ecancermedicalscience最新文献

{"title":"Benchmarking of radiobiological NTCP models in head and neck radiotherapy using independent computational pipelines: an institutional validation study with machine learning augmentation.","authors":"Kalyan Mondal, Abhijit Mandal, Anuj Vijay, Ganeshkumar Patel","doi":"10.3332/ecancer.2026.2147","DOIUrl":"10.3332/ecancer.2026.2147","url":null,"abstract":"<p><strong>Background & purpose: </strong>Normal tissue complication probability (NTCP) models require institutional validation before clinical implementation. Traditional radiobiological models, such as the Lyman-Kutcher-Burman (LKB) and Equivalent Uniform Dose (EUD) models, provide mechanistic dose-response frameworks, while machine learning (ML) approaches offer exploratory, data-driven alternatives that remain inadequately characterised in South Asian populations.</p><p><strong>Methods: </strong>This retrospective study included 51 head and neck cancer patients treated with definitive radiotherapy. Binary endpoints were Grade ≥2 xerostomia (n = 3), dysphagia (n = 5) and mucositis (n = 4), scored using Common Terminology Criteria for Adverse Events version 5.0. NTCP calculations were performed using two independent computational pipelines (MATLAB-based RBMODELv1 and a Python implementation), with agreement assessed using Bland-Altman analysis. Traditional NTCP models (LKB, EUD) were evaluated and compared with artificial neural networks and XGBoost in a hypothesis-generating framework using a stratified 70:30 train-test split. Model performance was assessed using the area under the receiver operating characteristic curve (area under the curve), accuracy and Spearman's rank correlation.</p><p><strong>Results: </strong>Excellent agreement was observed between computational pipelines (mean bias 0.8%, 95% limits -1.9% to 3.5%). Traditional models demonstrated strong rank-order correlation with toxicity grades (ρ = 0.61-0.79, p < 0.001) and high accuracy (LKB: 90.0%-94.1%). Institution-specific parameters differed from quantitative analyses of normal tissue effects in the clinic values, including a lower parotid TD50 (34.1 versus 39.0 Gy). Exploratory ML analyses showed numerically higher discrimination for parallel organs but not for mixed-architecture structures; however, severe class imbalance (3-5 events per endpoint) limits statistical reliability.</p><p><strong>Conclusion: </strong>Dual computational pipelines enable reproducible NTCP modeling for institutional use. Traditional radiobiological models perform acceptably after local calibration, while exploratory ML findings suggest potential organ-architecture-dependent patterns that require validation in adequately powered multi-institutional cohorts.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2147"},"PeriodicalIF":1.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline knowledge, attitudes and perceptions on the oncology profession among final-year medical students in Kenya: a cross-sectional study.","authors":"Mustafa Affey, Najma Mahamed Aden, Jamal Saman, Fatuma Affey, Abdirahman Maalim, Ibrahimrashid Mohamed Sheikh, Mohamedamin Abdullahi, Omar Abdihamid","doi":"10.3332/ecancer.2026.2146","DOIUrl":"10.3332/ecancer.2026.2146","url":null,"abstract":"<p><strong>Background: </strong>Kenya faces a rising cancer burden amid a critical shortage of oncology professionals. Undergraduate exposure, knowledge and attitudes shape specialty choices, yet local evidence remains scarce. This study assessed baseline knowledge, attitudes and perceptions of oncology among final-year medical students in Kenya to inform curriculum development, mentorship and workforce planning.</p><p><strong>Methods: </strong>A descriptive cross-sectional online survey was conducted among final-year Bachelor of Medicine and Bachelor of Surgery students across accredited Kenyan medical schools between April and May 2025. A structured Qualtrics questionnaire assessed sociodemographics, career intentions, oncology knowledge and exposure and attitudes toward oncology. Data were analysed using descriptive statistics. Participation was voluntary and anonymous. Ethical approval was obtained from the Mount Kenya University Ethics Review Committee (MKU/ISERC/5342).