Journal of the National Cancer Center最新文献

{"title":"Global, regional, and national burden of genitourinary cancers in 204 countries and territories, 1990–2021: a systematic analysis for the global burden of disease study 2021","authors":"Zhiyong Zhang , Yingwei Xie , Lei Liu , Yongtao Wang , Shuang Li , Li Chen , Xiangbo Zeng , Yuanchao Zhu , Yishan Zhang , Yongyuan Xiao , Fengjin Zhao , Bihong Xu , Xiaocen Liu , Wenbin Guo , Ganping Wang , Wenlian Xie , Wanlong Tan , Hao Ping , Zaosong Zheng","doi":"10.1016/j.jncc.2025.03.001","DOIUrl":"10.1016/j.jncc.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Genitourinary cancers constitute a significant portion of the global cancer burden and have emerged as a prominent cause of cancer-related mortality. However, there remains a paucity of up-to-date statistical analyses that meticulously examine the global and national shifts in the epidemiology of genitourinary cancers. Our study aimed to provide a comprehensive understanding of the global distribution and progression of genitourinary cancers through analyses of the recently updated 2021 Global Burden of Disease (GBD) database.</div></div><div><h3>Methods</h3><div>This study presented the incidence, mortality, disability-adjusted life years (DALYs), and their respective age-standardized rates for four genitourinary cancers (bladder, kidney, prostate, and testicular cancers) by sex, age, and location from 1990 to 2021. Estimates for these data were presented with their 95% uncertainty intervals (UIs). Estimated annual percentage changes (EAPCs) and Bayesian Age-Period-Cohort (BAPC) models were utilized to further quantify the temporal dynamics of age-standardized rates (ASRs) in genitourinary cancers. Countries and territories were categorized according to socio-demographic index (SDI) quintiles.</div></div><div><h3>Results</h3><div>Globally, with the exception of a sustained decline in age-standardized incidence rates (ASIRs) for bladder cancer (EAPC = −0.36%), the ASIRs for kidney, prostate, and testicular cancers demonstrated an upward trend from 1990 to 2021 (EAPC = 0.53%, 0.20%, and 1.43%, respectively). In terms of geographical regions, High-income North America had the highest ASIRs for both bladder (13.98 per 100,000 persons [95% UI, 12.96 to 14.61]) and prostate (47.02 per 100,000 persons [95% UI, 44.47 to 49.04]) cancers. Southern Latin America recorded the highest ASIRs for kidney (13.44 per 100,000 persons [95% UI, 12.27 to 14.73]) and testicular (4.98 per 100,000 persons [95% UI, 4.33 to 5.72]) cancers. Additionally, Central Europe (1.25% [95% CI, 1.12% to 1.38%]), East Asia (2.40% [95% CI, 2.21% to 2.59%]), Eastern Europe (3.74% [95% CI, 3.55% to 3.92%]), and the Caribbean (5.52% [95% CI, 4.32% to 6.74%]) exhibited the highest EAPCs for bladder, kidney, prostate, and testicular cancers, respectively. Unlike the ASIRs, age-standardized mortality rates (ASMRs) and age-standardized DALYs rates (ASDRs) showed a downward trend over time in all types of genitourinary cancers. The disease burdens of bladder, kidney, and prostate cancers were primarily distributed among older men, while testicular cancer mainly occurred in young men. Smoking remained the primary risk factor for bladder cancer. Meanwhile, high fasting plasma glucose and high body-mass index exerted increasingly significant impacts on bladder and kidney cancers, respectively, during the study period. Projections to 2050 suggest that the global burdens of genitourinary cancers are expected to decline to varying degrees. However, regional disparities ","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 3","pages":"Pages 330-345"},"PeriodicalIF":7.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The epidemiological landscape of lung cancer: current status, temporal trend and future projections based on the latest estimates from GLOBOCAN 2022","authors":"Yuting Ji ,&nbsp;Yunmeng Zhang ,&nbsp;Siwen Liu ,&nbsp;Jingjing Li ,&nbsp;Qianyun Jin ,&nbsp;Jie Wu ,&nbsp;Hongyuan Duan ,&nbsp;Xiaomin Liu ,&nbsp;Lei Yang ,&nbsp;Yubei Huang","doi":"10.1016/j.jncc.2025.01.003","DOIUrl":"10.1016/j.jncc.2025.01.003","url":null,"abstract":"<div><h3>Background</h3><div>Given the relatively unfavorable prognosis and significant geographic differences in lung cancer burden, it is critical to update the global landscape of lung cancer to inform local strategies.