BMC Cancer最新文献

{"title":"Novel Gene expression-based Risk Stratification tool predicts recurrence in Non-muscle invasive Bladder cancer.","authors":"Srivatsa N, Hari Ps, Rahul P, Lista Paul, Durgadevi Veeraiyan, Ambili Narikot, Vidya Veldore, Nishtha Tanwar, Peddagangannagari Sreekanthreddy, Hitesh Goswami, Rekha V Kumar, B S Srinath, Aruna Korlimarla","doi":"10.1186/s12885-025-14273-y","DOIUrl":"10.1186/s12885-025-14273-y","url":null,"abstract":"<p><strong>Background: </strong>Bladder cancer represents a heterogeneous disease with distinct clinical challenges. Non-muscle invasive bladder cancer (NMIBC) typically presents as indolent and slow-growing, yet a critical clinical challenge remains: identifying which patients will progress to muscle-invasive disease requiring radical interventions. Early detection of progression propensity is essential, as once muscle invasion occurs, the risk of distant metastasis increases substantially, and treatment shifts from conservative TURBT (Transurethral Resection of Bladder Tumor) to aggressive surgical interventions with significant morbidity. Current risk stratification methods fail to adequately predict this transition in approximately 30% of cases, highlighting the urgent need for more accurate prognostic tools.</p><p><strong>Objective: </strong>This retrospective study aimed to develop and validate a transcriptomics-based mRNA score for predicting early NMIBC recurrence, comparing its performance against traditional risk stratification methods.</p><p><strong>Methods: </strong>We analyzed mRNA expression profiles from primary retrospective NMIBC tumor specimens (n = 25) collected between [2018-2022]. Traditional risk stratification tools, including EORTC scoring, were applied alongside our novel mRNA-based risk score to evaluate predictive accuracy for recurrence.</p><p><strong>Results: </strong>The transcriptomics-based mRNA score demonstrated a median prediction accuracy of 90% across 10,000 resampling iterations for predicting early NMIBC recurrence, significantly outperforming traditional EORTC risk scores. Our comprehensive gene set identified 435 differentially expressed genes associated with recurrence. Kaplan-Meier analysis showed significantly different recurrence-free survival between high and low mRNA risk score groups (Bonferroni corrected p-value < 0.0001).</p><p><strong>Conclusions: </strong>This retrospective analysis confirms that mRNA expression-based risk stratification provides superior predictive accuracy compared to conventional clinicopathologic risk tools. Implementation of this gene signature could potentially reduce over-investigation and improve surveillance cost-effectiveness after TURBT in patients with primary high-risk NMIBC. These findings may transform the clinical management paradigm by enabling more personalized follow-up protocols based on molecular risk assessment.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"916"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126679","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":"Patient preferences for treatments in hormone receptor-positive/HER2-negative metastatic breast cancer in Italy: a discrete choice experiment study.","authors":"Grazia Arpino, Carmine De Angelis, Lorenzo Gerratana, Matteo Lambertini, Sarah Igidbashian, Rosanna Gramigna, Xavier Guillaume","doi":"10.1186/s12885-025-14308-4","DOIUrl":"10.1186/s12885-025-14308-4","url":null,"abstract":"<p><p>Hormone receptor (HR) positive (HR +) and human epidermal growth factor receptor 2 (HER2) negative (aka HER2 -) breast cancer (BC) is the most frequently diagnosed subtype. Recent development of next-generation endocrine therapies (e.g. selective estrogen receptor degraders (SERDs); third-generation aromatase inhibitors (AI) and targeted therapies (e.g., CDK4/6, PI3K, and mTOR inhibitors)) as well as antibody drugs conjugates (ADC, eg. T-DXd and SG) showed promising results with meaningful improvements in survival for patients with metastatic HR + HER2 - BC. Therapy selection is mainly based on clinical, tumor pathological and molecular characteristics as well as on efficacy based on trial data, nevertheless, side effect profiles are key differentiators of treatments in the metastatic setting. Therefore, understanding how patients evaluate various treatment attributes and how these change in different clinical situations is fundamental toward the choice of optimal therapeutic strategies for treating metastatic HR + HER2 - Stage IV patients. Here, we investigated treatment preferences of a total of 102 stage IV HR + HER2 - breast cancer patients in Italy by developing and applying a survey instrument based on discrete choice experiment (DCE). Treatment efficacy was the top valued attribute across all patient segments and the second most important attribute was the risk of grade ≥ 3 adverse events (AE). Overall, therapies with better outcomes of PFS or AE grade 3 or higher would have a higher impact on the preference to choose a treatment from a patient perspective.