European Journal of Cancer最新文献

{"title":"Insights on the association of anthropometric and metabolic variables with tumor features and genomic risk in luminal early breast cancer: Results of a multicentric prospective study","authors":"Pietro De Placido ,&nbsp;Rossana Di Rienzo ,&nbsp;Erica Pietroluongo ,&nbsp;Claudia Martinelli ,&nbsp;Margherita Tafuro ,&nbsp;Pietro Formisano ,&nbsp;Vittoria D’Esposito ,&nbsp;Francesca Benedetta Poggio ,&nbsp;Tommaso Ruelle ,&nbsp;Barbara Cardinali ,&nbsp;Vincenzo Di Lauro ,&nbsp;Giuseppe Buono ,&nbsp;Roberta Caputo ,&nbsp;Roberto Buonaiuto ,&nbsp;Aldo Caltavituro ,&nbsp;Paola Rocco ,&nbsp;Giuseppe Porciello ,&nbsp;Michelino De Laurentiis ,&nbsp;Lucia Del Mastro ,&nbsp;Claudio Vernieri ,&nbsp;Mario Giuliano","doi":"10.1016/j.ejca.2025.115409","DOIUrl":"10.1016/j.ejca.2025.115409","url":null,"abstract":"<div><h3>Background</h3><div>Hormone receptor-positive (HR+)/HER2-negative (HER2-) early-stage breast cancers (EBC) are treated with adjuvant endocrine therapy (ET), with chemotherapy (CT) reserved for high-risk cases. Obesity is linked to increased recurrence risk. The Oncotype DX® assay predicts prognosis and CT benefit. The PRO BONO study evaluated Oncotype DX test's impact on treatment decisions and explored associations between genomic risk, tumor features, and patient metabolic profiles.</div></div><div><h3>Materials and Methods</h3><div>Patients with HR+ /HER2-EBC undergoing Oncotype DX testing were enrolled. Body mass index (BMI), tumor characteristics (ER, PR, Ki67, grading, size, nodal status), a large panel of metabolic analytes, and Oncotype DX Recurrence Score® (RS) results were collected. Treatment recommendations (ET vs CT-ET) were recorded pre- and post-Oncotype DX, and concordance was determined using Cohen’s Kappa. Associations were tested using Chi-Square test and Spearman Correlation.</div></div><div><h3>Results</h3><div>Of the 248 EBC patients (2019–2021), Oncotype DX testing reduced CT use by 47.7 %. Higher RS positively correlated with serum triglycerides and inversely with GIP (all p &lt; 0.05). No significant association was found between patient BMI and RS result. Conversely, tumor size positively correlated with BMI (p = 0.0286) and with serum levels of leptin (p = 0.0079), PAI-1 (p = 0.0083), C-peptide (p = 0.0124), GIP (p = 0.0036), GLP-1 (p = 0.0476), glucagon (p = 0.0224), and insulin (p = 0.0327). A BMI≥ 30 and higher GLP-1 levels (&gt;148.85pg/ml) were independently associated with increased odds of having larger tumor size (&gt;2 cm).</div></div><div><h3>Conclusions</h3><div>Recurrence Score result significantly impacts treatment decisions in HR+ /HER2-EBC. RS result was not associated with BMI, although unfavorable metabolic profiles and obesity-related markers correlated with larger tumors. These findings highlight the need to further investigate the link between metabolic profiles and breast cancer biology.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"221 ","pages":"Article 115409"},"PeriodicalIF":7.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter Re: Association of pregnancy with tumour progression in patients with glioma","authors":"Chunxiao Dang ,&nbsp;Pengfei Liu ,&nbsp;Xiao Yu","doi":"10.1016/j.ejca.2025.115410","DOIUrl":"10.1016/j.ejca.2025.115410","url":null,"abstract":"","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"221 ","pages":"Article 115410"},"PeriodicalIF":7.