Cancers最新文献

{"title":"Consumption of Processed Meat and Unprocessed Red Meat and Risk of Bladder Cancer: A Pooled Analysis of 30 Cohort Studies.","authors":"Ziyu Wang, Nina Afshar, Allison M Hodge, Harindra Jayasekara, Stella Koutros, Piet A van den Brandt, Alicja Wolk, Molin Wang, Tao Hou, Hans-Olov Adami, Agneta Åkesson, Chrisa Arcan, Kimberly A Bertrand, Marisa Bittoni, David Bogumil, Hui Cai, Amanda J Cross, A Heather Eliassen, Jo L Freudenheim, Gretchen L Gierach, Edward L Giovannucci, Wen-Yi Huang, Paula Jakszyn, Rieko Kanehara, Victoria A Kirsh, Woon-Puay Koh, Candyce H Kroenke, James V Lacey, Linda M Liao, Erikka Loftfield, Chaoran Ma, Loic Le Marchand, Maria Elena Martinez, Anthony B Miller, Steven C Moore, Lorelei A Mucci, Heather M Munro, Marian L Neuhouser, Jessica L Petrick, Jenny N Poynter, Mark A Preston, Anna Prizment, Samantha Rees, Kim Robien, Thomas E Rohan, Sven Sandin, Norie Sawada, Eva S Schernhammer, Marissa M Shams-White, Martha J Shrubsole, Xiao-Ou Shu, Rashmi Sinha, Sabina Sieri, Mingyang Song, Meir J Stampfer, Rachael Z Stolzenberg-Solomon, Matthew Triplette, Caroline Y Um, Kala Visvanathan, Trang VoPham, Fenglei Wang, Renwei Wang, Sophia S Wang, Ying Wang, Elisabete Weiderpass, Lynne Wilkens, Walter C Willett, Jian-Min Yuan, Wei Zheng, Nathaniel Rothman, Brigid M Lynch, Debra T Silverman, Stephanie A Smith-Warner, Roger L Milne","doi":"10.3390/cancers18193203","DOIUrl":"10.3390/cancers18193203","url":null,"abstract":"<p><p><b>Background</b>: Processed meat and unprocessed red meat are considered carcinogenic and 'probably carcinogenic' to humans, respectively, but findings for bladder cancer remain inconsistent. <b>Objectives</b>: We assessed associations between processed meat and unprocessed red meat intake and bladder cancer risk using data from the Pooling Project of Prospective Studies of Diet and Cancer. <b>Methods</b>: Associations with bladder cancer risk were assessed using individual-level data from 30 cohort studies from North America, Europe, Australia and Asia. Diet was assessed at enrolment using validated food frequency questionnaires or diet histories. Following a pre-specified analysis plan, study- and sex-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression, adjusted for smoking status and duration and other potential confounders, and pooled using inverse-variance-weighted random-effects meta-analysis. <b>Results</b>: During median follow-up across cohorts of 8-29 years, among 2,575,971 participants, 20,780 were diagnosed with bladder cancer. Processed meat intake was associated with increased bladder cancer risk (HR comparing ≥40 with <5 g/day = 1.08; 95% CI: 1.02-1.15; HR per 20 g/day = 1.02; 95% CI: 1.00-1.03). Weaker evidence of association with increased risk was also observed for unprocessed red meat (HR comparing ≥100 with <20 g/day = 1.06; 95% CI: 1.00-1.13; HR per 50 g/day = 1.01; 95% CI: 0.99-1.03). There was no evidence of heterogeneity by study, sex, or region. <b>Conclusions</b>: Higher intakes of processed meat and unprocessed red meat were associated with a small increase in risk of bladder cancer. These findings are consistent with existing public health recommendations to limit consumption of red and processed meat.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191146","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":"Quality-of-Life and Weight Loss Outcomes Following an Individualized Nutrition and Physical Activity Counseling Program in Breast Cancer Survivors: A Prospective Single-Arm Pilot Study.","authors":"Shashi Kant, Ahmad Alhalabi, Nadeem Bilani, Iktej Singh Jabbal, María Herrán, Theresa Abdo, Saad Sabbagh, Kaylee Sarna, Amanda Stevenson, Diana Saravia, Candice Schwartz, Thomas Samuel, Zeina Nahleh, Elizabeth Stone","doi":"10.3390/cancers18193198","DOIUrl":"10.3390/cancers18193198","url":null,"abstract":"<p><strong>Purpose: </strong>Assess the feasibility of a 6-month individualized nutrition counseling and exercise program targeting a 10% body weight loss in breast cancer (BC) survivors, with secondary endpoints assessing metabolic parameters, cardiovascular function, and quality of life.</p><p><strong>Methods: </strong>This single-arm pilot study enrolled BC survivors with body mass index (BMI) ≥ 25 kg/m² in a counseling program with a registered dietitian, consisting of in-person and telephone visits over six months. Outcomes measured included weight, body composition, blood markers, cardiovascular function, and quality of life at 3 and 6 months.