International Journal of Clinical Oncology最新文献

{"title":"Clinical impact of adjuvant chemotherapy and regimen selection in Stage III colorectal cancer with impaired performance status: a multicenter cohort study.","authors":"Takuki Yagyu, Manabu Yamamoto, Chihiro Uejima, Akimitsu Tanio, Yasuro Kurisu, Shunsuke Shibata, Akemi Iwamoto, Takuji Naka, Yusuke Kono, Kyoichi Kihara, Teruhisa Sakamoto, Yoshiyuki Fujiwara","doi":"10.1007/s10147-026-03135-7","DOIUrl":"10.1007/s10147-026-03135-7","url":null,"abstract":"<p><strong>Background: </strong>The optimal use of adjuvant chemotherapy (ACT) in patients with impaired performance status (PS) has not been reliably determined, particularly regarding intensification of treatment with oxaliplatin (OX). In this study, we evaluated the clinical impact of ACT and OX in patients with Stage III colorectal cancer (CRC) and impaired PS.</p><p><strong>Methods: </strong>The cohort of this multicenter retrospective study comprised 566 patients with Stage III CRC and PS ≥ 1 who had undergone curative resection. Propensity score matching was used to compare outcomes between ACT (+) and ACT (-) groups. Additionally, stabilized inverse probability of treatment weighting was performed to compare outcomes of fluoropyrimidine (FP) monotherapy and OX-based regimens. The primary endpoint was disease-free survival (DFS).</p><p><strong>Results: </strong>After propensity score matching, ACT (+) was associated with significantly longer DFS than ACT (-) (HR 0.573, P = 0.003), with consistent findings for relapse-free survival, overall survival, and sensitivity analyses. Inverse probability of treatment weighting analyses showed that OX-based regimens did not achieve significantly longer DFS than did FP monotherapy (HR 1.143, P = 0.705). Exploratory subgroup analyses showed shorter DFS with OX in high-risk disease, but not in low-risk disease.</p><p><strong>Conclusions: </strong>ACT was associated with improved survival, even in patients with impaired PS. In contrast, OX-based combination therapy did not demonstrate a statistically significant additional survival benefit over fluoropyrimidine monotherapy in this cohort. These findings suggest that treatment strategies for Stage III CRC with impaired PS should be individualized, with careful consideration of the patient's condition rather than routinely intensifying treatment.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2301-2311"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470340","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":"Real-world evaluation of primary prophylactic use of granulocyte colony-stimulating factor in patients with metastatic castration-sensitive prostate cancer treated with triplet therapy.","authors":"Masataka Kubo, Fumihiko Urabe, Kojiro Tashiro, Hirokazu Kagawa, Yuya Iwamoto, Yosuke Kondo, Shun Saito, Shota Kawano, Shuhei Hara, Mimu Ishikawa, Kosuke Iwatani, Yu Imai, Sotaro Kayano, Mahito Atsuta, Shunsuke Tsuzuki, Toshihiro Yamamoto, Masaya Murakami, Tatsuya Shimomura, Hiroki Yamada, Jun Miki, Takahiro Kimura","doi":"10.1007/s10147-026-03137-5","DOIUrl":"10.1007/s10147-026-03137-5","url":null,"abstract":"<p><strong>Background: </strong>Triplet therapy with androgen deprivation therapy (ADT), docetaxel, and androgen receptor signaling inhibitors improves outcomes in metastatic castration-sensitive prostate cancer (mCSPC), but hematologic toxicity remains a major concern. The role of primary prophylactic granulocyte colony-stimulating factor (G-CSF) in real-world practice remains unclear. We evaluated its impact on toxicity and treatment delivery.</p><p><strong>Methods: </strong>This retrospective multicenter cohort study included 121 patients with mCSPC treated with ADT, docetaxel, and darolutamide across eight institutions (February 2023-December 2025). Primary G-CSF use was at physician discretion. Adverse events were graded per CTCAE v5.0. Relative cumulative dose (RCD) of docetaxel and febrile neutropenia (FN) incidence were assessed. Logistic regression identified factors associated with severe toxicity.