Frontiers in Oncology最新文献

{"title":"Predictive factors of incidental prostate cancer in patients undergoing surgery for presumed benign prostatic hyperplasia: an updated systematic review and meta-analysis.","authors":"Yang Wang, Xiancheng Li, Hua Yang, Chaoshan Yin, Yameng Wu, Xiaoke Chen","doi":"10.3389/fonc.2025.1561675","DOIUrl":"10.3389/fonc.2025.1561675","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to identify the clinical predictors of incidental prostate cancer (IPCa) after surgery for presumed benign prostatic hyperplasia (BPH).</p><p><strong>Methods: </strong>The literature was comprehensively searched using PubMed, Web of Science, Embase, and Cochrane databases in December 2024. We used pooled standardized mean difference (SMD) and odds ratio (OR) to describe the correlation between relevant risk factors and IPCa.</p><p><strong>Results: </strong>Twenty-one studies included 10,842 patients that were available for further analysis. After BPH surgery, 957 patients were histopathologically diagnosed with IPCa. The IPCa rate was 8.83%. Most importantly, our results identified that IPCa was significantly associated with age (pooled SMD = 0.36, <i>P</i> < 0.001), body mass index (BMI) (pooled SMD = 0.23, <i>P</i> < 0.001), preoperative prostate-specific antigen (pre-PSA) (pooled SMD = 0.43, <i>P</i> < 0.001), preoperative prostate-specific antigen density (pre-PSAD) (pooled SMD = 0.62, <i>P</i> = 0.028), resected prostate weight (pooled SMD = -0.22, <i>P</i> < 0.001), preoperative treatment with 5-alpha reductase inhibitors (5αRIs) (yes/no) (pooled OR = 0.60, <i>P</i> < 0.001), family history (yes/no) (pooled OR = 3.81, <i>P</i> = 0.029), digital rectal examination (DRE) findings (abnormal/normal) (pooled OR = 5.15, <i>P</i> < 0.001), and transrectal ultrasonography (TRUS) findings (abnormal/normal) (pooled OR = 2.92, <i>P</i> < 0.001). Additionally, sensitivity and subgroup analyses indicated that our findings were reliable and robust. However, we found no significant associations between IPCa and prostate volume, preoperative negative prostate biopsy, smoking history, history of hypertension, history of diabetes, history of dyslipidemia, and abnormal magnetic resonance imaging findings (all <i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Age, BMI, pre-PSA, pre-PSAD, resected prostate weight, preoperative treatment with 5αRIs, family history, abnormal DRE findings, and abnormal TRUS findings are independent factors predicting IPCa following BPH surgery. Before BPH surgery, factors such as age, BMI, pre-PSA, and pre-PSAD should be considered to assess the risk of IPCa. For high-risk patients, more detailed imaging and needle biopsy are recommended before surgery to avoid missed diagnosis. In the future, more large-scale and well-designed studies are needed to validate our results further.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD42025631346.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1561675"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of radiosensitive subpopulations <i>ex-vivo</i> with Raman microspectroscopy.","authors":"Aidan D Meade, Adrian Maguire, Jane Bryant, Daniel Cullen, Dinesh Medipally, Lisa White, John Armstrong, Mary Dunne, Emma Noone, Shirley Bradshaw, Marie Finn, Aoife M Shannon, Orla L Howe, Fiona M Lyng","doi":"10.3389/fonc.2025.1470431","DOIUrl":"10.3389/fonc.2025.1470431","url":null,"abstract":"<p><p>Although significant advances in understanding the molecular drivers of acquired and inherited radiosensitivity have occurred in recent decades, a single analytical method which can detect and classify radiosensitivity remains elusive. Raman microspectroscopy has demonstrated capabilities in the objective classification of various diseases, and more recently in the detection and modelling of radiobiological effect. In this study, Raman spectroscopy is presented as a potential tool for the detection of radiosensitivity subpopulations represented by four lymphoblastoid cell lines derived from individuals with ataxia telangiectasia (2 lines), non-Hodgkins lymphoma, and Turner's syndrome. These are classified with respect to a population with mixed radiosensitivity, represented by lymphocytes drawn from both healthy controls, and prostate cancer patients. Raman spectroscopic measurements were made <i>ex-vivo</i> after exposure to X-ray doses of 0 Gy, 50 mGy and 500 mGy, in parallel to radiation-induced G2 chromosomal radiosensitivity scores, for all samples. Support vector machine models developed on the basis of the spectral data were capable of discrimination of radiosensitive populations before and after irradiation, with superior discrimination when spectra were subjected to a non-linear dimensionality reduction (UMAP) as opposed to a linear (PCA) approach. Models developed on spectral data acquired on samples irradiated <i>in-vitro</i> with a dose of 0Gy were found to provide the highest level of performance in discriminating between classes, with performances of F1 = 0.92 ± 0.06 achieved on a held-out test set. Overall, this study suggests that Raman spectroscopy may have potential as a tool for the detection of intrinsic radiosensitivity using liquid biopsies.