Journal Description
Cancers
Cancers
is a peer-reviewed, open access journal of oncology published semimonthly online. The Irish Association for Cancer Research (IACR), Spanish Association for Cancer Research (ASEICA), Biomedical Research Centre (CIBM), British Neuro-Oncology Society (BNOS) and Spanish Group for Cancer Immuno-Biotherapy (GÉTICA) are affiliated with Cancers and their members receive a discount on the article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q2 (Oncology) / CiteScore - Q1 (Oncology)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 20.3 days after submission; acceptance to publication is undertaken in 2.6 days (median values for papers published in this journal in the first half of 2025).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Sections: published in 18 topical sections.
- Companion journals for Cancers include: Radiation and Onco.
- Journal Clusters of Oncology: Cancers, Current Oncology, Onco and Targets.
Impact Factor:
4.4 (2024);
5-Year Impact Factor:
4.8 (2024)
Latest Articles
Fab Antibody Fragments to Dog Leukocyte Antigen DR (DLA-DR) Directly Suppress Canine Lymphoma Cell Line Growth In Vitro and in Murine Xenotransplant Model
Cancers 2026, 18(1), 48; https://doi.org/10.3390/cancers18010048 (registering DOI) - 23 Dec 2025
Abstract
Background/Objectives: Canine Diffuse Large B-cell Lymphoma (cDLBCL) is characterized by a high prevalence of MHC II DR (DLA-DR) antigen overexpression. Murine anti-pan-DLA-DR monoclonal antibodies (mAbs) B5 and E11 have been previously observed to promote death of cDLBCL cells in vitro and in vivo.
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Background/Objectives: Canine Diffuse Large B-cell Lymphoma (cDLBCL) is characterized by a high prevalence of MHC II DR (DLA-DR) antigen overexpression. Murine anti-pan-DLA-DR monoclonal antibodies (mAbs) B5 and E11 have been previously observed to promote death of cDLBCL cells in vitro and in vivo. Consequently, DLA-DR antigens are considered a prospective target for passive immunotherapy aside from CD20. While infusion of anti-pan MHC II mAbs has demonstrated tumor suppression in cDLBCL xenografted immunodeficient mice, the relative contributions of direct cellular versus immune-mediated mechanisms to this therapeutic effect remain undefined. This study aimed to dissect these potential mechanisms of mAb E11. Methods: Canine lymphoma and leukemia cell lines CLBL1 and CLB70 were incubated with full E11 antibody or its F(ab′)2 and Fab fragments and cell viability was assessed with sub-G1 assay then, NOD-SCID mice were xenotransplanted with 1.5 × 107 canine CLBL1 cells expressing nanoluciferase and were infused either with mAb E11 or its fragments, each at 1 mg/kg body mass, twice weekly for three consecutive weeks. Tumor burden was monitored by assessing body weight, nanoluciferase activity in blood, and by flow cytometric analyses of bone marrow tumor cell content. Time to tumor progression (TTP) was calculated based on weight loss and luminescence measurements. Results: We observed cytotoxic activity of monovalent E11-Fab fragments in vitro and in vivo. The mean TTP for mice treated with irrelevant mouse IgG antibodies was 9.8 ± 4.65 days. In contrast, treatment with E11 Fab fragments resulted in a TTP of 19.1 ± 2.67 days, which was similar to that achieved with the full E11 mAb (19.5 ± 1.73 days) and E11 F(ab′)2 fragments (18.1 ± 2.9 days). Conclusions: Our findings demonstrate a potent antibody cytotoxicity mechanism that operates in vivo and is independent of cell surface MHC II crosslinking or Fc engagement. These data support the promising potential of E11-Fab fragments for further clinical development as a therapeutic agent in canine lymphoma.
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(This article belongs to the Special Issue Advances in B-Cell Lymphoma: From Diagnostics to Cure)
Open AccessArticle
Beyond Survival: Understanding Ethnic and Socioeconomic Disparities in Post-Cancer Healthcare Use in England
by
Tahania Ahmad, Abu Z. M. Dayem Ullah, Claude Chelala and Stephanie J. C. Taylor
Cancers 2026, 18(1), 47; https://doi.org/10.3390/cancers18010047 (registering DOI) - 23 Dec 2025
Abstract
Background: Cancer survivors represent a growing proportion of the UK population and often experience higher multimorbidity and healthcare needs. However, limited research in the UK has explored ethnic and socioeconomic disparities in healthcare resource use among long-term cancer survivors. Methods: Using linked primary
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Background: Cancer survivors represent a growing proportion of the UK population and often experience higher multimorbidity and healthcare needs. However, limited research in the UK has explored ethnic and socioeconomic disparities in healthcare resource use among long-term cancer survivors. Methods: Using linked primary care (Clinical Practice Research Data) and secondary care (Hospital Episode Statistics–Admitted Patient Care) data between 2010 and 2020, this population-based cohort study compared healthcare utilisation among 170,352 cancer survivors and 415,975 matched controls without a cancer diagnosis. Outcomes included primary care consultations and hospital admissions (planned and emergency). Analyses adjusted for age, sex, body mass index, smoking, ethnicity, and the Index of Multiple Deprivation. Negative binomial models were used to estimate incidence rate ratios (IRRs). Results: Cancer survivors averaged 33 more primary-care consultations over ten years than controls, with Pakistani, Indian, and White survivors recording the higher rates. Hospital admissions were consistently higher among survivors across all age groups, peaking in those aged 60–75 years. Planned admissions were highest among Black Caribbean (IRR 1.80 (95% CI 1.73–1.87)), Pakistani (IRR 1.71 (1.63–1.78)), and Bangladeshi (IRR 1.66 (1.53–1.80)) groups. Emergency admissions followed a similar trend, remaining statistically significant only for Pakistani survivors (IRR 1.23 (1.16–1.30)). A strong socioeconomic gradient was observed, with healthcare utilisation increasing as deprivation worsened. Conclusions: Cancer survivors experience substantially greater healthcare use than matched controls, with persistent ethnic and socioeconomic disparities. Strategies to reduce disparities should focus on earlier diagnosis, enhanced long-term care coordination, and culturally informed interventions addressing both cancer survivorship and multimorbidity.