</p><p><strong>Results: </strong>Primary G-CSF was independently associated with reduced risk of grade ≥ 3 neutropenia (OR 0.087; 95% CI 0.030-0.25; p < 0.001) and FN (OR 0.15; 95% CI 0.030-0.78; p = 0.022). Without prophylaxis, grade ≥ 3 neutropenia and FN occurred in 64.9% and 23.4%, respectively, mostly during cycle 1. Primary G-CSF did not significantly improve overall RCD; however, patients with FN had lower RCD (80.0% vs. 93.3%, p = 0.035) and were less likely to achieve RCD > 80% (45.0% vs. 74.3%, p = 0.009). Docetaxel discontinuation was lower with primary G-CSF (p = 0.032).</p><p><strong>Conclusion: </strong>Primary prophylactic G-CSF was associated with reduced hematologic toxicity, while FN was strongly linked to impaired treatment delivery. Early G-CSF use may help prevent hematologic toxicity, particularly in patients at high risk of FN.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2293-2300"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446088","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 lymph node yield on biochemical recurrence in patients with high-risk prostate cancer after robot-assisted radical prostatectomy.","authors":"Shuichi Morizane, Ahmed A Hussein, Zhe Jing, Abdul Wasay Mahmood, Kazunori Kanehira, Ali Ahmad, Salman Khan, Grace Harrington, Sarita Das, Sophia Wychowski, Mohammad Khan, Rayaan Cheema, Atsushi Takenaka, Khurshid A Guru","doi":"10.1007/s10147-026-03130-y","DOIUrl":"10.1007/s10147-026-03130-y","url":null,"abstract":"<p><strong>Background: </strong>This study evaluated the association between lymph node yield (LNY) and biochemical recurrence (BCR) after radical prostatectomy with pelvic lymph node dissection (PLND) in patients with intermediate to very high-risk prostate cancer.</p><p><strong>Methods: </strong>In total, 1234 patients with intermediate to very high-risk prostate cancer who underwent robot-assisted radical prostatectomy between 2004 and 2025 were reviewed. Patients were compared according to the median LNY, subgroup analyses were performed according to pathological nodal status and NCCN risk classification. Propensity score was used to match the pathological factors between LND groups. BCR-free survival and its predictors were assessed using the Kaplan-Meier method and Cox proportional hazard models.</p><p><strong>Results: </strong>According to NCCN classification, 18%, 49%, 25%, and 8% of patients were classified as favorable intermediate, unfavorable intermediate, high, and very high risk, respectively. The median follow-up period was 5.0 (interquartile range/IQR 2.6, 8.2) years, and 28% of patients developed BCR. The median LNY was 7 (IQR 4-11). Among patients without pN+ disease, 10-year BCR-free survival rates were 60% in those with LNY ≥ 7, compared with 48% in those with LNY < 7 (p = 0.032). This association was statistically significant only in the high-risk subgroup (p = 0.028). Race, PSA level, Gleason grade group ≥ 4, extraprostatic extension, seminal vesicle invasion, lymphovascular invasion, positive surgical margin, pN+ , and LNY ≥ 7 were independent predictors of BCR.</p><p><strong>Conclusions: </strong>Higher LNY was independently associated with improved BCR-free survival in node-negative patients undergoing limited PLND. More lymph node dissection in limited PLND may benefit selected high-risk patients.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2213-2222"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630207","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":"Predictive value of TTF-1 expression for stratifying outcomes between dual ICI and chemoimmunotherapy in patients with PD-L1-negative NSCLC.","authors":"Naoya Nishioka, Daiki Murata, Koichi Azuma, Kazuhiro Ito, Takashi Nomizo, Kazuhiko Yamada, Tatsuya Imabayashi, Kentaro Iwanaga, Kenji Chibana, Takayo Ota, Yuuya Nishii, Akira Nakao, Asuka Okada, Kosuke Hamai, Takenori Sakai, Taishi Harada, Keiko Tanimura, Kohei Yoshimine, Yosuke Tamura, Ryuichiro Takaki, Yasuhiro Goto, Makoto