Search Results (2,102)

Background: Crimean–Congo hemorrhagic fever (CCHF) is a severe zoonotic viral infection with high mortality rates. This study aimed to examine the prognostic value of new-generation inflammatory markers—CRP/albumin ratio (CAR), D-dimer/albumin ratio (DAR), D-dimer/fibrinogen ratio (DFR), and triglyceride-glucose index (TGI)—in predicting mortality among patients diagnosed with CCHF. Methods: This prospective study involved 76 patients with a positive polymerase chain reaction test for CCHF and 38 age- and sex-matched healthy controls between 15 April 2023 and 15 October 2024. Participants’ demographic, clinical, and laboratory data at presentation were recorded. Results: CAR, DAR, DFR, and TGI levels were significantly higher in the patient group compared to the control group (all p < 0.001). Furthermore, when mortal cases were compared with survivors, all of these markers were found to be significantly higher in the mortal group (p = 0.005, p = 0.004, p = 0.001, and p = 0.003, respectively). In Kaplan–Meier analysis, survival time was significantly shorter in patients with higher levels of these parameters (p < 0.001 for all). In the Receiver Operating Characteristic analysis conducted to differentiate mortal cases from survivors, DFR and TGI were identified as the markers with the highest predictive power (area under the curve: 0.938 and 0.899, respectively). Conclusions: Inflammatory markers CAR, DAR, DFR and TGI may serve as significant prognostic tools to predict mortality in CCHF. Full article

Background and Objectives: To evaluate the prognostic value of the Clinical–Pathologic Stage–Estrogen receptor status and Grade (CPS+EG) staging system, which combines clinical staging, pathological staging, oestrogen receptor (ER) status, and tumour grade in predicting survival outcomes in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer receiving neoadjuvant therapy (NACT). Materials and Methods: A retrospective review was performed on 245 female breast cancer patients who received anti-HER2 therapy alongside NACT at the Medical Oncology Department of Kartal Dr Lütfi Kırdar City Hospital, University of Health Sciences, from April 2012 to June 2024. The CPS+EG score was calculated using the MD Anderson Cancer Centre neoadjuvant treatment response calculator. Patients were categorised into two groups based on their CPS+EG score < 3 and ≥3. The primary outcomes assessed were disease-free survival (DFS) and overall survival (OS). Kaplan–Meier and log-rank tests were utilised for time-to-event analysis; Cox regression was used for multivariate analysis. A significance level of ≤0.05 was considered. Results: The median age of the patient cohort was 51 years (range: 27–82 years). Among these patients, 183 (74.6%) had a CPS+EG score less than 3, while 62 (25.3%) exhibited a score of 3 or higher. The median follow-up duration was 37.6 months. The pathological complete response (pCR) rate across the entire cohort was 51.8%. Specifically, the pCR rate was 56.3% in the group with CPS+EG scores below 3, and 38.7% in those with scores of 3 or higher (p = 0.017). Patients with CPS+EG scores less than 3 demonstrated superior overall survival (OS), which reached statistical significance in univariate analysis. Multivariate analysis identified the CPS+EG score as an independent prognostic factor for both overall survival and disease-free survival (DFS), with hazard ratios of 0.048 (95% CI: 0.004–0.577, p = 0.017) and 0.35 (95% CI: 0.14–0.86, p = 0.023), respectively. Conclusions: The CPS+EG score is an independent and practical prognostic marker, particularly for overall survival, in patients with HER2-positive breast cancer who have received neoadjuvant therapy. Patients with a CPS+EG score < 3 have higher pCR rates and survival rates. When used in conjunction with pCR, it can improve risk categorisation and contribute to the individualisation of adjuvant strategies in the post-neoadjuvant period. Due to its ease of calculation and lack of additional costs, this score can be instrumental in clinical practice for identifying high-risk patients. Our findings support the integration of the CPS+EG score into routine clinical decision-making processes, although prospective validation studies are necessary. Full article

