MaturitasPub Date : 2025-10-01DOI: 10.1016/j.maturitas.2025.108743
Hoang - Phuong Nguyen , Lan T.M. Dao , Le Phuong Hoang Anh , Tan - Sinh Thi Nguyen , Shivena Rachel Chua Uy , Thi Ha Nguyen , Thanh Van Hoang , Thi Thanh Toan Do , Thanh Liem Nguyen
{"title":"Prevalence of and risk factors for female sexual dysfunction in middle-aged Vietnamese women: A cross-sectional hospital-based study","authors":"Hoang - Phuong Nguyen , Lan T.M. Dao , Le Phuong Hoang Anh , Tan - Sinh Thi Nguyen , Shivena Rachel Chua Uy , Thi Ha Nguyen , Thanh Van Hoang , Thi Thanh Toan Do , Thanh Liem Nguyen","doi":"10.1016/j.maturitas.2025.108743","DOIUrl":"10.1016/j.maturitas.2025.108743","url":null,"abstract":"<div><h3>Objectives</h3><div>Female sexual dysfunction encompasses a variety of sexual issues that can impact a woman's sexual health and overall quality of life. This study assesses the prevalence and associated factors among Vietnamese women aged 40–50 at the Women's Health Center, Vinmec International General Hospital, Hanoi, Vietnam.</div></div><div><h3>Study design</h3><div>A hospital-based cross-sectional study was conducted with 204 women aged 40–50 years who visited the Women's Health Center, Vinmec International General Hospital, between October 2023 and June 2024. This study adheres to the STROBE guideline.</div></div><div><h3>Main outcome measures</h3><div>Participants completed a self-administered questionnaire covering medical and sexual histories, which included the validated Vietnamese versions of the Female Sexual Function Index and the Depression, Anxiety, and Stress Scale-21.</div></div><div><h3>Results</h3><div>The prevalence of sexual dysfunction was 45.1 %. The prevalence of stress was 31.4 %, anxiety 43.1 %, and depression 26.0 %. Six factors were associated with female sexual dysfunction: lower levels of education, skilled occupation, late bedtime, no or infrequent physical activity, low monthly average income, and no or infrequent communication of sexual desires to a partner.</div></div><div><h3>Conclusion</h3><div>The study suggests a high prevalence of female sexual dysfunction among Vietnamese women and identifies its associated risk factors. These results can serve as a practical reference for future screening and prevention efforts to address female sexual dysfunction in Vietnam.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108743"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245972","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":"Are older women with early-stage endometrial cancer undertreated and more likely to die from their cancer?","authors":"Jeremy Barben , Ariane Mamguem Kamga , Adrien Guilloteau , Valerie Quipourt , Leila Bengrine-Lefevre , Tienhan Sandrine Dabakuyo-Yonli","doi":"10.1016/j.maturitas.2025.108741","DOIUrl":"10.1016/j.maturitas.2025.108741","url":null,"abstract":"<div><div>Endometrial cancer is the most common gynecological malignancy in developed countries, mainly affecting older women and raising concerns about potential under-treatment. This study aimed to describe treatment patterns and assess net survival in older women with early-stage endometrial cancer.</div></div><div><h3>Study design</h3><div>This French retrospective observational study used a gynecological cancer registry. Patients diagnosed with FIGO I-II endometrial cancer from 1998 to 2018 were included and stratified by age (a younger group, under 70 years, and an older group, aged 70 years or more). A multiple penalized splines model was used.</div></div><div><h3>Results</h3><div>A total of 828 patients were included: 448 women aged under 70 and 380 aged 70 or more. Older patients belonged to higher-risk groups as defined by ESGO-ESTRO-ESP 2021 criteria (<em>p</em> < 0.001) and had a lower rate of low-grade endometrioid carcinoma (75.1 % vs. 85.7 %, <em>p</em> = 0.003). Treatment patterns did not differ by age; surgery plus adjuvant therapy remained the main treatment (69.7 % vs. 70.8 % in the older and younger groups, respectively, <em>p</em> = 0.87). 5-year net survival was 95.0 % (95 % CI: 92.6–97.6) for younger and 84.3 % (95 % CI: 78.8–90.3) for older women. The univariate hazard ratio for death in older vs. younger women was 2.38 (95 % CI: 1.19–4.74; <em>p</em> = 0.02). Multivariate analysis attenuated age's effect: hazard ratio 1.38 (95 % CI: 0.97–3.31; <em>p</em> = 0.06). Charlson Comorbidity Index and non-low-grade endometrioid histology predicted poorer survival. Diagnosis period was not associated with survival.</div></div><div><h3>Conclusion</h3><div>No significant difference in treatment was found according to age. Although age was associated with 5-year net survival in univariate analysis, this association was no longer observed after adjusting for diagnosis period, comorbidities, and histology.