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1470431"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypofractionated stereotactic radiotherapy using coplanar VMAT for single small brain metastasis: dosimetric analysis and clinical outcomes.","authors":"Jialu Lai, An Li, Xianhu Zeng, Jia Liu, Lin Zhou","doi":"10.3389/fonc.2025.1428922","DOIUrl":"10.3389/fonc.2025.1428922","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the dosimetric parameters and clinical outcomes of hypofractionated stereotactic radiotherapy (HSRT) for small brain metastases [BMs; planning target volume (PTV) ≤ 4 cm³) via coplanar volumetric modulated arc therapy (C-VMAT).</p><p><strong>Methods: </strong>Between March 2019 and February 2023, 68 patients with a single BM treated with Linac-based HSRT (24-39 Gy in three fractions) via C-VMAT and a 3-mm PTV margin were enrolled in this retrospective analysis. A frameless head-neck-shoulder thermoplastic mask, whose immobilization accuracy is inferior to that of specialized mask fixation systems, was used to immobilize patients. Dosimetric parameters and clinical outcomes were evaluated.</p><p><strong>Results: </strong>C-VMAT provided clinically satisfactory treatment plans, with median gradient index, conformity index, homogeneity index, and PTV coverage values of 4.30, 1.05, 1.28, and 98%, respectively. The median volumes of normal brain tissue receiving 18 Gy, 21 Gy, and 23 Gy were 7.29 cm³, 5.33 cm³, and 4.40 cm³, respectively. High delivery accuracy was observed, with a gamma passing rate ≥90% for all plans. As of June 2023, the median follow-up time was 9.1 months. The intracranial objective response rate and disease control rate were 64% and 96%, respectively. The median intracranial progression-free survival was 26.9 (95% CI, 12.7-41.1) months. The 1- and 2-year local control (LC) rates were 91.5% (95% CI, 80.1%-100%) and 83.2% (95% CI, 64.6%-100%), respectively. The 1- and 2-year intracranial control rates were 70.9% (95% CI, 55.2%-86.6%) and 51.2% (95% CI, 32.6%-69.8%), respectively. Only four irradiated lesions progressed at the end of follow-up. The cerebral radiation necrosis rate of all patients was 7.4%.</p><p><strong>Conclusion: </strong>C-VMAT HSRT combined with a 3-mm PTV margin is an effective and safe treatment modality for small BMs.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1428922"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis: a study of the microenvironment in cervical cancer (2000-2024).","authors":"Yun-Tao Zhang, Yan-Ni Wei, Chen-Chen Liu, Mai-Qing Yang","doi":"10.3389/fonc.2025.1508173","DOIUrl":"10.3389/fonc.2025.1508173","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of cervical cancer has increased in recent years. The tumor microenvironment (TME) is the local biological environment involved in tumor occurrence and development. This study aimed to conduct a comprehensive analysis of the global research on the TME in cervical cancer (CC), providing a knowledge framework in this field from a holistic and systematic perspective based on a bibliometric analysis.</p><p><strong>Methods: </strong>Studies focusing on the TME in cervical cancer were searched using the Web of Science Core Collection database. The annual output, cooperation, hotspots, research status, and development trends in this field were analyzed using bibliometric softwares (VOSviewer and CiteSpace).</p><p><strong>Results: </strong>A total of 1,057 articles published between 2000 and 2024 were selected. The number of publications and citations has recently increased. Cooperation network analysis indicated that China holds the foremost position in research on the TME in cervical cancer with the highest volume of publications, thus exerting the greatest influence. Fudan University had the highest output. Frontiers in Oncology showed the highest degree of productivity in this field. Rofstad, Einar K. made the most article contributions and was the most co-cited author. Four clusters were obtained after a cluster analysis of the keywords: TME, cervical cancer, immunotherapy, and prognosis. Immunotherapy, human papillomavirus, and biomarkers were relatively recent keywords that attracted increasing attention from researchers.