Current Oncology

8 pages, 1263 KiB

Open AccessCase Report

A Neuropsychiatric Prelude to Unveiling Small Cell Lung Cancer with Suspected Paraneoplastic Limbic Encephalitis: A Case Report

by Jessa Letargo, X. Melody Qu, Timothy K. Nguyen, Alexander V. Louie, Sara Kuruvilla and Enxhi Kotrri

Curr. Oncol. 2025, 32(6), 366; https://doi.org/10.3390/curroncol32060366 - 19 Jun 2025

Viewed by 382

Abstract

Small cell lung cancer (SCLC) is an aggressive form of lung cancer characterized by rapid growth and early metastases. As a neuroendocrine tumour, SCLC is especially notorious for various paraneoplastic syndromes, one of which is a rare neurological syndrome called paraneoplastic limbic encephalitis [...] Read more.

Small cell lung cancer (SCLC) is an aggressive form of lung cancer characterized by rapid growth and early metastases. As a neuroendocrine tumour, SCLC is especially notorious for various paraneoplastic syndromes, one of which is a rare neurological syndrome called paraneoplastic limbic encephalitis (PLE) that manifests with amnestic cognitive impairment and seizures. Here, we describe a case of a 53-year-old female who presented with neuropsychiatric symptoms of delusions, hallucinations, and cognitive impairment that started months prior to being diagnosed with extensive-stage SCLC. With no previous neuropsychiatric history, this raised the question of whether her presentation was related to PLE rather than a primary psychiatric condition, as initially diagnosed. Her symptoms improved with chemotherapy and radiation treatment of the underlying cancer, favouring a paraneoplastic etiology. Overall, this case underscores the importance of considering paraneoplastic syndromes in patients presenting with new neuropsychiatric symptoms, as early recognition and treatment can improve prognosis. Full article

(This article belongs to the Special Issue Clinical Advances and Therapeutic Challenges in Small-Cell Lung Cancer and Rare Thoracic Cancers)

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12 pages, 2749 KiB

Open AccessSystematic Review

KRAS Mutations as Predictive Biomarkers for First-Line Immune Checkpoint Inhibitor Monotherapy in Advanced NSCLC: A Systematic Review and Meta-Analysis

by Filip Marković, Jelena Milin-Lazović, Nikola Nikolić, Aleksa Golubović, Mihailo Stjepanović and Milica Kontić

Curr. Oncol. 2025, 32(6), 365; https://doi.org/10.3390/curroncol32060365 - 19 Jun 2025

Viewed by 332

Abstract

Recent research suggests a link between KRAS mutations and the effectiveness of ICIs, as KRAS-driven tumors may possess unique immunogenic features that influence the tumor microenvironment. These mutations can increase tumor mutation burden (TMB) and neoantigen load, potentially leading to improved responses to [...] Read more.

Recent research suggests a link between KRAS mutations and the effectiveness of ICIs, as KRAS-driven tumors may possess unique immunogenic features that influence the tumor microenvironment. These mutations can increase tumor mutation burden (TMB) and neoantigen load, potentially leading to improved responses to ICIs. This meta-analysis aims to consolidate existing evidence on the impact of KRAS mutations as a predictive factor for survival and treatment outcomes in patients with advanced NSCLC treated with ICIs. A comprehensive search strategy was designed by a biostatistician and pulmonologist, targeting PubMed, Web of Science, and Scopus databases up to May 2022. The outcomes assessed included overall survival (OS) and progression-free survival (PFS), reported as log hazard ratios (HRs) with corresponding standard errors (SEs). A pooled estimate of the HR effect size was calculated using Review Manager (RevMan, Cochrane Collaboration, London, UK). Heterogeneity among studies was evaluated using the Cochran Q test and the I² statistic. Ultimately, 10 articles were deemed suitable for inclusion in the systematic review from a total of 8722 screened titles and abstracts. The presence of KRAS+ mutations had a significant prognostic factor for better OS in NSCLC patients treated with checkpoint inhibitors (HR = 0.89, 95% CI: 0.79–0.99) and for better PFS in NSCLC patients treated with checkpoint inhibitors (HR = 0.72, 95% CI: 0.59–0.87). In conclusion, our study indicates that KRAS mutations may serve as a potential positive predictive biomarker in patients with advanced non-small-cell lung cancer treated with immune checkpoint inhibitor monotherapy. Full article

(This article belongs to the Section Thoracic Oncology)

