The prognostic significance of glandular involvement in high-grade squamous intraepithelial lesions (HSIL) following cervical conization remains unclear. This research aimed to evaluate the clinical impact of glandular involvement on surgical outcomes.

Between December 2019 and December 2020, 119 patients who underwent cervical conization were retrospectively observed. Patient characteristics, such as human papillomavirus (HPV) status, cytology results, glandular involvement, conization specimen depth and volume, margin status, and recurrence were collected and analyzed.

Glandular involvement was significantly associated with positive endocervical margins (22.0 % vs. 6.5 %, p = 0.017), higher prevalence of preceding HSIL or CIN (cervical intraepithelial neoplasm)2/CIN3 cytology (60.4 % vs. 42.0 %), and increased HPV16 infection among high-risk HPV positive patients (69.2 % vs. 34.8 %, p = 0.050). No significant differences were observed in recurrence rates among patients with HSIL with or without glandular involvement. Multivariable analysis identified that margin status is the only independent predictor of recurrence (positive margin: OR [odds ratio] 26.85, 95 % CI [confidence interval] 2.59-277.86, p = 0.006 or uncertain margins: OR 29.90, 95 % CI 1.09-818.17, p = 0.044).

While glandular involvement in HSIL is associated with positive endocervical margins, abnormal preceding cytology, and higher risk of HPV16 infection, it does not independently predict recurrence following conization. Instead, positive surgical margins are the primary factor of recurrence, highlighting the value of achieving complete excision to optimize patient outcomes.

The global population of elderly people is increasing, even in Japan. As a result, the number of elderly people requiring cancer treatment is also increasing, and it is necessary to assess the tolerability of elderly people. In recent years, the Comprehensive Geriatric Assessment (CGA), an objective assessment tool for evaluating elderly patients, has been introduced, but it is not yet common. In this study, we compared elderly cancer patients who were divided into standard treatment and non-standard treatment groups due to the subjective bias of healthcare providers and examined what was being subjectively selected without being conscious of it.

We retrospectively reviewed cases of patients aged 75 and older diagnosed with endometrial cancer, cervical cancer, or ovarian cancer at our hospital between April 1, 2018, and March 31, 2022, who surgery was deemed the standard treatment. Data on age, body mass index (BMI), performance status (PS), pre-treatment blood hemoglobin (Hb), albumin (Alb), creatinine (Cre), cancer antigen 125 (CA 125) levels, use of oral medications (antihypertensives, diabetes medications, anticoagulants, antiplatelet agents, diuretics), and history of malignancies were collected from electronic medical records. Patients who underwent standard treatment (standard treatment group) were compared to those who had changes in surgical content or received non-surgical treatments (non-standard treatment group).

In standard treatment group, age, nutritional status (body mass index, albumin and hemoglobin levels) and physical functions (performance status) were significantly higher, which are the main evaluation factors of CGA.

These results suggest that the bias of healthcare providers to some extent reflects the CGA.

Mirvetuximab soravtansine (MIRV), an anti-folate receptor 1/alpha (FRα, FOLR1) antibody-drug conjugate (ADC) with a companion diagnostic immunohistochemical (IHC) biomarker using VENTANA FOLR1 assay represents a precisely targeted chemotherapy for treating platinum-resistant recurrent epithelial ovarian cancer (PR-rEOC) patients with overexpression of FRα and possibly for platinum-sensitive rEOC (PS-rEOC) patients, regardless of status of FRα expression. The global phase III randomized clinical trial (RCT, MIRASOL) enrolling 453 highly FRα expressed PR-rEOC patients demonstrated that MIRV treatment provided statistically significant improvements in clinical outcomes compared to investigator's choice of chemotherapy (ICC), which included not only the progression free-survival (median PFS 5.6 months vs. 4.0 months, hazard ratio [HR] 0.65) but also the overall survival (median OS 16.5 months vs. 12.8 months, HR 0.67). Additionally, overall response rate (ORR) was significantly higher in MIRV treatment (42.3 % vs. 15.9 %). Moreover, the severe adverse events (AEs) and treatment-related AEs (TRAEs)-associated discontinuation in MIRV group were dramatically fewer (41.7 % vs. 54.1 %) and lower (9.2 % vs. 15.9 %), respectively compared to ICC group. These findings suggest that the treatment of choice may be the utilizing MIRV as the front-line for treating PR-rEOC patients if FRα expression of Pr-rEOC patients is high. Finally, any-grade ocular adverse events (OAEs) are particularly common in patients during MIRV treatment, arising in 125 (57 %); grade ≥3 in 34 (16 %), most frequently, blurred vision (18 [8 %]), keratopathy (21 [10 %]), cataract (11 [5 %]), and dry eye (8 [4 %]); however, fortunately, over 90 % with OAEs had either full resolution or documented final grade 1 or better. The current review also discusses OAE, based on its high incidence, frequent cause responsible to dose reduction and delaying therapy with impacting 11-35 % of patients and of the most importance, relative unfamiliarity to most gynecological oncologists in the routine clinical practice.

