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Search Results (14,478)

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22 pages, 17637 KB  
Article
N-Acetyl Aspartic Acid (NAA) Attenuates Stemness and Epithelial–Mesenchymal Transition and Enhances Radio- and Chemo-Sensitivity in Pancreatic Ductal Adenocarcinoma
by Fabiana Crispo, Rosa Lioy, Rosalia Dieli, Mara Martinelli, Carlo Calabrese, Antonella Bianculli, Vincenzo De Fina, Grazia Lazzari, Vito Metallo, Donatella Telesca, Gennaro Laus, Simona Loperte, Rosa Lerose and Carmela Mazzoccoli
Cells 2026, 15(17), 1616; https://doi.org/10.3390/cells15171616 (registering DOI) - 5 Sep 2026
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is characterized by poor clinical outcomes and limited responsiveness to conventional treatments. Beyond delayed diagnosis, its high mortality is linked to limited treatment choices and resistance to chemotherapy. Neoplastic cells characterized by stem-like features and epithelial–mesenchymal transition (EMT) activation [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is characterized by poor clinical outcomes and limited responsiveness to conventional treatments. Beyond delayed diagnosis, its high mortality is linked to limited treatment choices and resistance to chemotherapy. Neoplastic cells characterized by stem-like features and epithelial–mesenchymal transition (EMT) activation are crucial drivers of drug resistance and metastatic progression. Consequently, targeting these cellular programs could represent a promising therapeutic strategy for PDAC. N-acetyl-L-aspartic acid (NAA) is an endogenous metabolite, mainly localized in the central nervous system, where it facilitates acetate storage for lipid metabolism. Previous studies established its antineoplastic effect in neuroblastoma, promoting a more differentiated phenotype of cancer cells. Here we investigated the effects of NAA on BxPC-3 pancreatic cancer cells using both 2D and 3D models. NAA treatment induced a dose-dependent reduction in cell proliferation and led to a significant downregulation of stemness-associated surface markers, with concomitant upregulation of E-cadherin. Furthermore, NAA significantly enhanced cellular radiosensitization with a reduction in caveolin-1 and increased efficacy of gemcitabine in PDAC cells. Collectively, these results confirmed the anticancer activity of NAA and provide a rationale for further investigation of its synergistic effects with radiotherapy to yield better PDAC treatments. Full article
(This article belongs to the Special Issue The Power of Small Molecules in Cancer)
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17 pages, 1233 KB  
Article
Clinical Characteristics and Survival Outcomes of a Clinically Defined Treatment-Emergent Neuroendocrine/Aggressive-Variant Prostate Cancer Phenotype: A Retrospective Study
by Hakan Taban, Sercan Aksoy, Deniz Can Güven, Burak Yasin Aktaş, Feride Yılmaz, Ferit Aslan and Mustafa Erman
Medicina 2026, 62(9), 1702; https://doi.org/10.3390/medicina62091702 (registering DOI) - 5 Sep 2026
Abstract
Background and Objectives: Treatment-emergent neuroendocrine prostate cancer (t-NEPC) is an aggressive resistance phenotype arising during metastatic castration-resistant prostate cancer (mCRPC). Because metastatic biopsy is not routinely feasible in advanced disease, real-world data on clinically defined t-NEPC/aggressive-variant prostate cancer (AVPC)-like disease remain limited. [...] Read more.
