International Journal of Clinical Oncology最新文献

{"title":"Physical activity and cancer biology: a narrative review of molecular mechanisms and introduction of the SCRUM-MONSTAR LIFELOG study.","authors":"Shugo Yajima, Shin Kobayashi, Tadayoshi Hashimoto, Yoshiaki Nakamura, Riu Yamashita, Toshihiro Misumi, Yasutoshi Sakamoto, Satoshi Horasawa, Takao Fujisawa, Mitsuho Imai, Taro Shibuki, Yuichiro Tsukada, Hideaki Bando, Hitoshi Masuda, Takayuki Yoshino","doi":"10.1007/s10147-025-02798-y","DOIUrl":"10.1007/s10147-025-02798-y","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) has been consistently associated with improved cancer outcomes across multiple epidemiological studies. While the evidence for clinical benefits is strong, the underlying molecular mechanisms remain poorly understood. Recent technological advances now enable both continuous monitoring of PA through wearable devices and comprehensive molecular profiling through multi-omics approaches, including whole-genome sequencing (WGS)-based molecular residual disease (MRD) detection. This review examines current evidence regarding PA's effects on cancer biology and introduces the LIFELOG study, which aims to address critical knowledge gaps in this field.</p><p><strong>Methods: </strong>We review the current literature on PA and cancer with emphasis on molecular mechanisms, and present the design of the LIFELOG study, an ancillary study to MONSTAR-SCREEN-3. The LIFELOG study will enroll 170 post-surgical cancer patients who will wear the mSafety™ wrist device for continuous PA monitoring. We will investigate associations between PA metrics and multi-omics profiles including WGS-based MRD detection, transcriptome analyses, plasma proteomics, and gut microbiome analyses. The feasibility phase has already begun with encouraging preliminary results regarding device compliance and data quality.</p><p><strong>Discussion: </strong>Despite substantial evidence supporting PA's benefits in cancer prevention and survivorship, understanding which specific PA characteristics most effectively influence cancer outcomes remains unclear. The LIFELOG study represents the first comprehensive analysis integrating continuous PA monitoring with molecular profiling in cancer patients. By examining relationships between PA patterns and both MRD dynamics and multi-omics profiles, we aim to identify molecular mechanisms underlying exercise benefits and potentially guide development of evidence-based, precision PA interventions for cancer survivorship.</p><p><strong>Trial registration: </strong>This ancillary study (Institutional Review Board number: 2024-111, approved on November 18, 2024) is conducted under the MONSTAR-SCREEN-3 trial platform, which is registered in the UMIN Clinical Trials Registry (UMIN000053975, registered on March 27, 2024).</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1439-1447"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266166","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":"Palliative radiotherapy for bone metastases: conventional external beam radiotherapy.","authors":"Yuichi Kibe, Naoki Nakamura","doi":"10.1007/s10147-025-02795-1","DOIUrl":"10.1007/s10147-025-02795-1","url":null,"abstract":"<p><p>Conventional external beam radiotherapy (cEBRT) is effective for managing symptomatic bone metastases and continues to be in demand despite advances in stereotactic body radiotherapy. This review provides an overview of cEBRT for bone metastases, with a focus on the following: (1) Initial palliative radiotherapy: randomized controlled trials and meta-analyses have shown that single-fraction cEBRT at 8 Gy is as effective as multifractionated cEBRT for reducing pain due to bone metastases. Single-fraction cEBRT at 8 Gy may be a reasonable option for bone metastases with neuropathic pain in consideration of the burden on patients. The efficacy of radiotherapy for preventing skeletal-related events in bone metastases remains unclear. Prophylactic fixation followed by radiotherapy is recommended for long-bone metastases at high risk of fracture. (2) Palliative reirradiation: reirradiation is indicated for patients with insufficient pain relief or pain progression after initial radiotherapy for bone metastases. In palliative reirradiation for spinal metastases, the tolerance dose of the spinal cord needs to be carefully considered due to the risk of radiation myelitis. (3) Treatment strategies for metastatic spinal cord compression (MSCC) or spinal bone metastases with instability: treatment decisions for MSCC, including radiotherapy or decompression surgery followed by radiotherapy, need to be carefully considered by a multidisciplinary team, including radiation oncologists and orthopedic surgeons. Moderate-dose corticosteroids (dexamethasone bolus of 10-16 mg) are recommended in combination with radiotherapy for MSCC. Spinal instability caused by spinal bone metastases is an indication for fixation surgery, and postoperative radiotherapy needs to be considered.