Cancers最新文献

{"title":"Has the Early Majority Been Reached? Specialised Inpatient Palliative Care Utilisation in Common Solid Tumours in Germany.","authors":"Marcel A Kamp, Martina Kern, Nazife Dinc, Birgitt van Oorschot, Lukas Radbruch, Christiane von Saß","doi":"10.3390/cancers18193163","DOIUrl":"10.3390/cancers18193163","url":null,"abstract":"<p><p><b>Background:</b> Randomised trials indicate that early integration of specialised palliative care improves quality of life and, in some studies, survival in advanced cancer, yet its implementation in inpatient oncology remains inconsistent. This study quantifies the coded utilisation of specialised inpatient palliative care in German hospitals and interprets adoption patterns using the diffusion of innovations theory. <b>Methods:</b> We conducted a cross-sectional analysis of nationwide hospital cases reimbursed under the German diagnosis-related groups (DRG) system in 2023. The analysis included the most common solid malignancies and assessed the utilisation of specialised inpatient palliative care overall and stratified by metastatic status, tumour entity, comorbidities, and treating medical specialties. <b>Results:</b> Specialised inpatient palliative care was provided in 5.4% of hospital cases involving the most common malignant tumours. Among patients with organ metastases, utilisation increased to a median rate of 15.0% of hospital cases, with the highest rates observed in cases with brain (17.8%), bone (17.0%), and pleural metastases (16.1%). Palliative care involvement correlated positively with in-hospital mortality. Interpreted cautiously through the diffusion of innovations theory, which frames the 15 to 20% band as a heuristic landmark rather than a validated threshold, utilisation even in the metastatic subgroup reaches only the lower edge of this band, indicating that uptake remains confined to innovators and early adopters and has not extended to the early majority. <b>Conclusions:</b> Specialised inpatient palliative care remains underutilised in German oncology, reaching 5.4% of all cases and a median of 15.0% even in metastatic disease. Interpreted cautiously through the diffusion of innovations theory, which frames the 15 to 20% band as a heuristic landmark, uptake appears confined to early adopters and has not yet reached the early majority.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191421","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":"Histopathological and Quantitative Correlates of Intraoperative Narrow Band Imaging in Brain Metastasis Surgery.","authors":"Tadashi Higuchi, Shinsuke Abe, Satsuki Imaoka, Taisei Aoki, Yohei Nounaka, Atsushi Tsukiyama, Fumihiro Matano, Shigeyuki Tahara, Yasuo Murai","doi":"10.3390/cancers18193171","DOIUrl":"10.3390/cancers18193171","url":null,"abstract":"<p><strong>Background/objectives: </strong>Accurate intraoperative identification of the tumor-brain interface is important in brain metastasis surgery, but visual assessment under white light is subjective. Narrow-band imaging (NBI) enhances hemoglobin-dependent optical contrast without an exogenous agent; whether its intraoperative appearance corresponds to tumor tissue, and whether it measurably increases tumor-to-normal image contrast, has not been established in this setting.</p><p><strong>Methods: </strong>In this retrospective, single-center, exploratory study, we evaluated 25 consecutive patients with brain metastases resected using a 4K three-dimensional exoscope equipped with NBI. In three selected patients, spatially adjacent specimens were separately sampled from grayish-appearing and whitish-appearing regions and assessed histopathologically in a non-blinded, descriptive manner. In all 25 patients, paired white-light and NBI images were retrospectively analyzed in Fiji/ImageJ using regions of interest drawn over tissue visually judged to be tumor or normal brain.</p><p><strong>Results: </strong>In the three patients with paired histology, grayish-appearing specimens contained metastatic tumor cells and whitish-appearing specimens did not; this observation derives from a small, selectively sampled subset and should be regarded as preliminary. Across all 25 patients, absolute tumor-to-normal gray-value contrast was significantly greater under NBI than white light (69.628 ± 45.338 vs. 44.287 ± 29.640; mean paired increase, 25.342; 95% CI, 9.169-41.514; <i>p</i> = 0.0035; Cohen's dz = 0.647), although this increase was not observed in all patients.