Hibino, Tomohiro Oba, Toshiyuki Sumi, Hiroyasu Kaneda, Tadaaki Yamada, Koichi Takayama","doi":"10.1007/s10147-026-03157-1","DOIUrl":"10.1007/s10147-026-03157-1","url":null,"abstract":"<p><strong>Background: </strong>Thyroid transcription factor-1 (TTF-1) has emerged as a novel predictive biomarker associated with the prognosis and treatment response of non-squamous non-small-cell lung cancer (NSCLC) to cytotoxic chemotherapy. This study evaluated the clinical significance of TTF-1 expression in advanced NSCLC with programmed death-ligand 1 (PD-L1) < 1%, with a specific focus on its utility in stratifying treatment outcomes between dual immune checkpoint inhibitor (IO-IO) therapy and chemoimmunotherapy.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study across 22 Japanese institutions, evaluating 194 patients with advanced or recurrent non-squamous NSCLC and PD-L1 < 1% treated with IO-IO therapy or chemoimmunotherapy between 2019 and 2022. Survival outcomes were analyzed using multivariable Cox regression.</p><p><strong>Results: </strong>TTF-1-positive patients had significantly longer progression-free survival (PFS) and overall survival (OS) than TTF-1-negative patients [adjusted hazard ratio (HR) for PFS: 0.65, p = 0.009; adjusted HR for OS: 0.69, p = 0.04]. Among TTF-1-positive patients, no significant difference in survival was observed between IO-IO therapy and chemoimmunotherapy. By contrast, TTF-1-negative patients experienced significantly improved outcomes with chemoimmunotherapy than with IO-IO therapy (adjusted HR for PFS: 0.37, p = 0.01; adjusted HR for OS: 0.39, p = 0.02).</p><p><strong>Conclusion: </strong>TTF-1 expression may serve as a prognostic and potentially predictive biomarker in PD-L1-negative NSCLC patients. TTF-1-negative patients appeared to derive greater benefit from the addition of chemotherapy. These findings suggest that TTF-1 expression may have potential utility in guiding treatment selection and warrant prospective validation.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2481-2491"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673612","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":"Clinical indications and implications of metastasis-directed therapy and primary-site treatment in metastatic urothelial carcinoma.","authors":"Ryoichi Saito, Takeshi Sano, Toru Kanno, Rihito Aizawa, Akihiro Hamada, Toru Sakatani, Yuki Kita, Kimihiko Masui, Takashi Ogata, Takayuki Goto, Atsuro Sawada, Takashi Mizowaki, Takashi Kobayashi","doi":"10.1007/s10147-026-03171-3","DOIUrl":"10.1007/s10147-026-03171-3","url":null,"abstract":"<p><p>Metastatic urothelial carcinoma (mUC) is traditionally managed with systemic therapy; however, long-term disease control remains uncommon despite advances such as immune checkpoint inhibitors and antibody-drug conjugates. Interest has grown in integrating metastasis-directed therapy (MDT), including metastasectomy and stereotactic body radiotherapy (SBRT), and primary-site treatment (PST) in selected patients, aiming to reduce tumor burden, eliminate resistant clones, and enhance systemic therapy outcomes. Metastasectomy is not standard but may be considered for oligometastatic patients with good performance status and a favorable response to first-line therapy. Retrospective series have shown feasibility and durable control, especially with solitary lung or nodal metastases, although data are limited by selection bias and a lack of randomized trials. SBRT offers high local control and palliation, with a growing role in oligometastatic or oligoprogressive disease to delay progression and complement immunotherapy. PST after a favorable systemic response for metastatic bladder cancer, including conversion or consolidative cystectomy and palliative or ablative radiotherapy, provides additional disease control and symptom relief. In metastatic upper tract urothelial carcinoma, retrospective and SEER-based data studies similarly suggest a survival benefit from nephroureterectomy in selected patients. Circulating tumor DNA is emerging as a complementary biomarker for patient selection and response monitoring in advanced UC cases. Most evidence predates highly effective systemic therapies; thus, the clinical value and optimal integration of MDT and PST remain to be defined, requiring prospective validation and refined patient selection.