</p><p><strong>Results: </strong>A total of 78 breast cancer survivors were enrolled; 59 remained in the study at Month 3, and 54 completed the 6-month follow-up. The median age of participants was 58.5 years, and the cohort was predominantly White (72.4%). Among the 54 participants who completed 6-month follow-up, 11.1% achieved >10% weight loss and 29.6% achieved >5% weight loss. At 3 months, significant reductions were observed in BMI, body fat composition, and hemoglobin A1c (HbA1c), along with improvements in quality of life, depression, and anxiety. At 6 months, significant reductions were observed in weight, BMI, and body fat composition, with improvements in quality of life and depressive symptoms.</p><p><strong>Conclusions: </strong>This hybrid nutrition and exercise program was associated with observed improvements in weight loss and improved quality of life among BC survivors.</p><p><strong>Implications for cancer survivors: </strong>A low-burden, hybrid nutrition and exercise program integrated into routine oncology follow-up may help breast cancer survivors achieve weight loss while improving their quality of life.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191642","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":"Single-Session Versus Hypofractionated Gamma Knife Radiosurgery for Large Parasagittal Meningiomas: A Retrospective Comparative Study.","authors":"Mehmet Ali Tepebasili, Amir Salar Nazari, Ali Haluk Duzkalir, Dogu Cihan Yildirim, Mehmet Orbay Askeroglu, Mert Veznikli, Selcuk Peker","doi":"10.3390/cancers18193188","DOIUrl":"10.3390/cancers18193188","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Large parasagittal meningiomas (PSMs) present significant surgical challenges due to their proximity to the superior sagittal sinus, and the optimal radiosurgical strategy for large tumors remains debated. This study compared local control (LC) and treatment-related radiological and clinical outcomes after single-session (ss-GKRS) and hypofractionated (hf-GKRS) Gamma Knife radiosurgery in PSMs ≥8 cm³. <b>Methods:</b> Eighty-seven patients with 87 radiologically confirmed PSMs treated between April 2006 and February 2025 were reviewed. Patients with histopathologically confirmed atypical or anaplastic meningiomas or imaging features suspicious for higher-grade disease were excluded. Fifty-nine patients underwent ss-GKRS and 28 received hf-GKRS. The median tumor volume was 11.2 cm³ (range 8-37.8 cm³). LC was defined as tumor volume regression or stability on serial MRI. Radiological complications were defined as new or worsening peritumoral T2 hyperintensity, and clinical complications as new neurological symptoms. Time to local progression was compared using the log-rank test, with an exploratory volume cut point from ROC analysis. <b>Results:</b> The median follow-up was 62 months (range 12-186 months). Overall crude LC was 93.1%, including 89.8% (53/59) after ss-GKRS and 100% (28/28; exact 95% CI 87.7-100%) after hf-GKRS. All six local progressions occurred in the ss-GKRS group; however, freedom from local progression did not differ significantly between the groups (log-rank <i>p</i> = 0.137). In an exploratory volume-stratified analysis, LC was 100% in both groups for tumors ≤11.75 cm³. Among tumors >11.75 cm³, crude LC was 71.4% (15/21) after ss-GKRS and 100% (16/16) after hf-GKRS (Fisher exact <i>p</i> = 0.027). Post-treatment radiological edema occurred in 39.0% after ss-GKRS versus 25.0% after hf-GKRS (<i>p</i> = 0.235). <b>Conclusions:</b> Overall freedom from local progression did not differ significantly between ss-GKRS and hf-GKRS. No local failures were observed after hf-GKRS during its shorter available follow-up, including among tumors >11.75 cm³ in an exploratory analysis. These findings support hf-GKRS as a feasible treatment option for selected larger PSMs, but neither treatment superiority nor a definitive tumor-volume threshold can be established from this retrospective cohort.