Current oncology最新文献

{"title":"Exploring Body Composition Profiles in Patients with Gastrointestinal Cancers: A Cross-Sectional Analysis of the NUTRISCREEN Project.","authors":"Assunta Luongo, Francesco Pio Maria Di Carlo, Sergio Coluccia, Paola Rocco, Natalia Russo, Emanuela Racca, Maria D'Amico, Elisabetta Coppola, Davide D'Errico, Anna Crispo, Valeria Turrà, Piera Maiolino, Francesca Foschini, Lucrezia Silvestro, Anna Nappi, Carmela Romano, Antonio Avallone, Sandro Pignata, Giuseppe Porciello","doi":"10.3390/curroncol33100591","DOIUrl":"https://doi.org/10.3390/curroncol33100591","url":null,"abstract":"<p><p>Body composition (BC) analysis may integrate assessment of nutritional risk in patients with gastrointestinal cancers. Applying unsupervised machine learning techniques, we derived BC profiles (BCPs) and investigated their association with malnutrition risk and quality of life. This cross-sectional analysis includes gastrointestinal cancer patients enrolled in the NUTRItional and sarcopenia SCREENing project, part of the ONCOCAMP study (ClinicalTrials.gov ID: NCT06270602). Malnutrition assessment was performed using the NRS-2002, anthropometry and BC analysis; HRQoL was evaluated with the EORTC QLQ-C30 questionnaire. Principal component analysis and k-means clustering identified BCPs. Data from 189 patients (mean age: 66.3 ± 11.2 years) with gastric (37%), pancreatic (26.5%), rectal (24.3%) and hepatocellular carcinoma (12.2%) were analyzed. Overall, 36.5% of patients were at nutritional risk (NRS-2002 ≥ 3). Two BC clusters, High Muscle Profile (HMP) and Low Muscle Profile (LMP), were derived. Although no statistically significant association was observed in the overall cohort, multivariable analysis stratified by gender identified an association between LMP and nutritional risk among male patients (OR = 3.77, 95% CI: 1.08-14.3, <i>p</i> = 0.042); however, this finding should be considered exploratory. Nutritional risk, but not BC profiles, was associated with poorer Summary Score (β = 8.0, 95% CI: -14 to -2.3, <i>p</i> = 0.007) and higher Symptom Score (β = 9.8, 95% CI:4.5 to 15, <i>p</i> < 0.001). These preliminary results warrant further confirmation in larger, adequately powered longitudinal cohorts. Future studies should determine whether BCPs provide additional value beyond established nutritional screening and individual BC parameters in clinical practice.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Anastomotic Leak and 5-Year Oncologic Outcomes in Patients Undergoing Colorectal Cancer Resection: A Retrospective Cohort Study.","authors":"Ali Farsi, Mohammed Nassif","doi":"10.3390/curroncol33100587","DOIUrl":"https://doi.org/10.3390/curroncol33100587","url":null,"abstract":"<p><strong>Background: </strong>Anastomotic leak (AL) is a serious complication following colorectal cancer (CRC) resection. Its influence on long-term oncologic outcomes, including recurrence and survival, remains controversial.</p><p><strong>Methods: </strong>This retrospective cohort study aimed to evaluate the prevalence of AL following CRC resection with anastomosis for stage 1-3 CRC. Clinical, operative, oncologic, and follow-up data were collected. AL was diagnosed within 30 days postoperatively. Primary outcomes included recurrence and mortality.</p><p><strong>Results: </strong>A total of 204 patients were included, of whom 25 (12.3%) developed AL. CRC recurrence occurred in 28.0% of patients with AL compared with 24.6% without AL (<i>p</i> = 0.712). Median time to recurrence was shorter in patients with AL (7 vs. 15 months, <i>p</i> = 0.064). One-year mortality was higher in patients with AL (20.0% vs. 3.9%, <i>p</i> = 0.008), and time to mortality was shorter (7 vs. 35 months, <i>p</i> = 0.048). However, AL was not independently associated with mortality or poor outcome on multivariable analysis.</p><p><strong>Conclusions: </strong>AL following CRC resection was associated with earlier mortality and a trend toward earlier recurrence, although no independent association with long-term oncologic outcomes was demonstrated. A larger prospective study with standardized leak definitions would better clarify the relationships between AL and CRC outcomes.