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2114-2125"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764793","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":"Facility-level JSMO specialist availability and reconstructable treatment-process measures in colorectal cancer using C-CAT data.","authors":"Shinya Kajiura, Hironaga Satake, Naohiko Nakamura, Ryuji Hayashi","doi":"10.1007/s10147-026-03136-6","DOIUrl":"10.1007/s10147-026-03136-6","url":null,"abstract":"<p><strong>Background: </strong>C-CAT lacks patient-level data on Japanese Society of Medical Oncology (JSMO) specialist involvement. We assessed facility-level registry-listed JSMO specialist availability and C-CAT-reconstructable treatment-process and endpoint-ascertainment measures in colorectal cancer.</p><p><strong>Methods: </strong>This nationwide retrospective C-CAT facility-level analysis included 11,906 patients at 261 facilities. The primary exposure was facility-level JSMO specialist count (0-3 vs 4 +); the secondary exposure was gastrointestinal-domain JSMO specialist presence. The primary endpoint was time from systemic therapy start to recorded second-line treatment end. Facility-cluster robust Cox models were used. Endpoint ascertainment, missingness-focused sensitivity analyses, and overall survival (OS) were supportive/contextual.</p><p><strong>Results: </strong>Overall, 5349 patients at 181 facilities were in the 0-3 group and 6557 patients at 80 facilities in the 4 + group. Median time to recorded second-line treatment end was 20.2 versus 23.1 months (log-rank p < 0.001). In facility-cluster robust Cox models, the unadjusted HR for 4 + versus 0-3 specialists was 0.840 (95% CI 0.761-0.927; p < 0.001), attenuating after facility-category adjustment (HR, 0.948; 95% CI 0.853-1.055; p = 0.329) and clinical adjustment (HR, 0.968; 95% CI 0.866-1.082; p = 0.565). Second-line end-date availability was lower in the 4 + group (61.6% vs 69.1%). Supportive OS showed no specialist-associated survival advantage (median, 50.2 vs 51.3 months; clinically adjusted HR, 0.962; 95% CI 0.816-1.135; p = 0.648).</p><p><strong>Conclusions: </strong>C-CAT can reconstruct facility-level treatment-process and endpoint-ascertainment measures, but current C-CAT data do not support specialist-attributable clinical interpretation. Direct evaluation requires chemotherapy-specific national database elements.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2282-2292"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430372","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":"Pain response to re-irradiation for non-bone metastatic lesions: a single-institution retrospective study.","authors":"Kenji Makita, Yuichi Hiroshima, Masaki Nakamura, Hidenari Hirata, Masashi Wakabayashi, Satoshi Saito, Sadamoto Zenda","doi":"10.1007/s10147-026-03151-7","DOIUrl":"10.1007/s10147-026-03151-7","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding palliative re-irradiation (re-RT) for persistent or recurrent pain from non-bone metastatic lesions remains limited. This study evaluated pain response after re-RT in patients with persistent or recurrent painful non-bone metastases.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with persistent or recurrent painful non-bone metastases who underwent re-RT to the same previously irradiated lesion between January 2013 and October 2025 and had an evaluable pain assessment at 4 weeks, defined as 28 ± 7 days after re-RT initiation. Pain response was evaluated based on changes in pain scores and morphine dosage. Assessments were performed at 7 ± 3, 28 ± 7, 56 ± 7, and 84 ± 7 days after the initiation of re-RT, corresponding to approximately 1, 4, 8, and 12 weeks, respectively.