</p><p><strong>Results: </strong>Of 89 responses, 88 were analysed. Participants were equally male and female (50% each), with a mean age of 25 years. Most respondents were from the University of Nairobi (73%), followed by Moi University (17%) and other institutions. Seventy-seven percent reported a close friend or relative diagnosed with cancer. Community responses were mainly supportive (60%), though 32% viewed cancer as a 'death sentence' and 8% reported stigma or avoidance. Personal or family experience shaped perceptions for 61% and 81% cited cultural beliefs as influencing community reactions. Seventy-three percent had completed an oncology rotation, but only 30% attended oncology-focused workshops. Over half (53%) were unsure of cancer incidence in Kenya. Chemotherapy and radiotherapy were the most recognised treatments, with limited awareness of immunotherapy. Eighty-six percent agreed that oncology training should be strengthened. While 84% knew oncology is a recognised specialty in Kenya, only 42% were aware of local postgraduate programs. Most rated the undergraduate oncology curriculum as 'average' (42%). Twenty-five percent would consider oncology as a career, 51% were undecided and 24% would not. Motivators included clinical exposure and patient outcomes; deterrents were emotional burden, lack of mentorship, patient suffering and poor work-life balance. Suggested strategies included increased clinical exposure, structured mentorship, expanded residency slots and targeted incentives.</p><p><strong>Conclusion: </strong>Final-year Kenyan medical students acknowledge oncology as a career but face significant knowledge and exposure gaps. Strengthening undergraduate oncology education, expanding mentorship opportunities and creating clear postgraduate pathways are key to building a robust, homegrown oncology workforce in Kenya.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2146"},"PeriodicalIF":1.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of low-dose immune checkpoint inhibitors in low- and middle-income countries: a national survey of oncologists and hematologists in Mexico.","authors":"Andres Meraz-Brenez, Enrique Soto-Perez-De-Celis, Roberta Demichelis-Gomez, Leonardo Verduzco-Rodriguez, Arjun Gupta, Meera Ragavan, Fumiko Chino, Haydee Cristina Verduzco-Aguirre","doi":"10.3332/ecancer.2026.2144","DOIUrl":"10.3332/ecancer.2026.2144","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) have transformed the treatment landscape for multiple cancers but remain largely inaccessible in low- and middle-income countries (LMICs) due to high costs and limited availability. Pharmacokinetic and pharmacodynamic data, together with emerging clinical evidence, suggest that standard approved doses may exceed the threshold required for therapeutic efficacy, supporting the biological plausibility of low-dose strategies. In LMICs, such approaches could broaden access, yet their adoption is still limited. Eighty-one Mexican oncologists and hematologists answered a web-based survey designed to examine the use of low-dose ICI, reasons for implementation and barriers to adoption. All respondents reported at least one barrier to prescribing ICI, most commonly economic limitations or lack of coverage (71.6%). Nearly half (45.7%) reported having treated at least one patient with low-dose ICI, most often with the intention of reducing treatment costs (75.7%). Nivolumab was the most frequently used drug in low-dose regimens (75.7%), followed by pembrolizumab (43.2%). Commonly perceived barriers to prescribing low-dose ICI included concerns about efficacy and safety (51.9%), insufficient knowledge of dosing protocols (51.9%) and insurance approval limitations (43.2%). Confidence in efficacy was higher in the palliative compared to the curative setting. Only 19.7% of respondents felt sufficient evidence and resources were available to support the implementation of low-dose ICI. This study provides evidence on the use of low-dose ICI among physicians in Mexico, reflecting strategies motivated by cost reduction but hindered by safety concerns and perceived lack of evidence. As access to ICI remains a significant challenge in LMICs, the rigorous evaluation and implementation of low-dose regimens should be considered a research and policy priority.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2144"},"PeriodicalIF":1.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BCG in the fight against cancer: exploring its applications in diverse tumour types and future directions.","authors":"P Ignacio A Bianco, O Jeismar M Carballo, P Isaac R Blanca, Ana Federica Convit","doi":"10.3332/ecancer.2026.2142","DOIUrl":"10.3332/ecancer.2026.2142","url":null,"abstract":"<p><p>Bacillus Calmette-Guérin (BCG), originally a tuberculosis vaccine, is a standard immunotherapy for non-muscle-invasive bladder cancer (NMIBC). This review summarises BCG biology, including trained immunity, and evaluates clinical and translational evidence for BCG across solid tumours. We aim to distinguish guideline-supported indications from investigational uses and identify contexts where BCG may remain clinically relevant or trial-ready. Evidence is strongest in NMIBC, where outcomes depend on induction plus maintenance schedules and appropriate patient selection. Outside the bladder, intralesional and vaccine-adjuvant approaches show signals in selected melanoma and vaccine settings, while historical lung and colorectal trials largely failed to translate into durable benefit. Emerging preclinical work in hepatocellular carcinoma and breast cancer suggests potential synergy with modern immunotherapy strategies. BCG should be framed as a platform immunomodulator whose value beyond NMIBC requires mechanism-guided trials, clear safety boundaries and clinically anchored endpoints.