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108741"},"PeriodicalIF":3.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226560","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":"Age at menopause and the progression of frailty among middle-aged and older women: A prospective cohort analysis from CHARLS","authors":"Xinyue Zhang , Wei Yu , Yueqin Zhu , Runfei Zhang , Yuhua Zhang","doi":"10.1016/j.maturitas.2025.108742","DOIUrl":"10.1016/j.maturitas.2025.108742","url":null,"abstract":"<div><h3>Objective</h3><div>Menopause marks an important transition in women's health, with the age at menopause influencing a variety of later-life health risks. However, the impact of menopause timing on longitudinal progression of frailty among Chinese middle-aged and older women remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Study from 2011 to 2018. A total of 11,984 women aged 45 years and older who experienced natural menopause were included. Frailty index was calculated using 30 health deficits encompassing physical, cognitive, and psychological domains. Age at menopause was categorized as <40, 40–44, 45–49, 50–55, and > 55 years. Mixed-effects linear regression models were used to examine the association between age at menopause and frailty progression, adjusting for sociodemographic, lifestyle, and health-related confounders.</div></div><div><h3>Results</h3><div>Women who experienced menopause after age 55 exhibited the fastest frailty progression compared with those with menopause at age 50–55 (fully adjusted β = 0.43; 95 % confidence interval, 0.05 to 0.81; <em>P</em> = 0.027). Women who underwent menopause at ages 40–44 also had a significantly accelerated frailty progression (β = 0.35; 95 % confidence interval, 0.07 to 0.64; <em>P</em> = 0.016). In contrast, premature ovarian insufficiency (<40 years) was associated with lower baseline frailty index and a slower progression of frailty during follow-up.</div></div><div><h3>Conclusions</h3><div>Both early and late menopause are associated with accelerated frailty progression among Chinese middle-aged and older women. These findings highlight the need for early identification and targeted preventative interventions in women at risk of atypical menopause timing to promote healthy aging.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108742"},"PeriodicalIF":3.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246032","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}
MaturitasPub Date : 2025-09-26DOI: 10.1016/j.maturitas.2025.108738
Panagiotis Anagnostis , Sofia Goulopoulou , Julia K. Bosdou , Konstantinos Lallas , Vasileios Kotsis
{"title":"Long-term health consequences of childhood adverse events: A narrative review","authors":"Panagiotis Anagnostis , Sofia Goulopoulou , Julia K. Bosdou , Konstantinos Lallas , Vasileios Kotsis","doi":"10.1016/j.maturitas.2025.108738","DOIUrl":"10.1016/j.maturitas.2025.108738","url":null,"abstract":"<div><div>“Adverse childhood events” or childhood adversity is a term often used to describe trauma and sources of stress during childhood or adolescence. Childhood adversity may negatively affect multiple aspects of an adult's life, such as cardiovascular disease, cancer, mental disorders, including substance abuse, as well as infertility and gynecological conditions, such as endometriosis, fibroids and polycystic ovarian syndrome. A negative psychosocial environment during childhood may increase the incidence of cardiovascular risk factors, such as dyslipidemia, diabetes, arterial hypertension and abdominal obesity, even from adolescence. This accelerates atherosclerotic processes and predisposes to higher cardiovascular morbidity and mortality even from early adulthood. The higher the number and severity of childhood adverse events, the higher is the risk of cardiovascular disease. Adverse childhood events may also be implicated in tumorigenesis, since they have been associated with an increased risk of cancer, either directly or indirectly, due to increased prevalence of causal factors and behaviors, such as smoking and obesity. This is also the case for infertility and mental disorders. Although the exact pathogenetic pathways have not been clarified, chronic stress during childhood and adolescence, which provides a state of low-grade systematic inflammation and dysregulation of the hypothalamus-pituitary-adrenal axis, may be a common basis for these comorbidities. In any case, there is an exigent need for strategies to promptly identify and treat these patients at risk of developing these long-term health problems associated with childhood adversity.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108738"},"PeriodicalIF":3.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214787","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}
