Current Oncology

11 pages, 577 KiB

Open AccessArticle

Comparison of Mortality and Morbidity of Robotic Versus Laparoscopic Radical Nephrectomy for the Treatment of Renal Cell Carcinoma—An Analysis of the National Surgery Quality Improvement Program (NSQIP) Targeted Nephrectomy Database

by Vatsala Mundra, Siqi Hu, Renil Sinu Titus, Eusebio Luna-Velazquez, Zachary Melchiode, Jiaqiong Xu, Carlos Riveros, Sanjana Ranganathan, Emily Huang, Brian J. Miles, Dharam Kaushik, Christopher J. D. Wallis and Raj Satkunasivam

Curr. Oncol. 2025, 32(6), 358; https://doi.org/10.3390/curroncol32060358 - 17 Jun 2025

Abstract

Objectives: To compare the perioperative complications between robot-assisted (RARN) and laparoscopic (LRN) radical nephrectomy for the treatment of renal cell carcinoma (RCC). Methods: We conducted a retrospective study using the National Surgical Quality Improvement Program (NSQIP) Nephrectomy-Targeted database from 2019 to 2021. After [...] Read more.

Objectives: To compare the perioperative complications between robot-assisted (RARN) and laparoscopic (LRN) radical nephrectomy for the treatment of renal cell carcinoma (RCC). Methods: We conducted a retrospective study using the National Surgical Quality Improvement Program (NSQIP) Nephrectomy-Targeted database from 2019 to 2021. After using propensity score matching, we assessed the association between LRN vs. RARN and the outcomes of interest (primary outcomes of 30-day mortality, return to the operating room, myocardial infarction, and stroke; and secondary outcomes of perioperative complications and nephrectomy-specific outcomes). Results: Among the 1545 patients in the study (mean age: 62.9 ± 11.8 years), 722 underwent RARN and 823 underwent LRN. We did not observe any differences in the major complications between the two approaches. However, LRN was associated with an increased chance of surgical site infections compared with RARN (LRN 2.68% vs. RARN 1.19%, p = 0.047). LRN was also associated with a higher likelihood of a prolonged length of stay (OR 1.54, 95% CI: 1.15, 2.06, p = 0.004) and had a 2.7 times higher chance of conversion rate to open surgery (OR 3.70, 95% CI: 3.25, 4.15, p < 0.001) relative to RARN. However, RARN was associated with a longer operative time than LRN (estimated coefficient 30.67, p < 0.001). Conclusion: We found no significant difference in the major complications between RARN and LRN for patients undergoing radical nephrectomy. At the expense of a somewhat longer operative time, RARN was associated with a lower risk of SSI and a lower conversion rate to open RN. LRN and RARN should both be considered and selected on an individualized basis using tumor, patient, and physician factors. Full article

(This article belongs to the Section Genitourinary Oncology)

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35 pages, 392 KiB

Open AccessGuidelines

Postmastectomy Breast Reconstruction in Patients with Non-Metastatic Breast Cancer: An Ontario Health (Cancer Care Ontario) Clinical Practice Guideline

by Toni Zhong, Glenn G. Fletcher, Muriel Brackstone, Simon G. Frank, Renee Hanrahan, Vivian Miragias, Christiaan Stevens, Danny Vesprini, Alyssa Vito and Frances C. Wright

Curr. Oncol. 2025, 32(6), 357; https://doi.org/10.3390/curroncol32060357 - 17 Jun 2025

Abstract

Several postmastectomy breast reconstruction techniques and procedures have been implemented, although with limited evaluation of benefits and adverse effects. We conducted a systematic review on the plane and timing of reconstruction, and on the use of nipple-sparing mastectomy, acellular dermal matrix, and autologous [...] Read more.

Several postmastectomy breast reconstruction techniques and procedures have been implemented, although with limited evaluation of benefits and adverse effects. We conducted a systematic review on the plane and timing of reconstruction, and on the use of nipple-sparing mastectomy, acellular dermal matrix, and autologous fat grafting as the evidence base for an updated clinical practice guideline on breast reconstruction for Ontario Health (Cancer Care Ontario). Both immediate and delayed reconstruction may be considered, with preferred timing depending on factors such as patient preferences, type of mastectomy, skin perfusion, comorbidities, pre-mastectomy breast size, and desired reconstructive breast size. Immediate reconstruction may provide greater psychological or quality of life benefits. In patients who are candidates for skin-sparing mastectomy and without clinical, radiological, and pathological indications of nipple-areolar complex involvement, nipple-sparing mastectomy is recommended provided it is technically feasible and acceptable aesthetic results can be achieved. Surgical factors including incision location are important to reduce necrosis by preserving blood supply and to minimize nerve damage. There is a role for both prepectoral and subpectoral implants; risks and benefits will vary, and decisions should be made during consultation between the patient and surgeons. In patients who are suitable candidates for implant reconstruction and have adequate mastectomy flap thickness and vascularity, prepectoral implants should be considered. Acellular dermal matrix (ADM) has led to an increased use of prepectoral reconstruction. ADM should not be used in case of poor mastectomy flap perfusion/ischemia that would otherwise be considered unsuitable for prepectoral reconstruction. Care should be taken in the selection and handling of acellular dermal matrix (ADM) to minimize risks of infection and seroma. Limited data from small studies suggest that prepectoral reconstruction without ADM may be feasible in some patients. Autologous fat grafting is recommended as a treatment for contour irregularities, rippling following implant-based reconstruction, and to improve tissue quality of the mastectomy flap after radiotherapy. Full article

(This article belongs to the Section Breast Cancer)

18 pages, 489 KiB

Open AccessArticle

Prognostic Value of Multiple Manual Segmentation Methods for Diffuse Large B-Cell Lymphoma with ¹⁸F-FDG PET/CT

by Andrej Doma, Andrej Studen and Barbara Jezeršek Novaković

Curr. Oncol. 2025, 32(6), 356; https://doi.org/10.3390/curroncol32060356 - 16 Jun 2025

Abstract

Quantitative ¹⁸F-FDG PET/CT-derived metabolic metrics are strongly associated with patient outcomes in diffuse large B-cell lymphoma (DLBCL), but the lack of consensus on optimal segmentation thresholds limits standardization. This study evaluated the prognostic value of various metabolic tumor volume (MTV) segmentation approaches [...] Read more.

Quantitative ¹⁸F-FDG PET/CT-derived metabolic metrics are strongly associated with patient outcomes in diffuse large B-cell lymphoma (DLBCL), but the lack of consensus on optimal segmentation thresholds limits standardization. This study evaluated the prognostic value of various metabolic tumor volume (MTV) segmentation approaches in 140 stage II–IV DLBCL patients treated with standard immunochemotherapy. MTV was derived using fixed SUV (≥2.5, ≥4.0), relative (>41% SUVmax), and adaptive (liver-to-background) thresholds. Baseline MTV metrics significantly correlated with 3-year overall survival (OS3) in univariate analysis in overall cohort, with MTV41 showing the strongest association (HR: 1.27; p = 0.003). MTV25 and MTV41 remained significant in the stage 4 patient subgroup. However, in multivariate analysis, no MTV metric independently predicted OS3 when adjusted for the International Prognostic Index (IPI), which remained the dominant predictor (HR: 1.95; p < 0.0001). ROC analysis confirmed superior AUC for IPI (0.76) over PET-based metrics (0.64–0.69). Predictive models integrating IPI with PET metrics were robust but failed to improve prognostic accuracy beyond IPI alone. Although PET-derived MTV metrics provide prognostic value in univariate analysis, threshold selection has minimal impact, and their added value is limited when combined with IPI, reinforcing its role as the most reliable survival predictor in DLBCL. Full article

(This article belongs to the Special Issue Application of Nuclear Medicine in Cancer Diagnosis and Treatment)

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13 pages, 3443 KiB

Open AccessArticle

Tumor Invasion Distance Based on MRI Is a Novel Prognostic Indicator for I-IIIB Cervical Cancer Patients Treated with Radiotherapy

by Linying Liu, Jie Lin, Anyang Li, Ning Xie, Jianfeng Zheng, Youping Xiao, Xuefen Lin, Shizhong Wu, Haijuan Yu and Yang Sun

Curr. Oncol. 2025, 32(6), 355; https://doi.org/10.3390/curroncol32060355 - 16 Jun 2025

Abstract

Aims:This study aimed to identify the prognostic value of tumor invasion distance (TID) based on MRI findings in cervical-cancer (CC) patients treated with radiotherapy (RT). Methods: A total of 218 CC patients diagnosed at Fujian Cancer Hospital from December 2018 to [...] Read more.

