Cancers最新文献

{"title":"Single-Cell Sequencing: An Emerging Tool for Biomarker Development in Nuclear Emergencies and Radiation Oncology.","authors":"Jihang Yu, Md Gulam Musawwir Khan, Nada Mayassi, Bhuvnesh Kaushal, Yi Wang","doi":"10.3390/cancers17111801","DOIUrl":"10.3390/cancers17111801","url":null,"abstract":"<p><p>Next-generation sequencing (NGS) has been well applied to assess genetic abnormalities in various biological samples to investigate disease mechanisms. With the advent of high-throughput and automatic testing platforms, NGS can identify radiation-sensitive and dose-responsive biomarkers, contributing to triage patients and determining risk groups for treatment in a nuclear emergency. While bulk NGS provides a snapshot of the average gene expression or genomic changes within a group of cells after the radiation, it cannot provide information on individual cells within the population. On the other hand, single-cell sequencing involves isolating individual cells and sequencing the genetic material from each cell separately. This approach allows for the identification of gene expression and genomic changes in individual cells, providing a high-resolution view of cellular diversity and heterogeneity within a sample. Single-cell sequencing is particularly useful to identify cell-specific features of dose-response and organ-response genes. While single-cell RNA sequencing (scRNA-seq) technology is still emerging in radiation research, it holds significant promise for identifying biomarkers related to radiation exposure and tailoring post-radiation medical care. This review aims to focus on current methods of radiation dosimetry and recently identified biomarkers associated with radiation exposure. Additionally, it addresses the development of NGS techniques in the context of radiation situations, such as cancer treatment and emergency events, with a particular emphasis on single-cell sequencing technology.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282621","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":"Clinical Application of Next-Generation Sequencing for Molecular Classification in the Management of Endometrial Cancer: An Observational Cohort Study.","authors":"Sabrina Paratore, Angela Russo, Giusi Blanco, Katia Lanzafame, Eliana Giurato, Giovanni Bartoloni, Marco D'Asta, Mirella Sapienza, Valeria Solarino, Valentina Vinci, Giulia Maria Bonanno, Giuseppe Ettore, Roberto Bordonaro","doi":"10.3390/cancers17111806","DOIUrl":"10.3390/cancers17111806","url":null,"abstract":"<p><strong>Background/objectives: </strong>Endometrial cancer (EC) is the most common malignancy of the female genital tract. In 2013, The Cancer Genome Atlas analyzed the molecular profile of endometrial tumors identifying four risk classes (POLE ultramutated, mismatch repair-deficient, copy-number low-microsatellite stable, and copy-number high-serous-like. This classification is reshaping the current understanding of EC, enabling more refined risk stratification and uncovering potential therapeutic targets tailored to specific molecular subgroups. In the context of these four categories, it is possible to identify different molecular alterations that correlate with different prognoses.</p><p><strong>Methods and results: </strong>We retrospectively analyzed tissue samples from eighty-five EC patients, performing multigene profiling using a 50-gene next-generation sequencing (NGS) panel to categorize them into distinct molecular subtypes; we observed the following distribution: 5.9% POLE, 25.8% mismatch repair-deficient/microsatellite instability (MMRd/MSI), 11.8% p53abn/TP53mut, and 56.5% NSMP. A favorable concordance (97.6%) was shown in MSI NGS-based analysis and MMR IHC results, and the agreement rate of p53 IHC and <i>TP53</i> mutation was 92.3%. When we analyzed the correlation between molecular subtypes and clinicopathological features, we found that molecular subtypes significantly differentiated by grade, FIGO stage, and lymphovascular invasion (LVSI). These findings seem to support the effectiveness of our NGS-based classifier and its reliability in distinguishing both MSI and TP53 mutated cancers. This study also explored mutations in <i>PIK3CA</i>, <i>PTEN</i>, <i>KRAS</i>, <i>ERBB2</i>, and <i>ESR1</i> genes, noting their potential as targets for treatments. <i>PIK3CA</i> mutations were linked to favorable features, such as early disease stage and absence of LVSI.</p><p><strong>Conclusions: </strong>Our study highlights the potential of a medium-complexity NGS panel for supporting the molecular classification of endometrial cancer, complementing the existing diagnostic algorithms. By identifying additional biomarkers, we provided valuable insights into the genomic landscape of EC. However, further exploration of the molecular profiles is needed to validate these findings and improve the identification of patients at a higher risk of unfavorable outcomes.