MaturitasPub Date : 2025-09-25DOI: 10.1016/j.maturitas.2025.108737
Helena Slongo , Dulce C.P. Henriques , Alexandra P.N. Ongaratto , Helymar C. Machado , Renata M. Triglia , Cássia R.T. Juliato
{"title":"Microablative and non-ablative laser and radiofrequency treatment of genitourinary syndrome of menopause: A randomised controlled trial with four different energies","authors":"Helena Slongo , Dulce C.P. Henriques , Alexandra P.N. Ongaratto , Helymar C. Machado , Renata M. Triglia , Cássia R.T. Juliato","doi":"10.1016/j.maturitas.2025.108737","DOIUrl":"10.1016/j.maturitas.2025.108737","url":null,"abstract":"<div><h3>Objective</h3><div>This study compared the effects of four different types of energy treatments on women with genitourinary syndrome of menopause.</div></div><div><h3>Material and methods</h3><div>Four-arm single-blind randomised clinical trial, with 48 postmenopausal women with genitourinary syndrome of menopause. Participants were randomised into four groups: Group 1 received sessions of non-ablative Er:YAG laser; Group 2 received sessions of microablative CO2 laser; Group 3 underwent sessions of non-ablative radiofrequency; and Group 4 received sessions of fractional microablative radiofrequency. The primary outcome was the assessment of symptoms of genitourinary syndrome of menopause correlated with vaginal histological analysis at baseline and 1 month after the end of treatment. Secondary outcomes included sexual function and urinary symptoms, treatment satisfaction and major adverse events.</div></div><div><h3>Results</h3><div>All treatment modalities demonstrated significant improvement in dryness (<em>p</em> < 0.001) and dyspareunia (p < 0.001) measured by visual analogue scales and in vaginal symptoms assessed with the International Consultation on Incontinence Questionnaire-Vaginal Symptoms (p < 0.001), with no significant differences between groups. All treatment energies resulted in significant increases in tissue thickness (p < 0.001), layer number (p < 0.001), and collagen quantity and depth (p < 0.001), with no significant difference among the groups.</div></div><div><h3>Conclusions</h3><div>Both microablative and non-ablative energies, whether utilizing laser or radiofrequency, are effective treatments for the symptoms of genitourinary syndrome of menopause, with histological correlations observed and no notable differences in efficacy between modalities.</div></div><div><h3>Clinical trial registration</h3><div>Registered in REBEC (<em>Registro Brasileiro de Ensaios Clínicos</em>; Brazilian Registry of Clinical Trials). Trial registration number RBR-5vw3vpg. The protocol can be accessed at <span><span>https://ensaiosclinicos.gov.br/rg/RBR-5vw3vpg</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108737"},"PeriodicalIF":3.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254365","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}
MaturitasPub Date : 2025-09-25DOI: 10.1016/j.maturitas.2025.108739
Seok Woo Hong , Kyung Jae Yoon , Jeong-Hyun Kang
{"title":"Impact of diverse sleep characteristics on long-term skeletal muscle loss: A cohort study","authors":"Seok Woo Hong , Kyung Jae Yoon , Jeong-Hyun Kang","doi":"10.1016/j.maturitas.2025.108739","DOIUrl":"10.1016/j.maturitas.2025.108739","url":null,"abstract":"<div><h3>Objective</h3><div>Poor sleep may contribute to hormonal imbalance, increased adiposity, and disruption of energy metabolism. This study aimed to clarify the long-term impact of sleep characteristics on loss of skeletal muscle mass.</div></div><div><h3>Methods</h3><div>We analyzed data from 421,688 participants (220,902 males, 200786 females; mean age 39.1 ± 10.2 years) without a low skeletal muscle index at baseline. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Skeletal muscle mass was estimated using bioelectrical impedance analysis. Low skeletal muscle index was diagnosed by the Asian Working Group for Sarcopenia 2019 Consensus. Covariates included demographic characteristics, health behavior, and lifestyle-related factors, comorbidities, biochemical markers, and dietary intake. Multivariate Cox regression analyses were conducted to assess effects of sleep characteristics on incidence of low skeletal muscle index.