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191494","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":"Mediterranean Diet Adherence Tools in Post-Treatment Breast Cancer Survivors: A Scoping Review of Measurement Approaches and Associated Outcomes.","authors":"Katie E Johnston, Aoife M Twomey, Samantha J Cushen","doi":"10.3390/cancers18193185","DOIUrl":"10.3390/cancers18193185","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Nutrition is an important yet underexplored determinant of cancer survivorship outcomes. Emerging evidence suggests that greater adherence to the Mediterranean diet (MedD) is associated with improved health status, enhanced quality of life (QoL), and reduced mortality. However, evidence specifically targeting post-treatment breast cancer survivors remains limited, and substantial heterogeneity in MedD scoring tools and adherence thresholds restricts comparability across studies. This review aimed to (i) identify and characterise the tools used to assess MedD adherence in breast cancer survivors following completion of active treatment, including their components, scoring systems, and adherence thresholds; and (ii) map the range of health outcomes that have been examined in relation to MedD adherence in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review was conducted in accordance with PRISMA-ScR and Joanna Briggs Institute guidelines. PubMed, Embase, Scopus, Web of Science, and CINAHL were searched (2000-2026) for English-language intervention and observational studies reporting MedD adherence in adult female breast cancer survivors after treatment completion. Two reviewers independently extracted data, which were synthesised descriptively, including study characteristics, MedD scoring tools, adherence outcomes, and clinical, metabolic, and QoL findings. The methodological structure protocol of this scoping review was retrospectively registered in the Open Science Framework.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty studies (16 intervention, 4 observational; 16 non-overlapping cohorts; pooled n &lt;i&gt;N&lt;/i&gt; = 4174, excluding non-cancer comparators) met inclusion criteria. Ten MedD scoring tools were identified, most frequently MEDAS-14 (original or modified, 7/20 studies), varying in components (range 9-18), scoring approach, and adherence thresholds. Most intervention studies reported improved MedD adherence following intervention, generally as a within-group change; between-group differences in adherence were reported less often and inconsistently significant. Anthropometric outcomes (body weight, body mass index (BMI), waist circumference) were most frequently improved, but significant differences between groups were found in only a small number of controlled studies. Mortality was assessed in only one observational cohort study, which found no association with breast-cancer-specific outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This scoping review identified considerable heterogeneity in how MedD adherence is measured in breast cancer survivors, with ten different scoring tools identified across 20 studies. Although improvements in MedD adherence appear achievable, the evidence is limited by small sample sizes, heterogeneous assessment tools, and short intervention durations. Larger, standardised longitudinal studies are needed, particularly to determine whether MedD adherence influences cancer recurren","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191121","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":"Developing a Dual-Targeting CD33/CD70 CAR T-Cell Strategy Against Acute Myeloid Leukemia to Overcome Tumor Heterogeneity.","authors":"Emily C Sullivan, Nabil Saleem, Areeba A Hashmi, Kristopher A Knight, Austre Y Schiaffino Bustamante, Ahmed A Aljudi, Brandon J Fanelli, Sunil S Raikar","doi":"10.3390/cancers18193183","DOIUrl":"10.3390/cancers18193183","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) remains the deadliest form of leukemia in children and adults despite therapeutic advances in recent decades. Chimeric antigen receptor (CAR) T-cell therapy is one such therapeutic approach that has been explored preclinically and clinically in AML; however, its efficacy is limited by antigen heterogeneity. To overcome this roadblock, we propose a dual-targeting CAR T-cell strategy, targeting the AML-associated antigens CD33 and CD70.</p><p><strong>Methods: </strong>To recapitulate tumor heterogeneity, we genetically edited the AML cell line Molm-13 using CRISPR-Cas9 to generate distinct sublines, namely CD33+/CD70-, CD33-/CD70+, and CD33+/CD70+. Two dual-targeting CAR T-cell approaches were developed: a \"pooled\" product, in which CAR T cells directed towards CD33 or CD70 are combined and co-administered, and a \"co-transduced\" product, wherein one population of T cells is transduced with both CD33-CAR- and CD70-CAR-encoding viral vectors.