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a ChatGPT-based digital counseling intervention on anxiety and depression in patients with cancer: A prospective, randomized trial","authors":"Orhun Akdogan ,&nbsp;Galip Can Uyar ,&nbsp;Enes Yesilbas ,&nbsp;Kadriye Baskurt ,&nbsp;Nuri Alperen Malkoc ,&nbsp;Nuriye Ozdemir ,&nbsp;Ozan Yazici ,&nbsp;Berna Oksuzoglu ,&nbsp;Aytug Uner ,&nbsp;Ahmet Ozet ,&nbsp;Osman Sutcuoglu","doi":"10.1016/j.ejca.2025.115408","DOIUrl":"10.1016/j.ejca.2025.115408","url":null,"abstract":"<div><h3>Background</h3><div>Psychological distress is prevalent among newly diagnosed cancer patients, often exacerbating treatment-related anxiety and depression. Artificial intelligence (AI)-driven interventions, such as large language models (LLMs), offer scalable solutions for patient education. However, their effectiveness in mitigating psychological distress in oncology remains unverified.</div></div><div><h3>Methods</h3><div>We conducted a prospective, two-center, randomized controlled trial between July and October 2024 to evaluate the effect of a ChatGPT-based digital counseling intervention on anxiety and depression in chemotherapy-naïve cancer patients. Participants were randomized 1:1 to either a ChatGPT-assisted counseling group or a standard clinician-led education group. The primary outcome was the change in Hospital Anxiety and Depression Scale (HADS) scores before the second chemotherapy cycle. Secondary outcomes included patient engagement behavior and the accuracy of AI-generated responses. Multivariable logistic regression assessed independent predictors of anxiety and depression reduction. The trial is registered with ClinicalTrials.gov (NCT06854315).</div></div><div><h3>Findings</h3><div>Of 196 screened patients, 160 were randomized (ChatGPT: n = 80; control: n = 80). The final cohort comprised 150 patients (median age: 64 years; 53.3 % female). At follow-up, the ChatGPT group exhibited significantly lower median HADS-Anxiety (6 [0–17] vs. 8 [1–17]; P = 0.002) and HADS-Depression (6 [0–20] vs. 9 [0–19]; P &lt; 0.001) scores compared to controls. ChatGPT use was the strongest predictor of anxiety reduction (OR, 18.684; 95 % CI, 3.981–87.685; P &lt; 0.001). AI responses were deemed appropriate in 88.5 % of cases, with inaccuracies most common in dietary and sexual health recommendations.</div></div><div><h3>Interpretation</h3><div>A ChatGPT-based counseling intervention significantly reduced anxiety and depression among newly diagnosed cancer patients prior to chemotherapy. These findings support the potential integration of AI-driven digital tools as adjuncts to conventional oncology education, enhancing patient support and engagement. Further research is needed to refine AI implementation in clinical practice.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"221 ","pages":"Article 115408"},"PeriodicalIF":7.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body mass index and risk of Hodgkin's lymphoma: Insights from a Norwegian cohort study","authors":"Dagfinn Aune ,&nbsp;Marie Nordsletten ,&nbsp;Tor Åge Myklebust ,&nbsp;Trude Eid Robsahm ,&nbsp;Bjørn Steen Skålhegg ,&nbsp;Tom Mala ,&nbsp;Sheraz Yaqub ,&nbsp;Usman Saeed","doi":"10.1016/j.ejca.2025.115400","DOIUrl":"10.1016/j.ejca.2025.115400","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have reported positive associations between higher body mass index (BMI) and risk of Hodgkin's lymphoma. However, the evidence is not entirely consistent. We investigated the association between BMI and Hodgkin's lymphoma in a large Norwegian cohort with up to 50 years follow-up.</div></div><div><h3>Methods</h3><div>The analytical dataset included 1723,692 men and women aged 16–75 years at baseline in 1963–1975. Multivariable Cox regression analyses were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the associations between BMI and Hodgkin's lymphoma incidence.