</div></div><div><h3>Methods</h3><div>Based on the GLOBOCAN 2022, the age-standardized incidence rate (ASIR) and mortality rate (ASMR) were compared and linked to the Human Development Index (HDI) across different populations. The temporal trends in ASIR/ASMR were characterized as estimated annual percentage change (EAPC), and demographic projections were performed up to 2050.</div></div><div><h3>Results</h3><div>Globally, an estimated 2,480,675 cases and 1,817,469 deaths from lung cancer occurred in 2022. Both ASIR and ASMR of lung cancer varied widely by world region, with ASIR ranging from 2.06 to 39.38 per 100,000 and ASMR from 1.95 to 31.70 per 100,000. China alone accounted for &gt;40 % of cases and deaths worldwide. Both ASIR and ARMR of lung cancer increased with HDI (<em>R²</em>: 0.54 and 0.47, all <em>P</em> values &lt;0.001), regardless of gender. Based on available data, both ASIR during 2001–2010 and ASMR during 2001–2015 showed decreasing trends in males (EAPC: 1.50 % and −2.22 %) but increasing trends in females (EAPC: 1.08 % and 0.07 %). Similar trends in ASIR and ASMR were observed among the elder population (≥50 years); however, downward trends were observed in the younger population (&lt;50 years). Alongside the aging and growth of the population, estimated cases and deaths from overall lung cancer would increase by 86.2 % and 95.2 % up to 2050 as compared with estimates in 2022, respectively. Notably, increased early-onset lung cancer was only observed in transitioning countries, while decreased early-onset lung cancer was observed in transitioned countries.</div></div><div><h3>Conclusion</h3><div>Lung cancer maintained as the leading cancer burden worldwide. Unless timely preventive interventions in tobacco mitigation, early screening, and precise treatment, the global lung cancer burden is expected to increase in the future, especially for transitioning countries.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 3","pages":"Pages 278-286"},"PeriodicalIF":7.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer screening in adults aged 45–49: provider availability, CT colonography access, and screening rates","authors":"Rachel Liu-Galvin ,&nbsp;Zhigang Xie ,&nbsp;Young-Rock Hong","doi":"10.1016/j.jncc.2025.03.003","DOIUrl":"10.1016/j.jncc.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The US Preventive Services Task Force updated its colorectal cancer (CRC) screening guidelines in 2021, recommending screening for adults aged 45–49. This study aimed to evaluate CRC screening prevalence among this newly eligible population and assess its association with healthcare provider supply and CT colonography facility availability in 2022.</div></div><div><h3>Methods</h3><div>Using 2022 Behavioral Risk Factor Surveillance System data (n = 25,592), we estimated CRC screening prevalence among adults aged 45–49 and the prevalence of different screening modalities across various sociodemographic factors. We examined associations between screening rates and state-level healthcare provider supply using 2021–2022 Area Health Resources File data. Spearman rank-order correlations assessed relationships between provider supply, CT colonography facility availability, and screening prevalence.</div></div><div><h3>Results</h3><div>Overall CRC screening prevalence was 34.5% (95% CI: 33.4%–35.8%). Endoscopic tests were most common (74.9%), followed by stool-based tests (9.3%) and CT colonography (0.5%). Significant variations in screening modalities were observed across sociodemographic factors. Gastroenterology physician supply positively correlated with overall CRC screening prevalence (ρ = 0.42, <em>P</em> = 0.002) and endoscopy screening prevalence (ρ = 0.38, <em>P</em> = 0.005). CT colonography facility availability weakly correlated with CT colonography screening prevalence (ρ = 0.15, <em>P</em> = 0.316), although this was not significant.