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Same, but Different: Shared Hallmarks and Divergent Drivers in Adult, Pediatric and Canine Glioma.","authors":"R Timothy Bentley, Sagar M Utturkar, Harish Kothandaraman, Deepika Dhawan, Danni Liu, Matthew Beyers, Min Zhang, Deborah W Knapp, Nadia A Lanman","doi":"10.3390/curroncol33100592","DOIUrl":"https://doi.org/10.3390/curroncol33100592","url":null,"abstract":"<p><p>Malignant gliomas are the most common primary brain tumors, with dismal outcomes. Pet dogs have been proposed as a valuable model for studying gliomas. Here, we compare spontaneously occurring gliomas from adult and pediatric human and canine patients, focusing on the tumor microenvironment (TME) and the canonical pathways of human glioma dysregulation (RTK/RAS/PI(3)K, p53 and Rb). Transcriptomic, genomic, and methylation data from adult, pediatric, and canine samples were evaluated. Across cohorts, aberrant signaling in the three canonical pathways correlated with increasing tumor grade. Canine high-grade glioma (HGG) showed extensive pathway dysregulation, especially when incorporating differentially expressed genes such as TP53. PDGFRA was a key driver of glioma in purebred brachycephalic (\"short-skulled\") dogs. IDH1 mutations and hypermethylation were concentrated in adult tumors. Both species exhibited increased neutrophils, M2 macrophages, and regulatory T cells, coupled with depletion of key antitumor effectors. PD-1 and PD-L1 immune checkpoint biology was similarly preserved. Canine glioma seems to occupy a \"middle ground\" between pediatric and adult. Methylation patterns mirrored pediatric glioma, yet immune infiltration and pathway activation resembled adult HGG. Complex heterogeneity between patients was a major similarity between species. Despite different driver mutations, dogs and humans converge on a similar malignant, immune-suppressed TME.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' and Providers' Perceptions of the Implementation of a Stepped Care Cognitive-Behavioral Therapy for Insomnia in Routine Cancer Care: A Qualitative Post-Implementation Study.","authors":"Lauriane Giguère, Émilie Godin, Claudia Mc Brearty, Aude Caplette-Gingras, Marie-Pierre Gagnon, Lynda Bélanger, Charles M Morin, Josée Savard","doi":"10.3390/curroncol33100588","DOIUrl":"https://doi.org/10.3390/curroncol33100588","url":null,"abstract":"<p><p>Insomnia is one of the most commonly reported challenges among cancer patients and survivors. Cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment but remains underused in routine cancer care. A stepped-care CBT-I program was developed to address this gap. This study explores facilitators and barriers following the implementation of this program in four Québec cancer centers. Patients and providers participated in two individual interviews and seven focus groups. Interviews were guided by the Consolidated Framework for Implementation Research (CFIR). Data were transcribed and coded in NVivo using the CFIR codebook. A hybrid deductive-inductive thematic analysis was conducted. Codes were interpreted using Proctor's Implementation Outcomes Framework. A total of 14 patients and 18 providers were interviewed. Facilitators and barriers were divided into four key themes: (1) endorsement from trusted professionals; (2) fit with workflows and existing routines; (3) perceived burden for both patients and providers; and (4) readiness and motivation of both patients and providers. This analysis supports the acceptability, adoption, appropriateness, feasibility, and perceived sustainability of a stepped-care CBT-I in routine cancer care and suggests specific implementation strategies to optimize its implementation. Implementation of stepped-care CBT-I in routine cancer care has the potential to improve access to evidence-based treatments for insomnia and make it a standard component of survivorship care.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline and Dynamic Clinical-Laboratory Risk Models for Early Progression or Death During PD-(L)1 Blockade in Advanced NSCLC: Development and Internal Validation.","authors":"Mehmet Fatih Ozbay, Mehmet Hunur, Sertac Vurgun, Suleyman Alkan, Sema Sezgin Goksu, Mustafa Karaca","doi":"10.3390/curroncol33100593","DOIUrl":"https://doi.org/10.3390/curroncol33100593","url":null,"abstract":"<p><strong>Background: </strong>We developed clinical-laboratory models for early progression or death within 90 days (EPD90) during PD-1/PD-L1 blockade in advanced non-small cell lung cancer. EPD90 is a pragmatic early-risk endpoint, not a diagnosis of hyperprogressive disease.