Cancer最新文献

{"title":"Two-fold increased risk of melanoma in childhood cancer survivors","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35828","DOIUrl":"https://doi.org/10.1002/cncr.35828","url":null,"abstract":"<p>Childhood cancer survivors have a 2-fold increased risk of melanoma in comparison with the general population, with a 2-fold increased risk of death for those with invasive melanoma, according to the largest and most comprehensive study to date on melanoma in childhood cancer survivors.<span><sup>1</sup></span></p><p>“We have known for some time that childhood cancer survivors are at higher risk for melanoma compared to the general population, but to date have not been able to tease out the relevant risk factors for melanoma,” says the lead author of the study, Seth J. Rotz, MD, a pediatric hematologist/oncologist at the Cleveland Clinic in Ohio.</p><p>Previous studies have suggested a potential relationship between the therapeutic dose of radiation and melanoma, he adds, but the data are limited by the lack of large enough patient populations with granular data available.</p><p>To overcome these limitations, Dr Rotz and his colleagues used a large data set from the Childhood Cancer Survivor Study that included 25,716 participants. With a median follow-up of 26 years (range, 5–69 years), 160 survivors developed 177 melanomas. One hundred ten of these melanomas were invasive, 62 were in situ, and 5 were ocular.</p><p>In comparison with the expected risk of melanoma in the general population, survivors had a more than 2-fold increased risk of invasive skin and ocular melanoma, with no significant differences found after adjustments for the attained age of the survivor. Survivors had a more than 2-fold increased risk of death if they developed invasive melanoma at any site.</p><p>To examine treatment factors associated with the increased risk of melanoma, the researchers looked at two radiation measures: the maximum target dose received by any of the seven body regions evaluated (i.e., leg, arm, chest, abdomen, pelvis, neck, and head/brain) and the maximum target dose to various combinations of these seven radiation body regions mapped to areas of interest for melanoma. They also looked at cumulative exposures to chemotherapeutic drugs.</p><p>For radiation, the study is the first to find a dose-dependent relationship between radiation therapy and melanoma in childhood cancer survivors, with high-dose radiation exposure linked to melanoma. Survivors were at a significantly higher risk of developing melanoma if they received a cumulative radiation dose of ≥40 Gy. In comparison with the general population, the standardized incidence ratio for invasive skin or ocular melanoma was 2.0 (95% confidence interval [CI], 1.6–2.4).</p><p>The study also clarified the risk of exposure to specific types of chemotherapy and showed an increased risk of cutaneous melanoma in survivors treated with a cumulative cyclophosphamide equivalent dose of >20,000 mg/m<sup>2</sup> (hazard ratio [HR], 1.9; 95% CI, 1.1–3.6) or exposure to bleomycin (HR, 2.2; 95% CI, 1.2–4.1).</p><p>“Now that we know the risk factors, we should be able to clinically understand which patients","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143883897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and acceptability of the Comprehensive Oncology Rehabilitation and Exercise (CORE) clinical workflow algorithm in patients with newly diagnosed stage I–III breast cancer who undergo surgery as first-line treatment","authors":"Lea Haverbeck Simon PhD, MA,&nbsp;Carson Saviers-Steiger BS,&nbsp;Emily R. Dunston PhD, MS,&nbsp;Patrick Galyean BS,&nbsp;Elisabeth R. Kimball MS,&nbsp;Justine Mendez BS,&nbsp;Susan L. Zickmund PhD,&nbsp;Pamela A. Hansen MD,&nbsp;Cornelia M. Ulrich PhD, MS,&nbsp;Paul C. LaStayo PhD, PT,&nbsp;David Steinberg MD,&nbsp;Christopher S. Noren MS,&nbsp;A’Lisha Finch BS,&nbsp;Leanne Seckinger OT,&nbsp;Emma Braun MS,&nbsp;Jonathan Chipman PhD,&nbsp;Kirstyn E. Brownson MD,&nbsp;Sonal Oza MD,&nbsp;Adriana M. Coletta PhD, MS, RD","doi":"10.1002/cncr.35798","DOIUrl":"https://doi.org/10.1002/cncr.35798","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This pilot, mixed-methods, randomized controlled trial determined the feasibility and acceptability of the Comprehensive Oncology Rehabilitation and Exercise (CORE) clinical workflow algorithm. CORE was designed to connect patients with newly diagnosed breast cancer to exercise and rehabilitation services from the time of diagnosis throughout cancer care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In total, 72 patients with newly diagnosed, stage I–III breast cancer who required surgery as first-line treatment were randomized 2:1 to CORE or standard of care. CORE included a triaging tool of two questionnaires regarding self-reported exercise (the Godin Leisure Time physical activity questionnaire) and functional status (the Patient-Reported Outcomes Measurement Information System physical function questionnaire), which were administered at the check-in desk for routine breast surgical oncology clinic visits at the initial surgical consultation, postoperatively, and 24 weeks after surgery. Responses to questionnaires in the triaging tool triaged participants to one of three pathways within the algorithm: exercise service, rehabilitation service, or exercise self-management (not a service). Service pathways required referral by clinic staff. Feasibility was determined based on completing the triaging tool (≥66%) and referral completion (≥50%) at the initial surgical consultation visit. Acceptability was determined by four study participant focus groups and one clinic team focus group (≥50% positive response).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-three percent of participants in CORE (<i>n</i> = 40) completed the triaging tool. Among those triaged to a service pathway (<i>n</i> = 29), 62% completed their referral. Focus group feedback was primarily positive.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CORE clinical workflow algorithm is feasible and acceptable among women who have newly diagnosed stage I–III breast cancer with plans for surgery as first-line treatment. CORE was also acceptable among clinic staff.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Trials Registration</h3>\u0000 \u0000 <p>NCT04594473</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35798","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 resistance training on inflammatory biomarkers and associations with treatment outcomes in colon cancer","authors":"Seohyuk Lee MD,&nbsp;Chao Ma MS,&nbsp;Bette J. Caan DrPH,&nbsp;Alexandra M. Binder ScD,&nbsp;Justin C. Brown PhD,&nbsp;Amalia Pena Perez BA,&nbsp;Catherine Lee PhD,&nbsp;Erin Weltzien BA,&nbsp;Michelle C. Ross MPH,&nbsp;Charles P. Quesenberry PhD,&nbsp;Kristin L. Campbell PhD,&nbsp;Elizabeth M. Cespedes Feliciano ScD,&nbsp;Adrienne Castillo MS,&nbsp;Kathryn H. Schmitz PhD,&nbsp;Jeffrey A. Meyerhardt MD, MPH","doi":"10.1002/cncr.35865","DOIUrl":"https://doi.org/10.1002/cncr.35865","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Among patients with colon cancer undergoing adjuvant chemotherapy, the impact of resistance training with supplemental dietary protein on inflammatory changes during treatment, whether baseline or changes in inflammatory markers are associated with relative dose intensity (RDI), and the associations of inflammation with body composition were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter randomized clinical trial of 174 patients with colon cancer undergoing adjuvant chemotherapy assigned to a home-based resistance training program or usual care was conducted. High-sensitivity C-reactive protein (hsCRP), interleukin-6, tumor necrosis factor-α receptor-II, and growth differentiation factor-15 levels were assessed preintervention and following chemotherapy completion. Baseline body composition was evaluated via dual-energy X-ray absorptiometry. Multivariate analyses were adjusted for sociodemographic and clinical factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients randomized to resistance training versus usual care experienced similar changes in all inflammatory markers. Those in the highest versus lowest tertile of baseline hsCRP were more likely to have received RDI &gt;70% (odds ratio, 4.11; 95% CI, 1.29–13.1); however, changes across any of the inflammatory markers were not associated with RDI. Patients in the highest versus lowest tertiles of hsCRP, interleukin-6, and tumor necrosis factor-α receptor-II were more likely to have higher baseline body mass index, total lean mass, and total fat mass.