Background and Objectives: Treatment-emergent neuroendocrine prostate cancer (t-NEPC) is an aggressive resistance phenotype arising during metastatic castration-resistant prostate cancer (mCRPC). Because metastatic biopsy is not routinely feasible in advanced disease, real-world data on clinically defined t-NEPC/aggressive-variant prostate cancer (AVPC)-like disease remain limited. We aimed to characterize the clinical features, treatment patterns, survival outcomes, and prognostic factors of this clinically defined phenotype. Materials and Methods: We retrospectively reviewed 354 patients with prostate cancer treated at our institution between 2010 and 2020. Seventy-four patients with mCRPC who were clinically identified as having a t-NEPC/AVPC-like phenotype and had a treatment plan for platinum- and/or etoposide-based neuroendocrine-directed systemic therapy were included. Overall survival (OS) and radiographic progression-free survival (rPFS) were estimated using the Kaplan–Meier method, and prognostic factors were evaluated using Cox regression analyses. Results: At clinical identification of the phenotype, the median age was 66.4 years, and visceral metastases were present in 67.6% of patients, most commonly in the liver (55.4%). Median intervals from prostate cancer diagnosis and CRPC onset to clinical identification of the phenotype were 47.5 and 22.7 months, respectively. Neuroendocrine-directed therapy was initiated in 72 patients; platinum–etoposide was the most common first-line regimen (n = 41, 55.4%). Median OS was 4.4 months (95% confidence interval [CI], 2.9–5.8), and median rPFS was 3.5 months (95% CI, 2.7–4.2). In an exploratory, unadjusted analysis, median OS did not differ significantly between doublet chemotherapy and monotherapy (7.0 vs. 3.5 months; p = 0.167). Gleason score ≥9, hemoglobin <12 g/dL, and albumin <3.5 g/dL were independently associated with inferior OS. Conclusions: The clinically defined t-NEPC/AVPC-like phenotype was associated with an aggressive clinical course and poor survival. Earlier recognition, improved biomarker-based diagnostic strategies, and more effective therapeutic approaches are needed. Full article
(This article belongs to the Section Oncology)
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21 pages, 1957 KB  
Article
Fallopian Tube Cytology for Exploratory Detection of Adnexal Malignancy: Prospective Evaluation of the CytoSaLPs Score in an Ex Vivo Surgical Cohort
by Victoria Psomiadou, Sofia Lekka, Theodoros Panoskaltsis, Abraham Pouliakis, Eleni Tsouma, Natasa Novkovic, Helen J. Trihia, Olympia Tzaida, Dimitrios Korfias, Panagiotis Giannakas, Christos Iavazzo, Christos Papadimitriou, Nikolaos Vlahos and George Vorgias
Cancers 2026, 18(17), 2868; https://doi.org/10.3390/cancers18172868 - 4 Sep 2026
Abstract
Objective: Ovarian, fallopian tube, and primary peritoneal cancers remain among the deadliest gynecological malignancies, largely because most cases are diagnosed at an advanced stage and no effective screening strategy is currently available. Increasing evidence suggests that many high-grade serous ovarian carcinomas originate from [...] Read more.
Objective: Ovarian, fallopian tube, and primary peritoneal cancers remain among the deadliest gynecological malignancies, largely because most cases are diagnosed at an advanced stage and no effective screening strategy is currently available. Increasing evidence suggests that many high-grade serous ovarian carcinomas originate from the fallopian tube. We aimed to explore the diagnostic performance of ex vivo fallopian tube cytology and the CytoSaLPs score for detecting tubal and adnexal malignancies in women undergoing salpingectomy or salpingo-oophorectomy. Methods: We conducted a prospective single-center observational study including 304 women undergoing salpingectomy or salpingo-oophorectomy for benign, premalignant or malignant gynecological indications between 2020 and 2023. Ex vivo cytological brushing of the distal fallopian tube was performed before fixation, followed by histopathological examination using the SEE-FIM protocol where appropriate. The primary analysis was performed at the specimen level. Of 544 paired specimens initially available for cytology–histology correlation, 53 non-diagnostic cytological specimens were excluded from the primary diagnostic performance analysis, leaving 491 evaluable paired specimens. Fallopian tube cytological findings were compared with histopathology as the reference standard. The discriminatory ability of the CytoSaLPs score was explored using receiver operating characteristic analysis. Results: Fallopian tube cytology demonstrated high sensitivity for histologically confirmed tubal malignancy, although specificity was moderate. Based on the primary specimen-level analysis, sensitivity was 94.4% and specificity was 71.0%. When fallopian tube cytology was compared with ovarian histology, sensitivity was 72.9% and specificity was 72.4%. For the adnexa considered as a single anatomical entity, sensitivity was 76.5% and specificity was 70.7%. The CytoSaLPs score showed good discriminatory ability for fallopian tube malignancy (AUC 0.8534), moderate discrimination for ovarian malignancy (AUC 0.6790), and fair discrimination for adnexal malignancy (AUC 0.730). The optimal score thresholds were derived from the same dataset and should therefore be considered provisional. Three serous tubal intraepithelial carcinoma lesions were identified histologically; two showed cytological abnormalities and elevated CytoSaLPs scores, whereas one specimen was non-diagnostic. Conclusions: This exploratory proof-of-concept study suggests that ex vivo fallopian tube and the CytoSaLPs score may provide a structured approach for detecting cytological abnormalities associated with tubal and adnexal malignancy. However, the findings were obtained in a tertiary gynecologic oncology population under ex vivo conditions, non-diagnostic specimens occurred in approximately 10% of samples, and the scoring system was developed and evaluated within the same cohort. Independent external validation and evaluation using clinically applicable in vivo sampling methods are required before any clinical implementation can be considered. Full article