</p><p><strong>Conclusions: </strong>In this exploratory, non-blinded, retrospective study, NBI increased objective image contrast between visually identified tumor and normal brain relative to white light, and its grayish appearance corresponded to tumor tissue in a small histologically sampled subset. These findings support NBI as a feasible, agent-free adjunct that warrants prospective, blinded validation before its diagnostic accuracy or clinical benefit can be assessed.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191454","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":"Durvalumab Plus High-Dose Radiation in NSCLC III: Long-Term Results from the Austrian Radio-Oncological Lung Cancer Study Association Registry (ALLSTAR).","authors":"Katharina Hörmandinger, Elvis Ruznic, Marisa Klebermass, Brane Grambozov, Petra Feurstein, Josef Karner, Georg Gruber, Martin Heilmann, Falk Röder, Ute Ganswindt, Danijela Minasch, Franz Zehentmayr","doi":"10.3390/cancers18193173","DOIUrl":"10.3390/cancers18193173","url":null,"abstract":"<p><strong>Purpose: </strong>Chemoradioimmunotherapy (CRIT) with 60-66 Gy is the standard of care (SoC) for non-small-cell lung cancer (NSCLC) UICC stage III. The aim of this real-world data (RWD) study was to report the long-term impact of Durvalumab and radiation dose escalation on clinical outcomes.</p><p><strong>Material and methods: </strong>ALLSTAR is a nationwide prospective multicentre registry for NSCLC UICC stage III, in which 12/14 Austrian centres participated (ethics approval number: 1002/2019). The basis for the current analysis is the third data extraction, which was completed on 2 June 2025. Apart from the SoC, alternative dose-fractionation and sequential CRT concepts >66 Gy were also permitted. Durvalumab maintenance treatment for one year was administered at the discretion of the tumour board at each centre.</p><p><strong>Results: </strong>Compared to prior analyses by our group, 40 individuals who completed follow-up (FUP) were added to this final analysis, leading to a total patient population of 228 (156 CRT plus Durvalumab; 72 CRT). In 156 patients, Durvalumab was added to CRT, while 72 received CRT only. The median FUP periods were 41.0 (95%-CI: 36.7-45.4) and 37.8 months (95%-CI: 31.4-44.1) for the Durvalumab and CRT cohort, respectively. Radiation dose escalation combined with Durvalumab treatment was associated with a nominally higher ITC of 37 months (95%-CI: 24.5-not reached) compared with 17.7 months (95%-CI: 14.9-not reached) in patients receiving neither dose escalation nor Durvalumab (<i>N</i> = 135; HR = 0.61; 95%-CI: 0.37-1.006; <i>p</i>-value 0.051). With Durvalumab maintenance, a median PFS of 22.8 months (95%-CI: 19.4-38.3) was observed compared to 16.5 months (95%-CI: 12.6-24.5) without (<i>N</i> = 228; HR = 0.61; 95%-CI: 0.42-0.88; <i>p</i>-value 0.0071). Median OS was 52.6 months (95%-CI: 39.5-not reached) with Durvalumab compared to 27.4 months (95%-CI: 18.7-not reached) without (<i>N</i> = 228; HR = 0.52; 95%-CI: 0.34-0.78; log-rank <i>p</i>-value < 0.002). Median time to death or distant metastasis (TTDM) was 33.3 months (95%-CI: 23.5-45) in the Durvalumab cohort compared to 18.7 months (95%-CI: 14.8-not reached) in the CRT cohort (<i>N</i> = 228; HR = 0.60; 95%-CI: 0.42-0.89; log-rank <i>p</i>-value 0.01). Median time to death or local relapse (TDLR) with Durvalumab was 30.4 months (95%-CI: 23.5-51.1) compared to 17.2 months (95%-CI: 14.8-25.7) without (<i>N</i> = 226; HR = 0.58; 95%-CI: 0.40-0.83; log-rank <i>p</i>-value < 0.003).</p><p><strong>Conclusion: </strong>This final RWD analysis implies both a beneficial effect of high-dose irradiation combined with Durvalumab on ITC and the long-lasting impact of Durvalumab on PFS, OS, TTDM, and TDLR.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191479","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":"Negotiating Mortality: A Qualitative Systematic Review and Thematic Synthesis of the Psychosocial Experiences of Pancreatic Cancer Across the Illness Trajectory.","authors":"Lana Cook, Gillian Prue, Caitlin McShane, Mei Krishnasamy, Kate Furness, Susan McLaughlin, Gary Mitchell","doi":"10.3390/cancers18193177","DOIUrl":"10.3390/cancers18193177","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Pancreatic cancer is associated with poor survival and substantial psychosocial burden, yet little is known about the psychological, emotional, and social dimensions of patients' experiences across the illness