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"920"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12101022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126681","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":"Association of sarcopenia with all-cause and cause-specific mortality in cancer patients: development and validation of a 3-year and 5-year survival prediction model.","authors":"Feng Cui, Xiangji Dang, Daiyun Peng, Yuanhua She, Yubin Wang, Ruifeng Yang, Zhiyao Han, Yan Liu, Hanteng Yang","doi":"10.1186/s12885-025-14303-9","DOIUrl":"10.1186/s12885-025-14303-9","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a clinicopathological condition characterized by a decrease in muscle strength and muscle mass, playing a crucial role in the prognosis of cancer. Therefore, this study aims to investigate the association between sarcopenia and both all-cause mortality and cancer-specific mortality among cancer patients. Furthermore, we plan to develop risk prediction models using machine learning algorithms to predict 3-year and 5-year survival rates in cancer patients.</p><p><strong>Method: </strong>This study included 1095 cancer patients from the National Health and Nutrition Examination Survey (NHANES) cohorts spanning 1999-2006 and 2011-2014. Initially, we used the Least Absolute Shrinkage and Selection Operator (LASSO)-Cox regression models for feature selection. Subsequently, we employed multivariable Cox regression models to investigate the association between sarcopenia and all-cause and cancer-specific mortality in cancer patients. We developed five machine learning algorithms, including Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), LightGBM, and XGBoost, to predict 3-year and 5-year survival rates and to perform risk stratification.</p><p><strong>Results: </strong>The multivariable COX regression model showed sarcopenia significantly increases the risk of all-cause mortality (HR = 1.33, 95%CI:1.05, 1.70, P = 0.0194) and cancer-specific mortality (HR = 1.67, 95%CI:1.09, 2.55, P = 0.0176) in cancer patients. Among the five machine learning algorithms developed, the LightGBM model demonstrated strong performance in the 3-year and 5-year survival prediction tasks, making it the optimal model selection. Decision curve analysis and Kaplan-Meier curves further confirmed our model's ability to identify high-risk individuals effectively.</p><p><strong>Conclusions: </strong>Sarcopenia significantly increases the risk of mortality in cancer patients. We developed a survival prediction model for cancer patients that effectively identifies high-risk individuals, thereby providing a foundation for personalized survival assessment.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"919"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126670","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":"Fucosyltransferase 11 restrains ferroptosis via upregulation GPX4 expression in gastric cancer.","authors":"Bingbing Zhang, Yali Chen, Xuezhou Gu, Yu Zheng, Zhong Hua Jiang","doi":"10.1186/s12885-025-14340-4","DOIUrl":"10.1186/s12885-025-14340-4","url":null,"abstract":"<p><p>Ferroptosis is a novel iron-dependent type of programmed cell death that is characterized by the oxidation of lipids by divalent iron ions to produce lipid peroxides, which leads to cell death. Fucosyltransferase 11 (FUT11) is highly expressed in most tumors and is involved in tumorigenesis. However, there have been few studies regarding the relationship between FUT11 and ferroptosis. In this study, we found that FUT11 expression was abnormally high in gastric cancer (GC) cells and that the prognosis of patients with GC and high expression of FUT11 was poor. FUT11 expression was significantly correlated with the TNM stage of GC.Specific knockdown of FUT11 significantly inhibited the proliferation of GC cells, reduced the abundance of the key anti-ferroptotic protein glutathione peroxidase 4(GPX4), induced lipid peroxidation and ferroptosis in GC cells, and inhibited the proliferation of these cells. The overexpression of GPX4 reduced the inhibitory effect of FUT11 on GC cells. In addition, the knockdown of FUT11 significantly inhibited GC tumor growth in mice, and this inhibitory effect was reduced by the overexpression of GPX4. In conclusion, we have shown that FUT11 promotes GC progression by targeting GPX4, thereby inhibiting ferroptosis in GC cells. These findings suggest that FUT11 is a potential therapeutic target for GC.