using only pathological T and N factors as a simple and clinically implementable index.

Among 327 patients who received NST at our institution, 174 non-pathological complete response (non-pCR) cases who underwent axillary lymph node dissection were analyzed. Patients were classified according to the presence or absence of residual T and/or N factors (ypT+/ypN+, ypT+/ypN-, ypT-/ypN+). Disease-free survival (DFS) and cancer-specific survival (CSS) were assessed using Kaplan-Meier and Cox regression analyses.

Patients who achieved pCR had significantly better DFS and CSS (p<0.001 and p=0.010, log-rank) than those with residual disease. Among the non-pCR cohort, the ypT+/ypN+ group showed markedly worse DFS and CSS (p= 0.010 and p<0.001, log-rank) than patients without simultaneous residual T and N positivity. Multivariate analysis confirmed that concurrent ypT and ypN positivity was an independent predictor of poor DFS (hazard ratio=0.33; 95% confidence interval=0.17-0.62; p<0.001), along with high Ki67 expression.

Residual T and N positivity after NST represents a simple yet powerful prognostic indicator in breast cancer. This two-factor classification, easily derived from routine pathology, may serve as a practical reference for post-NST risk stratification and inform decisions regarding additional adjuvant treatment.

In Japan, contemporary real-world data that simultaneously assess effectiveness, safety, conversion feasibility, and long-term outcomes of first-line FOLFOXIRI-based chemotherapy for unresectable metastatic colorectal cancer (mCRC) remain limited. Here, we aimed to evaluate the real-world efficacy, safety, and long-term outcomes of this treatment as well as to identify factors associated with conversion surgery.

We conducted a retrospective single-center cohort study of consecutive patients with first-line FOLFOXIRI (±targeted agent). Progression-free survival (PFS) encompassed the entire first-line treatment period. Survival outcomes were analyzed using Kaplan-Meier and log-rank tests, with hazard ratios (HRs) estimated by Cox models. Adverse events (AEs) were graded according to CTCAE v5.0.

Of 59 patients (median FOLFOXIRI cycles: 7), bevacizumab was administered to 74.6%. The objective response rate was 66.1% and the disease control rate was 88.1%. Conversion surgery was achieved in 27.1% of patients, with R0 resection in 23.7% of the cohort. Patients undergoing conversion surgery had longer PFS and overall survival (OS) than those who did not. Conversion was associated with rectal primaries and the absence of peritoneal metastasis. In RAS-stratified analyses, PFS was similar, whereas OS was shorter in RAS-mutant tumors. Grade ≥3 neutropenia and febrile neutropenia occurred in 72.9% and 25.4% of patients, respectively; severe non-hematological AEs were rare, and no treatment-related deaths occurred.

In Japanese practice, first-line FOLFOXIRI achieved substantial disease control and clinically meaningful survival with manageable toxicity. R0 conversion was achieved in the subset with longer survival. A conversion-oriented triplet induction strategy may be considered for rectal cancer without peritoneal metastasis, irrespective of RAS status.

Lymphovascular invasion (LVI) is a strong prognostic factor associated with poor survival outcomes in breast cancer. However, the clinical benefit of postmastectomy radiotherapy (PMRT) for early-stage disease remains uncertain. This study aimed to evaluate PMRT efficacy and related prognostic factors in real-world settings.

We retrospectively analyzed 322 postoperative breast cancer patients with pathologically confirmed LVI who received radiotherapy (RT) between October 2017 and July 2020. Patients were categorized into two groups: Group A (pT1-2N1M0, n=273), who underwent modified radical mastectomy (MRM) with or without adjuvant RT; and Group B [stage II, ypN0 after neoadjuvant chemotherapy (NAC) and surgery, with or without adjuvant RT, n=49]. Intergroup differences were assessed using the chi-squared test, and Kaplan-Meier analysis estimated local recurrence-free survival (LRFS), disease-free survival (DFS), overall survival (OS), and distant DFS (DDFS).

Group A: Patients who received adjuvant RT had significantly improved 5-year LRFS (94.4% vs. 85.5%, HR=0.359, 95% CI=0.147-0.879; p<0.05) and DFS (88.9% vs. 78.8%, HR=0.488, 95% CI=0.253-0.940; p<0.05) compared to those without RT. No significant difference was observed in 5-year OS or DDFS. Subgroup analysis indicated a higher recurrence risk among patients with two to three positive lymph nodes or triple-negative tumors. Group B: Among patients who achieved ypN0 status, adjuvant RT significantly improved 5-year DFS (95.8% vs. 76.0%), OS (100.0% vs. 84.0%), and DDFS (100.0% vs. 80.0%) (p<0.05), with no significant difference in LRFS.