trajectory. This review aimed to identify, analyse, and synthesise empirical qualitative literature on the psychosocial aspects of receiving, living with, dying with, or surviving pancreatic cancer. <b>Methods:</b> Seven bibliographic databases were searched from inception to 4 September 2025, with reference list screening and forward citation tracking undertaken. Records were managed in Covidence. Following screening of 4357 titles and abstracts and 412 full texts, 30 papers representing 28 studies were included. Methodological quality was appraised using the JBI Critical Appraisal Checklist for Qualitative Research. Data were extracted into a shared Excel workbook and synthesised using Thomas and Harden's thematic synthesis approach. <b>Results:</b> Four overarching themes were developed: (1) from ambiguous symptoms to the shock and threat of diagnosis; (2) navigating care, information, and support; (3) embodied disruption, relational change, and reworking everyday life; and (4) living on borrowed time and coping with uncertainty and mortality. Across the included studies, pancreatic cancer was experienced as a profound disruption to participants' lives, futures, and sense of selves; involved complex informational and care-navigation work; altered everyday lives; and provoked ongoing uncertainty around progression, recurrence, and survival. <b>Conclusions:</b> Pancreatic cancer exerts a profound psychosocial impact across early and advanced disease, with psychological, social, and emotional challenges intertwined with complex symptomatology, functional decline, uncertainty, and mortality awareness. Thus, substantial unmet psycho-oncology and supportive care needs exist for patients and their families.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191361","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":"Preoperative CT Nodal Staging Versus Pathology in Colon Cancer: A Retrospective Multicentre Diagnostic Accuracy Study.","authors":"Tomasz Cwaliński, Mateusz Jagielski, Michał Kazanowski, Jacek Piątkowski, Maciej Ciesielski, Marcin Januszkiewicz, Zuzanna Bigus, Patryk Kaczor, Bartosz Kapturkiewicz, Paweł Lesiak, Sergii Girnyi, Damian Nowiński, Piotr Kurek, Natale Calomino, Marek Jackowski, Marek Bębenek, Luigi Marano","doi":"10.3390/cancers18193175","DOIUrl":"10.3390/cancers18193175","url":null,"abstract":"<p><strong>Background/objectives: </strong>Computed tomography (CT) informs preoperative staging in colon cancer, yet its diagnostic accuracy for lymph node involvement relative to pathological staging remains uncertain. We examined nodal concordance and multicentre variation in Poland.</p><p><strong>Methods: </strong>This retrospective diagnostic accuracy study included adults who underwent upfront resection for nonmetastatic colon cancer at five centres between January 2022 and August 2025. All underwent preoperative CT; recorded cN categories were dichotomised as cN0 versus cN+ (any positive cN category), and pathological pN was the reference. We estimated accuracy, sensitivity, specificity, predictive values, and kappa with 95% confidence intervals. A centre-adjusted exploratory analysis examined the association between cT3-4 and occult pN+ among cN0 patients.</p><p><strong>Results: </strong>Of 662 otherwise eligible patients, 590 had evaluable cN and pN. CT and pathology agreed in 386 (65.4%; 95% CI, 61.5-69.2; κ = 0.276; 95% CI, 0.199-0.353). Occult pN+ occurred in 73 of 335 cN0 patients (21.8%; 95% CI, 17.7-26.5); 131 of 255 cN+ patients were pN0 (51.4%; 95% CI, 45.3-57.4). Sensitivity was 62.9% and specificity 66.7%. Centre-level cN/pN completeness ranged from 73.5% to 100%. cT3-4 was associated with occult pN+ after centre adjustment (OR, 3.10; 95% CI, 1.71-5.62). Sensitivity analyses were materially consistent.</p><p><strong>Conclusions: </strong>Routine CT nodal classification showed limited concordance with pathology. The cT3-4 association is exploratory and does not establish a prediction or treatment selection rule; cN alone should not determine treatment.