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(This article belongs to the Section Cancer Survivorship and Quality of Life)
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Open AccessReview
Systemic Chemotherapy in Penile Squamous Cell Carcinoma: Mechanisms, Clinical Applications, and Evidence-Based Regimens
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Michalina Grudzińska, Mateusz Czajkowski, Maciej Dolny, Marcin Matuszewski, Piotr Mieczysław Wierzbicki, Agnieszka Rybarczyk and Oliver Walther Hakenberg
Cancers 2026, 18(1), 46; https://doi.org/10.3390/cancers18010046 (registering DOI) - 23 Dec 2025
Abstract
Background/Objectives: Penile squamous cell carcinoma (PSCC) is rare but aggressive. Systemic chemotherapy plays a crucial role in the management of node-positive or metastatic cases; however, the supporting evidence predominantly originates from small, non-randomized studies. This review provides a narrative analysis of the cytotoxic
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Background/Objectives: Penile squamous cell carcinoma (PSCC) is rare but aggressive. Systemic chemotherapy plays a crucial role in the management of node-positive or metastatic cases; however, the supporting evidence predominantly originates from small, non-randomized studies. This review provides a narrative analysis of the cytotoxic classes and regimens employed in PSCC and compares major clinical guidelines to facilitate informed decision-making in practice. Methods: English-language reports were identified in PubMed/Scopus/Google Scholar without date limits. Selection prioritized objective response, survival and toxicity outcomes, and guidance statements across neoadjuvant, adjuvant, and palliative settings. Results: Bleomycin-containing triplet regimens demonstrated efficacy but were associated with unacceptable pulmonary toxicity, leading to their discontinuation in clinical recommendations. Currently, cisplatin/taxane-based combinations remain fundamental in treatment protocols. The paclitaxel–ifosfamide–cisplatin (TIP) regimen achieves approximately 40–50% objective responses in phase II studies and may enable curative surgery, while taxane–cisplatin–5-fluorouracil (TPF) shows comparable efficacy with higher toxicity. For less fit patients, cisplatin–5-fluorouracil (PF) or carboplatin–taxane doublets are pragmatic alternatives. Single-agent taxanes or vinflunine offer modest second-line benefits. Although EAU–ASCO 2023, ESMO–EURACAN 2024, and NCCN v2.2025 are broadly in consensus, recommendations differ regarding eligibility thresholds and regimen preferences. Overall, the quality of the evidence remains low. Conclusions: TIP remains the reference neoadjuvant option for chemotherapy-fit patients with bulky nodal disease; doublets are reasonable when cisplatin fitness is limited; and bleomycin should be avoided. Harmonized eligibility criteria, biomarker-enriched studies, and coordinated multicenter trials are needed to improve outcomes in this rare malignancy.
Full article
(This article belongs to the Special Issue Penile Cancer and Rare Urogenital Malignancies: From Biology to Clinical Management)
Open AccessArticle
Pharmacologic Targeting of miR29b with Bortezomib and Sorafenib to Improve Decitabine Sensitivity in Patients with Acute Myeloid Leukemia: Results from a Phase 1 Dose-Escalation Trial
by
Shivani Handa, Kristin Koenig, Qiuhong Zhao, Alice S. Mims, Sumithira Vasu, Ramiro Garzon, Tamanna Haque, Don Benson, Rebecca B. Klisovic, Guido Marcucci, Alison R. Walker and Bhavana Bhatnagar
Cancers 2026, 18(1), 45; https://doi.org/10.3390/cancers18010045 - 23 Dec 2025
Abstract
Background: Decitabine efficacy in acute myeloid leukemia (AML) may be enhanced by the pharmacologic upregulation of microRNA miR-29b, a regulator of DNA methyltransferase (DNMT) expression. Bortezomib and sorafenib have been shown preclinically to increase miR-29b levels, providing a biologically informed strategy to sensitize
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Background: Decitabine efficacy in acute myeloid leukemia (AML) may be enhanced by the pharmacologic upregulation of microRNA miR-29b, a regulator of DNA methyltransferase (DNMT) expression. Bortezomib and sorafenib have been shown preclinically to increase miR-29b levels, providing a biologically informed strategy to sensitize leukemic blasts to DNMT inhibition. Objectives: To evaluate the safety, tolerability, biological activity, and preliminary efficacy of combining bortezomib and sorafenib followed by decitabine in patients with newly diagnosed or relapsed/refractory AML. Methods: This phase I, dose-escalation study enrolled 15 patients (11 untreated, 4 relapsed/refractory) who received fixed-dose bortezomib and sorafenib across three dose levels prior to decitabine. Dose escalation was guided by dose-limiting toxicities (DLTs) and an increase in miR-29b expression. Results: The regimen was generally well tolerated with the most frequent grade ≥3 adverse events of hypertension and febrile neutropenia. At the highest dose level, a ≥2-fold increase in miR-29b expression was observed in two of the six evaluable patients. The overall response rate was 33.3%, with clinical responses observed in both newly diagnosed and relapsed/refractory patients. However, changes in miR-29b expression did not consistently correlate with clinical response. Conclusions: Sequential treatment with bortezomib and sorafenib followed by decitabine is feasible and demonstrates acceptable safety in AML. Although the biologic modulation of miR-29b was variable, this trial provides a proof of concept for pharmacodynamic-guided dose finding in epigenetic therapy combinations.