</p><p><strong>Methods: </strong>This retrospective single-centre cohort included patients treated between January 2018 and March 2026. The four-item baseline score, EPS-4, combined bone metastasis, lactate dehydrogenase (LDH), albumin and C-reactive protein. Among patients alive and progression-free at day 42, D1 added six-week changes in neutrophil-to-lymphocyte ratio (NLR), and D2 additionally included LDH changes. Internal validation used bootstrap resampling and repeated cross-validation.</p><p><strong>Results: </strong>Among 282 patients, 83 (29.4%) had EPD90. In the common baseline complete-case set (<i>n</i> = 252; 76 events), EPS-4 had an apparent area under the curve (AUC) of 0.729 (95% confidence interval [CI] 0.665-0.793). In 238 landmark-eligible complete cases (56 subsequent events), adding NLR change increased AUC from 0.718 to 0.801. Adding LDH yielded an AUC of 0.816, a modest, statistically non-significant increment (delta AUC 0.016; <i>p</i> = 0.094). Bootstrap-corrected calibration slopes were 0.980 for D1 and 0.957 for D2.</p><p><strong>Conclusions: </strong>NLR provided the principal dynamic contribution. D1 is emphasized as the main dynamic model; D2 remains an exploratory extension with uncertain incremental value. Unavailable laboratory collection dates and lack of external validation limit interpretation. The models and proposed thresholds require independent validation before clinical use.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Stratification and Factors Associated with Heart Failure Hospitalization During Osimertinib Therapy.","authors":"Tomoya Sugimoto, Yoshihiro Noguchi, Rikuto Masuda, Sorami Tani, Tomohiko Harada, Yukio Toyama, Mitsuru Saguchi, Tomoaki Yoshimura","doi":"10.3390/curroncol33100586","DOIUrl":"https://doi.org/10.3390/curroncol33100586","url":null,"abstract":"<p><strong>Background: </strong>Osimertinib is the standard of care for epidermal growth factor receptor mutation-positive non-small cell lung cancer, but heart failure hospitalization (HFH) remains a concern, and no practical tool exists to stratify HFH risk during therapy.</p><p><strong>Methods: </strong>In this retrospective cohort study using a Japanese claims database, 5802 patients newly initiating osimertinib were followed for HFH during treatment. Baseline predictors assessed before the index date were selected by 10-fold cross-validated least absolute shrinkage and selection operator (LASSO) logistic regression and internally validated by bootstrapping (B = 500), repeating predictor selection in each resample. Cumulative incidence functions and Fine-Gray models treated death as a competing event; cause-specific Cox models served as sensitivity analyses.</p><p><strong>Results: </strong>HFH occurred in 169 patients (2.9%) during a median on-treatment follow-up of 9.3 months, with 268 competing deaths. LASSO retained seven predictors. The apparent concordance index (C-index) was 0.731 (95% confidence interval, 0.691-0.771) and the optimism-corrected C-index 0.718. Observed incidence increased 10.2-fold across predicted-risk deciles (1.03-10.50%). Fine-Gray and Cox estimates closely matched the logistic model.</p><p><strong>Conclusions: </strong>Baseline cardiovascular vulnerability stratifies HFH risk during osimertinib therapy. The nomogram, not externally validated, is best used as a screening aid to identify patients who may benefit from intensified cardiovascular monitoring.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors and a Polymetastasis-Free Survival Nomogram in Oligometastatic Head and Neck Squamous Cell Carcinoma Treated with Local Ablative Therapy.","authors":"Young Seob Shin, Si Yeol Song, Seung Hoon Han, Minsu Kwon, Yoon Se Lee, Young Ho Jung, Seung-Ho Choi, Seyoung Seo, Sung-Bae Kim, Sang-Wook Lee","doi":"10.3390/curroncol33100585","DOIUrl":"https://doi.org/10.3390/curroncol33100585","url":null,"abstract":"<p><p>Evidence supporting metastasis-directed local ablative therapy (LAT) in head and neck squamous cell carcinoma (HNSCC) with oligometastatic disease (OMD) is limited. We retrospectively reviewed 93 patients with HNSCC who developed OMD and received LAT to all metastatic sites between 2006 and 2025. Clinical variables, sarcopenia, nutritional status, and inflammatory indices were evaluated as potential predictors of overall survival (OS), progression-free survival (PFS), polymetastasis-free survival (PMFS), and polymetastatic conversion (PC). An exploratory prognostic nomogram for PMFS was developed to inform treatment decision-making. After a median follow-up