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1484-1491"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for early mortality among patients with gastrointestinal malignancy in the C-CAT database.","authors":"Rei Suzuki, Hiroshi Shimizu, Kentaro Sato, Hiroyuki Asama, Rei Ohira, Mitsuru Sugimoto, Rika Saito, Maiko Okano, Reiko Kimura-Tsuchiya, Motonobu Satio, Shigehira Saji, Tadayuki Takagi, Hiromasa Ohira","doi":"10.1007/s10147-025-02802-5","DOIUrl":"10.1007/s10147-025-02802-5","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive genomic profiling (CGP) is essential for precision medicine, but early mortality remains a concern for patients undergoing CGP. This study aimed to identify risk factors for early mortality and develop a prediction model for gastrointestinal (GI) malignancies on the basis of data from the Japanese C-CAT database.</p><p><strong>Methods: </strong>Data from 18,657 patients with pancreatic, biliary, colorectal, and upper GI cancers were collected from the C-CAT database and retrospectively analyzed. Early mortality was defined as mortality within 90 days after CGP submission. A prediction model was constructed via weighted scoring of clinical factors, and the model was subsequently validated. Survival analysis was conducted to assess the utility of this model for prognostic stratification.</p><p><strong>Results: </strong>The early mortality rate was 14.2%. Independent predictors of early mortality included cancer type (pancreatic/biliary), Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥2, metastases, disease progression, and male sex. The prediction model stratified patients into low- (6.1%), intermediate- (17.6%), high-risk (39.2%), and very high-risk (75.6%) groups with a moderate level of discrimination (C statistic: 0.70-0.73). Survival analysis revealed that the median survival times after CGP submission for each group were 384.0 days, 199.0 days, 114.0 days, and 48.0 days, respectively. We developed a web-based application for the prediction of early mortality via the link: https://mortality-within-90days-cgp.shinyapps.io/mortality_treatment_20250130/ .</p><p><strong>Conclusions: </strong>The prediction model effectively stratified patients on the basis of the risk of early mortality, thus supporting better patient selection and CGP timing.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1593-1601"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current advances and challenges in minimally invasive esophagectomy.","authors":"Eisuke Booka, Hiroya Takeuchi","doi":"10.1007/s10147-025-02806-1","DOIUrl":"10.1007/s10147-025-02806-1","url":null,"abstract":"<p><p>Advances in endoscopic equipment and thoracoscopic surgery have contributed to the increasing adoption of minimally invasive esophagectomy (MIE). Compared with open esophagectomy (OE), MIE is associated with longer operative times and offers many advantages, such as reduced blood loss and a lower incidence of pulmonary complications, including pneumonia. Two patient positions are commonly used for thoracoscopic esophagectomy (TE): left lateral decubitus position and prone position. MIE has demonstrated significant benefits in reducing postoperative respiratory complications. However, the optimal MIE technique, surgical approach, and patient positioning remain controversial. Recently, robot-assisted thoracoscopic and/or laparoscopic esophagectomy using the da Vinci Surgical System and other emerging robotic platforms has gained attention as an attractive surgical option. In addition, nonthoracic radical esophagectomy, performed via transcervical or transhiatal approaches using mediastinoscopic devices, has been developed as an alternative approach. Despite these technological advances, there is a lack of definitive scientific evidence establishing MIE as a superior alternative to OE. However, a recent randomized phase III trial (JCOG1409) confirmed the noninferiority of TE compared with OE in terms of overall survival of patients with thoracic esophageal cancer. Furthermore, MIE-including robotic-assisted and mediastinoscopic approaches-has been associated with lower pulmonary complication rates while maintaining comparable oncological outcomes. These findings support the adoption of MIE as a standard treatment modality in Japan. Future studies should focus on evaluating the long-term outcomes of MIE and determining the optimal integration of robotic assistance in the surgical management of esophageal cancer.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1463-1474"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative radiotherapy for painful non-bone-metastasis tumors.","authors":"Tetsuo Saito","doi":"10.1007/s10147-025-02803-4","DOIUrl":"10.1007/s10147-025-02803-4","url":null,"abstract":"<p><p>As suggested by the findings of our previous investigations, palliative radiotherapy for painful lesions other than bone metastases may be as commonly used in clinical settings as it is for painful bone metastases (PBMs). Given the substantial number of patients requiring radiotherapy for painful non-bone-metastasis tumors (PNTs), the absence of specific clinical guidelines for this subset of patients poses a significant issue. This review aims to explore the effectiveness of palliative radiotherapy for PNTs and compare it to the well-established evidence supporting its use for PBMs. Additionally, the review discusses the optimal dose-fractionation schedules in palliative radiotherapy for the management of PNTs.