</p><p><strong>Results: </strong>Pooled and co-transduced products demonstrated potent cytotoxicity against all Molm-13 populations, whereas single-antigen CAR approaches were not as effective when their respective target antigen was absent. Mice engrafted with CD33/CD70 heterogeneous Molm-13 cells were treated with pooled or co-transduced CD33/CD70 CAR T cells. Both groups exhibited a significant survival advantage over the untreated group, with the co-transduced approach showing a statistically significant advantage over the pooled group.</p><p><strong>Conclusions: </strong>In summary, engineering one T cell to express both CARs yielded superior cytotoxicity when targeting a heterogeneous AML blast population.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191216","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":"Six-Fraction Ultra-Hypofractionated Radiotherapy for Tumours Adjacent to or Involving the Brachial Plexus: A Retrospective Cohort Study.","authors":"Maximilian Sturz, Gabriela Studer, Christoph Glanzmann, Sergejs Unterkirhers, Philippe Logaritsch, Olga Unterkirhere","doi":"10.3390/cancers18193189","DOIUrl":"10.3390/cancers18193189","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Tumours abutting or involving the brachial plexus can cause pain and neurological deficits. We evaluated six-fraction ultra-hypofractionated radiotherapy with a simultaneous integrated boost (uhRT-SIB) in a predominantly palliative cohort. <b>Methods:</b> We retrospectively analysed consecutive patients treated from April 2022 to June 2026, with a data cut-off of 7 July 2026. Image-guided VMAT delivered 33 Gy and 24 Gy to the high- and lower-dose planning target volumes, respectively. Outcomes included the best documented CTCAE-based symptom response, study-defined volumetric response (>30% GTV reduction), freedom from local progression (FFLP), overall survival (OS), and neurological findings in routine clinical records. <b>Results:</b> Forty-four patients with 45 lesions were treated; 29/45 lesions (64.4%) contacted the plexus. The median observed follow-up was 7.8 months (range 0.6-40.6). Symptoms improved by at least one grade in 16/19 evaluable symptomatic patients (84.2%, 95% CI 62.4-94.5%). The median times to first documented benefit and best symptom grade among responders were 9 and 23 days. The first-scan volumetric response occurred in 24/30 evaluable lesions (80.0%, 95% CI 62.7-90.5%). Six- and 12-month FFLP were 84.7% (95% CI 63.9-94.0%) and 73.7% (95% CI 49.7-87.6%), respectively. The median OS was 9.6 months. No clinical diagnosis of radiation-induced brachial plexopathy was documented; neurological assessment was not standardised. <b>Conclusions:</b> In this predominantly palliative cohort, six-fraction uhRT-SIB was associated with symptom improvement in 84.2% of evaluable symptomatic patients, study-defined volumetric response in 80.0% of evaluable lesions, and 12-month FFLP of 73.7%. No clinical diagnosis of radiation-induced brachial plexopathy was documented during routine follow-up, although the assessment of late neurological toxicity was limited.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191577","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":"Prognostic Value of Systemic Inflammation Markers and Clinical Factors in Grade 4 Diffuse Glioma: A Multicenter Retrospective Real-World Study.","authors":"Ece Ulukal Karancı, Gamze Emin, Ahmet Oruç, Esma Uğuztemur, Atila Yıldırım, Melek Karakurt Eryılmaz, Asım Armağan Aydın","doi":"10.3390/cancers18193192","DOIUrl":"10.3390/cancers18193192","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Systemic inflammation contributes to tumor growth and spread. We aimed to evaluate the association of pretreatment inflammatory indices and clinical and laboratory factors with survival in newly diagnosed grade 4 diffuse glioma. <b>Methods:</b> A total of 120 patients diagnosed with grade 4 diffuse glioma at four centers between 2013 and 2026 were analyzed retrospectively. Nine indices derived from complete blood counts were calculated. Overall survival (OS) and progression-free survival (PFS) were analyzed with Kaplan-Meier and multivariable Cox regression. The cut-off for the systemic inflammation