Full article
(This article belongs to the Special Issue Preclinical and Clinical Research on the Efficacy of Anticancer Drugs)
Open AccessArticle
A Tissue Renewal-Based Mechanism Drives Colon Tumorigenesis
by
Ryan M. Boman, Gilberto Schleiniger, Christopher Raymond, Juan Palazzo, Anne Shehab and Bruce M. Boman
Cancers 2026, 18(1), 44; https://doi.org/10.3390/cancers18010044 - 23 Dec 2025
Abstract
Our Goal is to identify how colorectal cancer (CRC) arises in the single-layered cell epithelium (simple columnar epithelium) that lines the luminal surface of the large intestine. Background: We recently reported that the dynamic organization of cells in colonic epithelium is encoded by
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Our Goal is to identify how colorectal cancer (CRC) arises in the single-layered cell epithelium (simple columnar epithelium) that lines the luminal surface of the large intestine. Background: We recently reported that the dynamic organization of cells in colonic epithelium is encoded by five biological rules and conjectured that colon tumorigenesis involves an autocatalytic tissue renewal reaction. Introduction Our objective was to define how altered crypt turnover explains tissue disorganization that leads to adenoma morphogenesis and CRC. Hypothesis: Changes in rate of tissue renewal-based cell polymerization leads to epithelial expansion and tissue disorganization during adenoma histogenesis. Methods: Accordingly, we created a computational model that considers the structure of colonic epithelium to be a polymer of cells and that tissue renewal is autocatalytic. Indeed, self-renewal of stem cells in colonic crypts continuously produces cells that act like monomers to form a polymer of cells (an interconnected, continuous cell sheet) in a polymerization-based process. Our model is a system of nonlinear differential equations that simulates changes in human crypt cell population dynamics. Results: We investigated how changes occur in the proportion of different cell types during adenoma development in FAP patients. The results show premalignant colonic crypts have a decreased rate of tissue renewal due to APC-mutation. Discussion: This slower rate of cell polymerization causes a rate-limiting step in the crypt renewal process that expands the proliferative cell population size. Conclusions: Our findings provide a mechanism that explains how a prolonged rate of crypt renewal leads to tissue disorganization with local epithelial expansion, infolding, and contortion during adenoma morphogenesis.:
Full article
(This article belongs to the Special Issue Recent Advances in Basic and Clinical Colorectal Cancer Research)
Open AccessArticle
Assessment of Local and Metastatic Recurrence Following Robot-Assisted Radical Prostatectomy by Margin Status Using PSMA PET/CT Scan
by
Thomas Edward Ahlering, Yeagyeong Hwang, Michael Matthew Lee, Joshua Tran, Anders David Jens Carlson, Levon Kazarian, Karren Liang and Whitney Zhang
Cancers 2026, 18(1), 43; https://doi.org/10.3390/cancers18010043 - 23 Dec 2025
Abstract
Background: Local recurrences following radical prostatectomy (RP) are typically attributed to incomplete surgical resection or positive surgical margins (PSMs). Yet approximately 70% of men with PSMs never experience BCR. Prostate-specific membrane antigen PET scans (PSMA PET) are useful in detecting the incidence
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Background: Local recurrences following radical prostatectomy (RP) are typically attributed to incomplete surgical resection or positive surgical margins (PSMs). Yet approximately 70% of men with PSMs never experience BCR. Prostate-specific membrane antigen PET scans (PSMA PET) are useful in detecting the incidence and location of recurrence sites. This study explores the relationship between margin status and local and metastatic recurrences using PSMA PET scans. Methods: A retrospective study was conducted with prospectively collected data following RARP with BCR in 159 men undergoing PSMA PET (2017–2023). The primary outcome compared risk and location of recurrences between NSM vs. PSM. A total of 13 cases (8%) had “equivocal” PET scan findings which were assessed first as all positive and then all negative. Results: Of 159 men with BCR undergoing PSMA PET scans, 101 (63.5%) had NSMs and 58 (36.5%) had PSMs. Assuming all 13 “equivocal” scans were positive, the risk of a positive PSMA PET is NSMs vs. PSMs (73% vs. 69% p = 0.56). Local recurrence rates did not differ significantly (NSMs 39.2% vs. PSMs 45% p = 0.55), nor did lymph nodes (NSMs 61% vs. PSMs 58% p = 0.73) or bone lesions (NSMs 16.2% vs. PSMs 22.5% p = 0.41). Multivariate regression analysis showed that margin status was not a predictor of local recurrence (OR 1.40; 95% CI [0.65, 1.54]; p = 0.382). Conclusions: Local recurrence occurs at about the same rate independent of margin positivity status, suggesting that local recurrences appear to be more closely related to metastatic dissemination, not incomplete resection. These findings question the oncologic rationale for wider resections at the expense of functional outcomes.