</div></div><div><h3>Results</h3><div>Participants who developed low skeletal muscle index exhibited poorer general sleep quality. Notably, skeletal muscle index, body fat mass, visceral fat area, and body fat percentage all significantly differed with sleep quality. Biochemical assessment revealed significant variations in serum proteins, glucose metabolism markers, lipid profiles, kidney and liver function, and inflammatory markers with sleep quality. After adjusting for confounders, longer sleep latency and lower sleep efficiency remained significant contributors to low skeletal muscle index. Additionally, frequent use of sleep medication and severe sleep disturbances were significantly associated with low skeletal muscle index.</div></div><div><h3>Conclusion</h3><div>Poor sleep quality, particularly longer sleep latency, lower sleep efficiency, frequent use of sleep medication and severe sleep disturbance, significantly impacts maintenance of skeletal muscle mass.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108739"},"PeriodicalIF":3.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158793","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}
MaturitasPub Date : 2025-09-18DOI: 10.1016/j.maturitas.2025.108736
Marianne Koch , Hannah Sayahpour , Greta Lisa Carlin , Tim Dorittke , Rosa Loimer , Anika Dibon , Wolfgang Umek , Florian Heinzl , Barbara Bodner-Adler
{"title":"Characteristics of female overactive bladder syndrome: Results from a large retrospective cohort spanning 15 years","authors":"Marianne Koch , Hannah Sayahpour , Greta Lisa Carlin , Tim Dorittke , Rosa Loimer , Anika Dibon , Wolfgang Umek , Florian Heinzl , Barbara Bodner-Adler","doi":"10.1016/j.maturitas.2025.108736","DOIUrl":"10.1016/j.maturitas.2025.108736","url":null,"abstract":"<div><h3>Objectives</h3><div>This study analyzed subgroups of women with overactive bladder syndrome or mixed urinary incontinence to assess treatment success, time to success, therapy adherence, and demographic and clinical characteristics.</div></div><div><h3>Study design</h3><div>This retrospective cohort study was conducted with 1688 female patients diagnosed with overactive bladder or mixed incontinence. Data on patient demographics, clinical characteristics, treatment modalities, and outcomes were analyzed using descriptive statistics and Kaplan-Meier survival analysis.</div></div><div><h3>Main outcome measures</h3><div>Treatment success levels were categorized into no success, partial success, and complete success. Time to success was assessed using Kaplan-Meier curves. Demographic and clinical characteristics influencing outcomes were evaluated.</div></div><div><h3>Results</h3><div>Patients with mixed incontinence were younger, had a higher body mass index (BMI), had more comorbidities, and had more severe symptoms than those with isolated overactive bladder. Patients with overactive bladder were more often postmenopausal and had better early treatment success. Most patients improved early, though some required long-term follow-up. Significant differences in treatment utilization and outcomes were observed between subgroups. Polypharmacy, obesity, nocturia, and a diagnosis of mixed incontinence were associated with lower rates of success. Local estrogen, subtype of overactive bladder, and fewer medications predicted better outcomes and earlier response.</div></div><div><h3>Conclusions</h3><div>Personalized treatment strategies tailored to patient demographics and treatment history are crucial in managing overactive bladder and mixed incontinence effectively. The findings underscore the importance of long-term adherence to therapy and highlight areas for refining therapeutic interventions to optimize patient outcomes.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108736"},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202643","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}
MaturitasPub Date : 2025-09-17DOI: 10.1016/j.maturitas.2025.108732
Xiaojun Meng , Bolin Yang , Jibiao Chen , Chenlu He , Hanlu Yin , Jing Gu , Zhuping Xu , Yayong Ji
{"title":"Evaluation of intrinsic capacity impairment and associated factors in older people living with HIV in China","authors":"Xiaojun Meng , Bolin Yang , Jibiao Chen , Chenlu He , Hanlu Yin , Jing Gu , Zhuping Xu , Yayong Ji","doi":"10.1016/j.maturitas.2025.108732","DOIUrl":"10.1016/j.maturitas.2025.108732","url":null,"abstract":"<div><h3>Background</h3><div>Although intrinsic capacity (IC) has been evaluated among community-dwelling older people, IC among older people living with HIV (PLHIV) remains underexplored. This study investigated IC impairment and associated factors in older PLHIV in mainland China.