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17 pages, 1888 KiB

Open AccessArticle

Textbook Outcomes for Retroperitoneal Sarcoma Resection: A Multi-Centre Review

by Skyle Murphy, Christopher Allan, Andrew Barbour, Victoria Donoghue and B. Mark Smithers

Curr. Oncol. 2025, 32(6), 364; https://doi.org/10.3390/curroncol32060364 - 19 Jun 2025

Viewed by 193

Abstract

For patients with retroperitoneal sarcomas (RPSs), en-bloc resection with macroscopically negative margins remains the only potentially curative treatment. Textbook outcomes (TOs) are composite measures developed to compare ideal surgical outcomes for complex oncologic resections. The aims of this study were as follows: to [...] Read more.

For patients with retroperitoneal sarcomas (RPSs), en-bloc resection with macroscopically negative margins remains the only potentially curative treatment. Textbook outcomes (TOs) are composite measures developed to compare ideal surgical outcomes for complex oncologic resections. The aims of this study were as follows: to define TO for RPS resections; to investigate the impact of treating service and other variables on TO; and to investigate the impact of treating service on achieving a TO. Population-based data from the Queensland Oncology Repository (QOR) was used to perform a retrospective review of all adult patients who underwent resection for primary RPS in Queensland between 2012 and 2022. TO was defined as follows: en-bloc resection; macroscopically negative margins; no unplanned ICU admission, no Clavien–Dindo III or greater complications; hospital length of stay of 14 days or less; no readmission within 30 days; and no 90-day mortality. A TO was achieved in 82 (56.94%) of the 144 patients included in the study. A high-grade histological subtype, the resection of three or more contiguous organs, major vascular resection and treatment outside of a high-volume sarcoma centre (HVSC) were significant negative predictors of achieving TOs (p < 0.05). On multivariate analysis, treatment at a high-volume sarcoma centre was independently associated with a 2.6-fold increase in TO (1.18–5.88, p = 0.02). Achieving a TO was associated with higher five-year DFS (61.5% vs. 41.3%, p = 0.03) and OS (76% vs. 59.4%, p = 0.02). In our state, TOs provide a measure of the quality of RPS resection across multiple health services, with patients treated at high-volume sarcoma centres more likely to achieve a TO. TO rates are associated with improved five-year DFS and OS. Full article

(This article belongs to the Special Issue Sarcoma Surgeries: Oncological Outcomes and Prognostic Factors)

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16 pages, 2548 KiB

Open AccessArticle

Combined Predictive Value of GLIM-Defined Malnutrition and Preoperative Adipose Tissue ¹⁸F-FDG Uptake for Recurrence-Free Survival After Radical Gastrectomy in Patients with Gastric Cancer

by Xuan Zhou, Kailai Yin, Huanhuan Hong, Heqing Yi and Linfa Li

Curr. Oncol. 2025, 32(6), 363; https://doi.org/10.3390/curroncol32060363 - 19 Jun 2025

Viewed by 202

Abstract

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a standardized approach for assessing the nutritional status of patients and demonstrate strong predictive value for the prognosis of patients with gastric cancer. However, these criteria do not incorporate indicators of adipose tissue [...] Read more.

Background: The Global Leadership Initiative on Malnutrition (GLIM) criteria provide a standardized approach for assessing the nutritional status of patients and demonstrate strong predictive value for the prognosis of patients with gastric cancer. However, these criteria do not incorporate indicators of adipose tissue metabolic activity, which may reflect pro-tumor microenvironmental factors. This study investigated the combined predictive value of malnutrition, defined by the GLIM criteria, and preoperative adipose tissue ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) uptake for recurrence-free survival (RFS) in patients with gastric cancer following radical surgery. Methods: A total of 105 patients were retrospectively enrolled and classified into malnourished and non-malnourished groups based on the GLIM criteria. Preoperative ¹⁸F-FDG positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) was used to measure the mean standardized uptake value (SUVmean) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). The predictive values of these indicators for RFS in patients with gastric cancer were assessed. Results: Multivariate survival analysis was used to identify GLIM-defined malnutrition (p = 0.020) and increased preoperative VAT SUVmean (p = 0.042) as independent risk factors for RFS. The combined analysis revealed that patients with both malnutrition and a high preoperative VAT SUVmean had the poorest RFS (HR = 18.41, p < 0.001). The predictive model integrating GLIM criteria and VAT SUVmean outperformed the GLIM criteria alone. Conclusions: This study demonstrated that combining malnutrition defined by the GLIM criteria with preoperative visceral adipose tissue ¹⁸F-FDG uptake optimizes recurrence risk stratification and exhibits superior prognostic predictive efficacy compared to using the GLIM criteria alone. This approach provides new insights into individualized prognostic assessment and intervention strategies. Full article