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1500-1504"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of cancer type differences on chemotherapy-induced nausea and vomiting (CINV) incidence in oxaliplatin-based regimens for gastric and colorectal cancer: a retrospective study.","authors":"Nanaho Hiraga, Yosuke Ando, Hiroshi Matsuoka, Seira Nishibe-Toyosato, Tomohiro Mizuno, Hidetoshi Katsuno, Yoshiaki Ikeda, Kenji Kawada, Zenichi Morise, Koichi Suda, Shigeki Yamada","doi":"10.1007/s10147-025-02804-3","DOIUrl":"10.1007/s10147-025-02804-3","url":null,"abstract":"<p><strong>Background: </strong>The incidence of chemotherapy-induced nausea and vomiting (CINV) when using an oxaliplatin-based regimen may vary according to the cancer type. This study compared the occurrence of CINV in patients with gastric or colorectal cancers.</p><p><strong>Methods: </strong>This retrospective study included patients who received oxaliplatin-containing regimens for gastric or colorectal cancer. The incidence of CINV during the first treatment course was evaluated. Propensity score matching (PSM) was performed between gastric cancer (GC) and colorectal cancer (CRC) groups to compare the complete response (CR) and total control (TC) rates as indicators of antiemetic efficacy. The impact of primary tumor resection history, surgical procedure, and antiemetic agents was analyzed in the group with a higher incidence of CINV.</p><p><strong>Results: </strong>The GC group included 99 patients and the CRC group included 180 patients, with 60 patients per group, after PSM. The CR rate was significantly lower in the GC group (75.0%) than in the CRC group (95.0%) (P < 0.01). Before PSM, the TC rate varied significantly by resection type in patients with GC (P = 0.012), indicating that tumor resection influenced the TC rate (P = 0.015). In patients with GC who underwent tumor resection, neither dopamine 2 receptor antagonists (P = 0.090) nor neurokinin 1 receptor antagonist (P = 0.66) use was associated with a significant difference in the CR rate.</p><p><strong>Conclusion: </strong>Patients with GC have a higher incidence of CINV than those with CRC. In patients with GC, tumor resection significantly influenced the total control rate of CINV.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1602-1609"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative review of focal boost to intraprostatic dominant lesion in intensity-modulated radiation therapy for localized or locally advanced prostate cancer.","authors":"Rihito Aizawa, Takashi Mizowaki","doi":"10.1007/s10147-025-02799-x","DOIUrl":"10.1007/s10147-025-02799-x","url":null,"abstract":"<p><p>Local intraprostatic recurrence is one of the important recurrence patterns following definitive intensity-modulated radiation therapy (IMRT) that continues to pose a significant challenge. The technological advances in radiation therapy now facilitate selective dose escalation for intraprostatic dominant lesions (IPDLs). A novel IMRT method, focal boosting using simultaneous integrated boost IMRT (FB-SIB-IMRT), can achieve selective dose escalation to IPDLs while minimizing any increase in dose to organs at risk (OARs). In addition, this method is applied to hypofractionated EBRT, including stereotactic body radiation therapy (SBRT). To date, numerous prospective studies have reported clinical results of FB-SIB-IMRT for non-metastatic PCa. In this review, we describe and summarize clinical outcomes of previous studies, including the technological background, current status, and future perspectives regarding focal dose escalation for IPDLs using IMRT for non-metastatic PCa.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1448-1462"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247762","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":"Impact of second-line combination chemotherapy on post-progression survival in metastatic and recurrent pancreatic cancer.","authors":"Takafumi Mie, Masato Ozaka, Takeshi Okamoto, Tsuyoshi Takeda, Yoichiro Sato, Tatsuki Hirai, Takahiro Ishitsuka, Yuri Maegawa, Takaaki Furukawa, Yukari Suzuki, Takashi Sasaki, Naoki Sasahira","doi":"10.1007/s10147-025-02796-0","DOIUrl":"10.1007/s10147-025-02796-0","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy of the second-line combination chemotherapy (CC) for patients with metastatic or recurrent pancreatic cancer.</p><p><strong>Methods: </strong>We retrospectively analyzed consecutive patients with metastatic or recurrent pancreatic cancer, who received second-line chemotherapy after disease progression on first-line modified FOLFIRINOX (mFFX) or gemcitabine with nab-paclitaxel (GnP) between January 2014 and March 2023 at our hospital. Overall survival (OS), progression-free survival (PFS), and post-progression survival (PPS) were compared between first-line mFFX and GnP. In addition, OS, PFS, and PPS for second-line treatment with CC and single-agent chemotherapy (SAC) were compared using propensity score matching (PSM).</p><p><strong>Results: </strong>457 patients (mFFX/GnP: 122/335) were included. Median OS and PPS of mFFX and GnP were 15.5 months vs. 15.0 months (p = 0.73) and 7.7 months vs. 7.2 months (p = 0.37), respectively. After PSM, median OS and median PPS were significantly longer in the CC group than in the SAC group (OS: 16.3 months vs. 12.8 months, p < 0.01; PPS: 8.0 months vs. 5.5 months, p < 0.01). There was no difference in first-line PFS between the two groups (7.1 months vs. 6.4 months, p = 0.74). Performance status at the beginning of first-line treatment, and carbohydrate antigen 19-9 level, Glasgow prognostic score at the end of first-line treatment, and second-line CC were independently associated with OS.