(This article belongs to the Special Issue Study on Surgical Treatment of Ovarian Cancer)
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50 pages, 4044 KB  
Review
Targeting Reactive Species Stress and Nutrient Sensing to Enhance NK-Cell Function: Mechanistic Strategies for Overcoming Pancreatic Cancer Progression and Resistance Through Supplement Therapy
by Sara Fanijavadi and Lars Henrik Jensen
Int. J. Mol. Sci. 2026, 27(17), 7893; https://doi.org/10.3390/ijms27177893 - 4 Sep 2026
Abstract
Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest malignancies worldwide because of delayed diagnosis, rapid metastatic progression, profound immune suppression, and limited therapeutic responsiveness. The pancreatic tumor microenvironment is characterized by severe hypoxia, stromal desmoplasia, metabolic stress, and oxidative imbalance, all of [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest malignancies worldwide because of delayed diagnosis, rapid metastatic progression, profound immune suppression, and limited therapeutic responsiveness. The pancreatic tumor microenvironment is characterized by severe hypoxia, stromal desmoplasia, metabolic stress, and oxidative imbalance, all of which contribute to tumor progression and resistance to therapy. Among immune cells involved in antitumor defense, natural killer (NK) cells play an important role through direct cytotoxicity and cytokine production. However, NK-cell activity is frequently impaired in PDAC due to oxidative stress, altered nutrient availability, mitochondrial dysfunction, and dysregulated signaling pathways such as AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR). This review examines current evidence regarding the interactions among redox biology, nutrient sensing, NK-cell metabolism, and pancreatic cancer progression. Importantly, much of the available evidence derives from in vitro studies, animal models, or early-phase clinical investigations, and several findings remain controversial or inconsistent. Further well-designed clinical trials are needed to determine whether nutritional interventions, vitamin supplementation, and strategies targeting metabolic and redox pathways can safely and effectively enhance NK-cell function and improve clinical outcomes in patients with PDAC. Full article
(This article belongs to the Special Issue Pancreatic Cancer: Biomarkers and New Drug Development)
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14 pages, 239 KB  
Article
Disparities in Breast Cancer Diagnosis, Treatment, and Outcomes Among South Asian American Women
by Jasmin Hundal, Ishan Gupta, Ashiya Loomba, Yanwen Chen, Halle Moore, Sudipto Mukherjee and Abhay Singh
Cancers 2026, 18(17), 2866; https://doi.org/10.3390/cancers18172866 - 4 Sep 2026
Abstract
Background: South Asian Americans (SAAs) represent the fastest-growing U.S. immigrant group but remain underrepresented in breast cancer research. This study utilizes the National Cancer Database (NCDB) to evaluate differences in tumor characteristics, treatment patterns, and survival outcomes between SAAs and non-Hispanic Whites (NHWs). [...] Read more.
Background: South Asian Americans (SAAs) represent the fastest-growing U.S. immigrant group but remain underrepresented in breast cancer research. This study utilizes the National Cancer Database (NCDB) to evaluate differences in tumor characteristics, treatment patterns, and survival outcomes between SAAs and non-Hispanic Whites (NHWs). Materials and Methods: A retrospective cohort analysis was conducted using NCDB data from 2004–2021. Women with breast cancer were stratified by race/ethnicity (SAA vs. NHW), and demographic, clinical, and treatment variables were compared. Outcomes assessed were overall survival (OS) and treatment delays, defined as initiation of surgery, chemotherapy, or radiation therapy > 60 days after diagnosis. Multivariable Cox proportional hazards models assessed OS. Results: Among 2,363,627 patients, 20,561 (0.9%) were SAAs and 2,343,066 (99.1%) NHWs. SAAs were younger at diagnosis, with 37.6% aged 20–49 vs. 20.6% of NHWs (p < 0.001). Insurance coverage differed, with SAAs more likely privately insured (63.0% vs. 54.2%, p < 0.001), less likely on Medicare (17.2% vs. 37.9%), and more often uninsured (4.5% vs. 1.2%). Time to first treatment was longer for SAAs (39.55 vs. 37.17 days, p < 0.001). Surgical delays >60 days increased mortality by 59%, while chemotherapy delays raised it by 44%. SAAs demonstrated higher survival at 5, 10, and 15 years (93%, 87%, 81%) vs. NHWs (87%, 76%, 64%). Median survival was 225.8 months but not estimable for SAAs. SAAs presented with aggressive subtypes: triple-negative and HER2-positive tumors. Conclusions: SAAs present younger with aggressive subtypes and treatment delays yet maintain survival advantages; reducing care barriers and clarifying tumor biology are vital to improving outcomes. Full article
15 pages, 5893 KB  
Article
Dynamic Prediction of Survival Outcomes in Multiple Myeloma
by Kelly Quek, Cindy H. Lee, Yang Zhang, Barbara J. McClure, Runzhe Chen, Hamish S. Scott, Kate Vandyke, Andrew C. W. Zannettino and Chung Hoow Kok
Cancers 2026, 18(17), 2864; https://doi.org/10.3390/cancers18172864 - 4 Sep 2026
Abstract
Background: Multiple myeloma (MM) remains an incurable plasma cell malignancy characterized by marked clinical heterogeneity. Existing prognostic frameworks, including the International Staging System (ISS) and FISH-defined cytogenetic risk, are anchored at diagnosis and do not capture the evolutionary dynamics of disease or [...] Read more.