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191509","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":"Tunlametinib Suppresses Melanogenesis Induces Cell Cycle Arrest and Apoptosis in Giant Congenital Melanocytic Nevus Cells.","authors":"Jin-Ye Guan, Zhuo Chen, Wen-Shang Liu, Jia-Long Xu, Zhi-Yu Zhou, Lina Song, Dan Deng","doi":"10.3390/cancers18193166","DOIUrl":"10.3390/cancers18193166","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Giant congenital melanocytic nevus (GCMN) is a rare developmental disorder arising from abnormal proliferation and differentiation of neural crest-derived melanocytes. It poses substantial clinical challenges due to cosmetic disfigurement, malignant potential, and the limited efficacy of current treatments. This study aimed to investigate the therapeutic effects and underlying molecular mechanisms of tunlametinib (HL-085), a novel selective MEK1/2 inhibitor, in GCMN. <b>Methods:</b> Primary GCMN cells and human GCMN explants were isolated, cultured, and validated to establish in vitro cellular and explant models. Following tunlametinib treatment, global transcriptional changes were analyzed using bulk RNA sequencing. Melanogenesis was assessed via Fontana-Masson staining, Western blotting, and immunofluorescence. Cell viability, apoptosis, and cell cycle distribution were evaluated using the CCK-8 assay, flow cytometry, TUNEL staining, and Western blotting for apoptosis- and cell cycle-related proteins. <b>Results:</b> Tunlametinib treatment significantly suppressed melanogenesis in GCMN cells and explant tissues at the phenotypic, histological, and protein levels, and reduced cell viability in a concentration-dependent manner. Transcriptomic analysis revealed marked alterations in gene expression profiles following treatment, with prominent changes in apoptosis- and cell cycle-related genes. Subsequent cellular assays and tissue staining confirmed that tunlametinib significantly increased early apoptosis and induced G1/S cell cycle arrest. <b>Conclusions:</b> Collectively, our findings demonstrate that tunlametinib inhibits proliferation and melanin production in GCMN cells by modulating the RAS-ERK pathway, providing a theoretical basis for its use as a targeted therapeutic strategy for GCMN.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191556","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":"<i>TFAP2E</i> Expression Is Associated with Survival and a Transcriptomic Pattern in Ovarian Serous Carcinoma, Supported by Hallmark and Protein-Level Characterization.","authors":"Damian Kołat, Julia Gałęziewska, Paulina Buczek, Lin-Yong Zhao, Mateusz Kciuk, Żaneta Kałuzińska-Kołat, Małgorzata Kozłowska, Agnieszka Śliwińska, Renata Kontek, Elżbieta Płuciennik","doi":"10.3390/cancers18193168","DOIUrl":"10.3390/cancers18193168","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objectives:&lt;/b&gt; AP-2 transcription factors are increasingly recognized as key regulators in cancer biology. The &lt;i&gt;TFAP2E&lt;/i&gt; gene, which encodes the AP-2ε transcription factor, remains understudied in cancer compared with other AP-2 family members. The scarcity of studies examining potential AP-2ε targets and related genes limits our understanding of its functional significance. Moreover, related studies have not incorporated a screening step to select the tumor type for justified molecular investigation. Through comparison of tumor-normal expression differences in a pan-cancer spectrum, this study prioritized ovarian serous carcinoma for downstream assessment. &lt;b&gt;Methods:&lt;/b&gt; Expression patterns were evaluated using GENT2, GEPIA2, and TNMplot. After prioritizing ovarian serous carcinoma, &lt;i&gt;TFAP2E&lt;/i&gt; and related signatures in TCGA-OV were analyzed using transcriptomic and clinical data from GDC and CDR, followed by comparison of findings with the GSE32062 cohort. The workflow included survival and clinicopathological analyses, outcome-independent limma-voom differential expression analysis and WGCNA, MCODE clustering, gene ontology, immune subtype and stemness assessment, PCA, CancerHallmarks enrichment, clinically adjusted Cox and competing-risk survival modeling, and HPA-derived immunostaining evaluation. Additional analyses assessed WGCNA parameter stability and preservation in GSE32062, an outcome-independent MAD-based variability screen, AP-2 family coexpression, and promoter motif enrichment. &lt;b&gt;Results:&lt;/b&gt;&lt;i&gt;TFAP2E&lt;/i&gt; was downregulated in ovarian cancer across the three queried resources, whereas higher expression was associated with favorable survival across multiple endpoints. Differential expression and WGCNA identified a &lt;i&gt;TFAP2E&lt;/i&gt;-associated signature; its ontology indicated GPCR, stimulus responsiveness, and KRAS enrichment for the 933-gene module. The WGCNA pink module was stable across alternative settings, moderately preserved in GSE32062 (Zsummary = 7.86), and enriched in the outcome-independent MAD screening. GSE32062 supported concordant gene expression patterns and showed an association of &lt;i&gt;TFAP2E&lt;/i&gt; with progression-free survival. Exploratory immune analyses showed a modestly increased proportion of C5 tumors in the higher-expression groups, whereas differences in stemness were statistically insignificant. The &lt;i&gt;TFAP2E&lt;/i&gt; group associations with PFI and DSS in TCGA-OV and with PFS in GSE32062 remained significant after clinical adjustment; Fine-Gray sensitivity analyses gave consistent results for DSS. Immunohistochemistry provided protein-level characterization; eighteen entries differed between representative normal and tumor specimens, with lower tumor staining in fifteen. The seven-gene candidate set showed a clinically adjusted DSS association in TCGA-OV, which was not supported in the GSE32062 evaluation model. &lt;b&gt;Conclusions:&lt;/b&gt;&lt;i&gt;TFAP2E&lt;/i&gt; expression is associated with survival and a","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191253","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":"A Dual-Marker DNA Methylation Assay Enables High-Sensitivity Detection of Malignant Effusions Across Cancer Types.","authors":"Ting Wang, Ting Liang, Matthew Kafarski, Jian Liu, Yi Jing, Wen Liao, Hang Xing, Jia Feng, Tingting Bian, Lei Liu, Hui Sun, Xiaoli Zheng, Bin She, Xiaosha Ren, Joanne Lee, Qiushi Lin, Ming Chen, Liang Cheng, Hong Ge, Xiaoqun Dong, Yifei Liu","doi":"10.3390/cancers18193176","DOIUrl":"10.3390/cancers18193176","url":null,"abstract":"<p><p><b>Objective:</b> This study evaluated the diagnostic value of a combined <i>SHOX2</i> and <i>RASSF1A</i> methylation assay (LungMe^®) in differentiating malignant from benign pleural and peritoneal effusions. <b>Methods:</b> A total of 696 patients with pleural or peritoneal effusions were prospectively enrolled. Effusion sediment samples were analyzed by liquid-based cytology (TCT), cell block histology, and methylation-specific PCR for both <i>SHOX2</i> and <i>RASSF1A</i>. The final diagnosis was confirmed by clinical, imaging, and pathological follow-up. <b>Results:</b> Lung cancer was the predominant cause of malignant pleural effusions (71.96%), while malignant peritoneal effusions mainly resulted from ovarian, gastric, and liver cancers. The optimal ΔCt cutoffs for <i>SHOX2</i> and <i>RASSF1A</i> were ΔCt ≤ 9 and ΔCt ≤ 12, respectively. The combined methylation assay achieved a sensitivity of 79.1% and specificity of 90.4% for malignant effusions. When combined with cytology, the overall sensitivity increased from 34.7% (TCT alone) to 91.7%, with a positive predictive value (PPV) of 93.9% and a negative predictive value (NPV) of 86.7%. The assay showed high sensitivity across multiple tumor types, including 100% for esophageal and breast cancers, and ≥80% for lung cancer, gastric cancer, lymphoma, and cholangiocarcinoma. <b>Conclusions:</b> The combined SHOX2 and RASSF1A methylation assay has high diagnostic value for benign-malignant discrimination of pleural and peritoneal effusions, improving diagnostic sensitivity when combined with conventional cytology. Thus, within the context of this single-center study, the LungMe^® assay demonstrates promise in expanding pan-cancer diagnostics, but will require further multicenter external validation and prospective clinical studies before routine clinical adoption.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191242","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":"Beyond BMI: The Clinical Relevance of Sarcopenia and Muscle Quality in Gynecologic Oncology from Meta-Analyses to Practice-The Potential Role of Body Composition Assessment, Including BIA, in Supportive Care.","authors":"Beata Pięta, Karolina Gajewska, Małgorzata Mikołajczyk, Michalina Wiśniewska, Alicja Rzymska, Bartłomiej Burzyński, Paweł Rzymski","doi":"10.3390/cancers18193164","DOIUrl":"10.3390/cancers18193164","url":null,"abstract":"<p><p>Sarcopenia, low muscle mass, and low muscle radiodensity are increasingly being considered factors associated with treatment outcomes in patients with gynecological malignancies. Despite the growing body of evidence, body composition assessment is not routinely incorporated into clinical practice. The aim of this review was to present current evidence on the associations of muscle parameters with survival, complications, systemic treatment toxicity, and quality of life, as well as to