</div></div><div><h3>Results</h3><div>During 56.1 million person-years of follow-up, 1608 incident Hodgkin's lymphoma cases occurred. Compared to individuals with BMI 18.5-&lt; 25, the HRs (95 % CIs) for those with a BMI of 15-&lt; 18.5, 25-&lt; 30, and ≥ 30 were 0.87 (0.59–1.27), 1.05 (0.94–1.18), and 1.61 (1.35–1.91), respectively, and 1.57 (1.30–1.90) and 1.80 (1.24–2.62) for obesity grade 1 and grade 2, respectively. A positive association was also observed per 5 kg/m² increment with a HR (95 % CI) of 1.16 (1.08–1.24) overall, 1.20 (1.09–1.31) in women, and 1.08 (0.96–1.20) in men. Positive associations were also observed between obesity vs. normal weight in early adulthood (age 16–29 years) and Hodgkin's lymphoma (HR, 95 % CIs: 1.89, 1.10–3.22, p_trend&lt;0.0001, n = 489 cases) and between obesity and early-onset (age &lt;50 years at diagnosis) disease (HR, 95 % CIs: 1.67, 1.01–2.78, p_trend&lt;0.0001, n = 393 cases).</div></div><div><h3>Conclusion</h3><div>The positive associations observed between higher BMI overall and in young adulthood and Hodgkin's lymphoma and between BMI and early-onset disease emphasize the potential role of adiposity in development of this malignancy.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"221 ","pages":"Article 115400"},"PeriodicalIF":7.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 metformin use, immune mediated colitis and overall survival in patients treated with checkpoint inhibitor","authors":"Malek Shatila ,&nbsp;Carolina Colli Cruz ,&nbsp;Linfeng Lu ,&nbsp;Kian Abdul-baki ,&nbsp;Elliot Baerman ,&nbsp;Kei Takigawa ,&nbsp;Andres Urias Rivera ,&nbsp;Irene Jeong-Ah Lee ,&nbsp;Sean Ngo ,&nbsp;Gabriel Sperling ,&nbsp;Abdullah Sagar Aleem ,&nbsp;Raakhi Menon ,&nbsp;Andrew Sullivan ,&nbsp;Varun Vemulapalli ,&nbsp;Cristina Natha ,&nbsp;Tanvi Gupta ,&nbsp;Ayesha Khan ,&nbsp;Nitish Mittal ,&nbsp;Garrett Coleman ,&nbsp;Hamza Salim ,&nbsp;Yinghong Wang","doi":"10.1016/j.ejca.2025.115405","DOIUrl":"10.1016/j.ejca.2025.115405","url":null,"abstract":"<div><h3>Introduction</h3><div>Metformin is frequently prescribed to treat type 2 diabetes. Its primarily regulates hepatic and colonic glucose metabolism, but recent studies have suggested an anti-inflammatory effect, especially in colitis. It has been suggested that metformin may enhance immune checkpoint inhibition (ICI) efficacy for cancer treatment. Our study aims to explore the impact of metformin on ICI efficacy and the risk for colitis.</div></div><div><h3>Methods</h3><div>This was a single center, retrospective analysis of consecutive patients at a tertiary cancer center who received ICI between 01/2010–12/2022 and developed immune-mediated colitis (IMC). Patients were screened for colitis based on stool tests, then divided into two groups depending on metformin use prior to colitis onset. We collected data on demographic and colitis clinical information including treatments, and outcomes.</div></div><div><h3>Results</h3><div>A total of 953 patients were included. The incidence of IMC was higher among metformin users (7.6 %) than non-metformin users (4.9 %; p &lt; 0.01). There were no significant differences in colitis features and outcomes, except for longer hospital stay among metformin users (8 days vs 6 for non-metformin users; p = 0.03). Metformin use was associated with shorter overall survival vs non-metformin users among patients with IMC (p = 0.03).</div></div><div><h3>Discussion</h3><div>Our study is among the first to explore the impact of metformin on IMC and overall survival. We found that metformin use may be associated with higher risk of IMC. We also found an association between metformin use and shorter overall survival among patients who developed IMC. Larger studies with risk-stratified analysis are needed to validate our findings.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"221 ","pages":"Article 115405"},"PeriodicalIF":7.