Aims:This study aimed to identify the prognostic value of tumor invasion distance (TID) based on MRI findings in cervical-cancer (CC) patients treated with radiotherapy (RT). Methods: A total of 218 CC patients diagnosed at Fujian Cancer Hospital from December 2018 to December 2019 were included in the study. Cox regression analyses were conducted to identify independent prognostic factors for overall survival (OS), including low 1/3 vaginal involvement, a longer TID, and RT without chemotherapy. These factors were subsequently used to construct a nomogram for individualized risk prediction. Kaplan–Meier survival analysis was employed to evaluate survival outcomes and establish a risk stratification system. The performance of the new stratification was assessed using the linear trend χ² test, Akaike information criterion, and Harrell’s concordance index. Results: A longer TID was associated with worse 3-year OS (p < 0.001, HR: 3.42, 95% CI: 1.67–7.00). A longer TID, lower 1/3 vaginal involvement, and concurrent chemotherapy were independent prognostic survival factors for CC patients. Compared with the 2018 FIGO staging system, the new risk stratification system provided better monotonicity with a higher linear trend χ² value (28.03 vs. 9.35), better discriminatory ability with smaller Akaike information criterion (312 vs. 331), and a greater Harrell C statistic (0.74 vs. 0.65) for predicting 3-year OS. Conclusions: This was the first study to demonstrate the prognostic value of TID in CC patients who received RT. The new risk stratification system based on TID could complement the 2018 FIGO staging system in identifying high-risk patients for more intense treatment and care. Further prospective research with larger samples is warranted to confirm the significance of TID for CC patients treated with RT. Full article

(This article belongs to the Section Gynecologic Oncology)

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15 pages, 1854 KiB

Open AccessArticle

Design and Development of a Device (Sifilotto^®) for Tumour Tracking in Cervical Cancer Patients Undergoing Robotic Arm LINAC Stereotactic Body Radiation Therapy Boost: Background to the STARBACS Study

by Silvana Parisi, Giacomo Ferrantelli, Anna Santacaterina, Elvio Grazioso Russi, Federico Chillari, Claudio Napoli, Anna Brogna, Carmelo Siragusa, Miriam Sciacca, Antonio Pontoriero, Giuseppe Iatì and Stefano Pergolizzi

Curr. Oncol. 2025, 32(6), 354; https://doi.org/10.3390/curroncol32060354 - 16 Jun 2025

Abstract

Standard of Care (SOC) for locally advanced cervical cancer is represented by external beam radiation therapy concurrent with platinum-based chemotherapy and immunotherapy (cCIRT) followed by brachytherapy boost and immunotherapy maintenance. In some instances, it is impossible to perform brachytherapy due to patient and/or [...] Read more.

Standard of Care (SOC) for locally advanced cervical cancer is represented by external beam radiation therapy concurrent with platinum-based chemotherapy and immunotherapy (cCIRT) followed by brachytherapy boost and immunotherapy maintenance. In some instances, it is impossible to perform brachytherapy due to patient and/or cancer issues. In these circumstances, an external beam boost could be delivered. Using a robotic arm LINAC, it is mandatory to use intramucosal implanted fiducials which are needed for tumour tracking. To avoid invasive procedures, we developed an original intravaginal 3D-printed universal device containing gold fiducials embedded within it. In this paper, we describe the step-by-step procedure that allowed us to obtain the utility model patent, including the in vivo test (feasibility, reproducibility, device compliance) on seven patients within the study protocol “STereotActic Radiotherapy Boost in locally Advanced Cervical carcinoma patientS” (STARBACS). Full article

(This article belongs to the Section Gynecologic Oncology)

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15 pages, 460 KiB

Open AccessArticle

Evaluating the Impact of Common Non-Oncologic Medication Use During Radiotherapy in Patients with High-Risk Prostate Cancer

by Haley K. Perlow, Karishma Khullar, Ritesh Kumar, Sonya Sasmal, Kent Nakamoto, Yevgeniya Gokun, Jacob Eckstein, Rebekah Young, Dayssy A. Diaz, Douglas Martin, Katharine A. Collier, Lingbin Meng, Rahul R. Parikh, Steven Clinton and Shang-Jui Wang

Curr. Oncol. 2025, 32(6), 353; https://doi.org/10.3390/curroncol32060353 - 15 Jun 2025

Viewed by 47

Abstract

Introduction: The treatment efficacy of prostate cancer (PCa) radiotherapy (RT) can be inadvertently affected by the concurrent usage of non-oncologic medications. Many studies have associated the intake of several non-oncologic drugs with cancer specific outcomes. In this study, we report the impact of [...] Read more.

Introduction: The treatment efficacy of prostate cancer (PCa) radiotherapy (RT) can be inadvertently affected by the concurrent usage of non-oncologic medications. Many studies have associated the intake of several non-oncologic drugs with cancer specific outcomes. In this study, we report the impact of daily non-oncologic medications including aspirin, metformin, and statins on time to progression for patients with high-risk PCa. Methods: Patients with high- and very high risk PCa (NCCN definition of Gleason score ≥ 8, prostate-specific antigen (PSA) ≥ 20, or ≥cT3a) who received definitive RT at two institutions were included in this analysis. Progression was defined as either biochemical (PSA > nadir + 2 ng/mL), locoregional (prostate or lymph nodes, biopsy-proven), or development of distant metastases. Progression-free survival (PFS) was defined as the time elapsed from the start of RT to progression or last follow-up. Cox proportional hazards models evaluated the associations between non-oncologic medications and PFS. Results: There were 237 patients eligible for this analysis, of which 47 (19.8%) and 178 (75.1%) had at least clinical T3 disease or at least Gleason 8 disease, respectively. During RT, 82 (34.6%), 88 (37.1%), and 29 (12.2%) patients were taking aspirin, statin, or metformin, respectively. Overall, 54 patients (22.8%) experienced disease progression. Neither aspirin nor statin usage had a significant association with PFS. Patients prescribed metformin displayed worse PFS compared to patients not taking metformin (aHR: 2.46, 95% CI: 1.06–5.72). Conclusions: Aspirin and statin usage was not associated with likelihood of progression in this large cohort of patients with high-/very high risk PCa. Metformin use was associated with poorer PFS, albeit with a small event rate due to fewer patients taking metformin. Further studies are needed to clarify the impact of common non-oncologic medication use on outcomes for patients with high-risk PCa. Full article

(This article belongs to the Special Issue New and Emerging Trends in Prostate Cancer)

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10 pages, 1973 KiB

Open AccessCase Report

Mucinous Cystic Neoplasms in Male Patients: Histopathological and Molecular Diagnoses

by Lara Malaspina, Natale Calomino, Ludovico Carbone, Anastasia Batsikosta, Fabiola Rossi, Gianmario Edoardo Poto, Aurora Visani, Lucia Mundo, Bina Barbato, Ilaria Monteleone, Franco Roviello and Sergio Antonio Tripodi

Curr. Oncol. 2025, 32(6), 352; https://doi.org/10.3390/curroncol32060352 - 13 Jun 2025

Viewed by 87

Abstract

Cystic mucinous neoplasms (MCNs) of the pancreas are rare cystic tumors, accounting for approximately 2–5% of all pancreatic neoplasms. They predominantly occur in premenopausal women and are typically located in the body or tail of the pancreas. Due to their potential for malignant [...] Read more.