</p><p><strong>Discussion: </strong>This bibliometric analysis provides a data-based and objective introduction to the TME of cervical cancer, and offers readers a valuable reference for future research.</p><p><strong>Conclusions: </strong>Comprehensive research in this field was mainly distributed in the TME of cervical cancer through the analysis of keywords and documents. Sufficient evidence supports mechanism research and application exploration. Further research should explore new topics related to the TME of cervical cancer.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1508173"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint Inhibitor related myocarditis reported through the FDA adverse event reporting system: pharmacovigilance trends in reporting and outcomes.","authors":"David J Reeves, Kevin Leffers, Vijay U Rao","doi":"10.3389/fonc.2025.1498817","DOIUrl":"10.3389/fonc.2025.1498817","url":null,"abstract":"<p><strong>Introduction: </strong>As the use of immune checkpoint inhibitors (ICIs) continues to expand, it is important to be mindful of rare but serious side effects such as myocarditis. Multiple analyses of adverse effect databases have demonstrated an association between ICIs and myocarditis; however, given the rapid implementation of therapeutic use, introduction of multiple new ICIs, and expanding indications, it is unclear if trends are evolving in reporting and outcomes.</p><p><strong>Methods: </strong>We analyzed the FDA Adverse Event Reporting System to investigate the association between ICIs and myocarditis and trends in myocarditis outcomes among reports submitted between 2012 and the first quarter of 2023.</p><p><strong>Results: </strong>After removal of duplicate cases, 1,326 myocarditis cases were reported to the database in patients receiving ICIs. Of these, the majority of reported cases were in males (62%) and the median age was 69 years. Consistent with the increase in utilization, the number of cases reported per year increased with each passing year. The reporting odds ratio (ROR) for all ICI drugs included in the analysis was 30.1 (95% confidence interval: 28.4-32.0). RORs for the individual drugs ranged from 12.3 for durvalumab to 168.5 for nivolumab/ relatlimab. The overall fatality rate of all cases was 37%. A significant difference in fatality rate among reported cases was present when comparing outcomes in 2018 and 2022 (45% vs 33%, respectively, p=0.017).</p><p><strong>Discussion: </strong>Myocarditis continues to be associated with immune checkpoint inhibitors, with the number of reported cases increasing consistent with increasing utilization; however, the outcomes may be improving with less cases being reported as fatal.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1498817"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in diagnosing and managing sarcomatoid urothelial carcinoma of the renal pelvis: a case report.","authors":"Jian Lei, Wei Zhao, Tao He, Hui Huang, Huayong Jian, Mei Zhang, Xike Luo, Xiaochuan Gong, Yan Wang","doi":"10.3389/fonc.2025.1480790","DOIUrl":"10.3389/fonc.2025.1480790","url":null,"abstract":"<p><p>Sarcomatoid urothelial carcinoma of the renal pelvis is an extremely rare malignant tumor with a high risk of recurrence and metastasis and a poor prognosis. This case reports a 61-year-old male patient with renal pelvic sarcomatoid urothelial carcinoma who developed extensive lymph node metastasis 26 days after posterior laparoscopic radical nephrectomy for renal carcinoma, and the patient died on the 45th postoperative day, with the cause of death being advanced malignancy of the tumor. This case highlights the rapid progression of sarcomatoid urothelial carcinoma, and sarcomatoid variants should be identified as early as possible, with active multidisciplinary adjuvant therapy and closer follow-up when feasible. Retrospective analysis of this patient's treatment regimen and admission provides lessons for recognizing and aggressively managing this rare and fatal variant of urothelial carcinoma.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1480790"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"lncRNA HIF1A-AS2 acts as an oncogene to regulate malignant phenotypes in cervical cancer.","authors":"Yang Liu, Yunyan Zhang, Cha Chen, Bhaskar Roy, Qun Li, Wei Zhang, Xuan Zhang, Jieying Pu, Yuguang Li, Yanli Liu, Huanlan Liao, Jingjing Wang, Rui Zhou, Huiyan Zhuo, Youqiang Li","doi":"10.3389/fonc.2025.1530677","DOIUrl":"10.3389/fonc.2025.1530677","url":null,"abstract":"<p><strong>Background: </strong>Long noncoding RNAs (lncRNAs) HIF1A-AS2 is upregulated in multiple human cancers and are associated with various aspects of tumor progression. However, the molecular mechanisms of HIF1A-AS2 in cervical cancer (CC) remain largely unknown. In this study, we aim to investigate the expression pattern and signaling pathways of HIF1A-AS2 in CC.