Background/Objectives: Nivolumab has significantly improved outcomes in patients with metastatic non-small cell lung cancer (NSCLC); however, reliable prognostic biomarkers remain an unmet need. To address this gap, we developed the SUVmax-IPI, a novel prognostic index combining maximum standardized uptake value (SUVmax) from ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) with systemic inflammatory markers. This study aimed to evaluate the prognostic value of SUVmax-IPI in patients with NSCLC receiving nivolumab therapy. Methods: This multicenter retrospective analysis included 187 patients with metastatic NSCLC receiving nivolumab across 5 tertiary institutions. The SUVmax-IPI incorporated pretreatment SUVmax and laboratory-based inflammatory prognostic index (IPI) parameters. Survival outcomes were evaluated using Kaplan–Meier analysis with log-rank testing and multivariate cox regression. Results: Receiver operating characteristic (ROC) analysis established an optimal SUVmax-IPI cut-off of 241.9. Patients with SUVmax-IPI ≤ 241.9 had significantly better survival outcomes: median overall survival (OS) was 35 versus 15 months (p = 0.002). For progression-free survival (PFS), although a numerical difference favored patients with SUVmax-IPI ≤ 241.9 (median: 15 vs. 8 months), this did not reach statistical significance (log-rank p = 0.175). Multivariate analysis confirmed SUVmax-IPI as an independent predictor of survival (p = 0.002). Conclusions: The SUVmax-IPI represents a promising prognostic tool for patients with metastatic NSCLC who received at least 3 months of nivolumab, integrating metabolic and inflammatory parameters to predict survival outcomes. Full article

Background/Objectives: Modular dual mobility (MDM) cups are constituted by a cobalt-chromium liner inserted into a standard acetabular shell, allowing for intraoperative indication and supplementary screw fixation of the acetabular component. MDM could face mechanical and biological issues, with the associated risk of elevated blood metal ions levels and adverse local tissue reactions. Methods: This is a monocentric retrospective study on a consecutive series of 105 patients who underwent primary unilateral THA with the G7 Dual Mobility Acetabular System cup (Zimmer Biomet, Warsaw, IN, USA) from March 2019 to April 2023, and who were evaluated clinically and radiographically at a minimum two-year follow-up. All complications and revisions were recorded. Survivorship analysis with any revision surgery as endpoint was performed using Kaplan–Meier survival curves. Results: There were eighty-nine patients (follow-up rate 84.8%) who underwent clinical and radiographic follow-up. The mean follow-up was 2.5 ± 0.8 years. Revision-free survival was 98.0%. Three complications (2.8%) were recorded: one case of posterior dislocation, one periprosthetic joint infection and one post-traumatic periprosthetic femur fracture. Dislocation rate and infection rate were less than 1.0%. None of the patients were revised for adverse local tissue reactions. No cup loosening was observed. No cases of intraprosthetic dislocation, liner malseating or femoral notching were observed. Retroacetabular stress shielding was present in 43.0% of patients. Clinical scores significantly improved at the last follow-up compared with preoperative status (p < 0.0001): the final mean mHHS was 87.5 ± 5.3 and the final mean VAS was 0.5 ± 0.9. Conclusions: The Zimmer G7 modular dual mobility cup appears to be a safe and effective option and does not present specific implant-related mechanical and biological issues in primary total hip arthroplasty at a minimum two-year follow-up. Full article

Introduction: Neck-preserving total hip arthroplasty (THA) has gained interest for conserving bone stock, restoring biomechanics, and facilitating revision surgery. The Nanos^® femoral stem, designed for metaphyseal fixation while preserving the femoral neck, represents a reliable alternative to conventional THA. This study reports 15-year clinical and radiographic outcomes of the Nanos implant. Materials and Methods: We retrospectively reviewed 53 patients (35 males, 18 females) who underwent THA with the Nanos stem between 2008 and 2010. Patients were stratified into two groups according to age: <50 years (n = 24) and ≥50 years (n = 29). The primary diagnosis was osteoarthritis (95%), with a few cases of avascular necrosis or dysplasia. Clinical evaluation included the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Radiographic assessment focused on implant stability, osteolysis, and heterotopic ossifications. Kaplan–Meier survival analysis was performed with revision for any reason as the endpoint. Results: At 15 years of follow-up, both groups showed significant improvement (p < 0.001). In patients <50 years, HHS increased from 53.3 to 94.8 and WOMAC decreased from 79.9 to 3.5. In patients ≥50 years, HHS improved from 47.5 to 95.2 and WOMAC from 81.5 to 3.2. Radiographs confirmed stable fixation without osteolysis. Complications included two dislocations and one cortical perforation requiring revision. Kaplan–Meier survivorship at 15 years was 100% (<50) and 96.6% (≥50). Conclusions: The Nanos stem provided excellent long-term outcomes with low complication and revision rates. It should be considered one of several reliable short-stem options for younger, active patients, offering durable function while preserving bone stock. Full article