Cystic mucinous neoplasms (MCNs) of the pancreas are rare cystic tumors, accounting for approximately 2–5% of all pancreatic neoplasms. They predominantly occur in premenopausal women and are typically located in the body or tail of the pancreas. Due to their potential for malignant transformation, especially in cases associated with invasive carcinoma such as pancreatic ductal adenocarcinoma, early detection, complete surgical resection, and rigorous postoperative surveillance are essential. The occurrence of MCNs in male patients is exceedingly rare, comprising only about 2% of reported cases, and often resulting in preoperative diagnostic challenges. Molecular analyses have identified a strong association between KRAS mutations and disease progression in MCNs, underscoring their potential role as prognostic markers despite limited diagnostic utility. In this report, we present two additional cases of MCNs in male patients, highlighting their histopathological features and the ancillary investigations undertaken to support diagnosis. Full article

(This article belongs to the Section Surgical Oncology)

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12 pages, 663 KiB

Open AccessArticle

Renal Function Deterioration in Postoperative (Adjuvant) Chemotherapy for Colon Cancer—Real-Life Data

by Aleksandra Gładyś, Sylwia Kozak, Aleksander Jerzy Owczarek, Ewa Cedrych, Zofia Irena Niemir, Stanisław Łącki-Zynzeling, Anna Chudek, Izolda Mrochen-Domin, Iwona Gisterek-Grocholska and Jerzy Chudek

Curr. Oncol. 2025, 32(6), 351; https://doi.org/10.3390/curroncol32060351 - 13 Jun 2025

Viewed by 99

Abstract

The knowledge concerning mild-to-moderate renal toxicity of adjuvant chemotherapy (CTH) in colon cancer patients is scarce. We retrospectively evaluated changes in the estimated glomerular filtration rate (eGFR) after three months of adjuvant treatment and the overall renal risk of the 6-month regimen in [...] Read more.

The knowledge concerning mild-to-moderate renal toxicity of adjuvant chemotherapy (CTH) in colon cancer patients is scarce. We retrospectively evaluated changes in the estimated glomerular filtration rate (eGFR) after three months of adjuvant treatment and the overall renal risk of the 6-month regimen in 145 patients who completed three months of therapy at three oncological centers. A decrease in eGFR of at least 1.5 mL/min/1.73 m² after three months and 3.0 mL/min/1.73 m² after six months was considered relevant in terms of kidney-related cardiovascular risk. Out of 114 patients who completed a 6-month regimen, kidney function deterioration occurred in 62 (54.4%) after 3 months and in 54 (47.4%) after 6 months. Age ≥ 70 years (RR = 2.66; 95% CI: 1.15–6.16) and diabetes (RR = 2.52; 95% CI: 0.98–6.45) were risk factors for kidney outcomes during the first three months of CTH. However, renal function decline during the first three months did not increase the risk of further deterioration on CTH continuation. In conclusion, older age and diabetes are factors increasing the risk of renal function deterioration during adjuvant CTH in colon cancer patients without preexisting chronic kidney disease. However, the decline during the first three months does not allow for predicting further changes under continued adjuvant therapy. Full article

(This article belongs to the Special Issue Therapeutic Studies from Pre-Clinical to Clinical (Phase I–IV) for Gastrointestinal Cancers)

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18 pages, 2372 KiB

Open AccessArticle

Dynamic Evolution of Vascular Features Based on Magnetic Resonance Imaging to Predict Pathological Response, Patterns of Recurrence and Survival Outcomes in Breast Cancer Neoadjuvant Chemotherapy

by Qiong Wu, Mingxi Zhu, Huaying Xie, Xiaochuan Geng, Yan Wang, Ziping Wu, Yanping Lin, Shuguang Xu, Yumei Ye, Wenjin Yin, Zhiguo Zhuang, Jingsong Lu and Liheng Zhou

Curr. Oncol. 2025, 32(6), 350; https://doi.org/10.3390/curroncol32060350 - 13 Jun 2025

Viewed by 83

Abstract

Neoadjuvant chemotherapy (NAC), followed by surgery and adjuvant therapy, constitutes the prevailing therapeutic paradigm for patients with locally advanced breast cancer (LABC) [...] Full article

(This article belongs to the Section Breast Cancer)

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27 pages, 3066 KiB

Open AccessReview

Beyond Barriers: Achieving True Equity in Cancer Care

by Zaphrirah S. Chin, Arshia Ghodrati, Milind Foulger, Lusine Demirkhanyan and Christopher S. Gondi

Curr. Oncol. 2025, 32(6), 349; https://doi.org/10.3390/curroncol32060349 - 12 Jun 2025

Viewed by 385

Abstract

Healthcare disparities in cancer care remain pervasive, driven by intersecting socioeconomic, racial, and insurance-related inequities. These disparities manifest in various forms such as limited access to medical resources, underrepresentation in clinical trials, and worse cancer outcomes for marginalized groups, including low-income individuals, racial [...] Read more.

Healthcare disparities in cancer care remain pervasive, driven by intersecting socioeconomic, racial, and insurance-related inequities. These disparities manifest in various forms such as limited access to medical resources, underrepresentation in clinical trials, and worse cancer outcomes for marginalized groups, including low-income individuals, racial minorities, and those with inadequate insurance coverage, who face significant barriers in accessing comprehensive cancer care. This manuscript explores the multifaceted nature of these disparities, examining the roles of socioeconomic status, race, ethnicity, and insurance status in influencing cancer care access and outcomes. Historical and contemporary data highlight that minority racial status correlates with reduced clinical trial participation and increased cancer-related mortality. Barriers such as insurance coverage, health literacy, and language further hinder access to cancer treatments. Addressing these disparities requires a systemic approach that includes regulatory reforms, policy changes, educational initiatives, and innovative trial and treatment designs. This manuscript emphasizes the need for comprehensive interventions targeting biomedicine, socio-demographics, and social characteristics to mitigate these inequities. By understanding the underlying causes and implementing targeted strategies, we can work towards a more equitable healthcare system. This involves improving access to high-quality care, increasing participation in research, and addressing social determinants of health. This manuscript concludes with policy recommendations and future directions to achieve health equity in cancer care, ensuring optimal outcomes for all patients. Full article

(This article belongs to the Section Oncology Nursing)

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12 pages, 3172 KiB

Open AccessArticle

Integrating Radiologic and Clinical Features to Predict VSX1 Expression in Clear Cell Renal Cell Carcinoma

by Federico Greco, Andrea Panunzio, Daniele Sergi, Marco Cataldo, Caterina Bernetti, Alessandro Tafuri, Bruno Beomonte Zobel and Carlo Augusto Mallio

Curr. Oncol. 2025, 32(6), 348; https://doi.org/10.3390/curroncol32060348 - 12 Jun 2025

Viewed by 109

Abstract

Radiogenomics explores the connection between medical imaging features and underlying genetic profiles [...] Full article

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13 pages, 724 KiB

Open AccessArticle

Planned Liver Stereotactic Body Radiotherapy for Residual Colorectal Cancer Liver Metastases After Surgery: A Single-Arm Retrospective Study

by Sixuan Li, Dezuo Dong, Xuan Zheng, Hongzhi Wang, Kun Wang, Baocai Xing and Weihu Wang

Curr. Oncol. 2025, 32(6), 347; https://doi.org/10.3390/curroncol32060347 - 12 Jun 2025

Viewed by 111

Abstract

Given the promising outcomes of stereotactic body radiation therapy (SBRT) in treating colorectal cancer liver metastases (CRLMs), we proposed an innovative strategy combining surgery with planned liver SBRT for CRLMs. This retrospective study included patients who underwent curative-intent surgery combined with planned liver [...] Read more.

Given the promising outcomes of stereotactic body radiation therapy (SBRT) in treating colorectal cancer liver metastases (CRLMs), we proposed an innovative strategy combining surgery with planned liver SBRT for CRLMs. This retrospective study included patients who underwent curative-intent surgery combined with planned liver SBRT from July 2019 to October 2023. Planned liver SBRT was delivered to residual unresectable and unablatable lesions with maximum diameters of ≤5 cm. Outcomes included local failure (LF), intrahepatic recurrence-free survival (IHRFS), extrahepatic recurrence-free survival (EHRFS), progression-free survival (PFS), overall survival (OS), and radiation-related adverse events. A total of 69 patients were included. The 1-, and 2-year cumulative incidence rates of LF after SBRT were 7.7%, and 9.6%, respectively. The median PFS was 6.2 months, and the median OS was 45.8 months. Multivariate analysis identified RAS/BRAF mutations, extrahepatic metastases excluding lung involvement, and higher CEA as independent predictors of poorer OS. Intrahepatic recurrence was the predominant pattern of first disease progression after combination treatment. Acute grade 1–2 radiation-related adverse events occurred in 56.5% of patients, while grade 3 toxicities were reported in 4.3%. This approach offers favorable long-term outcomes, suggesting its potential to broaden the indications for curative-intent local treatments in CRLMs. Full article

(This article belongs to the Special Issue Recent Advances in Surgical Strategies for Managing Metastatic Colorectal Cancer)

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14 pages, 1373 KiB

Open AccessArticle

Cost Disparities with Age in the Treatment of Advanced Non-Small-Cell Lung Cancer (NSCLC) in Ontario, Canada

by Ying Wang, Greg Pond, Amiram Jacob Gafni, Chung Yin Kong and Peter M. Ellis

Curr. Oncol. 2025, 32(6), 346; https://doi.org/10.3390/curroncol32060346 - 12 Jun 2025

Viewed by 124

Abstract

Previous studies have noted associations between age and healthcare costs in non-small-cell lung cancer (NSCLC). However, the drivers of cost disparities have not yet been fully examined. This retrospective cohort study included deceased patients diagnosed with stage IV NSCLC in Ontario from 1 [...] Read more.

