Primary urethral adenocarcinoma in females is extremely rare, comprising less than 1% of female genitourinary cancers. Due to its rarity, treatment guidelines are unclear, and most cases present at advanced stages with a poor prognosis. Our case demonstrates the potential for urethra-sparing surgery as an effective treatment option in selected patients. A woman in her late 60s presented with a 2 cm urethral mass and haematuria. MRI revealed a lesion extending toward the vaginal introitus without invasion. She underwent wide local excision, and histopathology confirmed moderately differentiated urethral adenocarcinoma with immunohistochemical positivity for CDX-2, E-cadherin and cytokeratins 7 and 20. Given the complete resection, age and comorbidities, a multidisciplinary team recommended surveillance instead of radical surgery. At 12 months postoperatively, the patient remains recurrence-free and asymptomatic. Our case demonstrates that urethra-sparing surgery is a viable option in select patients. Individualised treatment approaches should be taken that balance oncological control with quality-of-life preservation.

This study aimed to thoroughly assess and evaluate recent studies comparing radiofrequency ablation (RFA) and surgical resection in older patients with hepatocellular carcinoma (HCC).

We searched the databases PubMed, Scopus, and Cochrane for articles published up to 31 October 2024. This review included studies comparing RFA and surgical resection in individuals with HCC aged 65 years or older. The exclusion criteria were non-human research, case reports, editorials, and studies involving patients with liver metastases or cholangiocarcinoma.

We found four retrospective cohort studies. The derived data showed no difference in one-year survival rates. However, the RFA group exhibited a better disease-free survival rate and a lower mortality rate than the surgical resection group.

RFA outperformed surgical resection in terms of overall and disease-free survival rates while showing no appreciable variation in the occurrence of complications. However, this study underscores the need for more extensive research utilizing larger sample sizes, particularly in low- and middle-income countries.

Multimodality therapy incorporating a combination of cytoreductive surgery (CRS), intraperitoneal (IP) and systemic therapy continues to evolve for peritoneal carcinomatosis (PC) However, treatment and outcomes vary depending on tumor of origin.

To develop Appropriate Use Criteria (AUC) guidelines to facilitate treatment decision-making for patients with PC based on available evidence.

The American Radium Society (ARS) multidisciplinary expert panel performed a comprehensive systematic review. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) methodology was used. These studies were used to inform the expert panel, which then rated the appropriateness of various treatments in seven representative clinical scenarios through a well-established modified Delphi consensus methodology.

Treatment of PC is often treated with a combination of CRS and IP ± systemic chemotherapy but specific recommendations exist for different tumor types and outcomes vary.

Treatment of PC is complex and varies depending on origin of primary tumor and extent of disease. These AUC assist in patient and treatment selection for different clinical scenarios.

A summary of recommendations is outlined to guide practitioners on the management of PC from different tumor origins.

Skin adnexal tumors represent a wide spectrum of benign and malignant neoplasms, presenting morphological differentiation toward various adnexal structures. Skin of color variations in skin architecture and melanin production have been documented, possibly affecting the development and progression of those tumors, as well as their clinical and dermoscopy image. Therefore, we present a case series of clinical and dermoscopy presentations of adnexal neoplasms in skin of color individuals (Africans and Indians). We also compare these findings with 11 case reports and three case series that presented dermoscopy traits in adnexal tumors in dark-skinned patients found in medical literature. The most common pigmentation trait found was brown blotches or brown structureless areas, corresponding to the increased epidermal pigmentation. Arborizing vessels, a characteristic of basal cell carcinoma (BCC), are frequently seen in trichoepitheliomas, cylindromas, and apocrine hydrocystomas, raising diagnostic challenges. Differentiating adnexal tumors from nodular BCC in skin of color poses a challenge due to overlapping features. Additional studies on the clinical evaluations of adnexal tumors are warranted. Early detection and prompt diagnosis are crucial, especially when differentiating benign adnexal tumors from malignant skin cancers, as this differential diagnosis significantly influences management and treatment outcomes.