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143830271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic landscape and clinical impact of homologous recombination repair gene mutation in small bowel adenocarcinoma","authors":"Toshiki Ozato ,&nbsp;Yoshiyasu Kono ,&nbsp;Shigeru Horiguchi ,&nbsp;Koichiro Tsutsumi ,&nbsp;Hideki Yamamoto ,&nbsp;Akira Hirasawa ,&nbsp;Daisuke Ennishi ,&nbsp;Shuta Tomida ,&nbsp;Shinichi Toyooka ,&nbsp;Motoyuki Otsuka","doi":"10.1016/j.ejca.2025.115401","DOIUrl":"10.1016/j.ejca.2025.115401","url":null,"abstract":"<div><h3>Background</h3><div>Small bowel adenocarcinoma (SBA) is a rare malignancy with a poor prognosis and limited treatment options. Although homologous recombination deficiency has been studied as a biomarker for other cancer types, the clinical and genomic implications of homologous recombination repair (HRR) gene mutations in SBA remain unclear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of 628 patients with advanced or recurrent SBA from a nationwide genomic database. Patients were categorized into HRR mutation and non-HRR mutation groups and compared for their clinical and genomic characteristics including tumor mutational burden (TMB) and microsatellite instability-high (MSI-H) were compared. Treatment efficacy and overall survival (OS) were assessed based on HRR gene mutation status and primary tumor site (duodenal adenocarcinoma [DA] vs. small intestinal carcinoma [SIC]).</div></div><div><h3>Results</h3><div>Patients with the HRR mutations had higher frequencies of TMB and MSI-H than those without the mutation (<em>P</em> &lt; 0.0001). In DA, HRR gene mutation positivity was associated with improved OS and higher overall response rates (ORR) to platinum-based chemotherapy (OS: not reached vs. 23.5 months, <em>P</em> = 0.040; ORR: 33 % vs. 19 %, <em>P</em> = 0.046), whereas no significant associations were observed with SIC.</div></div><div><h3>Conclusion</h3><div>HRR gene mutation may be a potential biomarker for platinum-based chemotherapy efficacy in SBA, especially in DA, highlighting the need for site-specific therapies.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"220 ","pages":"Article 115401"},"PeriodicalIF":7.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of assessment-to-treatment interval and metastatic biopsy site on the predictive value of PD-L1 expression at the 1 % cut-off level in melanoma","authors":"Cecilie D. Vestergaard ,&nbsp;Marco Donia ,&nbsp;Kasper Madsen ,&nbsp;Henrik Schmidt ,&nbsp;Adam A. Luczak ,&nbsp;Lars Bastholt ,&nbsp;Eva Ellebaek ,&nbsp;Inge M. Svane","doi":"10.1016/j.ejca.2025.115402","DOIUrl":"10.1016/j.ejca.2025.115402","url":null,"abstract":"<div><h3>Background</h3><div>Intratumoral PD-L1 expression at the 1 % cut-off predicts clinical outcomes and may guide first-line immune checkpoint inhibitor (ICI) selection for metastatic melanoma (MM). However, the impact of the interval between PD-L1 assessment and ICI initiation and the metastatic site used for PD-L1 evaluation, remains unclear.</div></div><div><h3>Methods</h3><div>In this nationwide cohort study we used the Danish Metastatic Melanoma Database (DAMMED) and the Danish Pathology Registry to analyze patients with MM treated with anti-PD-1 or anti-PD-1 plus anti-CTLA-4 from January 2017 to February 2024. Progression-free survival (PFS) and overall survival (OS) were analyzed using Log-rank tests and Cox regression.</div></div><div><h3>Results</h3><div>Data from 1137 patients were analyzed. Among patients with PD-L1 assessed within 90 days of treatment (n = 964; 55.2 % PD-L1 &lt;1 %, 44.8 % PD-L1 ≥1 %), combination therapy improved outcomes in PD-L1 &lt; 1 % (PFS adjusted (a)HR 0.62; 95 % CI 0.48–0.80; p &lt; 0.001, OS aHR 0.64; 95 % CI 0.48–0.85; p = 0.002), while outcomes were comparable for PD-L1 ≥ 1 % patients (PFS aHR 0.90; 95 % CI 0.62–1.30; p = 0.57, OS aHR 0.97; 95 % CI 0.60–1.57; p = 0.89). For PD-L1 assessed &gt; 90 days prior (n = 173), this pattern was less pronounced. Among 48 paired PD-L1 assessments from the same organ, discordance occurred in 25 %. Combination therapy improved PFS for patients with PD-L1 &lt; 1 % skin/subcutaneous (aHR 0.51; 95 % CI 0.34–0.76; p &lt; 0.001) and visceral metastases (aHR 0.65; 95 % CI 0.42–1.02; p = 0.060) while this association was not evident for lymph node metastases (aHR 0.79; 95 % CI 0.48–1.29; p = 0.35).