</div></div><div><h3>Conclusions</h3><div>CRC screening rates among newly eligible adults aged 45–49 appear to be suboptimal in 2022. Disparities in screening methods across sociodemographic factors highlight potential access barriers, particularly for endoscopic tests. The association between gastroenterology physician supply and screening rates emphasizes the importance of addressing projected workforce shortages. Targeted efforts are needed to increase CRC screening uptake in this age group and ensure equitable access to screening services.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 4","pages":"Pages 414-425"},"PeriodicalIF":9.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness of goserelin 10.8-mg compared to goserelin 3.6-mg in premenopausal and perimenopausal Chinese patients with hormone receptor positive breast cancer: a cohort study","authors":"Yongsheng Wang ,&nbsp;Xi Wang ,&nbsp;Jiong Wu ,&nbsp;Hong Liu ,&nbsp;Jiuda Zhao ,&nbsp;Jian Huang ,&nbsp;Jianxia Liu ,&nbsp;Youling Gong ,&nbsp;Hao Wang ,&nbsp;Huaqing Yang ,&nbsp;Guorong Zou ,&nbsp;Quchang Ouyang ,&nbsp;Guoqin Jiang ,&nbsp;Huijuan Liu ,&nbsp;Sujie Ni ,&nbsp;Binghe Xu ,&nbsp;Jinming Yu","doi":"10.1016/j.jncc.2025.02.006","DOIUrl":"10.1016/j.jncc.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Few studies compared the effectiveness of the 3-monthly goserelin 10.8-mg and the monthly 3.6-mg depot in inducing ovarian function suppression for premenopausal patients with hormone receptor positive (HR+) breast cancer. We conducted a large-scale real-world study (RWS) in China to validate the non-inferiority of goserelin 10.8-mg to the 3.6-mg depot.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective-prospective, non-inferiority study compared goserelin 10.8-mg with 3.6-mg in suppressing estradiol (E2) levels in premenopausal and perimenopausal patients with HR+ breast cancer. Eligible patients were identified, and their demographic and clinical data were obtained from hospital medical records. The observation period was 28 weeks. Propensity score matching (PSM) ensured baseline comparability. The primary endpoint was the proportion of patients with E2 suppression to postmenopausal level at Week 12±4. Difference in proportions and 95 % CI was calculated by Newcombe-Wilson score method. The non-inferiority margin was -10 %. Subgroup and sensitivity analyses assessed result robustness.</div></div><div><h3>Results</h3><div>From 1st January, 2015 to 15th December, 2023, 15,629 patients from 16 hospitals nationwide were screened, with 1,060 eligible patients included in the full analysis set (3.6-mg group: 678; 10.8-mg group: 382). Post-PSM, the primary endpoint was analyzed in 590 patients (295 in each group). At Week 12±4, the proportion of patients with E2 suppression was 99.1 % (95 % CI: 96.9 %–99.8 %) for goserelin 10.8-mg and 95.3 % (95 % CI: 91.0 %–97.6 %) for goserelin 3.6-mg. The difference was 3.8 % (95 % CI: 0.6 %–8.1 %) with the lower limit of 95 % CI greater than the non-inferiority margin. All subgroup analyses, including those based on age (≤45 or &gt;45 years) and previous chemotherapy (yes/no), and all sensitivity analyses on the primary endpoint were consistent with the main analysis.</div></div><div><h3>Conclusions</h3><div>This RWS validated the non-inferiority of goserelin 10.8-mg 3-monthly to 3.6-mg monthly in Chinese patients with HR+ breast cancer, where high E2 suppression rates were achieved in both goserelin dosage groups.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (NCT05184257).</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 4","pages":"Pages 392-401"},"PeriodicalIF":9.