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Inflammatory markers in patients with colon cancer undergoing adjuvant chemotherapy were not significantly impacted by randomization to a resistance training program but were associated with baseline body composition measures. Further investigations are needed to better elucidate the potential role of inflammatory markers and body composition in predicting important treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> ClinicalTrials.gov</h3>\u0000 \u0000 <p>NCT03291951</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to “Reevaluating the impact of physical inactivity on cancer risk: Methodological limitations and considerations”","authors":"Brigid M. Lynch PhD,&nbsp;Julie K. Bassett PhD,&nbsp;Roger L. Milne PhD,&nbsp;Alpa V. Patel PhD,&nbsp;Erika Rees-Punia PhD,&nbsp;I-Min Lee MBBS, ScD,&nbsp;Steven C. Moore PhD,&nbsp;Charles E. Matthews PhD","doi":"10.1002/cncr.35875","DOIUrl":"https://doi.org/10.1002/cncr.35875","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reevaluating the impact of physical inactivity on cancer risk: Methodological limitations and considerations","authors":"Janhavi Venkataraman MBBS, MS (Gen Surg), MRCS, MCh (Plastics), FIAS (ISAPS),&nbsp;Kefah Mokbel FRCS","doi":"10.1002/cncr.35873","DOIUrl":"https://doi.org/10.1002/cncr.35873","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testicular and ovarian Juvenile granulosa cell tumors in children and adolescents: Analysis of 113 patients registered to the German Registry for Rare Pediatric Tumors (STEP)","authors":"Dominik T. Schneider MD, PhD,&nbsp;Andrea Witowski MD,&nbsp;Michael Abele MD,&nbsp;Martin Benesch MD,&nbsp;Benedikt Bernbeck MD,&nbsp;Tabea Blessing MD,&nbsp;Bastian Brummel MD,&nbsp;Gabriele Calaminus MD,&nbsp;Ulrich Göbel MD, PhD,&nbsp;Norbert Graf MD,&nbsp;Christian Vokuhl MD, PhD,&nbsp;Kris Ann P. Schultz MD,&nbsp;Ines B. Brecht MD","doi":"10.1002/cncr.35861","DOIUrl":"https://doi.org/10.1002/cncr.35861","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In juvenile granulosa cell tumors (juvGCTs), impaired survival was reported after preoperative tumor rupture, peritoneal metastases, or high mitotic rate (≥20 mitoses per 10 high-power fields). Therefore, a risk stratification was developed to select patients for chemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2001 and 2019, 89 female patients and 24 male patients were prospectively enrolled. Histopathologic classification was according to the World Health Organization classification, and staging was according to Children's Oncology Group and International Federation of Gynecology and Obstetrics classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Testicular juvGCTs were detected as scrotal swelling during infancy. No recurrences were reported after orchiectomy. Patients with ovarian juvGCTs presented at a median age of 9.8 years with abdominal discomfort, isosexual precocity, or amenorrhea. After tumor resection, two of 52 patients with stage IA disease, one of 14 with stage IC1 disease (intraoperative rupture), 13 of 18 with stage IC2 or IC3 disease (preoperative rupture), and all five patients with stage II/III disease received chemotherapy. Four recurrences with two deaths were reported. Three recurrent tumors were initially stage IA with a high mitotic rate, and one was a stage II tumor. No recurrences were observed among patients who had stage IC2/IC3 disease, who had unfavorable prognoses in historical cohorts. The 5-year event-free survival was 0.95 ± 0.03 (85 of 89 patients), and overall survival was 0.97 ± 0.02 (87 of 89 patients).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Testicular and ovarian juvGCTs are clinically distinct entities. Although testicular juvGCTs exclusively present during infancy and have an excellent prognosis, ovarian juvGCTs may arise at any age and constitute potentially aggressive tumors. Centralized reference diagnostics and the establishment of counseling structures for the treatment of patients with ovarian juvGCTs improved prognosis compared with historical groups. The mitotic rate and incomplete surgery were identified as important risk factors in addition to tumor stage and should be considered in the risk-stratification of therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35861","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fragmented