India bears the highest global burden of oral cancer, with over 83,400 cases reported in 2022. The widespread use of smokeless tobacco and areca nut, particularly in rural and underserved communities, continues to drive this public health crisis. Despite government regulations and awareness campaigns, tobacco consumption remains high due to cultural acceptance, affordability, and accessibility of products like gutkha and khaini. This review examines the role of celebrity endorsements in tobacco cessation efforts, assessing their influence on public perception and behavior. Bollywood actors and sports icons, who hold immense cultural influence in India, have been leveraged in health campaigns to promote tobacco-free lifestyles. While some celebrity-driven initiatives have successfully raised awareness, surrogate marketing remains a critical challenge. Many celebrities indirectly endorse harmful products like pan masala and mouth fresheners, undermining tobacco control efforts. To counter this, stricter policies are needed to regulate celebrity endorsements, ensuring alignment with public health goals. This review highlights key strategies for maximizing the impact of celebrity-led health campaigns while minimizing the risks posed by surrogate marketing. By fostering sustained celebrity engagement and implementing robust policy measures, India can take significant steps toward reducing smokeless tobacco use and preventing oral cancer.

Acute Radiation Enteritis (ARE) is a common complication of pelvic radiotherapy, with incidence rates exceeding 60% in older adult populations. Especially, grade ≥2 ARE can lead to treatment interruptions, malnutrition, and even septic shock, thereby impairing patients' quality of life and survival outcomes. However, existing risk prediction models are predominantly developed based on younger populations or mixed cohorts, lacking sophisticated evaluation tools tailored to older adult patients.

To establish a predictive nomogram for grade ≥2 ARE in older adult cervical cancer patients undergoing radiotherapy, a retrospective cohort study of 251 older adult cervical cancer patients who received pelvic radiotherapy between January 2018 and March 2024 was conducted. Independent risk factors identified through univariate and multivariate logistic regression were incorporated into a nomogram. The model performance was validated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).

The incidence of grade ≥2 ARE in our cohort was 61.35%. Independent risk factors included age (OR = 1.881, 95%CI: 1.015-3.484), hypertension (OR = 4.577, 95%CI: 2.402-8.720), diabetes (OR = 5.503, 95%CI: 2.206-13.726), Dmean_R (OR = 1.309, 95%CI: 1.155-1.483), and lactate dehydrogenase-to-albumin ratio (LAR), (OR = 1.872, 95%CI: 1.381-2.538). The nomogram exhibited strong discriminative ability (0.825, 95% CI: 0.774-0.877), and excellent calibration (Hosmer-Lemeshow test, p = 0.744).

This nomogram integrates both clinical and dosimetric parameters to enable precise risk stratification for grade ≥2 ARE in older adult cervical cancer patients, facilitating personalized prevention strategies and optimized treatment planning.

Odontogenic cysts, originating from inflammatory or developmental processes of the tooth germ epithelium, represent the most common intraosseous pathology in the head and neck region. This retrospective study aimed to evaluate bone healing following the surgical removal of odontogenic cysts using fractal analysis.

Bone changes in 17 patients who underwent cyst enucleation were assessed using fractal dimension and lacunarity measurements on digital panoramic radiographs obtained before and six months after surgery. Statistical analyses included the Shapiro-Wilk test, paired t-test, Wilcoxon signed-rank test, repeated measures ANOVA, and the Friedman test.

At six months postoperatively, bone structure differences had largely normalized. In the cyst center, there were no statistically significant differences in fractal dimension or lacunarity (P > 0.05). At the cyst edge, fractal dimension remained statistically unchanged (P = 0.446), while lacunarity significantly decreased from 0.06 to 0.04 (P = 0.04). In unaffected control regions, no significant changes were observed (P > 0.05). Preoperative fractal dimension values significantly differed between regions (P < 0.001), but these differences were no longer significant postoperatively (P = 0.077). Lacunarity values showed no significant regional differences at either time point (P > 0.05).

Fractal analysis offers valuable insights into bone regeneration and may surpass traditional radiographic evaluations. Despite limitations such as small sample size and potential subjectivity in region of interest (ROI) selection, the results support the utility of fractal dimension and lacunarity in tracking bone healing after cyst surgery.

For esophageal squamous cell carcinoma(ESCC), neoadjuvant chemoimmunotherapy (nICT) constitutes an innovative therapeutic strategy. However, The relationship between its short-term efficacy and long-term prognosis requires further clarification. Therefore, this study aims to evaluate the prognostic significance of major pathological response (MPR) in ESCC patients receiving nICT.

This is a retrospective multi-center study enrolling 306 ESCC patients undergoing nICT. The primary endpoints were recurrence-free survival (RFS) and recurrence patterns. Propensity score matching (PSM) was applied to address heterogeneity between groups. Kaplan-Meier curves and Cox regression analysis were utilized to analyze survival difference.