In stage II LVI-positive breast cancer patients, adjuvant RT improves local control and leads to an increase in DFS but not OS. PMRT provides survival benefits for LVI-positive patients who achieve ypN0 status after NAC and is recommended. Larger studies are needed to validate these findings.

NF2-related schwannomatosis is a rare hereditary tumor predisposition syndrome, formerly known as Neurofibromatosis type 2 (NF2), and is characterized by the development of multiple schwannomas. The hallmark manifestation is the occurrence of bilateral vestibular schwannomas (VSs). Disease progression and clinical outcomes vary widely among patients, and conventional magnetic resonance imaging (MRI) metrics-such as tumor size-do not fully account for these differences. Radiomic analysis offers a quantitative approach to extract advanced imaging biomarkers that may capture tumor microstructure and growth behavior more accurately, potentially improving prognostication and individualized management in NF2.

A retrospective cohort of 32 patients with NF2 was analyzed, comprising 170 cranial MRI scans of 232 VSs (112 left, 120 right) acquired at different time points over the course of disease, with previously treated tumors excluded. Tumor growth was quantified as absolute and percentage growth rates per month. Radiomic features were extracted from segmented tumors and correlated with Common Terminology Criteria for Adverse Events (CTCAE) graded clinical findings. Hearing impairment was graded based on subjective function due to limited audiometric data.

In this exploratory analysis, no Spearman |ρ| >0.40 correlations were observed between radiomics features and tumor growth rates, nor among clinical parameters (excluding depression and anxiety). Right-sided tumors were associated with significantly greater hearing impairment compared to left-sided tumors despite comparable volumes (p=0.030). Age-stratified analyses revealed distinct patterns: in younger patients (<30 years), fast-growing tumors displayed more homogeneous texture profiles, while in older patients (>30 years), rapid growth was linked to greater heterogeneity.

Radiomic profiling indicates that both tumor laterality and patient age influence the relationship between imaging features and clinical outcomes in NF2-associated VS. Homogeneity was linked to aggressive growth in younger patients, heterogeneity characterized progression in older patients. These findings suggest that radiomic biomarkers may complement volumetric measures and support individualized monitoring and treatment strategies in NF2.

A smooth transition to subsequent treatments is crucial for improving the prognosis of patients with metastatic colorectal cancer who receive chemotherapy. This study aimed to examine how patient factors at the initiation of treatment influence the feasibility of transitioning to subsequent treatments in patients who received trifluridine-tipiracil plus bevacizumab (FTD/TPI + Bev) therapy.

This retrospective study included 80 patients treated with FTD/TPI + Bev therapy for metastatic colorectal cancer at Osaka City University Hospital between January 2016 and December 2023.

Patients who were able to transition to subsequent treatments showed a significantly longer overall survival after the discontinuation of FTD/TPI + Bev therapy than those who were not. Immunonutritional indicators, such as the serum albumin concentration and Geriatric Nutritional Risk Index (GNRI), were significantly elevated in patients who were able to proceed to subsequent treatments in comparison to those who were not able to do so.

A poor immunonutritional status at the initiation of FTD/TPI + Bev therapy may lead to a lower rate of transitioning to subsequent treatments, thus resulting in a worse prognosis.

The introduction of the HER2-low concept has redefined the biological spectrum of breast cancer. However, the clinicopathological and prognostic significance of HER2 expression in ductal carcinoma in situ (DCIS) remains unclear. This study aimed to reassess HER2 expression in DCIS using the HER2-low classification.

A total of 221 patients who underwent surgery and were pathologically diagnosed with DCIS at Osaka Metropolitan University hospital between June 2007 and December 2023 were retrospectively analyzed. HER2 expression was assessed using immunohistochemistry (IHC) and classified as HER2-0, HER2-low (IHC 1-2+), or HER2-high (IHC 3+). Clinicopathological features were compared among groups, and disease-free survival (DFS) and recurrence-free interval (RFI) were evaluated using Kaplan-Meier and Cox regression analyses.

HER2-0, HER2-low, and HER2-high were observed in 96 (43.4%), 80 (36.2%), and 45 (20.4%) patients, respectively. HER2 expression correlated significantly with estrogen receptor (p=0.011), progesterone receptor (p<0.001), comedonecrosis (p=0.030), calcification (p=0.019), and nuclear grade (p=0.006). Although no significant differences were found among the three groups, the HER2-0 subgroup tended to show longer RFI compared with HER2-positive cases (p=0.051). Multivariate analysis identified tumor size as an independent prognostic factor for DFS (hazard ratio=34.47, p=0.004).

HER2 expression redefined by the HER2-low concept reflects the biological diversity of DCIS. Evaluation of HER2 status as a continuous spectrum may aid in risk stratification and contribute to understanding early HER2-driven tumor evolution.