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of infraclavicular and supraclavicular lymph nodes in breast cancer patients receiving neoadjuvant chemotherapy: implications for regional lymph node classification","authors":"Yanyu Chen ,&nbsp;Yuzhi Song ,&nbsp;Zhonghua Han ,&nbsp;Hui Han ,&nbsp;Tianlan Tang ,&nbsp;Silin Chen ,&nbsp;Ruizhi Zhao ,&nbsp;Cheng Huang ,&nbsp;Guiqing Shi ,&nbsp;Yuping Lin ,&nbsp;Ying Wang ,&nbsp;Liuqing Jiang ,&nbsp;Jinhua Chen ,&nbsp;Chunsen Xu ,&nbsp;Fangmeng Fu ,&nbsp;Chuan Wang ,&nbsp;Yong Yang","doi":"10.1016/j.jncc.2025.02.005","DOIUrl":"10.1016/j.jncc.2025.02.005","url":null,"abstract":"<div><h3>Background</h3><div>Metastasis to the infraclavicular and supraclavicular lymph nodes (ISLNs) is an important factor that predicts poor survival in patients with breast cancer; however, pathological nodal staging does not traditionally include ISLNs because of their non-routine surgical dissection. This study aimed to evaluate the prognostic impact of ISLN metastasis and propose a refined nodal staging system tailored for patients undergoing neoadjuvant chemotherapy (NAC).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 1,072 patients with breast cancer with or without ISLN metastasis who received NAC at two institutions (Fujian cohort and Hebei cohort) from 2010 to 2022. We conducted detailed survival analysis to evaluate the diagnostic consistency and prognostic significance of ISLNs.</div></div><div><h3>Results</h3><div>There were no survival differences among patients with ISLN involvement across different assay methodologies and patient cohorts. Among 887 patients in the Fujian cohort, 238 patients (26.8 %) with positive ISLNs had significantly inferior 3-year progression-free survival (PFS, 75.9 % vs. 90.4 %, <em>P</em> &lt; 0.001) and overall survival (OS, 90.6 % vs. 95.9 %, <em>P</em> &lt; 0.001). After adjusting for potential confounders, ISLN involvement persisted as an independent predictor of both PFS and OS. We propose a refined axillary classification that combines pathological axillary staging post-NAC with ISLN involvement, revealing 3-year PFS rates of 95.3 %, 87.6 %, 73.4 %, and 64.5 % for the respective four groups defined by this refined classification combining axillary stage and ISLN status.</div></div><div><h3>Conclusions</h3><div>Involvement of the ISLNs was associated with a worse prognosis, underscoring their prognostic value. This finding highlights the potential of ISLN status to influence decisions regarding adjuvant treatment in patients with breast cancer.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 4","pages":"Pages 402-413"},"PeriodicalIF":9.4,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the tumor microenvironment: insights into immunotherapy and beyond","authors":"Wenhao Xu ,&nbsp;Jiahe Lu ,&nbsp;Hailiang Zhang ,&nbsp;Dingwei Ye","doi":"10.1016/j.jncc.2025.04.003","DOIUrl":"10.1016/j.jncc.2025.04.003","url":null,"abstract":"","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 4","pages":"Pages 426-428"},"PeriodicalIF":9.4,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in antibody-drug conjugates as cancer therapeutics","authors":"Jung Yin Fong ,&nbsp;Zhixin Phuna ,&nbsp;Di Yang Chong ,&nbsp;Christophorus Manuel Heryanto ,&nbsp;Yu Shyan Low ,&nbsp;Khang Chiang Oh ,&nbsp;Yan Huen Lee ,&nbsp;Allan Wee Ren Ng ,&nbsp;Lionel Lian Aun In ,&nbsp;Michelle Yee Mun Teo","doi":"10.1016/j.jncc.2025.01.007","DOIUrl":"10.1016/j.jncc.2025.01.007","url":null,"abstract":"<div><div>Antibody-drug conjugates (ADCs) represent a promising approach in targeted cancer therapy, combining the targeted precision of antibodies with the potency of cytotoxic payloads to selectively target tumour cell whilst minimising off-target effects. This review provides a comprehensive analysis of ADCs, encompassing their structural components, mechanisms of action, and clinical applications. It also examines recent technological advancements, particularly in antibody engineering and linker design, aimed at enhancing therapeutic efficacy and safety. The current clinical landscape is outlined, highlighting approved ADCs and promising candidates in clinical trials, while also addressing key challenges such as stability, half-life, and systemic toxicity. This review is based on an extensive literature survey from major databases such as Scopus and Web of Science, with a focus on keywords like “antibody-drug conjugates”, “ADC advancements”, and “next-generation ADC technologies”. By integrating insights from both preclinical and clinical perspectives, we highlight the transformative potential of ADCs in advancing modern cancer therapy.