The response of lateral pelvic lymph nodes (LPLNs) to various neoadjuvant treatments has not been thoroughly investigated. This study aims to compare the effects of long-course chemoradiotherapy (LCCRT) and total neoadjuvant therapy (TNT), i.e., short-course radiotherapy (SCRT) with consolidation chemotherapy, on LPLNs size reduction. The secondary objective is to compare the pathological positivity rates of LPLNs dissection (LPLND) postneoadjuvant treatment.

This is a retrospective analysis based on a prospectively maintained database. Patients with rectal cancer registered between January 2020 and December 2021 with radiologically positive LPLNs who underwent neoadjuvant radiation therapy were included. Patients were divided into two groups: LCCRT and TNT.

Among 1200 registered rectal cancer cases, 160 had positive LPLNs, with 142 included in the analysis. A total of 61 patients received LCCRT, and 81 patients received TNT. No significant differences were found in tumor (T) and node (N) staging between the groups. However, the TNT cohort had a significantly higher proportion of patients with metastases (p < 0.001), poorly differentiated tumors (p = 0.021), and extramural venous invasion (p = 0.002). Baseline mean nodal sizes were similar between groups. Postneoadjuvant nodal sizes were 5.3 mm for LCCRT and 6.2 mm for TNT, with mean reductions of 5.7 mm and 4.6 mm, respectively (p = 0.136 and 0.54). Surgery was conducted in 77% of the LCCRT group and 59% of the TNT group, with 22 (46.8%) and 26 (54.1%) undergoing LPLND in their respective groups. The pathological positivity rates for LPLNs were similar (27.3% versus 23.1%, p = 0.731).

SCRT with consolidation chemotherapy does not provide a significant advantage over LCCRT in reducing LPLNs size or reducing the need for LPLND.

To retrospectively evaluate and classify odontogenic cysts and tumours in paediatric patients, highlighting their clinical characteristics, diagnostic challenges and management strategies. A retrospective case series was conducted using archived clinical and histopathological data of paediatric patients (≤ 18 years) diagnosed with odontogenic cysts and tumour which were collected for the past 1 year (2023-2024). The majority of odontogenic lesions in the current case series appear between the ages of 13 and 18, which is the age at which permanent dentition occurs. Three of the cases had OKC, three had ameloblastoma and one had odontoma.

Paediatric odontogenic cysts and tumours, though rare, exhibit unique clinical and radiographic characteristics that differentiate them from adult cases. Early diagnosis and conservative treatment approaches are essential to preserve jaw development and minimize recurrence risks. Further prospective studies with long-term follow-up and genetic analysis are needed to improve the understanding and management of these lesions in paediatric patients.

• Odontogenic cysts and tumours are rare in paediatric patients and often present diagnostic challenges. • Adult-based data dominates current literature.

• This study presents paediatric-specific retrospective case series highlighting unique clinical, radiological and histopathological features of lesions. • It proposes a decision-making flowchart tailored for paediatric jaw lesions.

The surprise question is commonly used in clinical practice; however, the variability in how "surprise" is defined is unclear. We examined the variability in the predicted probability of survival for being "surprised" and "not surprised" among palliative care physicians across seven timeframes.

Palliative care specialists completed the surprise question for 3 days, 1 week, 2 weeks, 1 month, 2 months, 3 months, and 6 months for patients with advanced cancer at an outpatient clinic and concurrently predicted the probability of survival (0-100%). The primary outcome, coefficient of variation (CV) for the predicted probability of survival, was computed for "surprised" and "not surprised" answers for each physician and each timeframe. A mixed-effect logistic regression assessed the probability threshold for being "surprised."

Twenty physicians provided 3024 survival estimates for 216 patients (mean age 61, 50% female). When "surprised," physicians consistently predicted a probability of survival > 50%, with low variation among physicians (mean CV 6-23%) and across timeframes (mean CV 5-20%). In contrast, physicians who answered "not surprised" predicted a probability of survival from 2 to 100%, with high variation among physicians (mean CV 15-83%) and across timeframes (mean CV 22-69%). Variability increased with longer timeframes. The probability of survival thresholds for being "surprised" were ≥ 74%, ≥ 62%, ≥ 68%, ≥ 83%, and ≥ 84% for 1 week, 2 weeks, 1 month, 2 months, and 3 months, respectively.

We found low variability for predicted probability of survival when clinicians were "surprised" but high variability when they were "not surprised."