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(This article belongs to the Section Clinical Research of Cancer)
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Open AccessSystematic Review
Functional Outcomes After Reoperation for Recurrent Glioma: A Systematic Review and Meta-Analysis of Karnofsky Performance Status with Descriptive Health-Related Quality-of-Life Reporting
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Brooklyn Brekke-Kumley, Kamel Chebaro, Kristin Cler, Mackenzie Fox, Madison Lather, Chinmayi Balusu and Pamela R. Kinder
Cancers 2026, 18(1), 42; https://doi.org/10.3390/cancers18010042 - 23 Dec 2025
Abstract
Background/Objective: Gliomas are the most common primary brain tumors in adults, with recurrence rates varying by tumor grade and initial treatment. Reoperation is a key strategy for managing recurrence; however, its impact on functional status and health-related quality of life (HRQoL) remains insufficiently
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Background/Objective: Gliomas are the most common primary brain tumors in adults, with recurrence rates varying by tumor grade and initial treatment. Reoperation is a key strategy for managing recurrence; however, its impact on functional status and health-related quality of life (HRQoL) remains insufficiently defined. While HRQoL and neurocognitive outcomes have been described after primary treatment, far less is known following reoperation. This systematic review synthesizes available evidence on postoperative functional outcomes and summarizes HRQoL reporting in the reoperation literature. Methods: A systematic search of PubMed and Google Scholar retrieved 1336 articles. After removing duplicates (n = 76) and screening full texts (n = 42), 15 studies (total n = 1934; reoperation group n = 947) met the inclusion criteria. Studies were eligible if they employed validated functional or HRQoL instruments (e.g., Karnofsky Performance Status [KPS], FACT-G, SF-36, and EQ-5D-L). Due to limited and heterogeneous HRQoL reporting, only KPS could be aggregated for meta-analysis, and HRQoL measures were descriptively summarized. Results: Fixed-effect meta-analysis demonstrated a modest decline in postoperative KPS compared with preoperative scores (−3.28, 95% CI: −3.69 to −2.86; p < 0.001), though heterogeneity was high (I2 ≈ 97%). The random-effects model, accounting for interstudy variability, showed no significant overall change (+0.16 KPS, 95% CI: −4.04 to +4.35; p = 0.94; I2 ≈ 48%). The 95% prediction interval (−14.1 to +14.4) indicated that individual centers may observe either improvement or decline. Sensitivity analyses identified a small outlier study as a major contributor to heterogeneity; its exclusion did not materially alter the results. Conclusions: Across heterogeneous observational cohorts, reoperation for recurrent glioma was not associated with a consistent decline in functional status as measured by KPS, although substantial variability and uncertainty in outcomes remain. HRQoL reporting remains sparse and inconsistent, underscoring the need for prospective, multicenter studies employing standardized HRQoL instruments to better define quality-of-life trajectories after reoperation.
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(This article belongs to the Section Systematic Review or Meta-Analysis in Cancer Research)
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Open AccessArticle
Prediction of Bone Metastasis in Prostate Cancer Using Blood Glucose-6-Phosphate Dehydrogenase Activity: A Retrospective Medical Record Review
by
Chang-Hwan Yeom, Jiewon Lee, Keun-Joo Bae, Kangseok Kim, Jongsoon Choi and Myeong-Hun Lim
Cancers 2026, 18(1), 41; https://doi.org/10.3390/cancers18010041 - 23 Dec 2025
Abstract
Background: Globally, the incidence of prostate cancer is estimated to increase by approximately 80% by 2040 compared to 2018. Bone is the most common metastatic site in prostate cancer and accurate prediction of bone metastasis in prostate cancer is crucial for deciding
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Background: Globally, the incidence of prostate cancer is estimated to increase by approximately 80% by 2040 compared to 2018. Bone is the most common metastatic site in prostate cancer and accurate prediction of bone metastasis in prostate cancer is crucial for deciding treatment decisions. The aim of this study is to evaluate the potential of G6PD activity level as a biomarker for predicting bone metastasis in patients with prostate cancer. Methods: A total of 56 patients participated in this study and participants included in the study were prostate cancer patients aged 19 years or older who visited YCH Hospital. We compared G6PD activity levels according to presence of bone metastasis. Also, ROC analysis was conducted to evaluate the predictive performance of G6PD activity level for bone metastasis. Optimal cutoff value of G6PD activity level was determined using Youden’s index and corresponding sensitivity and specificity were calculated. Results: The median G6PD activity was significantly higher in the group with bone metastasis than in the group without bone metastasis. According to ROC curve analysis, the area under the curve (AUC) was 0.78 (95% CI, 0.66–0.90). The optimal cutoff value of G6PD activity level for predicting bone metastasis was determined to be 11.5 U/g Hb. At this cutoff value, sensitivity and specificity were 0.81 and 0.73, respectively. Conclusions: G6PD activity is a complementary non-invasive biomarker for predicting bone metastasis in patients with prostate cancer.
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(This article belongs to the Special Issue Advancements in “Cancer Biomarkers” for 2025–2026)
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Open AccessArticle
Para-Aortic Lymph Node Dissection and Metastasis Increase the Rate of Postoperative VTE in Gynaecological Cancers
by
Elzahra Ibrahim, Sharoon O’Toole, Lucy Norris and Feras Abu Saadeh
Cancers 2026, 18(1), 40; https://doi.org/10.3390/cancers18010040 - 22 Dec 2025
Abstract
Objective: We investigated the relationship between venous thromboembolism (VTE) and pelvic and para-aortic lymphadenectomy (LND) within the first 90 days post gynaecological cancer surgery. Methods: A retrospective cohort analysis was conducted on 1021 patients who underwent gynaecological cancer surgery between 2006 and 2019.
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Objective: We investigated the relationship between venous thromboembolism (VTE) and pelvic and para-aortic lymphadenectomy (LND) within the first 90 days post gynaecological cancer surgery. Methods: A retrospective cohort analysis was conducted on 1021 patients who underwent gynaecological cancer surgery between 2006 and 2019. Univariate and multivariate analysis was performed to assess the effects of LND and lymph node (LN) metastasis on VTE occurrence within 90 days post-surgery. Results: A total of 41 patients developed VTE within 90 days post-surgery. Para-aortic LND was significantly associated with VTE (p < 0.001), with the highest rates (14.6%) observed in patients who had >10 para-aortic LN removed. In patients with pelvic LN metastasis, 10 (7.5%) developed VTE; patients with >5 pelvic nodes positive for metastasis had an HR = 4.83 (95% CI: 0.99–13.9) after adjustment for age, duration of hospital stay, and surgical approach. The highest VTE rates (27.3%) occurred in patients with >5 para-aortic LN positive for metastasis, HR = 3.79 (95% CI 1.44–14.23) after adjustment for age, duration of hospital stay, and surgical approach (p = 0.011). Conclusions: Para-aortic LND significantly increases VTE risk within the first 90 days post-surgery. The risk is further amplified in cases with metastatic LN and persists even after adjustment for other risk factors for VTE. While extended thromboprophylaxis is standard for all cancer patients, our findings suggest that para-aortic LND—especially with nodal metastases—may help identify those who would benefit most from a more tailored, risk-based prophylaxis approach.