To analyse the data of a cohort of patients with conjunctival melanoma in order to analyse risk and guarding factors and to investigate the impact on metastatic disease with and without adjuvant therapy.

We have retrospectively analysed the impact of clinical aspects and adjuvant therapies after tumour excision or biopsy in 167 patients cared for at the University Hospital Essen and the University Hospital Tübingen, Germany. Clinical as well as histopathological data and therapeutic approaches were analysed with regard to regional (lymphatic) and/or distant (haematogenous) spread during follow-up. The Kaplan-Meier estimate method was used to analyse survival and the Cox regression hazard model to define the probability of metastases depending on different factors. P value of <0.05 was considered statistically significant.

167 cases of malignant conjunctival melanoma were retrospectively analysed. The patients received treatment and were followed up for 78.3±67.5 months. Local tumour recurrence occurred in n=79 patients (47.3%) after a mean of 41.5±70.33 months. 30 patients (37.9%) with a recurrence had not received adjuvant therapy. The overall rate of metastasis was 24.5% (n=41). In n=31 cases, regional lymphatic metastases were found after a follow-up of 48.9±63.5 months; in n=24 cases, distant metastases were found, occurring after 55.5±67.4 months. In n=14, the metastatic disease took both pathways. Ruthenium-106 brachytherapy performed in localised melanoma of the bulbar conjunctiva showed a relevant effect of decreasing the risk for haematogenous metastases by 74% (HR=0.256, p=0.003). 4 out of 54 patients developed distant metastases.

In conjunctival melanoma, it is important to perform an adjuvant therapy after excision. This reduces not only local recurrences but also significantly the risk for haematopoietic spread.

Women living with HIV (WLHIV) face a higher risk of developing cervical cancer. India carries a significant burden of HIV, with an estimated 2.5 million people living with HIV in 2023. While the introduction of more effective antiretroviral therapy has improved the life expectancy of WLHIV, it has also extended the risk window for persistent human papillomavirus (HPV) infection and cervical disease progression. Cervical cancer prevention through HPV vaccination and regular screening remains the cornerstone of public health efforts. This study specifically aims to evaluate the cost-effectiveness of various cervical cancer screening strategies (at different intervals) among WLHIV in India.

The study will be conducted in three interlinked components. First, a meta-analysis will be undertaken to evaluate the diagnostic accuracy of different screening strategies in detecting cervical lesions in WLHIV. Second, primary data collection will be carried out to estimate the treatment costs of cervical cancer and HIV among WLHIV. This phase will also include the collection of health-related quality of life (HRQoL) data, to inform utility estimates for the modelling component. A total of 135 participants will be enrolled for cost data assessment. Of these, a subset of 71 participants will also be included for HRQoL assessment. This data collection will be undertaken in four tertiary public sector hospitals located across four Indian states, that is, Mizoram, Maharashtra, Tamil Nadu and Karnataka. Lastly, a decision analytical model will be developed to simulate the process of screening, diagnosis and treatment for cervical cancer in a hypothetical cohort of WLHIV. A structured comprehensive review of literature will be undertaken to inform model input parameters related to the natural history of cervical disease, progression and mortality among WLHIV. Model calibration will be performed using a likelihood-based approach to ensure consistency with empirical epidemiological data. Probabilistic sensitivity analysis will also be conducted to assess the impact of joint parameter uncertainty on model outcomes.

Ethical approval has been obtained from Ethics Committees of Indian Council of Medical Research-National AIDS Research Institute (NARI), Pune (Protocol No. NARI/EC/Approval/2024/716); B. J. Medical College and Sassoon General Hospitals, Pune (Ref. No. BJGMC/IEC/Pharmac/ND-0824297-297); Cancer Institute (WIA), Adyar, Chennai (Ref. No. IEC/2024/Nov-07); the Mizoram State Cancer Institute, Zemabawk, Aizawl (Ref. No. D.12016/2/2013-MSCI/IEC) and the KLE Academy of Higher Education and Research, Belagavi, Karnataka. The study findings will be disseminated through publications in peer-reviewed journals.

Open radical cystectomy is the current standard treatment for bladder cancer. However, it is associated with high morbidity and mortality, particularly in the elderly. Recently, robotic surgery has become a minimally invasive approach. To this end, we aimed to evaluate the safety and complications of robot-assisted radical cystectomy (RARC) in elderly patients with urothelial carcinoma.