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"923"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126673","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":"Retrospective analysis of pembrolizumab-related adverse reactions and death outcomes based on the FAERS database.","authors":"Huilin Xu, Ying Huang, Nan Zhao, Han Hu, Dedong Cao","doi":"10.1186/s12885-025-14342-2","DOIUrl":"10.1186/s12885-025-14342-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the characteristics of adverse reactions in cancer patients treated with Pembrolizumab based on the U.S. Food and Drug Administration's Adverse Event Reporting System (FAERS) database, and to assess the characteristics and risk factors of fatality reports.</p><p><strong>Methods: </strong>The study data was sourced from the FAERS database, collecting adverse event reports related to Pembrolizumab from 2013 to June 2024. The main analysis variables included gender, age, cancer type, country, reporter type, and adverse reaction outcomes. Descriptive statistics, univariate analysis, and multivariate Logistic regression models were used to assess the relationship between each variable and fatal outcome.</p><p><strong>Results: </strong>A total of 46,883 adverse reactions were collected, including 5,483 reports with fatal outcomes. The number of events has been increasing since 2013, especially peaking in 2022 and 2023. The United States and Japan had the highest number of adverse reaction reports. The number of serious events reported increased significantly with age, especially in the 51-65 and 66-80 age groups. The age of patients who died was concentrated in the elderly group (≥ 65 years old), and the median treatment duration time of pembrolizumab was 17 days. Analysis showed that gender (OR = 0.75; 95%CI: 0.71-0.80, p < 0.01), age (OR = 0.89; 95%CI: 0.84-0.96, p < 0.01), and ingredients count (OR = 1.92; 95%CI: 1.84-2.01, p < 0.01) were significantly associated with the treatment duration of pembrolizumab.</p><p><strong>Conclusion: </strong>The serious adverse reactions in cancer patients treated with Pembrolizumab are closely related to patient individual characteristics and cancer types. It is necessary to strengthen the monitoring of high-risk groups such as the elderly in clinical treatment to reduce the risk of fatal outcomes.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"917"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126683","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":"Evaluation and implementation of multidisciplinary, standardized, guideline-based long-term follow-up care for adult survivors of childhood cancer in Germany: protocol of a prospective, multi-center, nationwide study (LE-Na).","authors":"C Cytera, K Baust, A Borgmann-Staudt, G Calaminus, K Egger-Heidrich, J Faber, D Grabow, T Halbsguth, A Kock-Schopenhauer, I R König, S Michaelis, A Neumann, A Puzik, S Schuster, F Wolters, C Arendt, M Sleimann, T Langer, J Gebauer","doi":"10.1186/s12885-025-14355-x","DOIUrl":"10.1186/s12885-025-14355-x","url":null,"abstract":"<p><strong>Background: </strong>Late effects can occur years to decades after cancer therapy, resulting in morbidity and reduced health-related quality of life. Clinical long-term follow-up (LTFU) enables timely diagnosis and treatment of these sequelae. So far, only a minority of childhood cancer survivors (CCS) in Germany regularly visit LTFU care facilities. The LE-Na study aims to: 1. implement and/or improve LTFU care structures for adult CCS in Germany, 2. inform former patients about late effects and LTFU care centers, 3. create a basis for future research by building up a central database, consent management and infrastructure, 4. establish a clinical LTFU cohort of adult CCS in Germany, 5. evaluate the implementation of the LFTU care, 6. enable the expansion of LTFU care structures nationwide, 7. integrate the developed LTFU care structures into the standard health care system.</p><p><strong>Methods: </strong>Within five years, approximately 5000 CCS will be invited to visit one of the 10 LTFU centers in Germany. Study participants are either contacted by the German Childhood Cancer Registry (GCCR), transitioned from the local pediatric oncology care unit, or recruited via media. They are assigned to one of three different risk groups based on an evidence-based risk stratification and receive standardized multidisciplinary follow-up care. Primary outcomes are satisfaction with the LTFU care offer as well as degree of health-related self-efficacy expectation. They will be assessed at two time points. A scientific evaluation of the implemented LTFU care will be enabled by a waitlist control group. The harmonized outcome data are documented in a standardized database.