of 28.2 months, the 3-year OS and PMFS rates were 67.2% and 51.7%, respectively. Local failure occurred in 9 patients, while disease progression was predominantly distant. An HPV-positive oropharyngeal primary tumor was associated with improved OS and PMFS, whereas non-lung metastatic sites were adverse prognostic factors for PFS, and having two or more metastases was adverse for PC. Lower serum albumin levels correlated with worse OS and PFS, and an increasing systemic immune-inflammation index (SII) showed borderline significance for OS and PMFS. A PMFS nomogram based on four clinical parameters achieved an optimism-corrected concordance index of 0.66. Long-term survival and high local control were observed in this selected cohort of HNSCC patients with OMD treated with LAT. Tumor type, metastatic site, tumor burden, and host nutritional and inflammatory indices were associated with survival and progression to PC.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactate Dehydrogenase-to-Albumin Ratio and Glasgow Prognostic Score as Prognostic Markers in Metastatic Breast Cancer Treated with CDK4/6 Inhibitors.","authors":"Ece Sahin Hafizoglu, Ferhat Ekinci, Mustafa Sahbazlar, Atike Pinar Erdogan","doi":"10.3390/curroncol33100582","DOIUrl":"https://doi.org/10.3390/curroncol33100582","url":null,"abstract":"<p><p><b>Background:</b> CDK4/6 inhibitors with endocrine therapy are standard first-line treatment for hormone receptor-positive, HER2-negative metastatic breast cancer, yet simple pretreatment prognostic markers are lacking. The LDH-to-albumin ratio (LAR) and the Glasgow Prognostic Score (GPS) both incorporate serum albumin and are each reported as prognostic, but have not been compared within a single cohort, and LAR has not been examined during CDK4/6 inhibitor therapy. This study evaluated both indices in this setting. <b>Methods:</b> Consecutive patients (<i>n</i> = 139) receiving palbociclib or ribociclib plus endocrine therapy (2020-2025) were analysed retrospectively. LAR was modelled continuously on the logarithmic scale, with hazard ratios per doubling; an external cut-off (46.27) served for Kaplan-Meier illustration only. GPS was calculated in its original form. As both contain albumin, each entered a separate multivariable Cox model with identical covariates. Endpoints were overall survival (OS) and progression-free survival (PFS). <b>Results:</b> Over a median follow-up of 50.0 months, 72 deaths and 110 progression events occurred. LAR was independently associated with OS (adjusted HR 2.87 per doubling, 95% CI 1.78-4.62, <i>p</i> < 0.001) and PFS (2.21, 1.45-3.35, <i>p</i> < 0.001). GPS was independently associated with OS (1.72, 1.05-2.82, <i>p</i> = 0.032) but not PFS (1.32, 0.88-1.98, <i>p</i> = 0.187). LAR-based models had lower Akaike information criterion values (ΔAIC 12.3 and 10.9), but concordance did not differ significantly between the indices (ΔC ≈ 0.04, <i>p</i> > 0.20). <b>Conclusions:</b> Baseline LAR, an inexpensive routine index, was associated with both endpoints, whereas GPS was associated with overall survival alone. Discrimination was modest for both indices (C-index ≤ 0.61) and did not differ significantly between them. External validation is required.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cisplatin-Induced Ototoxicity in Head and Neck Cancer: A Systematic Review of Current Evidence, Clinical Implications, and the Need for Standardized Monitoring.","authors":"Aurora Mirabile, Alert Vukatana, Mathilda Guizzardi, Giorgia Vaccarello, Leone Giordano, Raffaele Addeo","doi":"10.3390/curroncol33100584","DOIUrl":"https://doi.org/10.3390/curroncol33100584","url":null,"abstract":"<p><p><b>Background:</b> Cisplatin-based chemoradiotherapy remains a standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC), but cisplatin-induced ototoxicity is common, usually irreversible and inconsistently monitored. <b>Methods:</b> MEDLINE, EMBASE and the Cochrane Library were searched for English-language clinical studies in adults published between January 2016 and January 2026. Primary full-text clinical studies reporting at least one hearing, tinnitus, vestibular or ototoxicity outcome were eligible; conference-only abstracts, duplicate reports, reviews and consensus papers were not. Twenty-four studies were retained from the original database route. A targeted supplementary PubMed verification performed on 16 September 2026 with broader auditory and vestibular terminology