Previous studies have noted associations between age and healthcare costs in non-small-cell lung cancer (NSCLC). However, the drivers of cost disparities have not yet been fully examined. This retrospective cohort study included deceased patients diagnosed with stage IV NSCLC in Ontario from 1 April 2008 to 30 March 2014. Variables of interest were extracted from the Institute for Clinical Evaluative Sciences. Average monthly cancer-attributable costs (CACs), defined as the net additional costs due to cancer, determined by subtracting pre-diagnosis costs from post-diagnosis costs, were calculated by phases of care (staging, initial, continuing, and end-of-life). Regression analyses assessed predictors of cost variability. The median age of the 14,655 patients was 65 to 69 years; 54% were male and 29% had received chemotherapy. On both univariate and multivariate analysis, CACs decreased with age after cancer diagnosis across all phases of care (p < 0.001). Receiving chemotherapy contributed to higher costs in staging, initial, and continuing phases (OR 2.11, 95% C.I. 1.90–2.33, p < 0.01), and lower costs in the end-of-life phase (OR 0.77, 95% C.I. 0.72–0.81, p < 0.01). Our study showed that older patients had higher baseline healthcare costs and lower cancer-attributable costs following diagnosis of advanced NSCLC. Cost drivers, including treatment and gender, varied by phase of care. Full article

(This article belongs to the Special Issue The Role of Real-World Evidence (RWE) in Thoracic Malignancies)

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15 pages, 614 KiB

Open AccessArticle

Population-Based Real-World Outcomes of Post-Operative Adjuvant Brain Cavity Radiotherapy Versus Observation

by Zhang Hao (Jim) Li, Linden Lechner, Jennifer Wang, Nan Hui (Susan) Yao, Andrew Lee, Serge Makarenko, Mostafa Fatehi, Herve H. F. Choi, Ermias Gete, Fred Hsu, Waseem Sharieff, Shrinivas Rathod, Hannah Carolan, Jessica Chan, Roy Ma, Alan Nichol, Thi Nghiem and Justin Oh

Curr. Oncol. 2025, 32(6), 345; https://doi.org/10.3390/curroncol32060345 - 11 Jun 2025

Viewed by 218

Abstract

To evaluate the factors influencing the outcomes of patients who underwent surgical resection of brain metastasis followed by either surveillance or post-operative stereotactic radiosurgery/fractionated radiotherapy (SRS/SFRT), a retrospective multi-center chart review was performed on all patients who underwent brain metastases resection in British [...] Read more.

To evaluate the factors influencing the outcomes of patients who underwent surgical resection of brain metastasis followed by either surveillance or post-operative stereotactic radiosurgery/fractionated radiotherapy (SRS/SFRT), a retrospective multi-center chart review was performed on all patients who underwent brain metastases resection in British Columbia between 2018 and 2020. Patients with prior whole-brain radiotherapy were excluded from the study. The primary study endpoints included local recurrence, distant intracranial control, radionecrosis (RN), leptomeningeal disease (LMD), and overall survival (OS). The Kaplan–Meier method was used to analyze survival. The Cox proportional hazards model was used to perform univariable (UVA) and multivariable (MVA) analyses to identify predictors of local control. A total of 113 patients met the inclusion criteria. A total of 31 patients received adjuvant SRS/SFRT to the surgical cavity, while 82 went on observation. The 12-month local control was 69% (50–88%) for the SRS/SFRT cohort and 31% (18–45%) for the observation cohort (p < 0.001). The 12-month distant intracranial control was 44% (26–63%) for the SRS/SFRT cohort and 46% (30–62%) for the observation cohort (p = 0.9). Sensitivity analysis did not show a difference in overall survival (p = 0.6). En bloc resection (p < 0.05), resection without residual disease (p < 0.05), and SRS/SFRT (p < 0.001) were predictive of local control on MVA. Three SRS/SFRT patients (10%) and two observation patients (2%) developed LMD. Four SRS/SFRT patients experienced RN (13%), with no grade 3 or higher toxicities observed. Post-operative SRT outcomes based on real-world population data are consistent with the data from clinical trials and support the established guidelines. For patients requiring surgical resection of brain metastasis, en bloc gross total resection should be encouraged when feasible to reduce local recurrence. Full article

(This article belongs to the Section Neuro-Oncology)

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17 pages, 1075 KiB

Open AccessSystematic Review

Prognostic Relevance of Inflammatory Cytokines Il-6 and TNF-Alpha in Patients with Breast Cancer: A Systematic Review and Meta-Analysis

by Jhony A. De La Cruz-Vargas, Henry Gómez, Jesus E. Talavera, Cristhian Gonzales-Rospigliosi, Ariana Alessandra Córdova Salazar and Rafael Pichardo-Rodriguez

Curr. Oncol. 2025, 32(6), 344; https://doi.org/10.3390/curroncol32060344 - 11 Jun 2025

Viewed by 170

Abstract

Although cytokines mediate inflammation and inflammation facilitates cancer progression, few studies have evaluated the association between specific cytokines and the prognostic value of breast cancer. Therefore, this study aims to address the following question: What is the prognostic relevance of serum IL-6 and [...] Read more.

Although cytokines mediate inflammation and inflammation facilitates cancer progression, few studies have evaluated the association between specific cytokines and the prognostic value of breast cancer. Therefore, this study aims to address the following question: What is the prognostic relevance of serum IL-6 and TNF-alpha levels on overall survival and treatment response in women with breast cancer? A systematic review and meta-analysis of cohort studies was conducted. The databases consulted included PubMed/Medline, Web of Science, and EMBASE. A total of 1748 articles were identified, of which 10 were included in the review. A significant association was found between elevated levels of IL-6 and TNF-alpha with poor overall survival and poor treatment response. The meta-analysis showed an HR of 3.74 (95% CI: 1.84–7.6) for elevated IL-6 with high heterogeneity (I²: 61%; p = 0.07) and an HR of 3.13 (95% CI: 1.57–6.23) for TNF-alpha with low heterogeneity (I²: 0%; p = 0.9). The overall response rate was 75% (95% CI: 31–100%; I²: 92%). In conclusion, IL-6 and TNF-alpha emerge as prognostic inflammatory biomarkers in women with breast cancer and are associated with poor survival and poor treatment response. This study highlights the need to establish an international consensus on cutoff points and standardized determination methods to implement these biomarkers in clinical practice. Full article

(This article belongs to the Special Issue Advances in Immunotherapy for Breast Cancer)

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16 pages, 218 KiB

Open AccessArticle

Physician Attributes That Matter Most: Results from a Qualitative Inquiry of Oncologists, Patients Receiving Oncological Care, and Medical Students

by Kimberly McMillan, Deborah Akurang and Paul Wheatley-Price

Curr. Oncol. 2025, 32(6), 343; https://doi.org/10.3390/curroncol32060343 - 11 Jun 2025

Viewed by 157

Abstract

Background: Physician attributes significantly impact patient outcomes, satisfaction, and trust. Various attribute frameworks have been developed to help structure and guide undergraduate medical education and subsequent clinician practice; however, prioritization of these attributes vary by stakeholder (patients, physicians, medical students). Based on findings [...] Read more.