Background/Objectives: Advanced hepatocellular carcinoma (HCC) presents limited treatment options; however, immunotherapy demonstrates encouraging outcomes and acceptable adverse reactions in advanced HCC. This study evaluates the efficacy and safety of combining serplulimab, the bevacizumab biosimilar HLX04, and hepatic arterial infusion chemotherapy (HAIC) as a first-line therapy. Methods: This prospective, observational, single-center phase II trial enrolled untreated HCC patients with Barcelona Clinic Liver Cancer (BCLC) stage C. All patients received serplulimab (4.5 mg/kg) and HLX04 (15.0 mg/kg) every 3 weeks, followed by the HAIC-FOLFOX regimen. The primary endpoint was the objective response rate (ORR). Secondary endpoints included the disease control rate (DCR), progression-free survival (PFS), and safety. Results: A total of 32 patients were enrolled. The best outcomes showed an ORR of 53.1%, including 17 partial responses (PR, 53.1%) and 12 stable diseases (SD, 37.5%), resulting in a DCR of 90.6%. Subgroup analysis showed a higher ORR in patients with a single lesion and those receiving ≥3 treatment cycles, with an ORR of 60.7% in the latter group. Additionally, five patients underwent successful hepatectomy after ≥3 treatment cycles, with postoperative pathology confirming extensive tumor necrosis. Kaplan–Meier analysis estimated PFS rates of 89.9% (95% CI: 79.5–100.0%) at 6 months and 70.8% (95% CI: 54.2–92.4%) at 12 months. No deaths related to adverse events (AEs) occurred; four (12.5%) patients experienced grade IV AEs and twelve (37.5%) patients experienced grade III AEs. Conclusions: Serplulimab, HLX04, and HAIC combined as a first-line treatment for advanced HCC have demonstrated promising efficacy, particularly in patients completing ≥3 cycles, with an acceptable safety profile. Further investigation in larger trials is required. Full article

(1) Background: Invasive micropapillary carcinoma (IMPC) is a rare, aggressive breast cancer subtype marked by high lymph node metastasis rates. While Oncotype DX recurrence score (RS) offers prognostic information for patients with hormone-receptor-positive (HR+) breast cancer, its utility in IMPC—a histology with distinct biologic behavior—remains unvalidated. This study evaluates whether Oncotype DX offers prognostic information with respect to overall survival (OS) in non-metastatic, early-stage patients with IMPC of the breast. (2) Methods: The National Cancer Database (2004–2020) was queried to select for women with ER+/HER2−, T1-T2N0-N1 IMPC who underwent Oncotype DX testing and received no neoadjuvant therapy. Patients were stratified by RS: low (≤11), intermediate (12–25), and high (>25). Kaplan–Meier survival curves and log-rank tests compared 5-year OS between groups. Multivariable Cox proportional hazards models assessed RS as an independent predictor, adjusting for age, race, comorbidities, grade, radiation, and insurance status. (3) Results: A total of 1325 women met the selection criteria. The cohort demonstrated significant survival disparities by RS (log-rank p = 0.017). Five-year OS rates were 97.5%, 97.5%, and 93.7% for low, intermediate, and high-risk patients, respectively. Adjusted multivariate analysis confirmed RS as an independent prognosticator: low (HR = 0.31, 95% CI: 0.15–0.75) and intermediate (HR = 0.32, 95% CI: 0.15–0.75) scores correlated with reduced mortality versus high RS. Omission of radiation therapy (HR = 2.68, 95% CI: 1.05–6.86) and higher comorbidity burden (0 comorbidities vs. ≥2: HR = 0.25, 95% CI: 0.10–0.61) were significantly associated with worse survival. (4) Conclusions: Oncotype DX is predictive for OS in IMPC, with high RS (>25) portending poorer outcomes. The survival detriment associated with RT omission aligns with prior studies demonstrating RT benefit in higher-risk cohorts. These findings validate RS as a prognostic tool in IMPC and underscore its potential to refine adjuvant therapy, particularly RT utilization. Future studies should explore RS-driven treatment personalization in IMPC, including comorbidity management and adjuvant radiation to improve outcomes in this distinct patient population. Full article