</p><p><strong>Conclusion: </strong>Second-line CC achieved longer PPS and OS than SAC. To improve OS, it was important to receive second-line CC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1610-1620"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LH-RH agonist monotherapy for androgen receptor-positive recurrent and/or metastatic salivary gland cancer: a retrospective study.","authors":"Takuma Kishida, Tomohiro Enokida, Ryutaro Onaga, Nobukazu Tanaka, Yuta Hoshi, Takao Fujisawa, Ryo Kuboki, Hideki Tanaka, Susumu Okano, Makoto Tahara","doi":"10.1007/s10147-025-02785-3","DOIUrl":"10.1007/s10147-025-02785-3","url":null,"abstract":"<p><strong>Background: </strong>Although combination therapy consisting of a luteinizing hormone-releasing hormone (LH-RH) agonist and an Androgen receptor (AR) inhibitor has demonstrated promising clinical activity for recurrent and/or metastatic SGC (R/M SGC), few studies on LH-RH agonist monotherapy have been reported.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients with AR-positive, R/M SGC treated by monotherapy with LH-RH agonists in our institution from November 2004 to July 2023.</p><p><strong>Results: </strong>Nineteen patients were identified; the median age was 64 years (range 42-82), 10 had salivary duct carcinoma (52.6%), and 3 had adenocarcinoma, not otherwise specified (15.8%). LH-RH agonist monotherapy was delivered as first-line systemic therapy for R/M disease in 16 patients (84.2%). Nine patients (47.4%) achieved tumor size reduction in target lesions with a median tumor shrinkage of 11% (range 1-100%), resulting in an overall response rate and clinical benefit rate (rate of patients achieving a complete response, partial response, or stable disease lasting for at least 24 weeks) of 15.8% and 36.8%, respectively. The median duration of treatment with LH-RH agonist monotherapy was 5.1 months (range 0.3-63.4), accounting for 35.2% of the entire treatment period. Median progression-free survival and overall survival was 3.2 months (95% confidence interval (95% CI), 1.6-6.0) and 21.6 months (95% CI 9.9-34.4), respectively. No severe adverse events leading to treatment interruption or discontinuation were seen.</p><p><strong>Conclusion: </strong>LH-RH agonist monotherapy demonstrated a well-balanced profile between efficacy and safety and could be an alternative therapeutic option, especially for subjects not tolerable to combination therapy. (242 words).</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1562-1571"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous cryoablation versus robot-assisted partial nephrectomy for small renal cell carcinoma: a retrospective cost analysis at Japanese single-institution.","authors":"Mayu Uka, Toshihiro Iguchi, Kensuke Bekku, Tomoaki Yamanoi, Toshiharu Mitsuhashi, Hideo Gobara, Noriyuki Umakoshi, Takahiro Kawabata, Koji Tomita, Yusuke Matsui, Motoo Araki, Takao Hiraki","doi":"10.1007/s10147-025-02783-5","DOIUrl":"10.1007/s10147-025-02783-5","url":null,"abstract":"<p><strong>Background: </strong>No direct cost comparison has been conducted between percutaneous cryoablation (PCA) and robot-assisted partial nephrectomy (RAPN) for clinical T1a renal cell carcinoma (RCC) in Japan. This study aimed to compare their costs.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 212 PCAs (including 155 with transcatheter arterial embolization) and 119 RAPN cases performed between December 2017 and May 2022.</p><p><strong>Results: </strong>PCA patients were older with higher American Society of Anesthesiologists scores, Charlson Comorbidity Index, and history of previous RCC treatment, cardiovascular disease, and antithrombotic drug use than RAPN patients. PCA was associated with a significantly shorter procedure time and hospitalization duration with fewer major complications than those associated with RAPN. While PCA incurred a slightly lower total cost (1,123,000 vs. 1,155,000 yen), it had a significantly higher procedural cost (739,000 vs. 693,000 yen) and markedly worse total (- 93,000 vs. 249,000 yen) and procedural income-expenditure balance (- 189,000 vs. 231,000 yen) than those of RAPN. After statistical adjustment, PCA demonstrated significantly higher total (difference: 114,000 yen) and procedural costs (difference: 72,000 yen), alongside significantly worse total (difference: - 358,000 yen) and procedural income-expenditure balances (difference: - 439,000 yen). The incremental cost-effectiveness ratio was more favorable for PCA than for RAPN.</p><p><strong>Conclusion: </strong>For high- risk patients, PCA demonstrated a safer option with shorter hospitalization duration than those of RAPN. Although PCA was more cost-effective, its higher procedural cost and unfavorable income-expenditure balance require careful evaluation, especially for large tumors that require three or more needles.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"1621-1630"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247763","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}