</div></div><div><h3>Methods</h3><div>This cross-sectional study, conducted in China, enrolled older PLHIV aged ≥50 years. IC was assessed using detailed scales covering the domains of locomotion, vitality, cognition, psychology, and sensory capacity. Logistic regression analyses were used to explore the determinants of IC impairment in this population.</div></div><div><h3>Results</h3><div>Among 830 participants, 26.4 % (219/830) had impairment in at least one domain. A higher risk of IC impairment was associated with age ≥ 70 years (OR 2.44, 95 % CI 1.56–3.81), living with family members (OR 1.83, 95 % CI 1.24–2.69), being overweight or obese (OR 1.45, 95 % CI 1.03–2.04), impaired family function (OR 2.46, 95 % CI 1.65–3.66), and a high level of loneliness (OR 1.52, 95 % CI 1.04–2.24). In contrast, participants who were less likely to have IC impairment included those with an average monthly income ≥5000 RMB (OR 0.52, 95 % CI 0.32–0.86), those who exercised more than twice per week (OR 0.59, 95 % CI 0.42–0.82), and those with a baseline CD4<sup>+</sup> T cell count ≥200 cells/μL (OR 0.70, 95 % CI 0.50–0.98).</div></div><div><h3>Conclusion</h3><div>It is evident that some PLHIV are experiencing impairments across various domains. Formulating policies to support early preventive interventions and to provide timely medical intervention when needed is essential for promoting healthy ageing among older PLHIV.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108732"},"PeriodicalIF":3.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088675","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}
MaturitasPub Date : 2025-09-16DOI: 10.1016/j.maturitas.2025.108735
Yuanpu Wei , Weiming Chen , Hao Chen , Wenjie Yuan , Wei Zheng , Bin Zheng , Chun Chen , Zhang Yang
{"title":"Prognostic nutritional index predicts survival in older patients with resectable invasive lung adenocarcinoma","authors":"Yuanpu Wei , Weiming Chen , Hao Chen , Wenjie Yuan , Wei Zheng , Bin Zheng , Chun Chen , Zhang Yang","doi":"10.1016/j.maturitas.2025.108735","DOIUrl":"10.1016/j.maturitas.2025.108735","url":null,"abstract":"<div><h3>Introduction</h3><div>The clinical utility of preoperative inflammatory and nutritional indices remains unclear in older patients undergoing surgery for resectable invasive lung adenocarcinoma (IAC). This study evaluates the prognostic significance of these indices and develops a predictive model specifically for this vulnerable population.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 376 patients aged ≥70 years who underwent surgical resection for IAC. Eight preoperative inflammatory and nutritional indices were evaluated. Optimal cutoff values were identified using X-tile software. Prognostic implications for overall survival (OS) and progression-free survival (PFS) were assessed through Cox proportional hazards models and Kaplan–Meier analysis. A prognostic nomogram was developed and validated.</div></div><div><h3>Results</h3><div>Prognostic nutritional index (PNI) emerged as an independent prognostic factor for both OS (<em>p</em> = 0.038) and PFS (<em>p</em> = 0.008). Patients with low PNI (≤ 51.90) were significantly older (<em>p</em> = 0.006), predominantly male (<em>p</em> = 0.048), and had a history of smoking (<em>p</em> = 0.037). Kaplan-Meier analysis demonstrated significantly lower 5-year OS (82.5 % vs. 91.4 %, <em>p</em> = 0.007; HR = 0.356, 95 % CI 0.162–0.782) and PFS (83.5 % vs. 92.4 %, <em>p</em> = 0.006; HR = 0.366, 95 % CI 0.173–0.733) in the low PNI group compared with high PNI group. The developed nomogram incorporating PNI and other clinical variables demonstrated strong predictive capability, with area under the curve (AUC) values of 0.818, 0.834, and 0.811 for predicting 1-, 3-, and 5-year OS, respectively.</div></div><div><h3>Conclusions</h3><div>PNI serves as a robust independent prognostic marker in older patients with resectable IAC, suggesting potential utility for preoperative risk stratification and individualized perioperative management aimed at enhancing patient outcomes.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108735"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267818","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}
MaturitasPub Date : 2025-09-15DOI: 10.1016/j.maturitas.2025.108734
Haomin Wang , Huamei Ju , Shu Zhang , Haojie Li , Xia Chen
{"title":"Authors' reply to Hong Zhang et al","authors":"Haomin Wang , Huamei Ju , Shu Zhang , Haojie Li , Xia Chen","doi":"10.1016/j.maturitas.2025.108734","DOIUrl":"10.1016/j.maturitas.2025.108734","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108734"},"PeriodicalIF":3.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103019","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}