</p><p><strong>Results: </strong>Thirty-nine patients were included. The median follow-up was 128 days (interquartile range, 89-221 days). Re-RT regimens were 8 Gy in one fraction in 26 patients (67%), 20 Gy in five fractions in 12 (31%), and 30 Gy in 10 fractions in one (3%). The best overall pain response was observed in 26 patients (67%), including complete response in seven (18%) and partial response in 19 (49%). Among responders, 89% (23/26) achieved response within 4 weeks. The overall response rates were 25% (9/36) at 1 week, 51% (20/39) at 4 weeks, 63% (19/30) at 8 weeks, and 40% (10/25) at 12 weeks, respectively.</p><p><strong>Conclusion: </strong>In this small retrospective cohort, approximately half of the patients achieved pain relief after palliative re-RT, and most observed responses occurred within 4 weeks. These preliminary findings warrant further evaluation in larger prospective studies using standardized pain and analgesic assessments.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2435-2440"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548940","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":"Efficacy of a new surgical indicator for lung cancer with interstitial lung disease based on the gender-age-physiology staging system.","authors":"Yoshito Imamura, Keita Nakanishi, Heng Huang, Minoru Sugihara, Taiki Ryo, Yasuhisa Ichikawa, Tatsuya Masuda, Hirofumi Takenaka, Yuta Kawasumi, Hiroki Watanabe, Yuka Kadomatsu, Harushi Ueno, Taketo Kato, Shota Nakamura, Tetsuya Mizuno, Toyofumi Fengshi Chen-Yoshikawa","doi":"10.1007/s10147-026-03164-2","DOIUrl":"10.1007/s10147-026-03164-2","url":null,"abstract":"<p><strong>Background: </strong>Selecting the optimal surgical strategy for lung cancer patients with interstitial lung disease (ILD) remains difficult. This study evaluated the prognostic value of a newly proposed surgical indicator-the predicted ILD Gender-Age-Physiology (GAP) stage-which incorporates predicted postoperative pulmonary function into the conventional ILD-GAP stage.</p><p><strong>Methods: </strong>This study retrospectively analyzed 125 patients with clinical stage 1 lung cancer and ILD who underwent surgery during 2011-2023. Postoperative outcomes were compared according to surgical procedure and predicted ILD-GAP stage.</p><p><strong>Results: </strong>The 5-year overall survival (OS) rate was markedly superior in patients who underwent anatomical resection with a predicted ILD-GAP stage ≤ 2 than in those who underwent wedge resection (75.0% vs. 21.3%, p < 0.001). In contrast, survival did not differ between anatomical resection with a predicted ILD-GAP stage 3 and wedge resection (27.8% vs. 21.3%, p = 0.934). Multivariate analysis identified diffusing capacity of carbon monoxide (p = 0.043), anatomical resection with a predicted ILD-GAP stage ≤ 2 (p = 0.009), and pathological stage 1 (p = 0.035) as independent predictors of prognosis. Furthermore, the predicted ILD-GAP stage provided superior prognostic accuracy for 5-year OS compared with the original ILD-GAP stage (area under the curve: 0.735 vs. 0.653; p = 0.040).</p><p><strong>Conclusions: </strong>The proposed surgical indicator enhanced prognostic stratification in lung cancer patients with ILD. In particular, anatomical lung resection in patients with a predicted ILD-GAP stage ≤ 2 was identified as an independent favorable prognostic factor for 5-year OS, highlighting the importance of surgical planning.