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(This article belongs to the Section Clinical Research of Cancer)
Open AccessReview
Mechanisms of Immune Checkpoint Inhibitor Resistance in Hepatocellular Carcinoma and Strategies for Reversal
by
Xin-Ye Dai, Xiao-Juan Yang, Hong Wu, Ying-Hao Lv and Tian Lan
Cancers 2026, 18(1), 39; https://doi.org/10.3390/cancers18010039 - 22 Dec 2025
Abstract
The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment paradigm for hepatocellular carcinoma (HCC), establishing them as the cornerstone of systemic therapy for advanced stages of the disease. Nonetheless, the response rate remains limited, with only 15% to 20% of HCC
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The advent of immune checkpoint inhibitors (ICIs) has revolutionized the treatment paradigm for hepatocellular carcinoma (HCC), establishing them as the cornerstone of systemic therapy for advanced stages of the disease. Nonetheless, the response rate remains limited, with only 15% to 20% of HCC patients benefiting from ICIs. Approximately 70% to 80% of cases exhibit resistance to anti-PD1 therapy. Therefore, exploring the biomarkers that can be used to identify the response of patients with HCC to immunotherapy and elucidating the potential mechanisms of immunotherapy resistance contribute to the development of predictive biomarkers and are significant for overcoming resistance and enhancing treatment efficacy. This review synthesizes the current understanding of both primary and acquired resistance mechanisms to ICIs in HCC. Compared with existing reviews, this article uniquely integrates the latest evidence on metabolic reprogramming and tumor immune microenvironment (TIME) remodeling in HCC. It also emphasizes the mechanistic crosstalk between oncogenic signaling, immunosuppression, and metabolic adaptation, providing an updated and more comprehensive framework for understanding ICI resistance. It provides a valuable reference for future research aimed at overcoming therapeutic resistance in this malignancy.
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(This article belongs to the Section Cancer Immunology and Immunotherapy)
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Lung Ultrasound for Pleural Effusion in Cancer Patients: Advanced Ultrasound for Pleural Lesions—A Narrative Review
by
Hajo Findeisen, Christian Görg, Viktoria Zies, Michael Ludwig, Christoph F. Dietrich, Amjad Alhyari and Corinna Trenker-Burchert
Cancers 2026, 18(1), 38; https://doi.org/10.3390/cancers18010038 - 22 Dec 2025
Abstract
Background: Pleural effusion (PE) is a frequent complication in patients with malignancies and is often associated with poor prognosis. Lung ultrasound (LUS) has become an indispensable bedside tool for detecting, characterizing, and guiding the management of pleural effusions. Methods: This narrative review summarizes
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Background: Pleural effusion (PE) is a frequent complication in patients with malignancies and is often associated with poor prognosis. Lung ultrasound (LUS) has become an indispensable bedside tool for detecting, characterizing, and guiding the management of pleural effusions. Methods: This narrative review summarizes the current evidence on the diagnostic performance of LUS for PE in cancer patients, emphasizing recent advances in functional ultrasound techniques. Results: B-mode LUS can detect small-volume effusions and estimate their volume. Sonographic features such as echogenicity, septations, and pleural abnormalities can help differentiate transudative from exudative effusions. Shear-wave elastography and contrast-enhanced ultrasound provide additional functional information on tissue stiffness and perfusion. This information may help distinguish between malignant and benign pleural lesions and facilitate targeted biopsy when cytology is nondiagnostic. Compared with computed tomography, LUS offers superior evaluation of juxtadiaphragmatic and pleural surface abnormalities. It facilitates safe, real-time thoracocentesis. Recent innovations, including improved quality, affordable handheld ultrasound systems and artificial intelligence-based analysis, are expected to further enhance diagnostic precision and accessibility. Conclusions: Although LUS is a sensitive and versatile tool for assessing PE in cancer patients, it has limited diagnostic accuracy in distinguishing between benign and malignant effusions. Advanced techniques, such as shear-wave elastography and contrast-enhanced ultrasound, may further support the differentiation of malignant and benign diseases. Ongoing technological advances are likely to enhance the diagnostic accuracy and accessibility of lung ultrasound.
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(This article belongs to the Special Issue Advances in Lung Ultrasound in Cancer Patients)
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Total Quadriceps Resection in High-Grade Soft-Tissue Sarcomas of the Thigh: Surgical Technique and Long-Term Functional Outcomes in Surviving Patients
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Luis Rafael Ramos Pascua, Paula Casas Ramos, Rubén Álvarez García, Sergio Sánchez Herráez, Cristina Ojeda Thies, Maximiliano Eugenio Negri, Daniel Bustamante Recuenco and Jesús Enrique Vilá Rico
Cancers 2026, 18(1), 37; https://doi.org/10.3390/cancers18010037 - 22 Dec 2025
Abstract
Background: Reconstruction of the thigh extensor mechanism following wide excision of a soft-tissue sarcoma is difficult. The aim of this study was to describe the outcomes following complete quadriceps resection for large high-grade soft-tissue sarcomas. Methods: Ten patients with AJCC grade IIIB soft-tissue
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Background: Reconstruction of the thigh extensor mechanism following wide excision of a soft-tissue sarcoma is difficult. The aim of this study was to describe the outcomes following complete quadriceps resection for large high-grade soft-tissue sarcomas. Methods: Ten patients with AJCC grade IIIB soft-tissue sarcomas of the anterior thigh were treated with total wide margin quadricectomy, with a mean follow-up of 4 years (range: 51–163 months) in the five surviving patients with conservative surgical procedures. The minimum follow-up period for four of these patients was 8 years. The extensor mechanism was reconstructed with local muscle transfers (eight cases) or a neurotized free flap of the contralateral vastus lateralis (two cases). Results: Four patients died, two due to non-tumor related causes and two due to metastatic disease at 50 months and 43 months. The remaining six were alive and disease-free at the final follow-up. All patients received surgical revision due to wound necrosis. Another patient required an external hemipelvectomy due to early local recurrence of the disease. Functional results of the five patients who remained alive and retained their limb were good or excellent in two cases, acceptable in one, and poor in two, according to their MSTS scores. Average knee flexion was 80° (range: 10–150°). Passive extension was complete in all cases, though no patients achieved it actively. Extensor strength was 2/5 in four patients and 4/5 in the other. Conclusion: Total quadricectomy for high-grade soft-tissue sarcomas of the anterior thigh compartment ensures wide resection margins and local disease control, although local wound complications are common, particularly in older patients. Resection appears to be technically easier if performed distally to proximally in the thigh. Local muscle transfers are more suited for low-demand patients, while neurotized free muscle flaps are mainly an option for young, motivated patients.