</div></div><div><h3>Conclusions</h3><div>PD-L1 seems a reliable predictive biomarker in MM, when assessed on tissue obtained within 90 days prior to ICI initiation. Non-nodal metastatic sites appear preferable.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"221 ","pages":"Article 115402"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering the surgical approach in cutaneous melanoma: does wide local excision after a complete diagnostic excision reduce the risk of recurrence?","authors":"Iza Stekelenburg ,&nbsp;Annelien E. Laeijendecker ,&nbsp;Ruth C. van Doorn ,&nbsp;Annemiek Doeksen ,&nbsp;Willeke A.M. Blokx ,&nbsp;Yvonne M. Schrage ,&nbsp;Alexander C.J. van Akkooi ,&nbsp;Richard A. Scolyer ,&nbsp;Emily L. Postma ,&nbsp;Mary Ann El Sharouni","doi":"10.1016/j.ejca.2025.115366","DOIUrl":"10.1016/j.ejca.2025.115366","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines whether wide local excision (WLE) after complete diagnostic excision improves recurrence-free survival (RFS) in clinical stage I/II primary cutaneous melanoma.</div></div><div><h3>Background</h3><div>Since the 1950s, melanoma treatment has included a two-step surgical approach, involving diagnostic excision followed by WLE. WLE aims to achieve locoregional disease control by eliminating potential microsatellites and, thus, minimising the risk of locoregional recurrence and melanoma-related death. However, its impact on RFS is unclear, while it adds morbidity and costs.</div></div><div><h3>Methods</h3><div>This retrospective nationwide cohort study analysed pathology reports of a Dutch population-based cohort of newly diagnosed invasive cutaneous melanoma patients who underwent a complete diagnostic excision between January 1st, 2012, and December 31st, 2013. Data were obtained from the Dutch Nationwide Pathology Database (PALGA). Patients with completely excised superficial spreading and nodular melanoma located on the trunk and upper and lower extremities were included. Cox regression showed no significant RFS benefit from WLE.</div></div><div><h3>Results</h3><div>A total of 6189 eligible patients were included. WLE was not performed in 271 patients (4.4 %). Of those undergoing WLE (n = 5918), residual dermal invasive tumour cells were identified in 0.7 % (n = 44/5918). The overall recurrence rate was 7.7 % (n = 477/6189). Recurrence rates were 7.6 % for WLE cases (local: 2.5 %, nodal: 4.0 %, distant: 1.2 %) and 10.3 % when WLE was omitted. Cox regression showed no significant RFS benefit from WLE.</div></div><div><h3>Conclusion</h3><div>WLE does not significantly improve RFS in patients with completely excised cutaneous superficial spreading and nodular melanoma on the trunk or extremities.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"220 ","pages":"Article 115366"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global disparities in artificial intelligence-based mammogram interpretation for breast cancer: A scientometric analysis of representation, trends, and equity","authors":"Isabele A. Miyawaki ,&nbsp;Imon Banerjee ,&nbsp;Felipe Batalini ,&nbsp;Carlos A. Campello Jorge ,&nbsp;Leo A. Celi ,&nbsp;Marisa Cobanaj ,&nbsp;Edward C. Dee ,&nbsp;Judy W. Gichoya ,&nbsp;Zaphanlene Kaffey ,&nbsp;Maxwell R. Lloyd ,&nbsp;Lucas McCullum ,&nbsp;Sruthi Ranganathan ,&nbsp;Chiara Corti","doi":"10.1016/j.ejca.2025.115394","DOIUrl":"10.1016/j.ejca.2025.115394","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer (BC) is the most frequently diagnosed cancer and the leading cause of cancer death among women worldwide. Artificial intelligence (AI) shows promise for improving mammogram interpretation, especially in resource-limited settings. However, concerns remain regarding the diversity of datasets and the representation of researchers in AI model development, which may affect the models’ generalizability, fairness, and equity.