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2142"},"PeriodicalIF":1.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delays in childhood cancer care at a tertiary care centre in Pakistan: a single-centre study.","authors":"Ruqayya Manzoor, Hijab Shaheen, Ana Farooq, Nazia Rafique, Nuzhat Yasmeen, Junaid Jamshed","doi":"10.3332/ecancer.2026.2141","DOIUrl":"10.3332/ecancer.2026.2141","url":null,"abstract":"<p><strong>Background: </strong>Timely diagnosis and initiation of therapy are critical determinants of survival in childhood cancer. In Pakistan, paediatric oncology services are highly centralised, and most children, particularly from rural and low-income households, experience prolonged delays with limited evidence on their cumulative magnitude and determinants. This study determined patient, diagnostic, treatment and health-system delays and identified predictors of prolonged total delay, defined as a cumulative interval exceeding 30 days from symptom onset to treatment initiation, among children with newly diagnosed malignancies.</p><p><strong>Methods: </strong>Seventy-one children were analysed (median age 5 years; 67.6% male; 71.8% rural). Median total delay was 36 days interquartile range (IQR 49), with 57.7% experiencing prolonged delay. Survival and disease stage were significantly associated with delay duration; children with a total delay of 0-30 days achieved a 12-month event-free survival of 83.3%, which dropped to 60.0% for those with delays >90 days. Furthermore, 50.0% of children in the critical delay group presented with advanced Stages III or IV disease. Prolonged delay was independently associated with rural residence (adjusted OR 2.42), low household income (aOR 3.09), first healthcare contact outside a tertiary centre (aOR 3.96), lack of parental education, absence of caregiver awareness (aOR 2.85) and diagnosis of a solid tumour (aOR 2.67).</p><p><strong>Results: </strong>Seventy-one children were analysed (median age 5 years; 67.6% male; 71.8% rural). Median total delay was 36 days (IQR 49), with 57.7% experiencing prolonged delay. Patient delay exceeded 14 days in 46.5%, while health-system delay affected 61.9%. Diagnostic delays beyond 21 days occurred in 25.4% and treatment delays were comparatively limited (18.3%). Prolonged delay was independently associated with rural residence (adjusted OR 2.42, 95% CI 1.16-5.03), low household income (< 50,000 PKR; aOR 3.09, 95% CI 1.42-6.72), first healthcare contact outside a tertiary centre (aOR 3.96, 95% CI 1.82-8.63), lack of parental education, absence of caregiver awareness of childhood cancer (aOR 2.85, 95% CI 1.29-6.31) and diagnosis of a solid tumour (aOR 2.67, 95% CI 1.29-5.53).</p><p><strong>Conclusion: </strong>Delays in childhood cancer care in Pakistan arise from socioeconomic vulnerability, geographic inequity and fragmented health-system pathways at this single-centre site. These delays directly correlate with advanced-stage presentation and reduced survival. Decentralised diagnostics, standardised referral systems, primary healthcare training, social support and community awareness are urgently needed to reduce delays and enhance survival in resource-constrained settings.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2141"},"PeriodicalIF":1.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary healthcare utilisation and associated factors among post-treatment prostate cancer survivors in Tanzania: a cross-sectional study.","authors":"Rabson R Nakey, Gideon P Kwesigabo, Monica C Shabani, Yemela K Ndibalema, Aurelia J Temba","doi":"10.3332/ecancer.2026.2143","DOIUrl":"10.3332/ecancer.2026.2143","url":null,"abstract":"<p><p>Prostate cancer survivorship is becoming an increasingly important issue in Tanzania, especially because follow-up care is still heavily centralised in a few specialised centres. This model is difficult to sustain in a country with a limited number of oncologists and specialised facilities. At the same time, there is growing recognition both globally and locally that primary healthcare (PHC) should play a major role in supporting cancer survivors. With this in mind, the present study set out to determine the proportion of prostate cancer survivors who actually use PHC services after completing active treatment, and to identify the factors that influence this pattern of care. A cross-sectional study was conducted at Besta Super Specialised Polyclinic in Dar es Salaam, recruiting 213 survivors who completed radiotherapy between January 2021 and December 2023. Data were collected via medical record reviews and telephone interviews