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282510","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":"High Burden of Non-Clonal Chromosome Aberrations Before Onset of Detectable Neoplasia in Fanconi Anemia Bone Marrow.","authors":"Silvia Sánchez, Benilde García-de-Teresa, Marco A Mejía-Barrera, Pedro V Reyes-Jiménez, Antonio Paz-Martínez, Miguel A Martínez, Moisés Ó Fiesco-Roa, Angélica Monsiváis-Orozco, Bertha Molina, Leda Torres, Alfredo Rodríguez, Sara Frias","doi":"10.3390/cancers17111805","DOIUrl":"10.3390/cancers17111805","url":null,"abstract":"<p><p><b>Background/objectives:</b> Fanconi anemia (FA) is an inherited bone marrow failure syndrome characterized by chromosome instability and predisposition to develop myelodysplastic neoplasm (MDS) and acute myeloid leukemia (AML). Clonal chromosome aberrations (CCAs) in chromosomes 1, 3, and 7 frequently appear in the bone marrow (BM) of patients with FA and are associated with MDS/AML progression. Given the underlying DNA repair defect that characterizes FA, non-clonal chromosomal abnormalities (NCCAs) are expected to be common events in the FA BM; in this study, we investigated the presence and significance of NCCA and CCA in the bone marrow (BM) of patients with FA. <b>Methods:</b> Here, we transversally examined the BM karyotypes of 43 non-transplanted patients with FA, 41 with non-clinically detectable hematologic neoplasia and two with diagnosed MDS. We searched for the presence of NCCAs, complex karyotypes (CKs), and CCAs as well as their association with the natural history of the disease, including age, degree of BM failure, and neoplastic transformation. <b>Results:</b> NCCAs were observed in the metaphase spreads of 41/43 FA patients; CKs were observed in 25/43 patients; CCAs were found in 15/43 patients; CCAs involving chromosomes 1, 3 and/or 7 were found in four patients; and other autosomes were found in the remaining 11 patients. Overall, we observed a baseline large karyotypic heterogeneity in the BM of FA patients, demonstrated by the ubiquitous presence of NCCA; such karyotypic heterogeneity precedes the eventual emergence of CKs and selection of cells carrying fitness-improving CCAs. Finally, CCAs involving chromosomes 1, 3 and 7, well-known drivers of hematological malignancy in FA, become established. Overall, we observed that the frequency of NCCAs and CCAs increased with age, even though a significant correlation was not found. <b>Conclusions:</b> These observations fit the model of evolution towards cancer that comprises a first phase of macroevolution represented by NCCAs and karyotypic heterogeneity, followed by the establishment of clones with CCAs, leading to microevolution and cancer. NCCAs are the most frequent chromosomal alterations in the bone marrow of patients with AF and constitute a genome with extensive karyotypic heterogeneity that evolves into clones with more complex genomes and can eventually progress to cancer.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282528","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":"Socioeconomic Disparities in Breast Cancer Survival: Examining Potential Mediator Role of Oncotype DX(ODX) Test and Stage at Diagnosis Among HR+/HER2- Breast Cancer Women.","authors":"Pratibha Shrestha, Qingzhao Yu, Edward S Peters, Edward Trapido, Mei-Chin Hsieh, Tekeda Ferguson, Quyen D Chu, Xiao-Cheng Wu","doi":"10.3390/cancers17111802","DOIUrl":"10.3390/cancers17111802","url":null,"abstract":"<p><strong>Background: </strong>Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage.</p><p><strong>Methods: </strong>We used data from the Louisiana Tumor Registry to identify women aged 20-90 years diagnosed with stage I-II in 2011-2014 and stage I-III in 2015-2017 HR+/HER2- BC who underwent BC surgery. The follow-up cutoff date was 31 December 2020. Cox proportional hazard regression and generalized mediation analysis were both performed.</p><p><strong>Results: </strong>Of 8931 BC women, 41.4% underwent ODX testing. After adjusting for sociodemographic, tumor characteristic, and treatment variables, low SES women had a higher hazard of overall death (HR = 1.16, 95% CI: 1.02-1.32) and BC-specific death (HR = 1.37; 95% CI: 1.01-1.87) compared to high SES women. The ODX test and stage explained 9.0% and 11.2% SES differences in the hazard of overall death and 4.4% and 13.3% in BC-specific death, respectively.</p><p><strong>Conclusions: </strong>Low SES is associated with higher hazard rates of overall and cause-specific death among women with breast cancer, even after adjustment. Differences in Oncotype DX (ODX) testing and stage at diagnosis explained part of these disparities. Targeted interventions are needed to improve access to genomic testing and early detection to reduce SES-related disparities in breast cancer outcomes.