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(This article belongs to the Special Issue Advances in Soft Tissue and Bone Sarcoma (2nd Edition))
Open AccessArticle
Timepoint-Specific Benchmarking of Deep Learning Models for Glioblastoma Follow-Up MRI
by
Wenhao Guo and Golrokh Mirzaei
Cancers 2026, 18(1), 36; https://doi.org/10.3390/cancers18010036 - 22 Dec 2025
Abstract
Background: Differentiating true tumor progression (TP) from treatment-related pseudoprogression (PsP) in glioblastoma remains challenging, especially at early follow-up. Methods: We present the first timepoint-specific, cross-sectional benchmarking of deep learning models for follow-up MRI using the Burdenko GBM Progression cohort (n = 180).
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Background: Differentiating true tumor progression (TP) from treatment-related pseudoprogression (PsP) in glioblastoma remains challenging, especially at early follow-up. Methods: We present the first timepoint-specific, cross-sectional benchmarking of deep learning models for follow-up MRI using the Burdenko GBM Progression cohort (n = 180). We analyze different post-RT scans independently to test whether architecture performance depends on timepoint. Eleven representative DL families (CNNs, LSTMs, hybrids, transformers, and selective state-space models) were trained under a unified, QC-driven pipeline with patient-level cross-validation. Across both timepoints, accuracies were comparable (~0.70–0.74), but discrimination improved at the second follow-up, with F1 and AUC increasing for several models, indicating richer separability later in the care pathway. Results: A Mamba+CNN hybrid consistently offered the best accuracy–efficiency trade-off, while transformer variants delivered competitive AUCs at substantially higher computational cost, and lightweight CNNs were efficient but less reliable. Performance also showed sensitivity to batch size, underscoring the need for standardized training protocols. Notably, absolute discrimination remained modest overall, reflecting the intrinsic difficulty of TP vs. PsP and the dataset’s size and imbalance. Conclusions: These results establish a timepoint-aware benchmark and motivate future work incorporating longitudinal modeling, multi-sequence MRI, and larger multi-center cohorts.
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(This article belongs to the Section Methods and Technologies Development)
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Resolving Clinically Indeterminate Findings During Anal Cancer Surveillance with TTMV-HPV DNA
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Rafi Kabarriti, Shane Lloyd, James Jabalee, Laurie M. Gay, Tyler Slater, Kayleen Guzman, Corbin Jacobs, Sean Inocencio, Ray Lin, Cammie Nguyen, Iain MacEwan, Alexandra H. Crawford, Michael Rutenberg, Jaswinder Singh, Jennifer Ross, Sophia Kim-Wang, Chance Matthiesen, Kasha Neff, Gene-Fu Liu, Tiffany M. Juarez and Stanley L. Liauwadd
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Cancers 2026, 18(1), 35; https://doi.org/10.3390/cancers18010035 - 22 Dec 2025
Abstract
Background/Objectives: Surveillance for anal squamous cell carcinoma (ASCC) recurrence relies on clinical examination and imaging. Post-treatment edema, fibrosis, and inflammation can result in clinically indeterminate findings (CIFs) that delay diagnosis and increase patient and system burden. Circulating tumor tissue-modified viral (TTMV)-HPV DNA offers
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Background/Objectives: Surveillance for anal squamous cell carcinoma (ASCC) recurrence relies on clinical examination and imaging. Post-treatment edema, fibrosis, and inflammation can result in clinically indeterminate findings (CIFs) that delay diagnosis and increase patient and system burden. Circulating tumor tissue-modified viral (TTMV)-HPV DNA offers a biologically specific, noninvasive biomarker that may clarify equivocal assessments. Methods: In this multi-center retrospective study, 233 patients with HPV-associated ASCC were evaluated, including 185 with ≥1 post-treatment TTMV-HPV DNA test. CIFs were defined as exams or imaging results not definitively positive or negative for disease, and were paired with subsequent TTMV-HPV DNA tests. Concordance was defined by prespecified follow-up windows comparing TTMV-HPV DNA results with subsequent clinical outcomes. Results: Ninety patients (39%) experienced 214 CIFs, arising from exams (46%, 98) or imaging (54%, 116). Indeterminate rates by assessment were 7% for exams, 17% for imaging, and 1.3% for TTMV-HPV DNA testing. Overall, 52 CIF/TTMV-HPV DNA pairs were eligible for analysis, and TTMV-HPV DNA resolved disease status accurately for 48/52 (92%, 95% CI: 81.5–97.9). Negative tests predicted cancer-free status for 37/41 CIFs (90%), while 100% of positive tests (11/11) were concordant with clinically confirmed recurrence. In 73% of positive cases (8/11), TTMV-HPV DNA was the first indication of recurrence (median lead-time 29 days; IQR 25–147). Conclusions: TTMV-HPV DNA testing reliably clarifies clinically indeterminate findings during ASCC surveillance, demonstrating high accuracy (92%) and earlier detection of recurrence. These data support integration into post-treatment management to reduce diagnostic uncertainty and guide timely care.