Background/Objectives: This secondary analysis aims to evaluate various prognostic factors for overall survival (OS) and hepatic progression-free survival (hPFS) and to perform subgroup analyses regarding OS of patients with unresectable and chemotherapy-refractory liver metastases from colorectal cancer (LMCRC) treated by the combination therapy of transarterial chemoembolization (TACE) and microwave ablation (MWA) or with MWA alone. Methods: A total of 251 patients with unresectable and chemotherapy-refractory LMCRC were included retrospectively. Group A consisted of 184 patients who received a combination of TACE and MWA. A total of 67 patients were included in group B, who received only MWA. Group C summarizes the total number of 251 patients treated. For all groups, the influence of age, sex, number of metastases, the diameter and volume of the largest metastasis, and the occurrence of recurrence on OS and hPFS was determined using univariate cox regression analysis. OS was compared between patients with more than three metastases and those with three or fewer, as well as between patients with a diameter of largest metastasis of 3 cm or less with patients with a diameter of largest metastasis of more than 3 cm. The analysis of OS was carried out using the Kaplan–Meier method. Results: For all three groups, the parameters of age, sex, number of metastases, diameter and volume of the largest metastasis, complete ablation status, and recurrence were not significant prognostic factors for OS. The number of metastases had a statistically significant influence on hPFS in group C (p = 0.034) and trended towards significance in group A (p = 0.057). The mean OS of patients with three metastases or less was in all groups longer than patients with more than three metastases, however, with no statistically significant differences (p = 0.83, 0.451 and 0.84 for groups A, B and C, respectively). There were no significant differences regarding OS between patients with diameter of largest metastasis of 3 cm or less compared to patients with diameter of largest metastasis more than 3 cm in all groups (p = 0.316, 0.812 and 0.45 for groups A, B and C, respectively). Conclusions: We could not observe significant prognostic factors in the treatment of LMCRC on OS. Accordingly, patients with three metastases or less had non-significant longer OS than patients with more than three metastases. The number of metastases had a significant impact on hPFS of the whole patient cohort and borderline significant impact on hPFS in patients treated with TACE combined with MWA. Full article

Electricity price spikes are the most important characteristic of the electricity price time series. Operationally, they result from various stresses in the power system or the strategic bidding behavior of market participants. These high prices are important as they represent economic opportunities in the form of profits and savings. Theoretically, price spikes are defined as prices that exceed a threshold over a typically short duration. This definition serves as the basis for several established modeling approaches in the literature. In general, the threshold component determines the design of a price spike model, often overlooking the duration aspect. Therefore, this paper presents a simple yet informative model to quantify the duration of electricity price spikes using historical price data from different market jurisdictions. We approach the problem through the lens of survival analysis, a widely used technique for evaluating time-to-event data. Specifically, we use the Kaplan–Meier (KM) estimator, which enables a nonparametric evaluation of the survival (duration) of price spikes over time. We refer to this as the price spike duration model. Full article

Introduction: The “revolving” door is a phenomenon that refers to the rehospitalization of older patients who, after being discharged, soon require specialized hospital care again. Unfortunately, the use of tools able to predict this phenomenon is still limited. The aim of this study was to highlight the validity of the Blaylock Risk Assessment Screening (BRASS) Scale in objectively assessing the risk of rehospitalization and mortality among older patients. Methods: Patients were classified as low, medium, or high risk using the BRASS scale. Adverse events (rehospitalization or death) were recorded at baseline and at 12 months. Kaplan–Meier curves evaluated survival and rehospitalization across risk groups, and ROC analysis assessed the BRASS Scale’s predictive value for mortality. Results: Out of 179 enrolled older adults (mean age 67.7 years), 54.2% were classified as low risk, 29.5% as medium, and 16.8% as high risk based on the BRASS Scale. High-risk patients had significantly higher mortality (HR: 4.40; 95% CI: 1.60–12.19, p = 0.004) and lower survival rates, while intermediate-risk patients had increased rehospitalization (HR: 2.11; 95% CI: 1.09–4.08, p = 0.02). The BRASS scale showed good predictive value for mortality (AUC 0.76). Conclusion: The BRASS Scale has a good predictive value for negative outcomes, and it confirms that a substantial proportion of older patients are at risk of future hospital readmissions and complex discharges. These findings underscore the importance of early post-discharge care planning and the implementation of protected discharge programs. Full article