(This article belongs to the Section Gastrointestinal Oncology)

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18 pages, 1011 KiB

Open AccessReview

The Relationship Between Obesity and Cancer: Epidemiology, Pathophysiology, and the Effect of Obesity Treatment on Cancer

by Yasmin Ingram, Oluwasegun Olujide, Nabiha Sheikh, Alice Robinson, Jan Hoong Ho, Akheel A. Syed and Safwaan Adam

Curr. Oncol. 2025, 32(6), 362; https://doi.org/10.3390/curroncol32060362 - 19 Jun 2025

Viewed by 593

Abstract

There is growing evidence relating to the risk of cancer in people with obesity. Obesity is already established as one of the strongest predisposing factors to cancer, and ‘obesity-related’ cancers have been defined in previous studies. In this review article, we examine the [...] Read more.

There is growing evidence relating to the risk of cancer in people with obesity. Obesity is already established as one of the strongest predisposing factors to cancer, and ‘obesity-related’ cancers have been defined in previous studies. In this review article, we examine the epidemiological relationship and describe the potential pathophysiological mechanisms that underpin the association between obesity and cancer. These include hormonal and growth factors that are in abundance in persons living with obesity and thereby increase cancer risk. Additionally, the increased disposition towards chronic inflammation in obesity also confers cancer risk. We also examine the impact of obesity on cancer treatment outcomes, focusing on surgery, chemotherapy, and immunotherapy. Conversely, we underline the impact of weight loss on cancer risk by examining different weight loss strategies. Full article

(This article belongs to the Special Issue Diet and Physical Activity Management during Cancer)

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18 pages, 419 KiB

Open AccessArticle

SUPPORT MY WAY: Supporting Young People After Treatment for Cancer: What Is Needed, When This Is Needed and How This Can Be Best Delivered

by Nicole Collaço, Charlotte Ralph, Peter Dawes, Anne-Sophie Darlington, Andrew Davies, Ramya Ramanujachar, Louise Hooker and Samantha Sodergren

Curr. Oncol. 2025, 32(6), 361; https://doi.org/10.3390/curroncol32060361 - 19 Jun 2025

Viewed by 218

Abstract

As survival rates for teenagers and young adults (TYAs) with cancer exceed 80%, they are living longer post treatment, yet often experience prolonged health and quality of life concerns. Many TYAs also experience unmet support needs. This study aimed to identify TYAs support [...] Read more.

As survival rates for teenagers and young adults (TYAs) with cancer exceed 80%, they are living longer post treatment, yet often experience prolonged health and quality of life concerns. Many TYAs also experience unmet support needs. This study aimed to identify TYAs support needs following treatment at a UK hospital and explore how and when TYAs prefer to receive support. This study involved two phases: Phase 1 involved semi-structured interviews with 16 TYAs, 1–6 years post-treatment, aged 16–25 years at time of treatment completion and examined their experiences of support services, and preferences for future care. Phase 2 consisted of co-design workshops with eight TYAs and feedback from five healthcare/allied professionals (HCAPs) to refine and develop recommendations. Phase 1 findings revealed six key themes: (1) survivorship as disrupted continuity; (2) negotiating legitimacy and relational safety in help seeking; (3) support offered vs. support sought: pathways of referral and self-initiation; (4) emotional readiness as context dependent and non-linear; (5) support as an ecosystem, not a moment; and (6) personalised autonomy in support engagement. Phase 2 findings informed recommendations that emphasise the importance of flexible, personalised, and accessible post-treatment support, with pathways of care/support that can adapt to TYAs changing needs and preferences over time. Full article

(This article belongs to the Special Issue Quality of Life and Follow-Up Care Among AYA Cancer Survivors)

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18 pages, 3238 KiB

Open AccessArticle

Dosimetric Comparison of VMAT Alone and VMAT with HDR Brachytherapy Boost Using Clinical and Biological Dose Models in Localized Prostate Cancer

by Manuel Guhlich, Olga Knaus, Arne Strauss, Laura Anna Fischer, Jann Fischer, Stephanie Bendrich, Sandra Donath, Leif Hendrik Dröge, Martin Leu, Stefan Rieken, Annemarie Uhlig, Markus Anton Schirmer and Andrea Hille

Curr. Oncol. 2025, 32(6), 360; https://doi.org/10.3390/curroncol32060360 - 19 Jun 2025

Viewed by 274

Abstract

Background: Combining external beam radiotherapy (EBRT) with high-dose-rate (HDR) brachytherapy (BT) enables biologically effective dose escalation in prostate cancer. However, comparative evaluation of such regimens using radiobiological modeling remains limited. Methods: Dose regimens based on clinical practice were analyzed using α/β values of [...] Read more.