</p><p><strong>Discussion: </strong>By addressing CCS in Germany who have not received standardized LTFU care yet, the LE-Na study expects to improve nationwide LTFU care and therewith patient's satisfaction with the LTFU care offer as well as their health-related self-efficacy expectation.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"921"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126672","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":"Grading chondroid tumors through MRI radiomics: enchondroma, low-grade chondrosarcoma and higher-grade chondrosarcoma.","authors":"Hyerim Park, Jooyeon Lee, Seungeun Lee, Joon-Yong Jung","doi":"10.1186/s12885-025-14330-6","DOIUrl":"10.1186/s12885-025-14330-6","url":null,"abstract":"<p><strong>Background: </strong>To develop a multiclass radiomics model for differentiating chondroid bone tumors using preoperative MRI.</p><p><strong>Methods: </strong>This retrospective study included 120 patients (92 enchondromas, 16 low-grade chondrosarcomas, and 12 intermediate-to-high-grade chondrosarcomas) who underwent contrast-enhanced MRI between 2009 and 2019. Tumor segmentation was manually performed by a musculoskeletal radiologist and validated by a senior radiologist. We used least absolute shrinkage and selection operator (LASSO) and random forest (RF) for feature selection and classification, with and without synthetic minority oversampling technique (SMOTE). Model performance was evaluated using five-fold cross-validation with average precision, accuracy, area under the curve (AUC), and weighted kappa statistics.</p><p><strong>Results: </strong>The LASSO + RF model based on all sequences achieved the highest accuracy (0.826 ± 0.065) and AUC (0.967 ± 0.027). The highest mAP (0.750 ± 0.095) was observed in the SMOTE-enhanced T2WI-based model, highlighting the potential impact of class imbalance. Quadratic weighted kappa values ranged from 0.648 to 0.731 across models, indicating substantial agreement with pathological results.</p><p><strong>Conclusions: </strong>Preoperative MRI-based radiomics provides a robust method for the classification of chondroid bone tumors, potentially enhancing clinical decision-making.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"918"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126675","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":"Identifying the germline variation spectrum and predisposition genes in Chinese ovarian cancer using whole exome sequencing.","authors":"Xiaojing Guan, Sheng Liao, Fenglan Zhang, Qianyuan Zhu, Hao Qiu, Lan Qin, Xiao Zhang","doi":"10.1186/s12885-025-14302-w","DOIUrl":"10.1186/s12885-025-14302-w","url":null,"abstract":"<p><strong>Background: </strong>Next-generation sequencing (NGS) allows for the simultaneous sequencing of multiple cancer predisposition genes. We assessed the frequency and spectrum of germline variations in individuals with ovarian cancer (OC), using whole exome sequencing (WES).</p><p><strong>Methods: </strong>A total of 92 patients with OC, with or without a family history of cancer, were consecutively recruited between May 2020 and September 2023. Germline DNA was sequenced using WES.</p><p><strong>Results: </strong>Among the 12 canonical OC predisposition genes recommended by the National Comprehensive Cancer Network (NCCN) guidelines, 26 patients (28.26%) were found to have 28 pathogenic or likely pathogenic variations in 5 genes, including BRCA1 (n = 13), BRCA2 (n = 8), RAD51D (n = 4), BRIP1 (n = 2), and MSH2 (n = 1). Additionally, 24 patients (26.08%) harbored variants of uncertain significance (VUS) in canonical OC predisposition genes or other putative OC predisposition genes, including 3 loss of function variation: NM_001142548.1(RAD54L): c.1825C > T (p.Arg609Ter), NM_002907.3(RECQL): c.796C > T (p.Gln266Ter), and NM_001114132.2 (NBEAL1): c.5837dup (p.Tyr1946Ter). Moreover, we found that the detection rate of predisposition genes was correlated with a family history of malignancies and a personal history of other malignancies.</p><p><strong>Conclusions: </strong>Using WES, we found that 28.26% of patients with OC had germline cancer-predisposing variations. WES substantially improved the detection rates of a wide spectrum of variations in OC patients and uncovered putative predisposition genes.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"924"},"PeriodicalIF":3.4,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126677","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":"Lactate-associated gene MCU promotes the proliferation, migration, and invasion of pancreatic ductal adenocarcinoma.","authors":"Yuhang Chen, Fenglin Zhang, Suoyi Dai, Jiangang Zhao, Wenxun Cai, Ke Zhang, Xinghe Liao, Lianyu Chen","doi":"10.1186/s12885-025-14319-1","DOIUrl":"10.1186/s12885-025-14319-1","url":null,"abstract":"<p><strong>Background: </strong>The metabolism of lactate and lactylation of proteins are believed to influence tumor development through their effects on the tumor microenvironment and immune escape mechanisms. Nevertheless, its significance in pancreatic ductal adenocarcinoma (PDAC) has yet to be fully understood. This investigation sought to assess the predictive value and treatment implications of lactate-related genes (LRGs) in PDAC.