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282600","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":"Lenvatinib Is Highly Effective in Patients with Hepatocellular Carcinoma Related to Both Metabolic Dysfunction-Associated Steatohepatitis and Alcoholic Etiology: A Propensity Score Analysis.","authors":"Rodolfo Sacco, Edoardo G Giannini, Raffaella Tortora, Giovan Giuseppe Di Costanzo, Andrea Mega, Luca Marzi, Giulia Pieri, Andrea Pasta, Bruno Daniele, Piera Federico, Giuseppe Cabibbo, Maurizio Russello, Caterina Cocuzza, Luca Giacomelli, Marianna Silletta, Paolo Gallo, Umberto Vespasiani Gentilucci, Andrea Casadei-Gardini, Ernesto Claar, Adriano Pellicelli, Massimo Bellini, Filomena Morisco, Concetta Tatali, Valeria Pace Palitti, Antonio Izzi, Marco Di Stefano, Luca Rinaldi, Antonio Facciorusso","doi":"10.3390/cancers17111808","DOIUrl":"10.3390/cancers17111808","url":null,"abstract":"<p><p><b>Background and aims:</b> Metabolic dysfunction-associated steatotic liver disease (MASLD)-related hepatocellular carcinoma (HCC) may have distinct biological characteristics influencing systemic treatment response. However, the prognostic impact of MASLD vs. alcohol-related HCC in patients receiving lenvatinib remains unclear. This study aimed to assess lenvatinib's effectiveness and safety in these populations. <b>Methods:</b> A multicenter cohort of 378 HCC patients treated with lenvatinib (2019-2024) was analyzed. Propensity score matching was performed based on age, sex, tumoral stage, alpha-fetoprotein levels and Child-Pugh class. Survival was estimated using Kaplan-Meier analysis and compared with the log-rank test. Results were expressed as HR and 95% CI. <b>Results:</b> After matching, 115 patients per group were compared. Median OS was 21 months (95% CI: 20-23) in the group with metabolic dysfunction-associated steatohepatitis (MASH) and 19 months (95% CI: 18-21) in the group with alcohol etiology (<i>p</i> = 0.18). In multivariate analysis, only Child-Pugh class (HR 2.67, 95% CI: 1.84-5.41) and tumor stage (HR 2.18, 95% CI: 1.57-6.93) resulted as significant predictors of OS. Median PFS was 9 months (95% CI: 8-9) in patients with MASH and 9 months (95% CI: 7-10) in patients with alcohol etiology (<i>p</i> = 0.33). Only the Child-Pugh class was a significant predictor of PFS in univariate analysis (HR 1.56, 95% CI: 1.15-3.41; <i>p</i> = 0.03). No difference in terms of adverse event rate was observed between the two groups. <b>Conclusions:</b> Lenvatinib is effective in patients with both MASH- and alcohol-related HCC, with no difference in oncological outcomes between the two groups.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282556","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":"JAK Inhibitors and Risk of Cancer in IBD Patients.","authors":"Francesca Bernardi, Ilaria Faggiani, Tommaso Lorenzo Parigi, Alessandra Zilli, Mariangela Allocca, Federica Furfaro, Laurent Peyrin-Biroulet, Silvio Danese, Ferdinando D'Amico","doi":"10.3390/cancers17111795","DOIUrl":"10.3390/cancers17111795","url":null,"abstract":"<p><p>Janus kinase inhibitors, including tofacitinib, filgotinib, and upadacitinib, have emerged as effective therapeutic options for the management of inflammatory bowel diseases (IBDs). By targeting the JAK-STAT signaling pathway, these agents modulate immune responses and reduce inflammation. However, concerns regarding the potential risk of malignancy associated with their use have gained significant attention. The JAK-STAT pathway is not only critical for inflammatory signaling but also plays a pivotal role in cellular growth, differentiation, and tumor surveillance. Observational studies and clinical trial data in rheumatoid arthritis have reported malignancies, including non-melanoma skin cancer and solid tumors, in patients receiving JAK inhibitors, with evidence suggesting variable risks depending on the selectivity of the agent. Current evidence does not suggest an increased risk of oncogenesis in patients with IBDs. Balancing therapeutic efficacy with long-term safety requires ongoing vigilance; patient stratification based on risk factors; and tailored monitoring strategies to mitigate potential adverse effects, including malignancies, during JAK inhibitor therapy. Long-term follow-up data of up to 10 years offer reassuring evidence that JAK inhibitor therapy in IBD patients does not confer an increased risk of malignancies, supporting their continued use within appropriate clinical settings.