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(This article belongs to the Special Issue Roles of the Tumor Microenvironment on Liquid Biopsy (2nd Edition))
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Open AccessReview
ADA1-Driven Metabolic Refueling Enhances CAR T Cell Therapy for Solid Tumors
by
Alex Wade Song and Xiaotong Song
Cancers 2026, 18(1), 34; https://doi.org/10.3390/cancers18010034 - 22 Dec 2025
Abstract
CAR T cell therapy, while highly effective for hematological malignancies, continues to face significant hurdles in the treatment of solid tumors. Key challenges include severe nutrient deprivation and the presence of immunosuppressive metabolites such as adenosine in the tumor microenvironment, which limit CAR
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CAR T cell therapy, while highly effective for hematological malignancies, continues to face significant hurdles in the treatment of solid tumors. Key challenges include severe nutrient deprivation and the presence of immunosuppressive metabolites such as adenosine in the tumor microenvironment, which limit CAR T cell persistence and antitumor activity. This review focuses on current progress and future directions for ADA1-based metabolic reprogramming as a targeted approach to enhance CAR T cell function. We discuss recent advances, particularly the engineering of CAR T cells to express ADA1, which facilitates the local conversion of immunosuppressive adenosine into inosine, thereby supporting T cell metabolism and improving therapeutic outcomes. Preclinical studies, including our own, demonstrate that ADA1-expressing CAR T cells exhibit reduced exhaustion, greater metabolic flexibility, and enhanced antitumor efficacy in solid tumor models. The selective clearance of adenosine and supplementation of inosine directly address the metabolic barriers within the tumor microenvironment and provide an effective strategy to bolster CAR T cell responses. Integration of ADA1-driven metabolic refueling with future innovations in CAR design holds promise for overcoming key obstacles in solid tumor immunotherapy. We conclude by highlighting the potential of ADA1-based strategies and offering our perspective on their translation toward clinical application.
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(This article belongs to the Special Issue New Insights into Cancer Immunotherapy: From Immune Cell to Clinical Practice)
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Open AccessArticle
Atezolizumab Plus Bevacizumab for Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion: An Inverse Probability of Treatment Weighted Analysis
by
Jihoon Kim, Jin-Hyoung Kim, Byung Soo Im, Gun Ha Kim, Hee Ho Chu, Dong Il Gwon, Ji Hoon Shin, Ju Hyun Shim, Sang Min Yoon and Sehee Kim
Cancers 2026, 18(1), 33; https://doi.org/10.3390/cancers18010033 - 22 Dec 2025
Abstract
Background/Objectives: Management of hepatocellular carcinoma (HCC) with macrovascular invasion (MVI) varies between systemic immunotherapy and locoregional approaches. We compared atezolizumab plus bevacizumab (Atezo–Bev) with locoregional therapy in treatment-naïve patients. Methods: We conducted a retrospective cohort study of patients with image- or
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Background/Objectives: Management of hepatocellular carcinoma (HCC) with macrovascular invasion (MVI) varies between systemic immunotherapy and locoregional approaches. We compared atezolizumab plus bevacizumab (Atezo–Bev) with locoregional therapy in treatment-naïve patients. Methods: We conducted a retrospective cohort study of patients with image- or biopsy-proven HCC and MVI, Child–Pugh A/B, and ECOG 0–1 who received first-line Atezo–Bev or locoregional therapy (transarterial chemoembolization [TACE] with or without external-beam radiotherapy [RT]). Inverse probability of treatment weighting (IPTW) minimized baseline imbalances. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Modified RECIST assessed radiologic response, and major adverse events were classified using Society of Interventional Radiology criteria. Results: We analyzed 475 patients (Atezo–Bev, n = 191; locoregional therapy, n = 284). Baseline characteristics were similar, and IPTW achieved covariate balance. Median OS was 9.3 months with Atezo–Bev and 10.8 months with locoregional therapy; after IPTW, OS remained comparable (hazard ratio [HR] 0.95; 95% CI 0.76–1.19; p = 0.635). Median PFS was 6.0 versus 4.1 months, favoring Atezo–Bev; this persisted after IPTW (HR 0.64; 95% CI 0.52–0.79; p < 0.001). Objective response rates were similar (45% vs. 48%; p = 0.49). Major adverse events occurred in 11% of patients in both groups. Subgroup analyses showed no OS differences and a consistent PFS advantage with Atezo–Bev. Conclusions: In HCC with MVI, first-line Atezo–Bev achieved longer PFS than locoregional therapy, with comparable OS and safety, supporting Atezo–Bev as a valid and effective first-line option for disease control while locoregional modalities remain relevant within multidisciplinary care.