using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Prostate Cancer Module to assess symptom burden. The study found that 69.0% of survivors utilised PHC services, primarily at district hospitals (82.3%). Rural residence was the strongest predictor, with rural survivors over ten times more likely to access care than their urban counterparts. Higher education, early-stage diagnosis and severe treatment or sexual side effects also significantly increased utilisation. Interestingly, mild urinary symptoms were associated with higher PHC use compared to severe cases. These results suggest that a significant proportion of prostate cancer survivors in Tanzania are already engaged with PHC as a source for addressing survivorship issues, particularly those in rural settings with high symptom burdens. Given the persistent gaps and challenges in accessing specialised cancer services, it becomes even more important to recognise, understand and strengthen the role of PHC facilities as an essential part of the country's cancer care system.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2143"},"PeriodicalIF":1.5,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial omics and its applications for a tumour microenvironment characterization and precision medicine approach of gastric cancer.","authors":"José Darío Portillo-Miño, John Jairo Calderon, David Bettin Gonzalez, Yeison Carlosama, Lorena Lagarde, Rafael Parra-Medina","doi":"10.3332/ecancer.2026.2140","DOIUrl":"10.3332/ecancer.2026.2140","url":null,"abstract":"<p><p>Gastric cancer (GC) is a lethal disease due to heterogeneity and complexity from the point of view of epidemiology, epidemiology and public health policy and biological behaviour. Despite recent advances in the research field on the molecular and cellular characterisation of GC, the clinical outcomes have been ominous. Perhaps the unceasing research in future years, focusing on spatial omics, has revolutionary potential for transforming the conception and understanding of GC mechanisms, thereby enabling the discovery of targeted therapies that are most effective in improving survival. Under these circumstances, this review article lays the groundwork for an update of spatial omics, offering a comprehensive vision and its implications for understanding the landscape of GC research. Moreover, it highlights the recent advances and breakthroughs in heterogeneity and immunosuppressive tumour microenvironment.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2140"},"PeriodicalIF":1.5,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of routine endoscopic studies in staging locally advanced cervical cancer: a multicenter experience from a low and middle-income country.","authors":"Jorge Hoegl, Andreina Fernandes, Fernando Hidalgo, Sunangela Escalona, Anthony López, Yetsy Muñoz, Paola Morillo, Mary Carmen Hidalgo, Luisa López, María Briceño, María Mercedes Pérez","doi":"10.3332/ecancer.2026.2139","DOIUrl":"10.3332/ecancer.2026.2139","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic value of routine cystoscopy and rectosigmoidoscopy in staging locally advanced cervical cancer (LACC) in a low - middle - income country (LMIC) setting.</p><p><strong>Material and methods: </strong>A multicenter, retrospective cohort study of 233 patients with LACC (International Federation of Gynecology and Obstetrics 2018 stages IB3-IVB) in Venezuela. All patients underwent clinical examination, magnetic resonance imaging (MRI) and routine endoscopy. The primary outcome was the confirmation of mucosal invasion by endoscopy in patients without prior clinical or radiological suspicion.</p><p><strong>Results: </strong>Endoscopically confirmed bladder and rectal mucosal invasion occurred in 6.0% and 3.0% of patients, respectively. In 95% of all positive cases, suspicion was already present on MRI or clinical symptoms. MRI demonstrated high negative predictive values for bladder (95.9%, confidence interval (CI) 95% 92.5-98.1) and rectal (97.4% CI 95% 92.2-97.8) invasion. Notably, no treatment plan was modified solely based on endoscopic findings. Routine endoscopy was negative in 94% of cystoscopies and 97% of rectosigmoidoscopies.</p><p><strong>Conclusion: </strong>Routine endoscopic staging in LACC showed a very low diagnostic yield and no impact on therapeutic decisions in this LMIC setting. A selective, imaging-guided approach is safe, resource-efficient and aligns with international guidelines, advocating for a change in local protocols. These findings strongly support discontinuing routine endoscopy in LMIC staging protocols.