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282554","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":"Systemic Therapeutic Options in Radioiodine-Refractory Differentiated Thyroid Cancer: Current Indications and Optimal Timing.","authors":"Tamara Díaz Vico, Brezo Martínez-Amores Martínez, Luka Mihic Góngora, Paula Jiménez-Fonseca, Paloma Peinado Martín, Irene Grao Torrente, Alejandro García Muñoz-Nájar, Manuel Durán-Poveda","doi":"10.3390/cancers17111800","DOIUrl":"10.3390/cancers17111800","url":null,"abstract":"<p><p>Thyroid cancer (TC) remains a prevalent malignancy, with over 820,000 global cases diagnosed in 2022. Differentiated thyroid carcinoma (DTC), primarily papillary and follicular types, accounts for most cases and has a favorable prognosis with total thyroidectomy and radioiodine (RAI) ablation. However, 5-15% of patients develop RAI-refractory (RAI-R) disease, leading to a significantly poorer outcome. For RAI-R patients, treatment decisions depend on disease progression. Active surveillance is suitable for indolent cases, while symptomatic or progressive disease requires systemic therapy. Multikinase inhibitors (MKIs) such as lenvatinib and sorafenib serve as first-line options, with cabozantinib recently approved for resistant cases. Additionally, novel targeted therapies, including RET and NTRK inhibitors, and immune checkpoint inhibitors, are under investigation, offering a personalized approach. A key challenge is determining the optimal timing for systemic therapy, balancing progression-free survival (PFS) benefits against MKI-related toxicities, which significantly impact quality of life (QoL). Molecular testing can identify actionable mutations, guiding therapy selection. Clinical guidelines (ATA, ESMO) recommend initiating treatment based on disease progression and patient condition, integrating strategies such as active surveillance, surgery, and radiotherapy when appropriate. Despite advances, systemic therapies carry significant adverse events (e.g., hypertension, fatigue, gastrointestinal toxicity), necessitating careful monitoring to prevent dose reductions or interruptions. A multidisciplinary approach is essential to optimize patient outcomes and maintain QoL. As targeted therapies continue to evolve, further research is needed to refine treatment sequencing and improve outcomes for RAI-R TC. This review synthesizes current evidence to guide clinical decision-making.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282605","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":"Bone Marrow Myeloid-Lymphatic Progenitors Expand Tumor Lymphatic Vasculature Through Cell Fusion.","authors":"Shaswati Athaiya, Lisa Volk-Draper, Emma Cox, Kathy Robinson, Natalya Zinkevich, Sophia Ran","doi":"10.3390/cancers17111804","DOIUrl":"10.3390/cancers17111804","url":null,"abstract":"<p><p><b>Background:</b> Bone marrow (BM)-derived myeloid-lymphatic endothelial cell progenitors (M-LECPs) promote formation of tumor lymphatics that are responsible for metastasis to lymph nodes. The regenerative capacity of BM progenitors to other lineages is mediated through cell fusion, a process that delivers a pro-mitotic message directly to division-restricted cells. This suggested that M-LECPs might use a similar mechanism to induce division of lymphatic endothelial cells (LECs).</p><p><strong>Methods: </strong>To test this hypothesis, we determined expression of fusogenic markers in M-LECP produced in vitro and recruited to human or mouse tumors in vivo as well as quantified their fusion with LECs in both settings. Fusion in vivo was determined in female chimera mice grafted with male BM that have been implanted with MDA-MB-231 or EMT6 breast tumors. Co-staining for Y-chromosome and LEC-specific markers allowed us to quantify tumor lymphatic vessels fused with BM progenitors.</p><p><strong>Results: </strong>We found that both tumor-recruited and in-vitro-produced M-LECPs expressed multiple fusogenic regulators and possessed a significant fusogenic activity towards cultured and vessel-lining LECs. Y-chromosomes, a marker of fusion, were detected in nearly half of tumor lymphatics and were associated with mitotic division, vessel formation, and node metastasis. Both in vitro and in vivo assays showed dependency of fusion on Th2 and Toll-like receptor-4 (TLR4) pathways.</p><p><strong>Conclusions: </strong>This novel mechanism of tumor lymphatic formation triggered by fusion with BM myeloid-lymphatic progenitors suggests a variety of new targets for inhibition of metastatic spread.