Cancer survivors with a history of pelvic radiation may suffer devastating side effects best managed by cystectomy. Simple cystectomy is a less morbid alternative to radical cystectomy. While safe, concern exists that it may place patients at risk for incomplete treatment of secondary bladder malignancy. We assessed the rates of malignancy found on simple, post-radiation cystectomy specimens from patients with a history of radiation therapy for pelvic malignancies.

We reviewed all benign cystectomies at our institution from 2010 to 2023. Patients with a known history of urothelial cancer, cystectomy performed for malignancy, non-cancer survivorship indications (i.e. neurogenic bladder or trauma), and patients without a history of radiation were excluded. Surgical pathology was reviewed for residual and/or secondary malignancy.

111 patients had a history of radiation therapy and met inclusion criteria. Prostate cancer was the most common pelvic malignancy (83.8%). All patients had an end-stage bladder defined by our algorithmic assessment. No patients (0%) had evidence of urothelial malignancy on the final pathology of the post-radiation cystectomy specimen. There were no new diagnoses of secondary malignancy at the median follow-up of 30 (0.1-138) months. Of 42 patients with primary prostate cancer who had not undergone prior prostatectomy, 2 (4.8%) had residual prostate cancer in the remaining prostate on pathology.

In this cohort, secondary bladder malignancy was not identified. Rates of residual prostate malignancy were low in patients with radiation alone. Post-radiation simple cystectomy is a reasonable option for cancer survivors undergoing extirpative surgery where oncological control is not the primary indication.

To evaluate whether a new nasal airflow induction manoeuvre based on the Physiological Olfactory Recovery Technique (PORT) could be an effective alternative to current techniques for restoring olfactory function in laryngectomised patients.

This is a prospective observational cohort study, including patients who underwent total laryngectomy (TL) and primary tracheoesophageal puncture (TEP) placement for advanced laryngeal cancer (LC). To restore olfactory function, all patients underwent 10 sessions of PORT rehabilitation training at least 2 months after surgery. Outcomes in terms of olfactory acuity, subjective symptoms, and HRQoL were assessed using olfactometry and two structured questionnaires (the Chemosensory Complaints Score and University of Washington Quality of Life version 4), before and after treatment, and after a 6-month follow-up.

Twenty laryngectomised patients (15 men and 5 women, with a mean age of 65 ± 8 years) were enrolled in the study. These patients underwent proprioceptive training with a speech and language therapist and learnt the PORT method. Seventeen patients who were unable to smell before treatment became able to smell, while the remaining three patients, who were hyposmic at the beginning of treatment, became normosmic by the end. Following 10 sessions of the rehabilitation programme, all 20 patients demonstrated significant improvements across all outcome measures. These results were maintained in the long term.

For laryngectomised patients, PORT is an effective alternative to the Nasal Air Flow Induction Maneuver (NAIM) for olfactory rehabilitation. This technique enabled all rehabilitated patients to regain their daily 'olfactory gesture' physiologically.

To evaluate the feasibility and efficacy of patient-directed behavioral-physical intervention (BPI) for acute hiccups after chemotherapy in cancer patients.

In this prospective randomized controlled trial, cancer patients scheduled for chemotherapy were randomized into the BPI group and the control group. Patients in the BPI group were provided the Hiccup Knowledge Manual and instructional videos on six non-pharmacological behavioral-physical interventions for hiccups and were encouraged to use the interventions when they experienced acute chemotherapy-induced hiccups (CIH). The control group received routine medical attention. The primary endpoint was the median time to acute hiccup remission. The secondary endpoint was the incidence of anxiety and depression in patients and their family caregivers.

A total of 654 patients scheduled to receive chemotherapy were enrolled and randomly assigned (1:1) to the BPI group or the control group. After chemotherapy, 57 patients in the BPI group and 49 patients in the control group experienced acute hiccups. The median acute hiccup remission time was significantly shorter in the BPI group [0.17 h (95% CI 0.13 to 0.21 h)] than that in the control group [3.00 h (95% CI 1.48 to 4.52 h)] (P < 0.01). The mean anxiety and depression scores of patients were significantly lower in the BPI group than that in the control group (7.21 vs. 9.86, P < 0.01; 7.40 vs. 10.27, P < 0.01, respectively). Similarly, the average anxiety and depression scores of family caregivers were significantly lower in the BPI group than in the control group (3.91 vs. 8.31, P < 0.01; 4.30 vs. 8.90, P < 0.01, respectively).