144 achieved a MPR, while 68 achieved a pathological complete response (pCR). Cox regression analysis identified MPR as an independent prognostic factor [HR = 0.48, 95%CI= (0.28 - 0.82), P = 0.007]. Survival analysis demonstrated that MPR patients experienced significantly improved RFS compared to non-MPR patients, before (P<0.001) and after PSM (P = 0.016). Importantly, the RFS of MPR patients was comparable to that of pCR patients (P = 0.319 in the unmatched cohort; P = 0.456 in the matched cohort). Furthermore, adjuvant therapy did not provide additional recurrence-free benefits for MPR patients. Compared to pCR patients, MPR patients exhibited a similar recurrence rate, with similar recurrence sites.

MPR represents a significant prognostic indicator in ESCC patients undergoing nICT, demonstrating prognostic outcomes comparable to those of pCR. These findings indicated that MPR could function as a surrogate endpoint for pCR, potentially influencing treatment strategies by refining follow-up protocol and the implementation of adjuvant therapy.

For locally advanced rectal cancer (LARC) with a deficient mismatch repair/microsatellite instability-high (dMMR/MSI-H), particularly in patients not eligible for immunotherapy, the optimal treatment remains undetermined. This study was to evaluate the efficacy and safety of surgery, surgery and chemotherapy, surgery and chemoradiotherapy, in patients with LARC harboring dMMR/MSI-H.

Patients included from three university centers between August 1, 2012 and March 1, 2023, were categorized into three treatment groups: surgery vs. surgery + chemotherapy vs. surgery + chemoradiotherapy. The primary endpoint was overall survival (OS), with secondary endpoints of progression-free survival (PFS), local recurrence (LR), distant metastasis (DM), and toxicity. The Kaplan-Meier method was utilized to analyze OS and PFS; competing risk methods were employed to evaluate rates of LR and DM. Adjustments were performed utilizing inverse probability of treatment weighting (IPTW) and overlap weighting (OW) based on propensity score, employing logistic regression model. The Cox proportional hazards model was applied for both univariate and multivariate analyses to assess prognostic factors influencing patient OS and PFS.

A total of 119 patients were included, with 45 patients (37.8%) receiving surgery alone, 32 (26.9%) receiving surgery + chemotherapy, and 42 (35.3%) undergoing surgery + chemoradiotherapy. In both the unadjusted cohort and after IPTW and OW adjustments, the surgery alone group (vs. surgery + chemoradiotherapy) had improved OS, PFS, LR, but no significant differences in DM. However, no statistical difference was found between the surgery vs. surgery + chemotherapy groups in OS, PFS, and DM, except for significant differences in LR. Similar results were found in both neoadjuvant and adjuvant treatment cohorts. No adverse events of grade 5 occurred.

This study suggests surgery alone (without chemotherapy and/or radiotherapy) may be an optimal treatment for LARC patients with dMMR/MSI-H, particularly in those who cannot tolerate or access immunotherapy. The results of this study may be used to power a randomized trial for the approaches.

Esophageal diseases (ED) are a common category of upper gastrointestinal disorders, mainly including gastroesophageal reflux disease (GERD), esophagitis, Barrett's esophagus, achalasia, and esophageal cancer (EC). In recent years, the high recurrence rate of GERD and poor prognosis of EC are paid more attention, collectively contributing to the global burden of ED.

For this study, we systematically analyzed the global distribution of ED from 1990 to 2021, detailing the burden across different countries, regions, and socio-demographic index (SDI) levels. Furthermore, we explored temporal trends in ED burden over this period and conducted decomposition analysis, health inequality analysis, and frontier analysis. Finally, we projected trends in ED burden from 2022 to 2045, and quantify contributions of associated risk factors to disability-adjusted life years (DALYs) of EC.

The absolute numbers of incidence, mortality, and DALYs for GERD and EC showed increasing trends from 1990 to 2021, while their age-standardized rates (ASRs) demonstrated divergent patterns: stable for GERD and declining for EC. The highest ASRs were observed in low-middle SDI regions for GERD and high-middle SDI regions for EC, respectively, with population as a main driver. If current trends continue, the burden of GERD will continue to rise, whereas that of EC will persistently decline by 2045. In 2021, DALYs of EC were mainly attributed to smoking (36.5%) and alcohol use (16.2%).

For GERD and EC, the global burden continued to rise and decline from 1990 to 2021, respectively. Developing targeted public health strategies in different countries and regions is crucial for alleviating the global burden of ED.