response index (SIRI) was determined with maximally selected rank statistics. Ten machine learning models were compared with the Cox model using repeated cross-validation. <b>Results:</b> Median follow-up was 70 months. Median OS was 22.8 months (95% confidence interval [CI] 15.8-26.3) and median PFS was 10.9 months (95% CI 9.1-14.4). In the multivariable model, SIRI > 2.85 was independently associated with OS (hazard ratio [HR] 2.62, 95% CI 1.38-4.96, <i>p</i> = 0.003), and this association persisted in the isocitrate dehydrogenase (IDH)-wildtype subgroup (HR 3.06, 95% CI 1.27-7.39, <i>p</i> = 0.013). Hemoglobin was independently associated with PFS (HR per g/dL 0.84, 95% CI 0.73-0.96, <i>p</i> = 0.011). Smoking was an independent indicator of poor prognosis for both OS (HR 2.02) and PFS (HR 1.73). Ki-67 and tumor size were not associated with survival. Machine learning models did not outperform the Cox model, and their variable importance rankings were consistent with the classical analysis. <b>Conclusions:</b> Pretreatment SIRI, hemoglobin, and smoking were independently associated with survival in grade 4 diffuse glioma. These markers are available from routine tests and may contribute to prognostic assessment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191665","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":"Nasopharyngeal Angiofibroma in Adults: Age-Stratified Stage Distribution, Clinical Outcomes, and Exploratory Tumor-Normal Genomics.","authors":"Haoyuan Xu, Huankang Zhang, Wanpeng Li, Shixing Zheng, Xiaole Song, Jingjing Wang, Quan Liu, Dehui Wang, Zhuofu Liu","doi":"10.3390/cancers18193180","DOIUrl":"10.3390/cancers18193180","url":null,"abstract":"<p><strong>Background/objectives: </strong>Nasopharyngeal angiofibroma (NA) is generally benign, but recurrent disease and rare malignant transformation remain clinically relevant beyond adolescence. We examined adult clinical presentations, records of malignant transformation, and age-related differences in stage distribution.</p><p><strong>Methods: </strong>We retrospectively reviewed 289 surgically treated patients from January 2006 through June 2026. Radkowski stage distributions were compared between patients aged > 30 and ≤30 years using exact tests. Detailed clinical records were reviewed for 16 adults, and whole-genome sequencing (WGS) annotation summaries were examined for one tumor-blood pair.</p><p><strong>Results: </strong>Twenty-five patients (8.7%) were older than 30 years; stage was available for 287 patients. In the detailed adult subgroup, a prior pathology-slide record described focal malignant transformation with a Ki-67 index of approximately 50% in one recurrent tumor. Two other patients had database transformation entries without accompanying pathological documentation. Four recurrences and three deaths were recorded, all in stage IIIB disease. Three men had colorectal or rectal cancer histories. Low-, intermediate-, and advanced-stage tumors accounted for 36.0%, 36.0%, and 28.0% of adult cases, compared with 17.6%, 57.3%, and 25.2% of younger cases (<i>p</i> = 0.0493). The genomic annotations showed a C>A-predominant substitution spectrum.</p><p><strong>Conclusions: </strong>Adult NA included recurrent stage IIIB disease and a documented record of focal malignant transformation. Stage distributions differed between age groups. These clinical observations support pathological reassessment of recurrent tumors. The single-case genomic findings remain descriptive annotations.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191306","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":"Sleep Impairment in Oncology: Development of a Novel Patient-Centric Conceptual Model.","authors":"Harriet Makin, Sophie Van Tomme, Natalie V J Aldhouse, Samantha Wratten, Helen Kitchen, Chloe Carmichael, Cecile Gousset, Paul Cordero","doi":"10.3390/cancers18193191","DOIUrl":"10.3390/cancers18193191","url":null,"abstract":"<p><strong>Background/objectives: </strong>Up to 95% of cancer patients report sleep disturbances or disorders. These can potentially influence cancer development and outcomes. This study aimed to review the existing literature to understand the patient experience of cancer-related sleep impairment across indications and treatments, to improve awareness and inform disease treatment/management.