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(This article belongs to the Collection Advances in the Management of Hepatocellular Carcinoma)
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Therapeutic Potential of CAR-CIK Cells in Acute Leukemia Relapsed Post Allogeneic Stem Cell Transplantation
by
Martina Canichella, Paolo de Fabritiis and Elisabetta Abruzzese
Cancers 2026, 18(1), 32; https://doi.org/10.3390/cancers18010032 - 22 Dec 2025
Abstract
Adoptive cellular therapy with donor-derived T cells has always been an attractive strategy after allogeneic hematopoietic stem cell transplantation (allo-HSCT) to reduce the risk of relapse in acute myeloid and lymphoid leukemias. Donor lymphocyte infusion (DLI) is still the best-established option, especially in
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Adoptive cellular therapy with donor-derived T cells has always been an attractive strategy after allogeneic hematopoietic stem cell transplantation (allo-HSCT) to reduce the risk of relapse in acute myeloid and lymphoid leukemias. Donor lymphocyte infusion (DLI) is still the best-established option, especially in the preemptive phase when measurable residual disease (MRD) becomes positive and in the prophylactic setting—when MRD is not detectable. However, the clinical benefit of DLI is counterbalanced by the possible onset of graft-versus-host disease (GvHD), which continues to restrict its wide application. To address this challenge, several alternative cell-based strategies have been developed. One of these is represented by cytokine-induced killer (CIK) cells, generated from donor peripheral blood mononuclear cells through stimulation with anti-CD3 antibodies, interferon-γ, and interleukin-2. These cells are characterized by a hybrid phenotype, combining T-cell functions with natural killer-like properties, and exhibit antitumor activity in an MHC-unrestricted manner. CIK cells are generally well tolerated and associated with low toxicity but their efficacy is so far modest. Based on the experience of CAR-T in the treatment of B-cell lymphoid disease, CIK cells have been engineered with chimeric antigen receptors (CAR) developing the CARCIK cells. This novel cellular strategy represents a promising approach in the treatment of acute myeloid and lymphoid leukemia relapsed post-allo-HSCT. This review provides an overview of the current CAR-CIK experiences in the setting of acute leukemias and outlines future directions for their clinical translation.
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(This article belongs to the Special Issue Insights from the Editorial Board Member)
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Advances and Challenges in KRAS Mutation Detection and Clinical Implications
by
Maryam Sadat Mirlohi, Tooba Yousefi, Javad Razaviyan, Samira Nomiri, Esmail Pishbin, Meer-Taher Shabani-Rad, Mohammad Reza Ahmadian and Siamak Salami
Cancers 2026, 18(1), 31; https://doi.org/10.3390/cancers18010031 - 22 Dec 2025
Abstract
Aberrant activation of the RAS signaling pathway is a halmark of various cancers. This activation, is often caused by mutations in RAS genes or other pathway components and, drivesi uncontrolled cell growth and proliferation. Studies have demonstrated that certain codon mutations can significantly
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Aberrant activation of the RAS signaling pathway is a halmark of various cancers. This activation, is often caused by mutations in RAS genes or other pathway components and, drivesi uncontrolled cell growth and proliferation. Studies have demonstrated that certain codon mutations can significantly influence the clinical outcomes of cancer patients. Historically, KRAS was considered “undruggable”; however, recent advancements in drug discovery have led to the development of promising KRAS inhibitors. Accurately identifying the specific type of KRAS mutation in a patient is essential for making optimal treatment decisions. Several methods have been developed for detecting KRAS mutations to address this need, focusing on creating robust, rapid, sensitive, accurate, and cost-effective approaches, particularly for point-of-care applications. Starting with the Ras family and RASopathies, this review provides a comprehensive overview of KRAS mutation detection methods, ranging from research-use-only techniques to in vitro diagnostic-certified tests. Published results are critically evaluated in terms of accuracy, sensitivity, cost, throughput, and suitability for various sample types and clinical settings. This, offers researchers and clinicians an up-to-date resource for.
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(This article belongs to the Special Issue RAS Proteins and Their Regulators in Human Cancer)
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Special Issue on Skin Cancers of the Head and Neck
by
Kaiwen Chen, Shaun A. Nguyen, Kaitlyn A. Roberts, Warren B. Chun and Cherie-Ann O. Nathan
Cancers 2026, 18(1), 30; https://doi.org/10.3390/cancers18010030 - 21 Dec 2025
Abstract
In this Special Issue of Cancers, we bring together a collection of five studies that capture the rapidly evolving landscape of skin malignancies of the head and neck [...]
Full article
(This article belongs to the Special Issue Skin Cancers of the Head and Neck)
Open AccessArticle
Development and Validation of a CT Radiomics-Deep Learning Model for Predicting Surgical Difficulty in Pancreatic and Periampullary Tumors
by
Tao Hu, Yuan Sun, Yan Li and Ming Li
Cancers 2026, 18(1), 29; https://doi.org/10.3390/cancers18010029 - 21 Dec 2025
Abstract
Background: Pancreatic and periampullary cancers are common tumors of the digestive tract. As a radical surgical approach, laparoscopic pancreaticoduodenectomy requires crucial preoperative assessment of its surgical difficulty. Materials and methods: A retrospective cohort of 150 patients who underwent LPD between June 2019 and
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Background: Pancreatic and periampullary cancers are common tumors of the digestive tract. As a radical surgical approach, laparoscopic pancreaticoduodenectomy requires crucial preoperative assessment of its surgical difficulty. Materials and methods: A retrospective cohort of 150 patients who underwent LPD between June 2019 and June 2023 was enrolled. The criteria for defining the difficult group were identified as unplanned conversion to open procedure, intraoperative blood loss, and operative time. Participants were randomly allocated to a training set (n = 105) or a testing set (n = 45) in a 7:3 ratio. Hand-crafted radiomics (HCR) features and deep learning-derived radiomics (DLR) features were extracted from portal venous phase CT images, focusing on gross tumor volume and gross peri-tumor volume. A hybrid prediction model was developed using a support vector machine algorithm, with performance evaluated through receiver operating characteristic analysis, calibration curves, and decision curve analysis (DCA). Results: The combined model demonstrated significantly superior discriminative ability, achieving an area under the curve (AUC) of 0.942 (95% CI: 0.893–0.992) in the training set and 0.848 (95% CI: 0.738–0.958) in the testing set. This performance exceeded both the standalone HCR model (testing AUC = 0.754) and the DLR model (testing AUC = 0.816). DCA further confirmed the clinical utility of the combined model, showing the highest net benefit across threshold probabilities exceeding 20%. Conclusions: The novel integrated model combining hand-crafted and deep learning-derived radiomics features enables effective prediction of surgical difficulty in laparoscopic pancreaticoduodenectomy.
Full article
(This article belongs to the Section Methods and Technologies Development)
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