Background: Stomach adenocarcinoma is a major contributor to worldwide mortality and significantly impacts life expectancy. The main objective of the current study was to identify a prognostic biomarker for stomach adenocarcinoma to advance translational medicine and improve patient outcomes. Method: various databases (GEPIA, UALCAN, miRNet, StarBase, and Kaplan Meier plotter) bioinformatics tools (cytoscape) and were used in this study. Results: Ten novel unfavorable prognosis-associated genes were identified. In addition, 41 potential miRNAs were predicted. ELAVL3-hsa-mir-29a-3p and CALCR-hsa-mir-29a-3p were identified as the two critical networks in the oncogenesis of stomach adenocarcinoma via bioinformatics analysis. Subsequently, the binding of lncRNAs to hsa-mir-29a-3p was predicted utilizing the starBase and miRNet databases. Following the execution of both expression and survival analyses for the predicted lncRNAs, it was determined that only one lncRNA, KCNQ1OT1, exhibited significant overexpression in stomach adenocarcinoma, and its elevated expression was associated with an unfavorable prognosis. Subsequently, we constructed a triple ceRNA network involving mRNA, miRNA, and lncRNA, which is associated with the prognosis of stomach adenocarcinoma. Conclusions: In summary, the current study provides an extensive ceRNA network that highlights novel prognostic biomarkers for stomach adenocarcinoma. Full article

Background/Objectives: Aortic stenosis (AS) is an increasingly recognized end-stage renal disease (ESRD) complication. This study aimed to identify AS incidence and prevalence in Korean patients with ESRD, assess the effect of AS on all-cause mortality, and determine associated risk factors unique to this population. Methods: This retrospective study used Korean National Health Insurance Service data from 2009 to 2021 and included adult patients with ESRD undergoing maintenance dialysis. AS was identified based on diagnostic codes, and 4:1 propensity score matching was conducted. Temporal trends in AS incidence and prevalence were analyzed in terms of sex and age. Kaplan–Meier survival analysis and Cox proportional hazards models were employed for all-cause mortality assessment. Results: Among 91,466 eligible patients, 708 (0.77%) had AS. AS incidence and prevalence increased from 8.05 to 35.29 and from 8.05 to 77.43 per 10,000, respectively, from 2009 to 2021, and were higher in women than in men. Age-stratified analysis revealed the greatest burden in patients aged ≥80. AS in the matched cohort (n = 2875) was associated with <10-year survival (13% vs. 24%, p < 0.001), with differences evident from age 60 onward. Multivariable analysis revealed AS as an independent mortality predictor (hazard ratio: 1.23, 95% confidence interval: 1.08–1.40, p = 0.002). Older age, atrial fibrillation, stroke, and a higher Charlson Comorbidity Index were significant mortality predictors among patients with AS. Conclusions: AS burden in dialysis-dependent patients with ESRD is markedly increasing, particularly among women and older adults, and is independently associated with elevated mortality. Full article

Background/Objectives: In Spain, pancreatic ductal adenocarcinoma (PDAC) is the seventh leading cause of cancer-related death, with only 20% of patients eligible for surgery at diagnosis. For the remaining majority, prognosis is poor and effective non-surgical strategies are needed. Stereotactic MR-guided adaptive radiotherapy (SMART) may facilitate the delivery of ablative doses of radiation safely with low toxicity. This study reports the first national experience in Spain with SMART for patients with borderline resectable (BRPC) or locally advanced pancreatic cancer and evaluates its feasibility, safety, and early clinical outcomes. Methods: A prospective observational study was conducted including 28 patients with histologically confirmed BRPC or LAPC treated between August 2023 and December 2024. All patients received induction chemotherapy—mainly FOLFIRINOX (57.1%)—followed by SMART delivered in five fractions (40–50 Gy) using a 0.35T MR-guided linear accelerator. Daily online adaptive recontouring and replanning were performed for all 140 treatment fractions. Toxicities were assessed using CTCAE v5.0, and survival outcomes were estimated using Kaplan–Meier analysis. Results: The median patient age was 67 years, and 71.4% of tumors were located in the pancreatic head. At a median follow-up of 7.4 months after SMART (12.25 months from diagnosis), 6-month local progression-free survival (LPFS) was 89.3% from the start of SMART and 82.1% from diagnosis. Distant progression-free survival (DPFS) at 6 and 12 months was 92.9% and 68.2%, respectively. Median progression-free survival (PFS) was 11.5 months, and the median treatment-free interval was 5.7 months. Median overall survival (OS) was not reached; 6- and 12-month OS rates were 89.3% and 74.1%, respectively. Treatment-related toxicity was limited to grade 2 abdominal pain in 14.3% of patients, with no grade ≥3 adverse events attributed to SMART. Conclusions: SMART is a feasible and safe treatment modality for BRPC and LAPC in real-world clinical practice. These encouraging early outcomes support further clinical investigation and broader implementation. Full article