</p><p><strong>Methods: </strong>We analyzed PDAC data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO), identifying LRGs. Using weighted gene co-expression network analysis (WGCNA) and consensus clustering, we delineated lactate subtypes and extracted differentially expressed genes. Functional enrichment and gene set enrichment analysis (GSEA) analyses were conducted to explore pathways. A lactate-linked risk signature was constructed using Lasso-Cox regression, and its prognostic value was validated. In vitro experiments were executed to examine the function of MCU in PDAC cells. In vitro experiments were conducted to detect the malignant potential of MCU in PDAC cells and its effect on lactic acid metabolism.</p><p><strong>Results: </strong>Two lactate subtypes were identified, with distinct gene expression profiles and clinical outcomes. The risk signature, comprising four LRGs, predicted survival with significant accuracy. In vitro, MCU knockdown reduced cell proliferation, migration, invasion, and stemness, confirming its role in PDAC malignancy. At the same time, it can also inhibit lactate production and glycolysis processes.</p><p><strong>Conclusion: </strong>Our investigation underscores the importance of LRGs in PDAC, providing a novel prognostic signature and therapeutic target.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"913"},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118752","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 doctor-shopping behavior on patient survival in lung cancer: findings from a 11-year cohort study using Korean claims data.","authors":"Minwoo Hong, Il Yun, Jong Youn Moon","doi":"10.1186/s12885-024-13416-x","DOIUrl":"10.1186/s12885-024-13416-x","url":null,"abstract":"<p><strong>Background: </strong>This population-based cohort study aimed to explore the impact of doctor-shopping behavior (DSB) on the survival of new patients with lung cancer in Korea to make policy suggestions for the efficient use of medical care for cancer patients.</p><p><strong>Methods: </strong>The cancer cohort data used in this study were obtained from the Korean National Health Insurance Service database, which contains claim records for all cancer patients in Korea between 2009 and 2021. After setting the washout period and exclusion criteria, 280,030 patients were found to be eligible for the analysis. The outcome variables were death within 30 days, 90 days, 1 year, and survival over 5 years after the first diagnosis. DSB, a variable of interest, was defined as the number of visits from the first diagnosis to the first treatment, and was classified into four quartiles. A multiple logistic regression model was used to examine the effects of DSB on the survival of patients with lung cancer.</p><p><strong>Results: </strong>Compared to patients who visited the doctor less than once (Q1), those with 2-9 visits (Q2, Q3) had a lower likelihood of death within 30 days, 90 days, and 1 year, and a higher probability of survival over 5 years. However, patients with more than 10 visits (Q4) had significantly increased odds of death. Moreover, those with excessive doctor shopping had about a 12% decrease in the likelihood of surviving beyond 5 years compared to those with minimal visits (95% CI: 0.85-0.92). Stratified analysis revealed that, especially when patients who are middle class or higher living in metropolitan cities engage in excessive doctor shopping, the likelihood of death within 1 year increases by 14-18%, and the survival rate over 5 years decreases by 12-18%, compared to those who rarely doctor shopped.</p><p><strong>Conclusion: </strong>For patients with lung cancer, moderate doctor shopping can positively affect survival, while excessive visits can increase mortality. This effect was more notable among patients with middle or higher incomes and those living in metropolitan cities. These results highlight the need for policies that regulate the use of medical resources, especially among patients with greater access to medical care, to ensure the efficient utilization of medical care for improved health outcomes.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"914"},"PeriodicalIF":3.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118749","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}