Background: Combining external beam radiotherapy (EBRT) with high-dose-rate (HDR) brachytherapy (BT) enables biologically effective dose escalation in prostate cancer. However, comparative evaluation of such regimens using radiobiological modeling remains limited. Methods: Dose regimens based on clinical practice were analyzed using α/β values of 1.5 and 3 Gy for the prostate. Ten patients with available planning CT, pelvic MRI, and ultrasound-guided BT plans were retrospectively evaluated. Physical and biological dose distributions were recalculated for various EBRT and HDR-BT combinations. Biological effective dose (BED) values were determined for the prostate and organs at risk (OARs: anterior rectal wall, bladder base, urethra). Regimens yielding the highest ΔBED between prostate and OARs were considered most favorable. Results: All regimens met clinical dose constraints. The most favorable ΔBED profiles for bladder and rectum were observed with HDR-BT regimens (2 × 15 Gy) combined with either 23 × 2 Gy or 15 × 2.5 Gy EBRT, independent of the assumed α/β value. EBRT-only regimens achieved superior urethral sparing, while higher HDR doses led to increased urethral exposure. Conclusions: This study underscores the value of radiobiological modeling in differentiating and optimizing prostate cancer radiotherapy strategies. While the trade-offs between dose escalation and OAR sparing are clinically known, our biologically driven analysis provides a more quantitative foundation for selecting and tailoring combined EBRT/HDR-BT regimens in practice. Full article

(This article belongs to the Special Issue Radiotherapy for Genitourinary Cancer)

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17 pages, 584 KiB

Open AccessReview

Molecular Genetics of Renal Cell Carcinoma: A Narrative Review Focused on Clinical Relevance

by Braden Millan, Lauren Loebach, Ruben Blachman-Braun, Milan H. Patel, Jaskirat Saini, W. Marston Linehan and Mark W. Ball

Curr. Oncol. 2025, 32(6), 359; https://doi.org/10.3390/curroncol32060359 - 18 Jun 2025

Viewed by 380

Abstract

Molecular testing in renal cell carcinoma (RCC) has allowed for a better understanding of the biology of both sporadic and hereditary diseases, where genetic testing is currently recommended in the guidelines for a select population with risk factors. Historically, screening, surveillance, and management [...] Read more.

Molecular testing in renal cell carcinoma (RCC) has allowed for a better understanding of the biology of both sporadic and hereditary diseases, where genetic testing is currently recommended in the guidelines for a select population with risk factors. Historically, screening, surveillance, and management decisions were based solely on clinicopathologic data; however, we now know that molecular profiling can enhance decision making, altering the treatment plan, approach, or selection of systemic therapy and enhancing the delivery of precision oncologic care. Advances and the increasing availability of next-generation sequencing technologies have improved the identification of germline and somatic variants in key RCC-associated genes. Given the molecular heterogeneity of RCC, these modern methods can identify unique genetic events that occur in a single individual, allowing for distinction between a metachronous tumor from metastases. Separate four-tier systems have been proposed to categorize germline and somatic variants according to their clinical significance, which should be highlighted. Additionally, emerging technologies, such as liquid biopsy, show potential for enhancing precision oncology in RCC. With this said, challenges, such as variant interpretation, ethical considerations, and accessibility, persist. This review examines the molecularly defined RCC, genetic testing methodologies currently available, their current clinical applications, limitations, and future directions. Full article

(This article belongs to the Section Genitourinary Oncology)

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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

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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

Viewed by 335

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)

17 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

Viewed by 281

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

Viewed by 223

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

Viewed by 249

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 273

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 235

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 292

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 300

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 1628

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 343

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 589

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 368

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 561

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 1009

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 426

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 519

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 486

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 1574

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 949

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)

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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 759

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 532

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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Curr. Oncol., Volume 32, Issue 6 (June 2025) – 77 articles

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