Background: Physician attributes significantly impact patient outcomes, satisfaction, and trust. Various attribute frameworks have been developed to help structure and guide undergraduate medical education and subsequent clinician practice; however, prioritization of these attributes vary by stakeholder (patients, physicians, medical students). Based on findings from two previous studies completed by the research team, we sought to understand the context in which individuals in these stakeholder groups prioritize particular physician attributes. We adopted a qualitative approach, conducting semi-structured interviews with patients (N = 11), doctors (N = 11), and medical students (N = 12), for a total sample of 34. Results: Thematic analysis of data resulted in the following five themes: caring, communicator, expert, professional, curiosity and open-mindedness. Central to our findings was the need for a positive, trusting provider–patient relationship, which was framed as the conduit to quality patient care (both receiving and providing). The attributes believed to support this central finding differed, noting that “caring”, “curiosity and open-mindedness” are not typical in physician attribute frameworks. Findings suggest there is a central guiding philosophy shaping what medical students, physicians and patients alike, need in the context of the provider–patient relationship, which transcends particular attributes. The guiding philosophy of relational inquiry is used to further situate study findings. Conclusions: Integrating a central guiding philosophy can add additional depth and nuance to attribute frameworks, ensuring considerations for qualities that transcend particular attribute characteristics, such as “caring” and “curiosity and open-mindedness” are also explicitly used to help structure and guide undergraduate medical education and subsequent clinician practice. Full article

9 pages, 1235 KiB

Open AccessArticle

Diffuse-Type Tenosynovial Giant Cell Tumor of the Knee: Clinical Course After Anterior Open Synovectomy

by Alessandro Bruschi, Eric Staals, Andrea Sambri, Luca Cevolani, Marco Gambarotti, Alberto Righi, Michele Fiore, Eleonora Villari, Stefano Pasini, Maria Giulia Pirini, Massimiliano De Paolis and Davide Maria Donati

Curr. Oncol. 2025, 32(6), 342; https://doi.org/10.3390/curroncol32060342 - 11 Jun 2025

Viewed by 136

Abstract

Diffuse type tenosynovial giant cell tumor (D-TGCT) of the knee presents with stiffness, pain and swelling with surgery being the mainstay treatment. However, the literature lacks data on clinical course of range of motion, pain (ROM), and swelling after open synovectomy for D-TGCT. [...] Read more.

Diffuse type tenosynovial giant cell tumor (D-TGCT) of the knee presents with stiffness, pain and swelling with surgery being the mainstay treatment. However, the literature lacks data on clinical course of range of motion, pain (ROM), and swelling after open synovectomy for D-TGCT. Therefore, this study aims to evaluate clinical course after open anterior synovectomy. A retrospective analysis was conducted on 214 patients treated for TGCT at our Institutions between 2010 and 2023. 51 patients with anterior knee D-TGCT who underwent open anterior synovectomy were included. Pre- and postoperative assessments included ROM, pain (VAS scale), and reported swelling. The mean knee flexion increased from 100° (SD 14.28) preoperatively to 131.8° (12.64) at 12 months post-surgery. Knee extension remained stable, ranging from 178.4° preoperatively to 179.2° at the final follow-up. Pain decreased from a mean of 5.0 (SD 2.8) preoperatively to 0.5 (SD 0.7) at 12 months. Swelling was initially reported in 90.4% of patients, with 95.74% of them showing improvement at six months, and 100% at 12 months. Open anterior synovectomy effectively improves knee function, pain, swelling in patients with anterior knee D-TGCT, although functional recovery may take up to 6–12 months. Full article

(This article belongs to the Section Bone and Soft Tissue Oncology)

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16 pages, 786 KiB

Open AccessArticle

Implementation of Organ Preservation for Locally Advanced Rectal Cancer in Canada: A National Survey of Clinical Practice

by Megan Delisle, Victoria Ivankovic, Doris Goubran, Eliane Yvonne Paglicauan, Mariam Alsobaei, Nicole Alcasid, Mary Farnand and Kristopher Dennis

Curr. Oncol. 2025, 32(6), 341; https://doi.org/10.3390/curroncol32060341 - 10 Jun 2025

Viewed by 149

Abstract

Purpose: Organ preservation (OP) is an increasingly recognized treatment for locally advanced rectal cancer. However, variability in patient selection, treatment regimens, and surveillance can hinder widespread adoption. We conducted a national, cross-sectional survey evaluating how OP is implemented across Canada. Methods: Between June [...] Read more.

Purpose: Organ preservation (OP) is an increasingly recognized treatment for locally advanced rectal cancer. However, variability in patient selection, treatment regimens, and surveillance can hinder widespread adoption. We conducted a national, cross-sectional survey evaluating how OP is implemented across Canada. Methods: Between June and July 2023, surgeons, radiation oncologists, and medical oncologists with expertise in OP from all 44 Canadian radiation centers completed an electronic survey about the implementation of OP at their centers. Primary OP was defined as administering neoadjuvant therapy with the explicit goal of avoiding surgery. Secondary OP was defined as deferring planned surgery only when there was an unexpected yet sufficient clinical response. Results: Responses from 40 radiation centers (response rate 90.9%) identified that 20 (50.0%) offered primary and secondary OP, 11 (27.8%) offered only secondary, and 8 (20.0%) offered neither. The most common treatment in primary OP was chemoradiation with consolidation chemotherapy (17/20, 89.5%). When assessing the response in primary OP, endoscopic biopsies were more commonly performed with a near-complete response (10/20, 50.0%) than a complete response (4/20, 20.0%). Watch-and-wait surveillance was more frequently offered for a complete response (17/31, 54.8%) than a near-complete response (4/31, 12.9%). Challenges included limited MRI (21/40, 52.5%), clinic time (18/40, 45.0%), timely surgery if required (16/40, 40.0%), and limited familiarity with the protocols and evidence (15/40, 37.5%). Conclusion: OP is recognized nationwide but is inconsistently implemented. Challenges raise concerns about the current feasibility of OP in Canada and highlight the need for less resource-intensive, complex OP protocols. Full article

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16 pages, 5847 KiB

Open AccessGuidelines

Updated Guidelines for the Diagnosis and Treatment of Endometrial Carcinoma: The Polish Society of Gynecological Oncology (2025v)

by Jacek J. Sznurkowski, Lubomir Bodnar, Anna Dańska-Bidzińska, Andrzej Marszałek, Pawel Blecharz, Anita Chudecka-Głaz, Dagmara Klasa-Mazurkiewicz, Artur Kowalik, Agnieszka Zołciak-Siwinska, Aleksandra Zielinska, Mariusz Bidziński and Włodzimierz Sawicki

Curr. Oncol. 2025, 32(6), 340; https://doi.org/10.3390/curroncol32060340 - 9 Jun 2025

Viewed by 754

Abstract

In 2023, the Polish Society of Gynecologic Oncology (PSGO) published clinical recommendations for the diagnosis, treatment, and care of women with endometrial cancer (EC), developed using the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. A 2025 update was initiated in [...] Read more.

In 2023, the Polish Society of Gynecologic Oncology (PSGO) published clinical recommendations for the diagnosis, treatment, and care of women with endometrial cancer (EC), developed using the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. A 2025 update was initiated in response to new evidence, particularly regarding systemic therapies for metastatic, advanced, or recurrent EC, and the introduction of an updated FIGO classification. A targeted literature review identified relevant phase III clinical trials and systematic reviews, including RUBY, GY-018, AtTend, and DUO-E. These trials were critically assessed by an Expert Panel in accordance with the AGREE II methodology. Updated recommendations were formulated based on this evidence, with a comparative analysis of the old and new FIGO staging systems and visual updates to treatment pathways. Key changes include the addition of immunotherapy (I/O) plus chemotherapy (CHTH) as first-line treatment for all molecular subtypes of high-grade endometrioid and non-endometrioid carcinomas, replacing chemotherapy alone. For MMRp-positive cases, the 2025 version introduces the use of Olaparib alongside Durvalumab and CHTH. HER2-positive MMRp serous carcinoma remains eligible for trastuzumab in combination with CHTH. Second-line treatment guidance remains unchanged for patients who did not receive I/O plus CHTH initially. However, options for those previously treated with this combination are still under evaluation. This update ensures alignment with the latest international standards and reinforces evidence-based, personalized care for EC patients. Full article

(This article belongs to the Section Gynecologic Oncology)

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13 pages, 253 KiB

Open AccessReview

Myelofibrosis: Treatment Options After Ruxolitinib Failure

by Ruth Stuckey, Adrián Segura Díaz and María Teresa Gómez-Casares

Curr. Oncol. 2025, 32(6), 339; https://doi.org/10.3390/curroncol32060339 - 9 Jun 2025

Viewed by 485

Abstract

While allogeneic hematopoietic stem cell transplantation remains the only curative therapy for patients with myelofibrosis, its applicability is limited both by the high morbidity and mortality associated with the procedure and by the fact that only a minority of patients are eligible due [...] Read more.