</p><p><strong>Methods: </strong>The study included a group of 20 CC patients, from whom tumor tissue specimens were collected. Additionally, three distinct CC cell lines (HeLa, SiHa, CaSki) were utilized. Quantitative real-time PCR (qRT-PCR) was used to assess the transcript levels of HIF1A-AS2 in these samples. Functional studies were performed by CCK-8, Transwell and Apoptosis assays. Databases including JASPAR, miRDB and Targetscan were used for the transcription factor or target miRNA prediction, subsequent dual luciferase activity assay, chromatin immunoprecipitation (ChIP) and Ago2 immunoprecipitation (RIP) were also adopted for validation.</p><p><strong>Results: </strong>The study demonstrated that HIF1A-AS2 expression was elevated in clinical cervical cancer specimens and cultured cell lines in comparison to normal controls. Knockdown of HIF1A-AS2 notably inhibited the proliferation and invasion of cervical cancer cells, while inducing apoptosis. In contrast, HIF1A-AS2 overexpression promoted cellular proliferation and invasion and suppressed apoptosis. It was also identified that c-Jun functions as a transcription factor, activating HIF1A-AS2 expression. Additionally, HIF1A-AS2 was found to serve as a molecular sponge for miR-34b-5p, negatively regulating its expression. Furthermore, HIF1A-AS2 controlled the expression of radixin (RDX) by sponging the miR-34b-5p pathway.</p><p><strong>Conclusion: </strong>Our findings indicate that c-Jun-activated HIF1A-AS2 acts as an oncogenic factor in CC by sponging miR-34b-5p to target radixin. These findings suggest that HIF1A-AS2 might be a viable and promising therapeutic target for cervical cancer treatment.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1530677"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep cervical stromal invasion predicts poor prognosis in patients with stage II endometrioid endometrial cancer: a two-centered retrospective study.","authors":"Wenyu Shao, Yu Xue, Zhiying Xu, Jun Guan, Huaying Wang, Xiaojun Chen, Yulan Ren","doi":"10.3389/fonc.2025.1450054","DOIUrl":"10.3389/fonc.2025.1450054","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of depth of cervical stromal invasion (CSI) on the prognosis of International Federation of Gynecology and Obstetrics (FIGO) stage II endometrioid endometrial cancer (EEC).</p><p><strong>Methods: </strong>Patients with FIGO stage II EEC confirmed by postoperative histopathology and consecutively admitted to the Obstetrics and Gynecology Hospital of Fudan University and Fudan University Shanghai Cancer Center between 2008 and 2017 were included in this study and reviewed retrospectively.</p><p><strong>Results: </strong>Two hundred and ninety-seven patients were included in this study. There were 253 (253/297, 85.2%)patients with superficial (<50%) and 44 (44/297, 14.8%) cases with deep (≥50%) CSI. The median follow-up time was 75.0 months (range: 5-175 months). Patients in the ≥50% CSI group had a poorer prognosis compared to the <50% CSI group (recurrence-free survival [RFS]: adjusted hazard ratio [aHR] = 6.077, 95% Confidence Interval [CI]: 2.275-16.236, disease-specific survival [DSS]: aHR = 7.259, 95% CI: 2.546-20.695). Deep CSI was an independent predictor of local recurrence (aHR=5.537, 95% CI: 1.804-16.991). Post operative external beam radiation therapy (EBRT) was correlated with a reduced risk of recurrence (aHR = 0.288, 95% CI: 0.097-0.859).</p><p><strong>Conclusion: </strong>Deep CSI is a poor prognostic factor for RFS and DSS in patients with FIGO stage II EEC. Postoperative EBRT can improve both RFS and DSS. Those findings imply that a detailed pathological report on the depth of CSI would be helpful in better understanding its impact on prognosis and selecting an appropriate postoperative treatment for the patient.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1450054"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary testicular metastasis post-prostatectomy for prostatic ductal adenocarcinoma: case report and literature review.","authors":"Bo Chang, Manqing Zhang, Yifan Hou, Wenbin Li, Song Li, Jianhua Zhang, Chenyang Wang, Qiangqiang Zhang, Junqing Hou","doi":"10.3389/fonc.2025.1464446","DOIUrl":"10.3389/fonc.2025.1464446","url":null,"abstract":"<p><strong>Background and purpose: </strong>Prostatic ductal adenocarcinoma (PDA) constitutes a rare and notably aggressive histological subtype within the spectrum of prostate malignancies, distinguished by a heightened propensity for recurrence and metastasis compared to prostatic acinar adenocarcinoma (PAA). Testicular metastasis in PDA is exceptionally rare. Despite sporadic reports in the literature, a consensus regarding the optimal therapeutic approach remains elusive. This study retrospectively analyzes a singular case of PDA manifesting with solitary testicular metastasis after laparoscopic radical prostatectomy (LRP), consolidating insights into clinical, histopathological, molecular, and therapeutic aspects, alongside existing scholarly discourse.