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2139"},"PeriodicalIF":1.5,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional status at diagnosis and follow-up and its impact on short-term clinical outcome in children with cancer: a real-world report from India.","authors":"Rajul M Gala, Maya Prasad, Shyam Srinivasan, Venkata Rama Mohan Gollamudi, Chetan Dhamne, Nirmalya Roy Moulik, Badira Parambil, Akanksha Chichra, Gaurav Narula, Girish Chinnaswamy","doi":"10.3332/ecancer.2026.2137","DOIUrl":"10.3332/ecancer.2026.2137","url":null,"abstract":"<p><p>Nutritional status (NS) in children with cancer may impact a wide range of outcomes, and remediation of under and over-nutrition may potentially improve outcomes. Children with cancer at our centre were classified as undernourished (UN) body mass index (BMI Z-score ≤-2 standard deviations (SD) World Health Organisation (WHO) or mid-upper-arm circumference (MUAC) <12.5 cm for <5 years (WHO) or <25th percentile for >5 years (Frisancho)), well-nourished (WN) (BMI Z-score -1 SD to +1 SD or MUAC 12.5-13.5 cm for <5 years or 25-50th percentile for >5 years) and over-nourished (ON) (BMI Z-score ≥+1 SD or MUAC ≥75th percentile for >5 years). NS was assessed at three time-points: diagnosis, 3- and 6-month follow-up. Trends in NS and impact on outcomes (event-free survival (EFS) and overall survival) were analysed. At diagnosis (n = 2,086) and 6-month follow-up (n = 1,245), 30.9% and 41.7% were WN, 65.3% and 52.2% UN and 3.8% and 6.1% ON. During the course of treatment, 45.5% gained weight and 11.6% lost weight. The highest prevalence of undernutrition at diagnosis was seen in acute myeloid leukaemia (73.3%), lymphoma (68.8%) and bone tumours (68.7%). Two-year EFS was 71.3% ± 1.82% in WN children, 71.3% ± 5.19% in ON children and 68.4% ± 1.28% in children UN at diagnosis (p = 0.004). Children who gained weight between diagnosis and follow-up had a 2-year EFS of 82.8% ± 1.60% versus 76% ± 1.70% in those without weight gain (p = 0.022). Undernutrition at diagnosis as well as during treatment leads to increased relapse as well as mortality. Weight gain and improved NS appear to impact clinical outcomes, highlighting the need for targeted nutritional interventions in children with cancer.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2137"},"PeriodicalIF":1.5,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of pathologically positive lymph node in clinico-radiologic T4b oral squamous cell carcinoma: a meta-analysis.","authors":"Sameer Pandey, Sooraj Pillai, Megha Punetha, Santhosh Rao","doi":"10.3332/ecancer.2026.2138","DOIUrl":"10.3332/ecancer.2026.2138","url":null,"abstract":"<p><strong>Background: </strong>Clinico-radiologic T4b oral squamous cell carcinoma (OSCC) lesions form the most advanced cohort of oral malignancy. Survival outcomes depend on major prognostic determinants, such as nodal status. The anatomic extent of disease determines triage for curative-intent surgery.</p><p><strong>Purpose: </strong>The purpose of the meta-analysis was to find the incidence of lymph-node metastasis and estimate the survival outcomes of patients with cT4b OSCC treated with curative intent surgery.</p><p><strong>Data sources: </strong>PubMed, Scopus, Ovid, Cochrane Library, Embase and ClinicalKey databases were searched from July 2005 to July 2024. A manual search of speciality journals was conducted from July 2005 to July 2024, without any language restriction and reporting only human studies.</p><p><strong>Study selection: </strong>All randomised controlled trials (RCTs), non-RCTs, prospective, retrospective studies based on cT4b OSCC of all subsites except tongue were included in the review.</p><p><strong>Methods for selecting the study: </strong>Studies were reviewed by two reviewers, and a third reviewer resolved any disagreements.</p><p><strong>Data extraction and synthesis: </strong>The extracted data were recorded in a pre-piloted Excel sheet. The synthesis of results was performed using MedCalc version 23.0.6 software.</p><p><strong>Main outcomes and measures: </strong>A PRISMA-guided systematic review was conducted. Data on the incidence of N0 disease, the number of cases with clear surgical margins, overall survival and disease-free survival were recorded. Based on data homogeneity, a proportional meta-analysis was performed to evaluate the weighted incidence of N0 disease.</p><p><strong>Results: </strong>Eleven studies were shortlisted for data extraction. Due to heterogeneous surgical techniques and criteria for surgical margins and survival duration, outcomes were analysed only for the incidence of N0 disease. Results suggested that 40.58% of patients had pathologically N0 disease. There was statistically significant heterogeneity (I2 = 93%).</p><p><strong>Conclusion and relevance: </strong>Among patients with cT4b OSCC, 40.58% have negative neck disease, with carefully evaluated information on anatomic spread, a curative intent surgical treatment plan can be designed.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"20 ","pages":"2138"},"PeriodicalIF":1.5,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13354812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}