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 4","pages":"Pages 362-378"},"PeriodicalIF":9.4,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating tumor DNA as a biomarker of prognosis prediction in colorectal cancer: a systematic review and meta‐analysis","authors":"Qingxin Zhou ,&nbsp;Xiaowei Chen ,&nbsp;Baoqi Zeng ,&nbsp;Meng Zhang ,&nbsp;Nana Guo ,&nbsp;Shanshan Wu ,&nbsp;Hongmei Zeng ,&nbsp;Feng Sun","doi":"10.1016/j.jncc.2024.05.007","DOIUrl":"10.1016/j.jncc.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>Circulating tumor DNA (ctDNA) is increasingly being used as a potential biomarker in colorectal cancer (CRC) patients. However, the role of ctDNA in CRC prognosis prediction remains unclear. The objective is to systematically assess the clinical value of ctDNA in colorectal cancer prognosis prediction throughout the treatment cycle.</div></div><div><h3>Methods</h3><div>PubMed, Web of Science, Embase, Cochrane Library, Scopus, and clinical trials.gov database was searched from January 2016 to April 2023. Observational studies and randomized clinical trials reporting on ctDNA and prognostic outcomes in CRC patients were included. Pooled hazard risk ratios (HRs) were calculated for the primary outcomes, relapse-free survival (RFS), and overall survival (OS). Random-effects models were preferred considering the potential heterogeneity.</div></div><div><h3>Results</h3><div>Sixty-five cohort studies were included. Association between ctDNA and shorter RFS or OS was significant, especially after the full-course treatment recommended by the guidelines (HR = 8.92 [ 95 % CI: 6.02–13.22], <em>P</em> &lt; 0.001, <em>I²</em> = 73 %; HR = 3.05 [ 95 % CI: 1.72–5.41], <em>P</em> &lt; 0.001, <em>I²</em> = 48 %) for all types of CRC patients. Despite the presence of heterogeneity, subgroup analyses showed that the cancer type and ctDNA detection assays may be the underlying cause. Besides, ctDNA may detect recurrence earlier than radiographic progression, but no uniform sampling time point between studies might bring bias. However, ctDNA detection did not appear to correlate with pathological complete response achievement in patients with locally advanced rectal cancer.</div></div><div><h3>Conclusion</h3><div>ctDNA detection was significantly associated with poorer prognosis. The potential applications in prognostic prediction are promising and remain to be evaluated in other fields.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 167-178"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-field vs two-field lymphadenectomy in thoracic ESCC patients: a multicenter randomized study (NST 1503)","authors":"Yousheng Mao ,&nbsp;Shuoyan Liu ,&nbsp;Yongtao Han ,&nbsp;Shiping Guo ,&nbsp;Chun Chen ,&nbsp;Shugeng Gao ,&nbsp;Anlin Hao ,&nbsp;Hongbing Duan ,&nbsp;Wentao Fang ,&nbsp;Renquan Zhang ,&nbsp;Zhentao Yu ,&nbsp;Xiangning Fu ,&nbsp;Xiaofei Li ,&nbsp;Qun Wang ,&nbsp;Lijie Tan ,&nbsp;Zhigang Li ,&nbsp;Yin Li ,&nbsp;Zhirong Zhang ,&nbsp;Wenqiang Wei ,&nbsp;Yan Fang ,&nbsp;Jie He","doi":"10.1016/j.jncc.2025.01.002","DOIUrl":"10.1016/j.jncc.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>3-field lymph node dissection (3FL) frequently lead to much more perioperative complications than 2-field lymph node dissection (2FL). This study was designed as a non-inferiority trial to evaluate whether 3FL could be omitted without compromising overall survival (OS) and disease-free survival (DFS) in the patients with resectable thoracic esophageal squamous cell cancer (ESCC) and negative right recurrent laryngeal nerve lymph nodes (RRLN-LNs).