Learning and self-directed implementation of behavioral-physical interventions have potential effects in shortening the median time to remission of acute CIH. It may also reduce anxiety and depression in patients and their family caregivers. Due to the limitations of this preliminary study, further research is warranted.

The study complied with relevant Chinese laws, rules, and regulations (Measures for the Ethical Review of Biomedical Research Involving Humans, etc.), as well as the WMA Declaration of Helsinki and the CIOMS International Ethics Guidelines for Human Biomedical Research, and followed the protocol approved by the medical ethics committee and the informed consent form to carry out clinical trials (research) to protect the health and rights of subjects. This study was approved by the Ethics Committee of Shangjin Nanfu Hospital West China Hospital and was registered in the World Health Organization (WHO) international clinical trials registered organization registered platform ( https://www.chictr.org.cn ; ChiCTR2400081049; February 21, 2024).

To compare the accuracy of ISUP grade groups (GG) determined from MRI-targeted and systematic biopsies with radical prostatectomy (RP) specimens using the 2014 and 2019 ISUP recommendations, and to identify predictors of upgrading.

We analyzed 212 consecutive patients who underwent both MRI-targeted and systematic biopsies followed by RP at the Jules Bordet Institute from October 2019 to January 2025. GG were assigned per 2019 ISUP guidelines, using the highest Gleason score, either from the global score of MRI-targeted lesions (including perilesional cores) or from individual systematic biopsy cores. Sensitivity analyses explored an empirical update to the 2019. ISUP recommendations by excluding minor higher-grade patterns (< 5%). Accuracy was compared using McNemar's test and weighted kappa (κ) statistics. Predictors of upgrading were identified via multivariable logistic regression and CHAID analysis.

The 2019 ISUP recommendations improved concordance with RP specimens by 8% (CI: 0.02-0.14, p = 0.002), reduced downgrading rates by 11% (CI:0.16 - 0.06, p < 0.001) and shown upgrading in 16% of cases (n = 33/212), representing a 3% increase compared to 2014 ISUP criteria (CI: 0.0008-0.06, p = 0.03). Weighted κ-values improved between the 2014 (κ = 0.58), 2019 (κ = 0.72) and updated 2019 ISUP recommendations (κ = 0.77). PSA-level (odds ratio [OR]: 1.11, 95%CI: 1.04-1.18, p = 0.001) and number of cores with clinically significant (Cs-) PCa (OR: 0.67, 95%CI: 0.54-0.82, p < 0.001) were independent predictors of upgrading. CHAID analysis confirmed that patients with ≤ 4 positive cores had a higher risk of upgrading (20% vs. 8.2%).

The 2019 ISUP recommendations enhance PCa grading accuracy. The number of cores with csPCa is a key predictor of upgrading and should inform treatment decisions. These findings support the integration of the 2019 ISUP guidelines into clinical practice to improve risk stratification and minimize overtreatment.

Colorectal cancer causes a substantial amount of cancer-related illness and death around the world. However, minimally invasive surgeries, like laparoscopic and robotic-assisted operations, have transformed how we treat colon cancer. Though both techniques offer benefits, their effectiveness compared to each other is still a point of contention, especially when it comes to tumors in the left or right colon. This is a retrospective cohort analysis aimed at comparing the perioperative and short-term efficacy of laparoscopic surgery and robotic surgery for left and right colon cancer. To ensure fairness in comparison, we employed propensity score matching. We conducted a study looking back at patient records to compare how well laparoscopic surgery (a minimally invasive technique) and robotic surgery work for left and right colon cancer, both during and shortly after the operation. To make sure our comparison was fair, we used a method called propensity score matching. Our study included 626 patients who were treated at the same hospital between July 2017 and July 2023. We carefully matched patients based on things like their age, BMI, and any pre-existing health conditions to account for potential differences We specifically examined several outcomes, including the duration of surgeries, the amount of blood lost during the operation, any complications that occurred afterward, and quick recovery markers such as the time to the first bowel movement and the length of hospital stay. Our findings indicated that robotic surgery generally took longer than laparoscopic procedures. However, a notable benefit was less blood loss during robotic operations. Patients who underwent robotic surgery also reached recovery milestones faster, such as their first gas and stool passage. Considering the various factors, we observed that both surgical approaches led to similar recovery times in the hospital and comparable numbers of complications. And perhaps most importantly for patients, we saw no real difference in the oncological results. This means that whether it was robotic or laparoscopic surgery, the surgeons were equally successful in getting clear surgical margins and retrieving a sufficient lymph nodes to check for cancer spread. Robotic surgery offers benefits like less blood loss and faster recovery, but both robotic and laparoscopic methods show similar oncological outcomes and complication rates. The choice should depend on the patient's needs and the surgeon's expertise.