</p><p><strong>Methods: </strong>A targeted literature review of published qualitative studies exploring sleep impairment in oncology was conducted in MEDLINE, Embase, and PsycINFO. Concepts were extracted from the reviewed articles, and patient quotes or author descriptions/interpretations were subject to secondary analysis using semantic, qualitative, directed content analysis techniques via ATLAS.ti. Results informed the development of a patient-centric conceptual model.</p><p><strong>Results: </strong>From 482 identified publications, 22 publications were selected for in-depth review and concept extraction, collectively including 531 patients across 25 different oncology indications. Cancer-related sleep impairment frequently affected patients living with cancer, who reported difficulty obtaining good quality sleep, including difficulty falling asleep and staying asleep. Sleep problems were triggered by the emotional anxiety of life with cancer, cancer-related symptoms, treatments and side effects, and external factors. Poor sleep greatly impacted daily life for patients, with difficulties in daily life causing further sleep impairment, in a cyclical relationship.</p><p><strong>Conclusions: </strong>This study determined that there is an unmet need for treatment of sleep impairment in oncology to improve patient outcomes. The holistic conceptual model developed in this study can provide an important basis for selecting, developing, or modifying outcome measures to assess relevant sleep outcomes, facilitating discussion between patients and clinicians and improving disease treatment/management.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191567","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":"Variability in the Risk of Malignancy in Bethesda IV Thyroid Nodules: Results from the EUROCRINE Surgical Registry.","authors":"Piotr Wiśniewski, Maciej Śledziński, Marcin Barczyński, Andrzej Rafał Hellmann","doi":"10.3390/cancers18193186","DOIUrl":"10.3390/cancers18193186","url":null,"abstract":"<p><p><b>Background/Objectives:</b> The management of Bethesda IV (follicular neoplasm) thyroid nodules remains controversial, in part due to wide variation in the reported risk of malignancy (ROM-BIV). Understanding this variability is essential for documenting systemic inconsistencies in ROM-BIV estimates and for developing more consistent risk-stratification strategies. This study aimed to quantify ROM-BIV variability across European centers and conduct an exploratory analysis of the trade-offs associated with hypothetical risk-based thresholds within a surgically selected cohort. <b>Methods:</b> We analyzed data from 15,251 patients with Bethesda IV thyroid nodules enrolled in the EUROCRINE registry. Multilevel logistic regression models were used to estimate ROM-BIV and assess variation across centers and countries, adjusting for patient- and nodule-level characteristics. Threshold analysis and decision curve analysis were employed as illustrative mappings of trade-off mechanisms within the surgically treated cohort to explore how varying risk levels affect classification outcomes. <b>Results:</b> Adjusted center-level ROM-BIV demonstrated marked variability, ranging from 5.5% to 65.5%. Intraclass correlation coefficients (ICCs) were 11.4% for institutions and 9.7% for countries, indicating meaningful clustering of ROM-BIV at both levels. The fixed component of the model showed limited-to-moderate discrimination (AUC-ROC 0.647; 95% CI, 0.637-0.656). Exploratory analysis illustrated the inherent trade-off between reducing potential overdiagnosis and maintaining sensitivity for malignancy detection. Decision curve analysis indicated a theoretical net benefit over default strategies, although no specific clinical threshold could be recommended based on these retrospective data. <b>Conclusions:</b> Substantial variability in ROM-BIV across European centers may reflect differences in institutional selection, diagnostic practices, clinical management, and reporting, rather than biological variance. These findings highlight the need for standardization of diagnostic and reporting pathways. Risk-based models must be positioned as supportive tools for individualized management and require rigorous prospective validation in unselected populations before any clinical implementation can be considered.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191512","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}