</div></div><div><h3>Methods</h3><div>cT1b-3N0–1M0 thoracic ESCC patients were managed in 3 arms during open or minimally invasive McKeown esophagectomy according to the results of frozen section examination for RRLN-LNs: if positive, direct 3FL (RRLN[+]-3FL); if negative, 2FL (RRLN[-]-2FL) or 3FL (RRLN[-]-3FL) by randomization.</div></div><div><h3>Results</h3><div>Based on frozen section, of the 829 finally recruited patients, 121 (13.6 %) had positive RRLN-LNs and direct 3FL (RRLN[+]-3FL); 766 had negative RRLN-LNs and were randomized into the RRLN [-]-2FL (386 cases) or RRLN[-]-3FL (380 cases) group. The cervical LN metastasis rate in the RRLN[+]-3FL group (28.9 %) was significantly higher than that in the RRLN[-]-3FL group (8.3 %) (<em>P</em>&lt;0.001). The 5-year OS and DFS were 72.2 % and 65.1 % in the RRLN[-]-3FL group and 68.8 % and 62.8 % in the RRLN[-]-2FL group (OS, <em>P</em> = 0.163; DFS, <em>P</em> = 0.378), versus 50.3 % and 41.2 % in the RRLN[+]-3FL group (both <em>P</em>&lt;0.001), respectively.</div></div><div><h3>Conclusions</h3><div>Additional cervical lymphadenectomy can be avoided in the patients with middle or lower thoracic ESCC and negative RRLN-LNs by frozen section treated by upfront surgery.</div><div>Trial Registration: ClinicalTrials.gov Identifier NCT02448953.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 203-211"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel risk stratification system for primary small-cell carcinoma of the esophagus: indication for prognostication and staging","authors":"Yong Yang ,&nbsp;Jing Yu ,&nbsp;Silin Chen ,&nbsp;Xiaomin Wang ,&nbsp;Furong Wu ,&nbsp;Cheng Huang ,&nbsp;Yuping Lin ,&nbsp;Tianlan Tang ,&nbsp;Tiantian Gao ,&nbsp;Zewei Zhang ,&nbsp;Yiping Zhang ,&nbsp;Liyan Wang ,&nbsp;Junqiang Chen ,&nbsp;Zhenyang Zhang ,&nbsp;Weijie Wang ,&nbsp;Jiangbo Lin ,&nbsp;Ying Wang ,&nbsp;Yuanji Xu ,&nbsp;Lei Zhao","doi":"10.1016/j.jncc.2025.02.003","DOIUrl":"10.1016/j.jncc.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Primary small cell carcinoma of the oesophagus (PSCCE) is a gastrointestinal tumour of rare onset. The current study was to investigate the role of a novel risk stratification system (RSS) for PSCCE.</div></div><div><h3>Methods</h3><div>The study included patients with PSCCE attending any of five medical institutions in China in 2008–2021, four of which served as a training set (n = 422) for construction of the RSS while the other served as a separate cohort (n = 256) for validation of the model. The RSS was established based on covariates associated with overall survival (OS) with a two-sided <em>P</em>-value of &lt; 0.05 in multivariable regression. Survival discrimination of RSS was assessed.</div></div><div><h3>Results</h3><div>In the training cohort, multivariate regression analysis revealed age, Eastern Cooperative Oncology Group score, and initial lymph node metastasis to be independent prognostic factors for OS in non-distant metastatic PESCC; concurrent hepatic metastasis was the only significant predictor of distant metastatic PESCC. Accordingly, the RSS was developed and could classify patients into four subgroups: low-risk localized disease (LLD, defined as non-distant metastasis PESCC without risk factors, n = 58); high-risk localized disease (HLD, defined as non-distant metastasis PESCC with ≥ 1 risk factor, n = 199); low-risk metastatic disease (LMD, defined as metastatic PESCC without concomitant liver metastases, n = 103); and high-risk metastatic disease (HMD, definded as metastatic disease with synchronous liver metastases, n = 63). Three-year OS rates were 52.5%, 29.5%, 14.4%, and 5.7% for LLD, HLD, LMD, and HMD, respectively. When compared with the tumor-node-metastasis (TNM) system, RSS showed a consistently superior ability to predict OS in both the training and validation cohorts.</div></div><div><h3>Conclusion</h3><div>The RSS is a reliable stratification model that could be used to optimize treatment for PESCC.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 212-220"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}