We performed a retrospective single-center analysis of 103 patients who underwent RARC between May 2018 and May 2024. The patients were divided into an elderly group (age, ≥ 80 years; n = 24) and a younger group (n = 79).

The American Society of Anesthesiologists Physical Status Classification System scores were significantly lower in the elderly group than in the younger group. No significant differences were observed between the two groups in terms of demography. Operative time was shorter in the elderly group than in the younger group. Conversely, the postoperative hospital stay was shorter in the younger group than in the elderly group. There were no significant differences in the frequency or severity of complications between the two groups; however, the incidence of ileus was significantly higher in the elderly group. In addition, higher age, ileus, and days to drain removal were identified as independent factors that prolonged hospitalization.

RARC is a safe treatment option for elderly patients with bladder cancer, with complication profiles comparable to those in younger patients. However, the increased risk of ileus and prolonged hospitalization in elderly patients highlights the need for cautious perioperative management to optimize outcomes in this growing population.

Web-based lifestyle interventions to promote healthy diet and physical activity among cancer survivors and their partners are recent developments; therefore, few studies have reported patterns of website use or associations with behavior change.

The primary aim was to describe website use in the DUET (Daughters, Dudes, Mothers, and Others Together) trial and examine the associations between website use and changes in diet quality, moderate to vigorous physical activity (MVPA), and body weight.

This secondary analysis used data from 28 survivor-partner dyads (BMI ≥25 kg/m²) randomized to the 6-month DUET web-based weight loss intervention, which released weekly e-learning sessions on diet and exercise. Website use was quantified as weeks of access, time spent, and frequency of page views. Diet quality was assessed using 2-day dietary recalls; MVPA was measured by the Godin Leisure-Time Exercise Questionnaire and accelerometry. Weight was measured on a scale. Website use was summarized descriptively, and associations were examined using Spearman partial correlations.

Participants had a mean age of 58 (SD 12.5) years; 78.6% (44/56) identified as female, 66.1% (37/56) were non-Hispanic White, and 86% (24/28) were breast cancer survivors. On average, participants viewed 11.2 (SD 7.4) weeks of the 24-week intervention, or a total of 312.9 (SD 255.7) minutes per participant. Sessions (n=2736), Home Page (n=975), and Tools (n=967) features showed the highest activity (5885 total page views). Website use was higher among adults aged 65 years and older than younger participants, showcased by duration of use (mean 14.4, SD 7.4 weeks vs mean 9.2, SD 6.8 weeks; P=.009), time spent per week (mean 17.0, SD 9.7 minutes vs mean 10.5, SD 10.6 minutes; P=.01), and total number of page views (mean 135.7, SD 90 vs mean 85.3, SD 111.9; P=.008); higher website use was also reported among women versus men in terms of duration of use (mean 12.8, SD 7.1 weeks vs mean 5.6, SD 5.9 weeks; P=.003), time spent per week (mean 14.6, SD 10.3 minutes vs mean 7.4, SD 10.3 minutes; P=.02), and total number of page views (mean 120, SD 110.2 vs mean 50.3, SD 64.4; P=.01). Diet quality was positively associated with website use (weeks: r=0.50; P<.001; time: r=0.45; P<.001; total page views: r=0.46; P<.001; and sessions page views: r=0.39; P=.005). Self-reported MVPA was also positively associated with website use (weeks r=0.37; P=.007; time: r=0.36; P=.009; total page views: r=0.36; P=.01; and sessions page views: r=0.35; P=.01). No significant associations were detected for accelerometry-measured MVPA or weight.

Cancer survivors and their partners engaged with the DUET web-based platform to support diet and physical activity (with use particularly high among older adults and females). However, larger, more diverse dyadic web-based lifestyle interventions are needed to confirm these findings.

ClinicalTrials.gov NCT04132219; https://clinicaltrials.gov/study/NCT04132219.

Enhanced recovery after surgery (ERAS) guidelines recommend early postoperative mobilization to reduce complications, but adherence is often suboptimal, highlighting the need for effective tools to monitor and encourage movement. The Mindray enhanced patient monitoring (ePM)/electrophysiology (ep) pod, capable of tracking activity, vital signs, sleep, and pain, offers high-precision postoperative monitoring and is well-suited for research on activity feedback.

The study aims to assess whether wearable device-based (ePM/ep pod) activity feedback could reduce postoperative complications within 30 days of colorectal cancer (CRC) surgery.