</p><p><strong>Methods: </strong>We present the case of a 63-year-old gentleman diagnosed with pure PDA (pT3aN0, Gleason score 4 + 4 = 8), exhibiting a serum prostate-specific antigen (PSA) level exceeding 100 ng/ml. Subsequently, the patient underwent androgen deprivation therapy (ADT) followed by LRP. Subsequently, at 17 months post-LRP, local recurrence and a right testicular mass emerged, prompting pelvic radiotherapy and docetaxel chemotherapy. Ultimately, the patient underwent right orchiectomy 65 months post-LRP, with pathological findings confirming metastatic PDA. Four months post-orchiectomy, PSA levels declined to 1.77 ng/ml. Additionally, a comprehensive review of published literature concerning PDA complicated by testicular metastasis was conducted.</p><p><strong>Results: </strong>The patient derived therapeutic benefits from ADT, LRP, radiation therapy, and orchiectomy, resulting in objective symptom alleviation and a reduction in PSA. Nevertheless, docetaxel proved inefficacious. The literature review indicated variability in outcomes across diverse treatment modalities.</p><p><strong>Conclusions: </strong>Prolonged surveillance is imperative for patients diagnosed with PDA. Urologists must remain vigilant regarding uncommon sites of metastasis, particularly in instances of elevated PSA.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1464446"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable AI in medical imaging: an interpretable and collaborative federated learning model for brain tumor classification.","authors":"Qurat-Ul-Ain Mastoi, Shahid Latif, Sarfraz Brohi, Jawad Ahmad, Abdulmajeed Alqhatani, Mohammed S Alshehri, Alanoud Al Mazroa, Rahmat Ullah","doi":"10.3389/fonc.2025.1535478","DOIUrl":"10.3389/fonc.2025.1535478","url":null,"abstract":"<p><strong>Introduction: </strong>A brain tumor is a collection of abnormal cells in the brain that can become life-threatening due to its ability to spread. Therefore, a prompt and meticulous classification of the brain tumor is an essential element in healthcare care. Magnetic Resonance Imaging (MRI) is the central resource for producing high-quality images of soft tissue and is considered the principal technology for diagnosing brain tumors. Recently, computer vision techniques such as deep learning (DL) have played an important role in the classification of brain tumors, most of which use traditional centralized classification models, which face significant challenges due to the insufficient availability of diverse and representative datasets and exacerbate the difficulties in obtaining a transparent model. This study proposes a collaborative federated learning model (CFLM) with explainable artificial intelligence (XAI) to mitigate existing problems using state-of-the-art methods.</p><p><strong>Methods: </strong>The proposed method addresses four class classification problems to identify glioma, meningioma, no tumor, and pituitary tumors. We have integrated GoogLeNet with a federated learning (FL) framework to facilitate collaborative learning on multiple devices to maintain the privacy of sensitive information locally. Moreover, this study also focuses on the interpretability to make the model transparent using Gradient-weighted class activation mapping (Grad-CAM) and saliency map visualizations.</p><p><strong>Results: </strong>In total, 10 clients were selected for the proposed model with 50 communication rounds, each with decentralized local datasets for training. The proposed approach achieves 94% classification accuracy. Moreover, we incorporate Grad-CAM with heat maps and saliency maps to offer interpretability and meaningful graphical interpretations for healthcare specialists.</p><p><strong>Conclusion: </strong>This study outlines an efficient and interpretable model for brain tumor classification by introducing an integrated technique using FL with GoogLeNet architecture. The proposed framework has great potential to improve brain tumor classification to make them more reliable and transparent for clinical use.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1535478"},"PeriodicalIF":3.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}