care and misaligned incentives of stakeholders in breast cancer care for the uninsured in the United States","authors":"Madhushree Zope MD, MS,&nbsp;Richard Sullivan MBBS, PhD,&nbsp;Lily Gutnik MD, MPH","doi":"10.1002/cncr.35878","DOIUrl":"https://doi.org/10.1002/cncr.35878","url":null,"abstract":"<p>Access to and provision of breast cancer care in the United States for uninsured and underinsured patients is influenced by a complex network of advocates, legislative bodies, health care providers, and patients. The National Breast and Cervical Cancer Early Detection Program of 1990 and Breast and Cervical Cancer Prevention and Treatment Act of 2000 were milestone health policy changes that increased access to breast and cervical cancer screening, diagnosis and treatment for vulnerable populations. Implementation of these policies has been faced with challenges from the administrative, patient and provider perspectives. This commentary sheds light on the landscape of breast cancer care for the uninsured in the United States today, and identifies gaps that may benefit from universal healthcare policy.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35878","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 Medicaid expansion on racial disparities among patients with gastrointestinal cancer","authors":"Naveen Manisundaram MD, MPH,&nbsp;Rebecca A. Snyder MD, MPH,&nbsp;Chung-Yuan Hu PhD,&nbsp;Sandra R. DiBrito MD, PhD,&nbsp;Joshua N. Herb MD,&nbsp;George J. Chang MD, MS, MHCM","doi":"10.1002/cncr.35879","DOIUrl":"https://doi.org/10.1002/cncr.35879","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Racial minority groups experience disparities in cancer treatment and mortality. This study aimed to investigate the effect of Medicaid expansion on the existing racial disparities in all-cause mortality among patients with gastrointestinal malignancies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional cohort study of patients with pancreatic ductal adenocarcinoma (PDAC), colorectal cancer (CRC), and gastric adenocarcinoma (GC) of any stage was conducted using data from the National Cancer Database (2009–2019). Using difference-in-difference (DID) analysis, the authors compared adjusted 2-year mortality rates among Black and White patients residing in states with expanded Medicaid benefits (MES) and non-MES before (2009–2013) and after (2014–2019) Medicaid expansion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 86,052 patients were included in this analysis, including 19,188 patients with PDAC, 60,404 with CRC, and 6460 with GC. Two-year mortality rates decreased among Black patients with PDAC residing in MES but not those residing in non-MES following Medicaid expansion (DID, –9.4%; 95% confidence interval [CI], –14.4% to –4.4%; <i>p</i> &lt; .001). Mortality decreased more among Black and White patients with CRC in MES compared to those in non-MES following Medicaid expansion (DID, –2.9%; 95% CI, –5.7 to –0.04; <i>p</i> = .047 and DID, –4.2%; 95% CI, –5.8 to –2.5; <i>p</i> &lt; .001, respectively). Black patients with GC in MES experienced a marked reduction in mortality compared to those in non-MES (DID, –7.7%, 95% CI, –16.1 to 0.56; <i>p</i> = .07).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Medicaid expansion was associated with a greater reduction in 2-year mortality rates among Black patients residing in MES compared to those residing in non-MES. Existing racial disparities in mortality remained the same or worsened in non-MES but were mitigated in MES following Medicaid expansion in almost all comparisons.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovarian juvenile granulosa cell tumor: A report from the International Ovarian and Testicular Stromal Tumor and International Pleuropulmonary Blastoma/DICER1 Registries","authors":"Anne K. Harris MPH,&nbsp;Alexander T. Nelson MD,&nbsp;Dave Watson PhD,&nbsp;Paige H. R. Mallinger MS,&nbsp;Yoav H. Messinger MD,&nbsp;A. Lindsay Frazier MD,&nbsp;Allen Stering MD,&nbsp;Stacy L. Snyder MD,&nbsp;Carolyn Fein Levy MD,&nbsp;Junne Kamihara MD, PhD,&nbsp;Cynthia E. Herzog MD,&nbsp;Joanne Lagmay MD,&nbsp;Steve Foresto MD,&nbsp;Kenneth S. Chen MD,&nbsp;Kyle M. Devins MD,&nbsp;Robert H. Young MD,&nbsp;D. Ashley Hill MD,&nbsp;Louis P. Dehner MD,&nbsp;Anil K. Tadavarthy MD,&nbsp;Jennifer N. Stall MD,&nbsp;Deborah F. Billmire