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2524-2534"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792553","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":"Prognostic significance of predicted skeletal muscle index after curative-intent resection for non-small cell lung cancer.","authors":"Kenji Kameyama, Satoru Okada, Machiko Nishi, Tatsuo Furuya, Chiaki Nakazono, Atsuki Uchibori, Tomoki Nishimura, Rintaro Kawanishi, Masayoshi Inoue, Tsunehiro Ii","doi":"10.1007/s10147-026-03158-0","DOIUrl":"10.1007/s10147-026-03158-0","url":null,"abstract":"<p><strong>Background: </strong>Reduced physiological reserve and overall systemic state are important determinants of prognosis in non-small cell lung cancer (NSCLC). The predicted skeletal muscle index (pSMI), calculated from serum creatinine to cystatin C ratio, age, body weight, and hemoglobin, has been proposed as a laboratory-based surrogate of skeletal muscle mass; however, its prognostic value in surgically treated NSCLC remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 199 patients who underwent curative-intent resection for NSCLC between 2019 and 2023. Patients were classified into low and high pSMI groups using previously reported sex-specific cutoff values. Overall survival (OS) and relapse-free survival (RFS) were evaluated using Kaplan-Meier methods and multivariable Cox proportional hazards models. The prognostic performance of pSMI was compared with body mass index (BMI), prognostic nutritional index (PNI), and CT-derived SMI.</p><p><strong>Results: </strong>pSMI correlated with CT-derived SMI and BMI, and low pSMI was more frequent in patients with larger tumors and vascular invasion. Sixty-four patients (32.2%) were classified into the low pSMI group and 135 (67.8%) into the high pSMI group. Low pSMI was associated with worse OS and RFS. After adjustment for age, pathological stage, vascular invasion, and either BMI, PNI, or CT-derived SMI, low pSMI remained independently associated with worse RFS (adjusted hazard ratio 2.48-2.87, all p < 0.05). In contrast, BMI, PNI, and CT-derived SMI were not independently associated with RFS.</p><p><strong>Conclusions: </strong>Low pSMI was independently associated with worse RFS after resection for NSCLC. pSMI may capture aspects of systemic vulnerability and facilitate preoperative risk stratification in patients undergoing surgery for NSCLC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2470-2480"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663977","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":"Stage-dependent differences of long-term outcomes between chemoradiotherapy and surgery for squamous cell carcinoma of the anal canal: a multicenter retrospective cohort study.","authors":"Norihiro Shimoike, Koya Hida, Takashi Sakamoto, Kazutaka Obama, Kazutaka Yamada, Kenichi Sugihara","doi":"10.1007/s10147-026-03128-6","DOIUrl":"10.1007/s10147-026-03128-6","url":null,"abstract":"<p><strong>Objectives: </strong>Efficacy comparisons between surgery and chemoradiotherapy (CRT) in the treatment of squamous cell carcinoma (SCC) of the anal canal have not been performed enough. Herein, we aim to reveal the long-term outcomes of CRT and surgery for SCC of the anal canal and to assess the optimal clinical stage-dependent treatment strategy.</p><p><strong>Methods: </strong>We retrospectively assessed patients with SCC who were treated via CRT or surgery between 1991 and 2015 at 47 medical institutions in Japan. The associations of the treatment strategy with the overall survival (OS) and the cumulative incidence of the first recurrence categorized as local failure, inguinal lymph node metastasis, or distant recurrence were examined.</p><p><strong>Results: </strong>The OS following CRT and surgery for clinical stages ≤ II were similar (adjusted hazard ratio [aHR] 0.89, 95% confidence intervals [CI] 0.48-1.63); however, surgery was associated with lower OS for clinical stage III (aHR 1.82, 95% CI 1.06-3.11). Local failure was more likely to occur after CRT, and inguinal node metastasis occurred more frequently after surgery.</p><p><strong>Conclusions: </strong>Optimal treatments for anal canal SCC differ by clinical stage. Despite lacking QOL and organ preservation data, surgery might be an alternative option for stage I-II disease regarding long-term survival. More rigorous comparative studies are warranted.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":"2234-2242"},"PeriodicalIF":3.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792677","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}