We conducted an open-label, evaluator-blind, randomized controlled trial involving patients aged ≥18 years scheduled for CRC surgery. Patients were randomized to a feedback group or a control group. Both groups were set the same target activity time postoperatively based on ERAS guidelines. The feedback group received real-time visual feedback of movement time daily through the ePM/ep pod device, while the control group did not receive feedback. The primary outcome was the comprehensive complication index (CCI) within postoperative 30 days. Secondary outcomes included daily activity time, pain Numeric Rating Scale scores for rest and movement during the first 3 postoperative days, length of stay, percentage of reaching the scheduled mobilization target, 30-day postoperative mortality rate, and the times of first exhaust and defecation.

Two hundred thirty-nine patients were recruited between February 2023 and September 2023, with 216 randomized (n=108 for each group). There was no significant difference in CCI within 30 postoperative days between the control group (median CCI 0, range 0-20.90) and the activity feedback group (median CCI 0, range 0-12.20). The estimated mean difference was -0.59 (95% CI -3.56 to 2.38; P=.66). Sensitivity analysis excluding patients with low device compliance did not alter these findings. No significant differences between groups were found in daily activity time, length of hospital stay, or pain scores. Post hoc analysis revealed significant negative correlations between 30-day CCI and activity on the second day after operation (r=-0.166) and the third day after operation (POD3) (r=-0.264; P<.05 for both). Linear regression indicated that POD3 activity significantly reduced CCI (β=-.025; 95% CI -0.045 to -0.006; P=.01), with peak CCI reduction at 215 minutes of activity.

In the context of ERAS, this study found no evidence that activity stimulation based on feedback from the wearable device (ePM/ep pod) could reduce 30-day postoperative CCI in patients undergoing CRC surgery. However, the ePM/ep pod could accurately record daily activity duration, which may be negatively correlated with CCI on POD3.

Breast cancer is the most common cancer in women in Brazil. Despite universal coverage through the Unified Health System (Sistema Único de Saúde [SUS]), major inequities in access, timely diagnosis, and treatment persist when compared with the private sector. We assessed 5-year overall survival (OS) according to health care coverage to provide robust real-world evidence of survival inequities.

This retrospective cohort study included 63,663 women with invasive breast cancer diagnosed between 2012 and 2019 using the largest South American hospital-based cancer registry (Registro Hospitalar de Câncer da Fundação Oncocentro de São Paulo). Survival probabilities were estimated using the Kaplan-Meier method, and differences across groups were tested with log-rank statistics. Cox proportional hazards models were applied to assess the association between health care coverage and mortality, adjusting for demographic, clinical, and treatment variables.

Patients in the public system (83%) were older, had lower educational attainment, were more often diagnosed with advanced-stage disease (41% v 21.0%), and were less likely to receive minimal standard treatment (75% v 81%). The 5-year OS rate was 66.2% in the SUS group and 79.7% in the private care group. After adjustment, patients with SUS faced a 53% higher risk of death (hazard ratio, 1.53 [95% CI, 1.44 to 1.63]).

Universal health coverage does not guarantee equitable outcomes. Disparities in the stage at diagnosis, treatment access, and social determinants translate into marked survival inequities. Our findings highlight the urgent need for system-level reforms and targeted investments in oncology capacity in Brazil and across the low- and middle-income countries.

Our study is motivated by evaluating the role of hematopoietic cell transplantation (HCT) after chimeric antigen receptor T-cell (CAR-T) therapy for ALL, a debated topic. Because patients may receive HCT at different times after CAR-T infusion or never, HCT post-CAR-T should be considered as a time-varying covariate (TVC).

Standard Cox models and Kaplan-Meier (KM) curves (naïve method) assume that TVC status is known and fixed at baseline, which can yield biased estimates. Landmark analysis is a popular alternative but depends on a chosen landmark time. Time-dependent (TD) Cox model is better suited for TVC although visualizing survival curves is complex. The newly proposed Smith-Zee method generates appropriate survival curves from TD Cox models.

To address these challenges, we developed an open-source R Shiny tool integrating multiple models (naïve Cox, landmark Cox, and TD Cox) and curves (naïve KM, landmark KM, Smith-Zee, and Extended KM) to facilitate TVC analysis. Reanalysis of post-CAR-T HCT's effect on leukemia-free survival (LFS) showed consistent results between naïve and TD Cox models, whereas landmark analyses varied by landmark time. A separate data analysis of chronic graft-versus-host disease and survival showed that substantial differences emerged across statistical methods. Simulations revealed increased bias in naïve methods when TVC changed late and minimal bias when TVC changes occurred early relative to time to events.

We recommend TD Cox models and Smith-Zee curves for robust TVC analysis. Our R Shiny tool supports standardized analyses without requiring data sharing, thereby promoting collaboration across different institutions and providing a practical tool to advance survival analysis in oncology research.