While allogeneic hematopoietic stem cell transplantation remains the only curative therapy for patients with myelofibrosis, its applicability is limited both by the high morbidity and mortality associated with the procedure and by the fact that only a minority of patients are eligible due to age or comorbidities. Ruxolitinib, a JAK1/JAK2 inhibitor, is the standard first-line therapy for intermediate- and high-risk MF, offering symptom relief and splenic volume reduction but lacking a clear survival benefit. Its use may be limited by hematologic toxicities, increased infection risk, and an inability to prevent disease progression. Ruxolitinib failure remains a significant clinical challenge, with resistance mechanisms not fully elucidated. The approval of other JAK inhibitors—fedratinib, pacritinib, and momelotinib—has expanded treatment options, particularly for patients with cytopenias or transfusion dependence. Moreover, many other targeted agents are in development in clinical trials, as monotherapy or in combination with ruxolitinib. This review provides an update on the use of JAK inhibitors and novel agents, with a focus on treatment options for ruxolitinib-resistant or refractory patients. As therapeutic strategies evolve, optimizing treatment sequencing and incorporating next-generation sequencing will be critical for improving patient outcomes. Full article

(This article belongs to the Special Issue 2nd Edition—Haematological Neoplasms: Diagnosis and Management)

18 pages, 4257 KiB

Open AccessSystematic Review

Artificial Intelligence in Laryngeal Cancer Detection: A Systematic Review and Meta-Analysis

by Ali Alabdalhussein, Mohammed Hasan Al-Khafaji, Rusul Al-Busairi, Shahad Al-Dabbagh, Waleed Khan, Fahid Anwar, Taghreed Sami Raheem, Mohammed Elkrim, Raguwinder Bindy Sahota and Manish Mair

Curr. Oncol. 2025, 32(6), 338; https://doi.org/10.3390/curroncol32060338 - 9 Jun 2025

Viewed by 303

Abstract

(1) Background: The early detection of laryngeal cancer is crucial for achieving superior patient outcomes and preserving laryngeal function. Artificial intelligence (AI) methodologies can expedite the triage of suspicious laryngeal lesions, thereby diminishing the critical timeframe required for clinical intervention. (2) Methods: We [...] Read more.

(1) Background: The early detection of laryngeal cancer is crucial for achieving superior patient outcomes and preserving laryngeal function. Artificial intelligence (AI) methodologies can expedite the triage of suspicious laryngeal lesions, thereby diminishing the critical timeframe required for clinical intervention. (2) Methods: We included all studies published up to February 2025. We conducted a systematic search across five major databases: MEDLINE, EMCARE, EMBASE, PubMed, and the Cochrane Library. We included 15 studies, with a total of 17,559 patients. A risk of bias assessment was performed using the QUADAS-2 tool. We conducted data synthesis using the Meta Disc 1.4 program. (3) Results: A meta-analysis revealed that AI demonstrated high sensitivity (78%) and specificity (86%), with a Pooled Diagnostic Odds Ratio of 53.77 (95% CI: 27.38 to 105.62) in detecting laryngeal cancer. The subset analysis revealed that CNN-based AI models are superior to non-CNN-based models in image analysis and lesion detection. (4) Conclusions: AI can be used in real-world settings due to its diagnostic accuracy, high sensitivity, and specificity. Full article

(This article belongs to the Section Head and Neck Oncology)

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10 pages, 396 KiB

Open AccessReview

Oncology Nurses’ Attitudes, Knowledge, and Practices in Providing Sexuality Care to Cancer Patients: A Scoping Review

by Omar Alqaisi, Maha Subih, Kurian Joseph, Edward Yu and Patricia Tai

Curr. Oncol. 2025, 32(6), 337; https://doi.org/10.3390/curroncol32060337 - 7 Jun 2025

Viewed by 342

Abstract

Sexual health in cancer care is often overlooked. This study examines oncology nurses’ knowledge and practices regarding sexuality care, identifying barriers and facilitators. A Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-guided search of Scopus, ScienceDirect, PubMed, and EBSCO focused on studies [...] Read more.

Sexual health in cancer care is often overlooked. This study examines oncology nurses’ knowledge and practices regarding sexuality care, identifying barriers and facilitators. A Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-guided search of Scopus, ScienceDirect, PubMed, and EBSCO focused on studies from 2014 to 2024. Of 1735 identified studies, only 11 met inclusion criteria. Findings revealed a lack of knowledge among nurses and dissatisfaction with sexual healthcare. Barriers include time constraints, cultural factors, and personal reservations. Routine discussions are often absent due to inadequate training. Education- and system-based strategies are needed to enhance nurses’ competence in addressing sexual concerns. Implementing training programs, structured records, evaluation tools, concept maps, and system support would improve patient care and oncology nursing practices. Addressing these gaps with practical measures can enhance communication, patient satisfaction, and quality of life. This unique analysis was conducted by two experienced advanced nurses in the Middle East, where discussions about sex are often regarded as taboo. Full article

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25 pages, 5327 KiB

Open AccessArticle

Evaluating the Cost-Effectiveness of Cervical Cancer Screening and Treatment in Western Romania

by Ion Petre, Șerban Mircea Negru, Florina Buleu, Radu Dumitru Moleriu, Marina Adriana Mercioni, Izabella Petre, Anca Bordianu, Vladiana Turi, Luciana Marc, Daian Ionel Popa and Daliborca Cristina Vlad

Curr. Oncol. 2025, 32(6), 336; https://doi.org/10.3390/curroncol32060336 - 7 Jun 2025

Viewed by 353

Abstract

Background and Objectives: As a leading European country in terms of cervical cancer incidence and mortality, there has been a pressing need for Romania to upgrade its cervical cancer management. The criteria set by the International Federation of Gynecology and Obstetrics indicate that [...] Read more.

Background and Objectives: As a leading European country in terms of cervical cancer incidence and mortality, there has been a pressing need for Romania to upgrade its cervical cancer management. The criteria set by the International Federation of Gynecology and Obstetrics indicate that different treatments should have a similar trend concerning progression-free survival and overall survival at all the various stages of cervical cancer. This study aimed to assess the cost-effectiveness (CE) of the primary treatment plans related to the survival rate for cervical cancer screening in the western part of Romania and provide some recommendations. Materials and Methods: Descriptive statistics and a correlation model were used to examine costs. AI models have been developed to forecast the CE of different treatments using the above-mentioned studies on overall survival rates and treatment-related toxicity rates for five years. The costs of cervical cancer treatment were sourced from the public health department, the oncology clinic in the western region of Romania, and the County Hospital available for each stage. Results: Treatment expenses vary by cancer stage, with a significant increase from stages IA/IB to IIA, stabilizing between IIA and IIIC (about €7800–€8300), followed by a steep decline in IVA and a more pronounced decrease in IVB and in situ. The results highlight certain treatment combinations and their costs, indicating that the highest costs (exceeding €8000) are linked to multimodal treatments, which encompass surgery, chemotherapy, radiotherapy, and brachytherapy. Conclusions: Advanced cancer stages (IIA–IIIC) entail the highest treatment costs due to intricate, multimodal therapy, whereas early stages (IA, IB, in situ) and late terminal stages (IVB) are linked to considerably reduced treatment costs. Full article

(This article belongs to the Section Health Economics)

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10 pages, 821 KiB

Open AccessArticle

Increased Pre-Operative Lung Immune Prognostic Index Score Is a Prognostic Factor in Cases of Pathological T3 Renal Cell Carcinoma

by Hayato Hoshina, Toru Sugihara, Masayuki Kurokawa, Ei-ichiro Takaoka, Satoshi Ando, Haruki Kume and Tetsuya Fujimura

Curr. Oncol. 2025, 32(6), 335; https://doi.org/10.3390/curroncol32060335 - 7 Jun 2025

Viewed by 197

Abstract

We assessed the efficacy of the lung immune prognostic index (LIPI) in predicting the progression of pathological T3 renal cell carcinoma (RCC). The LIPI scores of patients with pathological T3 RCC were calculated in the pre- and post-operative phases. Patients were divided into [...] Read more.