The intricate interplay between epithelial and fibroblast cells within the tumor microenvironment plays a crucial role in driving triple-negative breast cancer progression. This crosstalk involves the exchange of various signaling molecules, including growth factors, cytokines, extracellular matrix components, and extracellular vesicles. Recently, we demonstrated that triple-negative breast cancer extracellular vesicles carry and release a specific combination of miRs, including miR-185-5p, miR-652-5p, and miR-1246 (from here on, referred as combo-miRs), into normal fibroblasts, effectively reprogramming them into cancer-associated fibroblasts. Here, we show that the conditioned medium from the fibroblasts activated by combo-miRs exerts a pro-tumorigenic effect on epithelial cells, enhancing the viability and migratory potential while driving increased invasiveness in patient-derived breast cancer organoids. A proteomic analysis of conditioned medium from combo-miRs activated fibroblasts revealed 76 significantly upregulated secreted proteins compared to control. Bioinformatic analysis identified the transcriptional factor PATZ1 as a potential regulator of the 12 most highly upregulated proteins. Consistently, in-silico predictions and in vitro experiments confirmed that PATZ1 is a direct target of miR-185-5p and miR-652-5p. The downregulation of PATZ1 by these miRNAs led to increased levels of the secreted proteins in the conditioned medium from combo-miRs activated fibroblasts. Furthermore, the conditioned medium from PATZ1-knockout mesenchymal embryonic fibroblasts and normal fibroblasts with silenced PATZ1 similarly enhanced the migratory potential of MCF10A cells, further supporting the critical role of PATZ1 in regulating tumor-promoting mechanisms. These findings provide valuable insights into the dynamics of the TME in TNBC, highlighting combo-miRs and PATZ1 as promising targets for future therapeutic interventions.

General health risk factors may vary significantly across different education groups. These disparities in lifestyle choices can contribute to the development of chronic conditions, including gastrointestinal disorders. Barrett's esophagus (BE), a premalignant condition associated with increased risk of esophageal cancer, may be influenced by these social determinants of health. This work explores how education status shapes the prevalence of BE, considering how key health risk factors in different education groups impact the development of the condition.

We analyzed data from a cohort of 5160 Austrian individuals who underwent esophagogastroduodenoscopy (EGD) and screening colonoscopy. Participants were categorized into three education groups: low (n = 1933), medium (n = 2780), and high (n = 447). The distribution of risk factors across education groups was observed and the prevalence of BE (including any BE and dysplastic BE) was assessed using univariate and multivariable regression analyses, adjusting for potential confounders such as age, sex, metabolic syndrome, smoking, alcohol consumption, reflux severity, hiatal hernia and proton pump inhibitor intake.

General health risk factors, such as metabolic syndrome, alcohol consumption, gastroesophageal reflux and smoking are more prevalent in lower education groups, contributing to a higher burden of chronic diseases. The prevalence of histologically confirmed Barrett's esophagus was low across all education levels, showing no significant differences (p = 0.90). Nondysplastic BE was present in 1% of participants, with similar rates across the low, medium and high education groups (1% each). Only one case of high-grade dysplasia (HGD) was found in the medium education group. In the unadjusted analysis no significant link was found between education level and Barrett's esophagus. Compared to those with lower education, the odds were 1.25 (95% confidence interval, CI: 0.71-2.19, p = 0.443) for medium and 0.91 (95% CI: 0.31-2.69, p = 0.864) for high education. In the fully controlled model, accounting for age, sex, metabolic syndrome, smoking, alcohol consumption, reflux severity, hiatal hernia, and proton pump inhibitor use, the association remained nonsignificant, with odds ratios of 1.15 (95% CI: 0.55-2.40, p = 0.719) for medium and 1.01 (95% CI: 0.30-3.36, p = 0.986) for high education.

Our study indicates that education level is associated with the distribution of general risk factors, but it is not a key factor in Barrett's esophagus risk in an asymptomatic screening population. Although education impacts health outcomes in many conditions, its influence on BE seems minimal. Future research should explore broader socioeconomic factors, such as income, occupation and healthcare access for a better understanding of the BE risk and detection disparities.