MD,&nbsp;Dominik T. Schneider MD,&nbsp;Kris Ann P. Schultz MD","doi":"10.1002/cncr.35862","DOIUrl":"https://doi.org/10.1002/cncr.35862","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ovarian juvenile granulosa cell tumors (juvGCT) are rare sex cord-stromal tumors that occur primarily in children and adolescents. This study summarizes the clinical presentation and outcomes of patients with juvGCT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were enrolled in the International Ovarian and Testicular Stromal Tumor and/or International Pleuropulmonary Blastoma/<i>DICER1</i> Registries. Available medical records were abstracted, and pathology was centrally reviewed. Surgical staging was classified using the 2014 International Federation of Gynecology and Obstetrics (FIGO) criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 70 patients with juvGCT enrolled and were diagnosed between 2001 and 2024; most patients (81%, 57 of 70) presented with FIGO stage I disease. Adjuvant chemotherapy was given in 30% (21 of 70); all regimens were platinum-based. Three-year event-free survival among patients with stage IA tumors was 80.2% (95% confidence interval [CI], 62.4%–100.0%), IC1 was 87.4 (95% CI, 72.4%–100.0%), IC2-IC3 was 63.6% (95% CI, 40.7%–99.5%), and II-IV was 48% (95% CI, 24.6%–93.8%). Of the patients with recurrent juvGCT with known mitotic index (MI), all had MI greater than 19 mitoses per 10 high power fields (HPF) at diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Outcomes were worse for patients with FIGO stage ≥IC2 disease and for tumors with &gt;19 mitoses per 10 HPF. Given the prognostic significance of MI, the authors strongly recommend the assessment of MI for all juvGCTs. More information about tumor biology is critical to identify which patients may benefit from adjuvant chemotherapy and to facilitate the development of novel therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing artificial intelligence in breast cancer screening: Women’s preferences","authors":"Alison Pearce BAppSci(OT), MPH, PhD,&nbsp;Stacy Carter BAppSci, MPH(Hons), PhD,&nbsp;Helen ML Frazer MBBS, RANZCR, M Epi Biostat, GAICD,&nbsp;Nehmat Houssami MBBS (Hons), MPH, M Ed, FAFPHM, FASBP, PhD,&nbsp;Mary Macheras-Magias,&nbsp;Genevieve Webb,&nbsp;M. Luke Marinovich BA(Hons), MPH, PhD","doi":"10.1002/cncr.35859","DOIUrl":"https://doi.org/10.1002/cncr.35859","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial intelligence (AI) could improve accuracy and efficiency of breast cancer screening. However, many women distrust AI in health care, potentially jeopardizing breast cancer screening participation rates. The aim was to quantify community preferences for models of AI implementation within breast cancer screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online discrete choice experiment survey of people eligible for breast cancer screening aged 40 to 74 years in Australia. Respondents answered 10 questions where they chose between two screening options created by an experimental design. Each screening option described the role of AI (supplementing current practice, replacing one radiologist, replacing both radiologists, or triaging), and the AI accuracy, ownership, representativeness, privacy, and waiting time. Analysis included conditional and latent class models, willingness-to-pay, and predicted screening uptake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 802 participants preferred screening where AI was more accurate, Australian owned, more representative and had shorter waiting time for results (all <i>p</i> &lt; .001). There were strong preferences (<i>p</i> &lt; .001) against AI alone or as triage. Three patterns of preferences emerged: positive about AI if accuracy improves (40% of sample), strongly against AI (42%), and concerned about AI (18%). Participants were willing to accept AI replacing one human reader if their results were available 10 days faster than current practice but would need results 21 days faster for AI as triage. Implementing AI inconsistent with community preferences could reduce participation by up to 22%.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 9","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35859","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143861609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}