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282480","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":"Development of a Digital Application Program Based on an Institutional Algorithm Sustaining the Decisional Process for Breast Reconstruction in Patients with Large and Ptotic Breasts: A Pilot Study.","authors":"Federico Ziani, Andrea Pasteris, Chiara Capruzzi, Emilio Trignano, Silvia Rampazzo, Martin Iurilli, Corrado Rubino","doi":"10.3390/cancers17111807","DOIUrl":"10.3390/cancers17111807","url":null,"abstract":"<p><strong>Background/objectives: </strong>Immediate implant-based breast reconstruction is an established option for selected patients undergoing mastectomy. However, patients with large and ptotic breasts present specific reconstructive challenges, often requiring tailored approaches to minimize complications and optimize aesthetics. This pilot study aimed to evaluate the clinical feasibility and effectiveness of a mobile application developed to support intraoperative decision-making based on an institutional algorithm for breast reconstruction. It is also important to underline that this pilot study was exploratory in nature and primarily aimed at assessing feasibility and adherence to an app-based decision pathway, rather than comparative efficacy.</p><p><strong>Methods: </strong>We conducted a prospective observational study from October 2023 to December 2024 at the University Hospital of Sassari. Female patients with large and ptotic breasts undergoing immediate implant-based reconstruction were included. A mobile app, developed using MIT App Inventor 2, implemented our institution's algorithm and guided surgeons through both preoperative and intraoperative decision-making. Surgical options included subpectoral, prepectoral with autologous fascial flaps, or prepectoral with acellular dermal matrix (ADM) reconstruction, depending on flap thickness and fascia integrity.</p><p><strong>Results: </strong>Sixteen patients (21 reconstructed breasts) were included. Surgical planning and execution followed app-generated recommendations in all cases, with no intraoperative deviations. Subpectoral reconstruction was performed in six patients, prepectoral with ADM in eight, and prepectoral with fascial flaps in two. The app was rated positively by all surgeons and facilitated consistent decision-making.</p><p><strong>Conclusions: </strong>The proposed mobile application, described in this pilot study, proved to be a feasible and effective decision-support tool for implant-based breast reconstruction in patients with challenging anatomy. It standardized surgical choices, supported training, and has the potential to enhance reproducibility and safety in complex reconstructive procedures.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282499","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":"Risk Factors for Malignant Transformation in Inverted Sinonasal Papilloma: A Systematic Review and Meta-Analysis.","authors":"Andrea Ambrosini-Spaltro, Giulia Querzoli, Anna Caterina Leucci, Angela Camagni, Paolo Farneti, Elisa D'Angelo, Elisa Donini, Alicia Tosoni, Ernesto Pasquini, Paolo Galli, Maria P Foschini","doi":"10.3390/cancers17111798","DOIUrl":"10.3390/cancers17111798","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Inverted sinonasal papilloma (IP) is a benign epithelial proliferation that can recur and undergo malignant transformation. We performed a systematic review and meta-analysis to answer the following question: what are the risk factors for malignant transformation in IP? <b>Methods</b>: A search was performed in PubMed and Embase databases. Numbers of affected individuals in exposed versus non-exposed individuals, or odds ratio values, were compared for each specific risk factor examined. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias. To assess the overall quality of evidence, we used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Meta-analyses were conducted using the fixed-effects and the random effects models. Heterogeneity of the results was assessed by I² statistic output. Meta-analyses and forest plots were obtained using Review Manager (RevMan) software version 5.4. <b>Results</b>: After examining 1875 results (942 from PubMed; 933 from Embase), 26 articles were selected. Among the 26 selected articles, the number of cases examined ranged from 14 to 162. All studies examined a population of 1271 IPs, with a carcinoma incidence of 230/1271 (18.1%). Three meta-analyses were performed for the following risk factors: smoking, alcohol, and HPV. Using the fixed-effects model, significant values were obtained for smoking (<i>p</i> = 0.002) and HPV (<i>p</i> < 0.001), with moderate and low quality of evidence, respectively. Alcohol did not reach statistical significance (<i>p</i> = 0.95). <b>Conclusions</b>: This study demonstrates that both smoking and HPV are risk factors for IP malignant transformation. Possible interventions include smoking cessation and HPV vaccination in individuals affected by IP.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"17 11","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12153903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282597","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}