identified six additional eligible full-text studies, which were included through the PRISMA 2020 'other methods' pathway, for a total of 30 studies. Risk of bias was appraised for all 30 studies with RoB 2, ROBINS-I and Joanna Briggs Institute (JBI) tools by a single review author; duplicate independent appraisal was not performed and is reported as a limitation. Meta-analysis had been planned but was not undertaken because audiometric frequencies, grading systems, follow-up intervals and effect measures were not comparable; this is reported as a protocol deviation. <b>Results:</b> The 30 studies comprised approximately 10,500 participants, although two reports used overlapping Hungarian patient samples and several studies included non-HNSCC populations. Reported ototoxicity ranged from 13% (severe, irreversible loss after weekly cisplatin with cochlear-sparing radiotherapy) to 72% (screen-detected loss in a survivorship clinic), reflecting different definitions rather than a single underlying rate. Comparative HNSCC cohorts consistently reported more hearing loss with 100 mg/m² every three weeks than with weekly 40 mg/m². Ten of the 30 studies were at high, serious or critical risk of bias, with one additional comparative study at moderate-to-serious risk; the long-term randomized comparison reported inferior locoregional control with weekly 30 mg/m². Baseline hearing, cochlear radiation exposure, monitoring adherence and pharmacogenetic susceptibility were further determinants. Objective vestibular dysfunction was documented in the absence of dizziness. No pharmacological otoprotective strategy is established in adults. <b>Conclusions:</b> Cisplatin ototoxicity is a core survivorship endpoint. Weekly dosing may reduce hearing toxicity in selected settings but must not be read as universal oncological equivalence. Standardized definitions, baseline and longitudinal testing, cochlear-dose reporting and prospective evaluation of vestibular outcomes and otoprotective agents are the priorities.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Progression with Nodal Involvement Is a Predictor of Early Mortality in Mycosis Fungoides: A Retrospective, Registry-Based Cohort Study.","authors":"Charalampos Filippatos, Despina Fotiou, Alexandros Briasoulis, Ioannis Ntanasis-Stathopoulos, Evangelos Terpos, Maria Gavriatopoulou","doi":"10.3390/curroncol33100583","DOIUrl":"https://doi.org/10.3390/curroncol33100583","url":null,"abstract":"<p><p>Nodal involvement is a key indicator of advanced disease in mycosis fungoides (MF). While progression within 24 months is prognostic of survival in other indolent lymphomas, such clinical benchmarks in MF remain underexplored. We aimed to evaluate whether early nodal progression after the initial diagnosis serves as an independent, dynamic clinical predictor of early mortality in patients with MF. This retrospective, registry-based study utilized data from TriNetX. Evaluating post-diagnosis timepoints from 12 to 36 months, the 12-month landmark demonstrated the greatest survival divergence and was selected as the optimal threshold for early nodal progression. Patients without nodal involvement within the first 12 months served as controls. To mitigate immortal time bias, a strict 12-month landmark analysis was employed. Among 25,419 screened patients, 2132 (8.4%) developed nodal involvement within the first 12 months (NODE12). At the 12-month landmark, 21,840 patients were evaluable: 1832 with NODE12 and 20,008 controls. At this landmark, the 5-year overall survival rate was 74.8% for NODE12 patients versus 87.8% for controls (<i>p</i> < 0.001). In multivariable Cox regression, NODE12 was an independent predictor of early mortality (aHR = 1.97, 95% CI: 1.77-2.20, <i>p</i> < 0.001), alongside advanced age (aHR = 3.58, <i>p</i> < 0.001) and lymphocytosis (aHR = 1.69, <i>p</i> < 0.001). This survival disadvantage was further confirmed in the PSM sensitivity analysis of 1992 matched pairs (HR = 1.96, 95% CI: 1.66-2.31, <i>p</i> < 0.001). In conclusion, NODE12 is a dynamic clinical milestone identifying a high-risk MF phenotype. Similar to POD24 in B-cell lymphomas, NODE12 identifies a high-risk patient subgroup that may benefit from closer monitoring and refined risk stratification.</p>","PeriodicalId":11012,"journal":{"name":"Current oncology","volume":"33 10","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149263949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}