Post-traumatic osteoarthritis (PTOA) is a distinct form of knee osteoarthritis characterized by accelerated joint degeneration following injury. It poses unique challenges in post-menopausal women due to hormonal changes and altered bone metabolism that create complex pathophysiological environments. This retrospective cohort study compared the effectiveness of different anti-osteoporotic medications in preventing total knee replacement (TKR) in 6155 postmenopausal women with PTOA treated between 2011 and 2021. We compared raloxifene and denosumab, with alendronate serving as the reference group. The primary outcome was TKR occurrence. Cox proportional hazards regression and inverse probability of treatment weighting (IPTW) were performed to estimate hazard ratios, with Kaplan–Meier survival analysis for time-to-event assessment. Participants’ mean (SD) age was 69.4 (10.0) years. Given the retrospective nature and typical delayed presentation of PTOA symptoms, cohort entry was defined as the concurrent diagnosis of PTOA and osteoporosis requiring anti-resorptive therapy. Over a mean follow-up of 5.47 years, 26 patients (0.42%) underwent TKR. Raloxifene was associated with a significantly reduced TKR risk compared to alendronate (IPTW-HR 0.81, 95% CI 0.67–0.99, p = 0.040), representing a 19% relative risk reduction. Kaplan–Meier analysis demonstrated raloxifene maintained the lowest cumulative TKR incidence compared to alendronate and denosumab over time, particularly beyond 5 years. These findings suggest that raloxifene may offer superior joint protection compared with alendronate and denosumab in postmenopausal women with PTOA, supporting its potential as a disease-modifying therapeutic option for this vulnerable population. Full article

Background/Objectives: To evaluate the clinicopathological features, treatment, and survival outcomes and to identify independent prognosticators for recurrence and mortality in patients with endometrioid ovarian cancer. Methods: The medical records of patients diagnosed with endometrioid ovarian carcinoma between January 2010 and December 2022 were reviewed retrospectively. Demographic and disease-related data were evaluated. Kaplan–Meier survival analysis using log rank test and Cox regression was performed. Results: Seventy-six patients were included in the study. The median age at diagnosis was 54 years (range 31–86). A total of 85.5% of the patients were diagnosed with early-stage disease and 88.1% of the tumours represented low-grade carcinomas. Synchronous endometrioid endometrial cancer was confirmed in 19.7% of the cases. All patients underwent surgical management and 65.8% received adjuvant chemotherapy. Median follow-up time was 67.5 months. The 5-year disease-free survival and overall survival were 92.1% and 93.4%, respectively. The risk of cancer-related death was higher in advanced stages (HR = 13.86; 95% CI 2.16–57.17; p < 0.001) and in the presence of residual disease (HR = 15.18; 95% CI 2.36–87.17; p < 0.002). Residual disease and advanced stages were also identified as independent risk factors for disease relapse with HR = 16.04 (95% CI 2.61–93.7; p < 0.002) and HR = 11.73 (95% CI 1.92–41.6; p < 0.001), respectively. Conclusions: Endometrioid ovarian carcinoma usually affects younger patients with the majority of the cases representing low-grade carcinomas diagnosed at early stages. Residual disease and advanced stages are independently associated with inferior survival outcomes. There was no significance of lymph node dissection and adjuvant chemotherapy in the overall and recurrence-free survival rates. Further research focusing on molecular profiling should aim to define the prevalence and the prognostic value of major molecular alterations and develop precise stratification models to plan personalised treatment for optimal care. Full article