discuss the opportunities and limitations of computed tomography (CT) and bioelectrical impedance analysis (BIA) in body composition monitoring. A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases, primarily covering publications from 2019 to 2026, together with earlier studies relevant to the topic. Systematic reviews, meta-analyses, and selected observational, longitudinal, and interventional studies were included. The available evidence indicates that low muscle mass and low muscle radiodensity are primarily associated with poorer overall survival and an increased risk of selected postoperative complications. Evidence regarding progression-free survival, disease recurrence, chemotherapy toxicity, and quality of life remains less consistent. Low muscle mass may occur independently of body weight and body mass index (BMI); therefore, routine anthropometric assessment may fail to identify adverse changes in body composition. CT image analysis enables quantitative assessment of muscle mass and evaluation of muscle radiodensity, whereas BIA may serve as a complementary tool for repeated body composition monitoring. However, its use is limited by the effects of hydration status, edema, and ascites, as well as by the lack of validated cut-off values for patients with gynecological malignancies. Body composition assessment should be interpreted in conjunction with evaluations of muscle strength, physical performance, nutritional status, treatment toxicity, and quality of life. Prospective studies are needed to determine whether body composition monitoring and the implementation of targeted supportive care improve treatment tolerance and clinical outcomes.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191430","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":"A Contemporary Review of Resectability and Treatment Strategies for Colorectal Liver Metastases: Part 2-Advanced Surgical Techniques, Conversion Strategies, and the Expanding Boundaries of Treatment.","authors":"Jennifer A Kalil, René Adam, Nicholas Meti, Peter Metrakos","doi":"10.3390/cancers18193169","DOIUrl":"10.3390/cancers18193169","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Most patients with colorectal liver metastases (CRLM) present with disease beyond upfront technical resectability. Advances in systemic therapy, surgical technique, and liver-directed therapies have expanded the proportion of patients who can achieve curative-intent treatment, yet substantial heterogeneity in practice persists. This review provides a structured synthesis of current management strategies for borderline resectable, initially unresectable, and never resectable CRLM. <b>Methods</b>: A structured literature search of PubMed/MEDLINE, Embase, Scopus and the Cochrane Library was performed to identify studies published between 2000 and 2026 using the eligibility criteria described in Part 1 of this review. Findings were synthesized narratively across systemic, surgical, and liver-directed treatment strategies. <b>Results</b>: Future liver remnant augmentation through regenerative procedures offers higher rates of conversion to resection in borderline cases. Conversion chemotherapy enables secondary resection in 12-35% of initially unresectable patients, with regimen selection guided by RAS/BRAF status, primary tumor sidedness, and performance status; however, most pivotal trials were designed for the broader metastatic colorectal cancer population, with conversion to resection rarely serving as the primary endpoint. For never resectable liver-only disease, liver transplantation demonstrates survival advantage in highly selected patients and iterative local therapy remains an area of active investigation. Across all settings, achieving complete local treatment remains the strongest determinant of long-term survival. <b>Conclusions</b>: Management of complex CRLM requires individualized, multidisciplinary decision-making with repeated reassessment of resectability throughout treatment. The evidence is constrained by heterogeneous resectability definitions, reliance on trials not designed for CRLM-specific endpoints, and limited data on several emerging strategies. Standardized eligibility frameworks and CRLM-specific trial designs are needed to advance the field.</p>","PeriodicalId":9681,"journal":{"name":"Cancers","volume":"18 19","pages":""},"PeriodicalIF":4.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191217","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}