We assessed the efficacy of the lung immune prognostic index (LIPI) in predicting the progression of pathological T3 renal cell carcinoma (RCC). The LIPI scores of patients with pathological T3 RCC were calculated in the pre- and post-operative phases. Patients were divided into zero-point, one-point, and two-point groups according to their LIPI score and into the upstage and non-upstage groups according to the pre- and post-operative increase in LIPI score. Overall survival (OS) was evaluated using Kaplan–Meier curves stratified by group. Univariate and multivariate analyses of OS were performed via Cox proportional hazard regression analysis. LIPI scores were calculated in 80 patients wherein blood sampling data were available. The upstage and non-upstage groups comprised eight and seventy-two patients, respectively. Kaplan–Meier curves showed a significant difference in the pre- to post-operative LIPI score upstage group. LIPI score change was a poor prognostic factor using univariate analysis (OS: hazard ratio (HR) = 4.10, 95% confidence interval (CI) = 1.07–15.61, p = 0.038) and multivariate analysis (OS: HR = 4.38, 95% CI = 1.13–16.89, p = 0.031). An increase in the LIPI score in the pre-operative phase was a poor prognostic factor for pathological T3 RCC. Full article

(This article belongs to the Section Surgical Oncology)

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12 pages, 2925 KiB

Open AccessArticle

Using Machine Learning Approaches on Dynamic Patient-Reported Outcomes to Cluster Cancer Treatment-Related Symptoms

by Nora Asper, Hans Friedrich Witschel, Louise von Stockar, Emanuele Laurenzi, Hans Christian Kolberg, Marcus Vetter, Sven Roth, Gerd Kullak-Ublick and Andreas Trojan

Curr. Oncol. 2025, 32(6), 334; https://doi.org/10.3390/curroncol32060334 - 6 Jun 2025

Viewed by 290

Abstract

In patients undergoing systemic treatment for cancer, symptom tracking via electronic patient-reported outcomes (ePROs) has been used to optimize communication and monitoring, and facilitate the early detection of adverse effects and to compare the side effects of similar drugs. We aimed to examine [...] Read more.

In patients undergoing systemic treatment for cancer, symptom tracking via electronic patient-reported outcomes (ePROs) has been used to optimize communication and monitoring, and facilitate the early detection of adverse effects and to compare the side effects of similar drugs. We aimed to examine whether the patterns in electronic patient-reported outcomes, without any additional clinician data input, are predictive of the underlying cancer type and reflect tumor- and treatment-associated symptom clusters (SCs). The data were derived from a total of 226 patients who self-reported on the presence and severity (according to the Common Terminology Criteria for Adverse Events (CTCAEs)) of more than 90 available symptoms via the medidux^TM app (versions 2.0 and 3.2, developed by mobile Health AG based in Zurich, Switzerland). Among these, 172 had breast cancer as the primary tumor, 19 had lung, 16 had gut, 12 had blood–lymph, and 7 had prostate cancer. For this secondary analysis, a subgroup of 25 patients with breast cancer were randomly selected to reduce the risk of overfitting. The symptoms were aggregated by counting the days on which a particular symptom was reported, resulting in a symptom vector for each patient. A logistic regression model was trained to predict the type of the respective tumor from the symptom vectors, and the symptoms with coefficients above (0.1) were graphically displayed. The machine learning model was not able to recognize any of the patients with prostate and blood–lymph cancer, likely as these cancer types were barely represented in the dataset. The Area Under the Curve (AUC) values for the three remaining cancer types were breast cancer: 0.74 (95% CI [0.624, 0.848]); gut cancer: 0.78 (95% CI [0.659, 0.893]); and lung cancer: 0.63 (95% CI [0.495, 0.771]). Despite the small datasets, for the breast and gut cancers, the respective models demonstrated a fair predictive performance (AUC > 0.7). The generalization of the findings are limited especially due to the heterogeneity of the dataset. This line of research could be especially interesting to monitor individual treatment trajectories. Deviations in the electronic patient-reported symptoms from the treatment-associated symptom patterns could dynamically indicate treatment non-adherence or lower treatment efficacy, without clinician input or additional costs. Similar analyses on larger patient cohorts are needed to validate these preliminary findings and to identify specific and robust treatment profiles. Full article

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10 pages, 483 KiB

Open AccessArticle

Germline TP53 p.R337H and XAF1 p.E134* Variants: Prevalence in Paraguay and Comparison with Rates in Brazilian State of Paraná and Previous Findings at the Paraguayan–Brazilian Border

by Edith Falcon-de Legal, Marta Ascurra, Rosa Vega-Paredes, Elis Sade, Magna Monteiro, Mariana Paraízo, Magali Colman, Angeles Gutierrez Florentin, Cesar Ojeda, Horacio Legal-Ayala and Andreas Ries

Curr. Oncol. 2025, 32(6), 333; https://doi.org/10.3390/curroncol32060333 - 6 Jun 2025

Viewed by 276

Abstract

Adrenal cortex carcinoma (ACC) in children is a rare tumor that is probably of multifactorial origin and is mainly associated with genetic and environmental alterations. In the south and part of the southeast of Brazil, as well as in the Paraguayan region bordering [...] Read more.

Adrenal cortex carcinoma (ACC) in children is a rare tumor that is probably of multifactorial origin and is mainly associated with genetic and environmental alterations. In the south and part of the southeast of Brazil, as well as in the Paraguayan region bordering the Brazilian State of Paraná, ACC prevalence is higher than in any other country, which is associated with the high prevalence of the TP53 p.R337H variant in Paraná (0.30%), Santa Catarina (0.249%), cities around Campinas-SP (0.21%), and the Paraguayan cities on the border with Paraná (0.05%). Recent research suggests that the co-segregation of XAF1-E134* and TP53-R337H mutations leads to a more aggressive cancer phenotype than TP53-R337H alone. Breast cancer may be mildly influenced by co-segregation with XAF1 p.E134*, and this variant can also confer risk for sarcoma. Objectives: The objectives of this study were to (1) estimate the prevalence of the germline TP53 p.R337H and XAF1 p.E134* variants in Paraguay (excluding cities on the border with Paraná State, Brazil) and (2) estimate whether the ethnic origin of TP53 p.R337H carriers in Paraguay is similar to that of ethnic groups in Paraná (possible Portuguese/Spanish origin). Materials and methods: DNA tests for the identification of TP53 p.R337H were carried out from 2016 to 2019 at the Bio-Materials Laboratory of Facultad Politecnica, UNA, and at the Research Center in Biotechnology and Informatics (CEBIOTEC), Asunción, Paraguay. Polymerase chain reaction followed by restriction enzyme digestion (PCR-RFLP) was used to identify TP53 p.R337H, and real-time PCR (RT-PCR) was employed for XAF1 p.E134*. Peripheral blood samples from 40,000 Paraguayan newborns (NBs) were used for the TP53 p.R337H tests. The XAF1 p.E134* tests (RT-PCR) were performed on samples from 2000 Paraguayan newborns at the Pelé Pequeno Principe Research Institute, Curitiba, PR, Brazil. Results: The TP53 p.R337H variant was not found in any of the 14 Paraguayan departments investigated. A total of 12 of the 2000 Paraguayan NBs were positive for one XAF1 p.E134* allele. Conclusions: The hypothesis of Spanish immigrants carrying p.R337H to Paraguay was disproved. TP53 p.R337H neonatal testing in Paraguay is not recommended, except when there are families with Brazilian ancestry presenting cancer cases. Additional epidemiological studies are required to determine the likelihood of the identified prevalence of the XAF1 p.E134* allele (1/153) in NBs from Paraguay without TP53 p.R337H to present cancer risk. This study complements the first national initiative for the DNA screening of newborns aimed at mapping the TP53 p.R337H and XAF1 p.E134* variants in Paraguay (based on the regions of residence of the newborns). Full article

(This article belongs to the Special Issue Updates on Diagnosis and Treatment for Pediatric Solid Tumors)

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24 pages, 1878 KiB

Open AccessArticle

Quality of Life of Lung Cancer Patients with Immune-Related Endocrinopathies During Immunotherapy: A Prospective Study Based on the EORTC QLQ-C30 and QLQ-LC13 Questionnaires in Romania

by Simona Coniac, Mariana Cristina Costache-Outas, Ionuţ-Lucian Antone-Iordache, Alexandra-Valentina Anghel, Maria-Alexandra Bobolocu, Andreea Zamfir, Horia-Dan Liscu, Andreea-Iuliana Ionescu and Corin Badiu

Curr. Oncol. 2025, 32(6), 332; https://doi.org/10.3390/curroncol32060332 - 5 Jun 2025

Viewed by 319

Abstract

(1) Background: Globally, lung cancer is the leading cause of cancer death, but immunotherapy has impressively improved the outcomes, generating longer progression-free survival and overall survival. Endocrine immune-related adverse events (irAEs) are mostly irreversible and need life-long hormonal substitution therapy. The evaluation of [...] Read more.