</div></div><div><h3>Methods</h3><div>We performed a scientometric analysis of studies published in 2017, 2018, 2022, and 2023 that used screening or diagnostic mammograms for BC detection to train or validate AI algorithms. PubMed (MEDLINE) and EMBASE were searched in July 2024. Data extraction focused on patient cohort sociodemographics (including age and race/ethnicity), geographic distribution (categorized by World Bank country income levels and regions), and author profiles (sex, affiliation, and funding sources).</div></div><div><h3>Results</h3><div>Of 5774 studies identified, 264 met the inclusion criteria. The number of studies increased from 28 in 2017-2018 to 115 in 2022-2023 - a 311% increase. Despite this growth, only 0–25 % of studies reported race/ethnicity, with most patients identified as Caucasian. Moreover, nearly all patient cohorts originated from high-income countries, with no studies from low-income settings. Author affiliations were predominantly from high-income regions, and gender imbalance was observed among first and last authors.</div></div><div><h3>Conclusion</h3><div>The lack of racial, ethnic, and geographic diversity in both datasets and researcher representation could undermine the generalizability and fairness of AI-based mammogram interpretation. Addressing these disparities through diverse dataset collection and inclusive international collaborations is critical to ensuring equitable improvements in breast cancer care.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"220 ","pages":"Article 115394"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical evaluation of sentinel lymph node biopsy in pT1b and pT2a melanoma patients: A nationwide population-based study","authors":"Robert C. Stassen ,&nbsp;Antonius W. Schurink ,&nbsp;Astrid A.M. van der Veldt ,&nbsp;Loes M. Hollestein ,&nbsp;Cornelis Verhoef ,&nbsp;Dirk J. Grünhagen","doi":"10.1016/j.ejca.2025.115365","DOIUrl":"10.1016/j.ejca.2025.115365","url":null,"abstract":"<div><h3>Introduction</h3><div>Sentinel lymph node biopsy (SLNB) aims to stage patients. According to the 8th edition of the American Joint Committee on Cancer(AJCC) staging manual, patients with pT1b or pT2a melanoma can be eligible for adjuvant immunotherapy, however, only if they have a sentinel node (SN) tumour burden &gt; 1 mm. This study aims to determine the percentage of patients with pT1b or pT2a that will become eligible for adjuvant immunotherapy following SLNB.</div></div><div><h3>Methods</h3><div>A nationwide, population-based study was conducted using data from the Dutch Pathology Databank. Patients diagnosed with pT1b and pT2a melanoma between 2002 and 2023 were included. The primary endpoint was the number of SNs with a tumour burden &gt; 1 mm.</div></div><div><h3>Results</h3><div>We identified 36,606 patients of who 16,042 underwent SLNB. SN positivity was 5 % for patients with pT1b melanoma, and 11 % for pT2a melanoma. A tumour burden &gt; 1 mm was found in 1.5 % and 4.1 %, translating to a number needed to treat (NNT) of 69 for pT1b and 25 for pT2a.</div></div><div><h3>Conclusion</h3><div>This nationwide study demonstrated a low incidence of positive SNs and minimal likelihood of significant clinical outcomes following SLNB. Given the high NNT to be eligible for adjuvant immunotherapy, SLNB may no longer be justified for pT1b melanoma. For patients with pT2a melanoma, SLNB should be considered carefully, balancing limited clinical benefits against potential risks.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"220 ","pages":"Article 115365"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}