(1) Background: Globally, lung cancer is the leading cause of cancer death, but immunotherapy has impressively improved the outcomes, generating longer progression-free survival and overall survival. Endocrine immune-related adverse events (irAEs) are mostly irreversible and need life-long hormonal substitution therapy. The evaluation of the quality of life of lung cancer patients experiencing endocrine toxicities during immune checkpoint inhibitor (ICI) treatment is relevant for both patients and healthcare providers. (2) Methods: This was a prospective cohort study of lung cancer patients treated with immune checkpoint inhibitors in a tertiary-level hospital in Romania from 1 December 2021 to 30 September 2024. Quality of life was assessed using versions of the EORTC QLQ-C30 and EORTC QLQ-LC-13 validated and translated into the Romanian language. We investigated several clinical variables to evaluate their impact on QoL. (3) Results: Fifty-nine lung cancer patients were evaluated for their QoL before ICI initiation and at the end of the study. Endocrine-irAEs occurred in 17 lung cancer patients (28.8%). Quality of life as assessed using the EORTC questionnaires was statistically significantly improved, even in patients experiencing endocrine-irAEs. (4) Conclusions: Our prospective cohort study succeeded in delivering the proof of concept of an increased QoL in lung cancer patients who had developed endocrine-irAEs under immunotherapy. Despite toxicities, especially rather frequent endocrine-irAEs, ICIs enabled durable disease control and symptom relief, improving the QoL of the overall trial population. As more lung cancer patients undergo immunotherapy in metastatic or early stages, we draw attention to this particular patient population with autoimmune endocrinopathies, as they will live longer and require life-long hormonal therapy. Full article

(This article belongs to the Special Issue Palliative Care and Supportive Medicine in Cancer)

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14 pages, 971 KiB

Open AccessArticle

PTEN Mutations Associated with Increased Recurrence and Decreased Survival in Patients with Prostate Cancer Spinal Metastasis

by Albert Antar, Yuanxuan Xia, Abdel-Hameed Al-Mistarehi, Pritika Papali, Melanie Alfonzo Horowitz, Shreya Sriram, Shahab Aldin Sattari, Carly Weber-Levine, Sushanth Neerumalla, Benjamin Z. Mendelson, Sang Lee, Kristin J. Redmond, Ali Bydon, Timothy F. Witham, Nicholas Theodore and Daniel Lubelski

Curr. Oncol. 2025, 32(6), 331; https://doi.org/10.3390/curroncol32060331 - 4 Jun 2025

Viewed by 356

Abstract

Introduction: Prostate cancer with spinal metastases (PCSM) is associated with high morbidity and mortality. The impact of biomarkers on the prognosis of spinal metastases, however, remains unclear. Objective: This study explored associations between potential biomarkers, treatment modalities, survival, and neurological outcomes in PCSM [...] Read more.

Introduction: Prostate cancer with spinal metastases (PCSM) is associated with high morbidity and mortality. The impact of biomarkers on the prognosis of spinal metastases, however, remains unclear. Objective: This study explored associations between potential biomarkers, treatment modalities, survival, and neurological outcomes in PCSM patients. Methods: We conducted a retrospective analysis of 68 patients as part of a neurosurgical cohort with PCSM at a comprehensive cancer center from 2013 to 2023, examining the influence of potential biomarkers, treatment modalities, and demographics on prognosis. The primary outcomes were the identification of biomarkers, overall survival (OS) in years, survival after spinal metastasis in years, spinal metastasis recurrence, and postoperative neurological outcomes via Frankel scores. Results: All the patients (n = 68) had adenocarcinoma, and the median age was 69 years. The mortality rate was 66% with a median OS of 6 years. Seventy-two biomarkers were identified. An accelerated failure time model (AFT) showed that radiotherapy to the prostate increased the OS (TR = 1.805, p = 0.001), while smoking status (TR = 0.625, p < 0.001) and PTEN gene mutations (TR = 0.504, p = 0.006) were associated with decreased OS. Kaplan–Meier analysis associated PTEN mutations with reduced median OS using the Gehan–Breslow–Wilcoxon test (3.50 vs. 9.49 years; p = 0.001). PTEN mutations were trending towards but were not significant for decreased survival following spinal metastases (2.04 vs. 3.15 years; p = 0.08). Both PTEN (p = 0.02) and Tumor Protein 53 (TP53, p = 0.01) mutations were associated with increased spinal metastasis recurrence when analyzed using Fisher’s exact test. No differences were observed in the median OS or survival after spinal metastases among patients with or without androgen receptor splice variant-7 (AR-V7), prostate-specific membrane antigen (PSMA), TP53, or other analyzed biomarkers. Similarly, neither age, receipt of chemotherapy, nor radiotherapy to the spine correlated with OS. Only chemotherapy was associated with a decreased postoperative Frankel Score (p = 0.002). Conclusions: PTEN mutations and smoking status were associated with decreased OS in patients with PCSM. Both PTEN and TP53 mutations were associated with increased spinal metastasis recurrence. Receipt of radiotherapy to the prostate was correlated with prolonged survival, whereas receipt of radiotherapy to the spine was not. Chemotherapy was associated with decreased postoperative neurological outcomes. Full article

(This article belongs to the Section Genitourinary Oncology)

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12 pages, 1651 KiB

Open AccessCase Report

Perivascular Epithelioid Cell Tumor (PEComa) of the Sigmoid Colon: Case Report and Literature Review

by Gintare Slice, Rokas Stulpinas, Tomas Poskus and Marius Kryzauskas

Curr. Oncol. 2025, 32(6), 330; https://doi.org/10.3390/curroncol32060330 - 3 Jun 2025

Viewed by 215

Abstract

Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms characterized by perivascular epithelioid cell proliferation. They can occur in various organs, but colonic PEComas are exceptionally rare, showing diagnostic challenges due to their nonspecific clinical presentation and similar features to those of other [...] Read more.

Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms characterized by perivascular epithelioid cell proliferation. They can occur in various organs, but colonic PEComas are exceptionally rare, showing diagnostic challenges due to their nonspecific clinical presentation and similar features to those of other colorectal tumors. We present a case of a 61-year-old female with defecation accompanied by blood clots, initially diagnosed with a suspected tumor in the sigmoid colon. Despite initial biopsy yielding non-informative material, repeat colonoscopy and imaging studies revealed a malignant tumor with multinucleated giant (osteoclast-like) cells and probable p53 mutation, most likely of mesenchymal origin. Robotic surgical resection was performed, and ultimately pathological examination refined the diagnosis as a malignant PEComa of the colon. This case demonstrates the importance of considering PEComa in the differential diagnosis of colonic tumors. Further research is needed to ascertain the clinical behavior and optimal treatment for colonic PEComas. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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Open AccessReview

Mechanisms and Functions of γδ T Cells in Tumor Cell Recognition

by Jing Tang, Chen Wu, Jintong Na, Yamin Deng, Simin Qin, Liping Zhong and Yongxiang Zhao

Curr. Oncol. 2025, 32(6), 329; https://doi.org/10.3390/curroncol32060329 - 3 Jun 2025

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Abstract

γδ T cells are among the first line of defense in the immune system, playing a crucial role in bridging innate and adaptive immunity. Although γδ T cells are crucial for tumor immune surveillance, the complete mechanism by which γδ T cell receptors [...] Read more.

γδ T cells are among the first line of defense in the immune system, playing a crucial role in bridging innate and adaptive immunity. Although γδ T cells are crucial for tumor immune surveillance, the complete mechanism by which γδ T cell receptors identify molecular targets in target cells remains unknown. Target cells can produce phosphoantigens (PAgs) via the mevalonate pathway or the methylerythritol phosphate pathway. The BTN3A1–BTN2A1 complex undergoes conformational changes in its extracellular domains upon binding to PAgs, leading to Vγ9Vδ2 T cell recognition. However, the structural basis of how Vγ9Vδ2 T cells recognize changes in this complex remains elusive. This review provides a detailed overview of the historical progress and recent discoveries regarding how Vγ9Vδ2 T cells recognize and target tumor cells. We also discuss the potential of γδ T cells immunotherapy and their role as antitumor agents. Full article

(This article belongs to the Section Cell Therapy)

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Curr. Oncol., Volume 32, Issue 6 (June 2025) – 69 articles

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