Background: Multiple myeloma (MM) remains an incurable plasma cell malignancy characterized by marked clinical heterogeneity. Existing prognostic frameworks, including the International Staging System (ISS) and FISH-defined cytogenetic risk, are anchored at diagnosis and do not capture the evolutionary dynamics of disease or treatment response, leaving an unmet need for risk models that retain prognostic validity longitudinally. Methods: Using transcriptomic data from 762 CD138-selected MM plasma cells from newly diagnosed patient samples in the MMRF CoMMpass study (NCT01454297), we computed single-sample pathway activity scores for 469 curated cancer-relevant pathways (MSigDB Hallmark; Reactome) and learned a Bayesian causal network linking pathway activity to survival. The model was validated in five independent diagnostic cohorts (n = 1255) and in two independent treatment and relapsed/refractory cohorts (n = 319). Longitudinal risk tracking was additionally assessed in a 46-patient subset of the discovery cohort with serial pre- and post-treatment sampling. Results: The network identified five pathways associated with survival: unfolded protein response (UPR), FLT3 signaling through SRC family kinases, G2M DNA replication checkpoint, metabolism of selenium compound (SeMet), and nicotinate metabolism. The composite survival score stratified patients into high-risk (n = 76; 10%) and standard-risk groups with markedly divergent survival (median 1170 days vs. not reached; p < 0.0001). The score remained an independent prognostic factor after adjustment for age, sex, ISS stage, and KRAS, TP53, and UBR5 mutational status (HR 4.93; 95% CI 2.96–8.19; p < 0.001), and replicated across all five external diagnostic cohorts. Critically, the model retained prognostic discrimination in previously treated (GSE57317; p < 0.0001) and relapsed/refractory (GSE9782; p < 0.0001) settings, and patients transitioning from standard- to high-risk between serial samples exhibited significantly inferior survival compared to standard-risk patients. Conclusions: This pathway-based Bayesian network provides a reproducible, dynamically applicable risk model for MM that captures information complementary to ISS and FISH-defined cytogenetics. The framework supports longitudinal patient monitoring and may inform trial enrichment strategies and closer surveillance for high-risk subpopulations. Full article
(This article belongs to the Special Issue Advances in Cancer Data and Statistics: 2nd Edition)
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13 pages, 651 KB  
Article
Clinical Patterns in Patients with Basal Cell Carcinoma: A 10-Year Single-Center Retrospective Study
by Eliza Rebeka Siemaszko-Oniszczuk, Przemysław Hałubiec, Anna Wojas-Pelc and Andrzej Kazimierz Jaworek
Medicina 2026, 62(9), 1696; https://doi.org/10.3390/medicina62091696 - 4 Sep 2026
Abstract
Background and Objectives: Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer, and its global incidence rate constantly rises. However, there are no current epidemiological data for many regions, including Małopolska in southern Poland. This study aimed to characterize the [...] Read more.
Background and Objectives: Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer, and its global incidence rate constantly rises. However, there are no current epidemiological data for many regions, including Małopolska in southern Poland. This study aimed to characterize the clinical and histological profile of patients with BCC and to identify factors associated with local recurrence and the presence of multiple tumors. Materials and Methods: We performed a single-center, retrospective observational study consistent with STROBE guidelines at the Department of Dermatology and Allergology, University Hospital in Cracow. The included patients were adults with at least one histologically confirmed BCC treated between 2015 and 2025. Demographic, clinical, histopathological, and follow-up data were collected at patient and lesion levels. The results were evaluated using univariable tests, multivariable logistic regression, Kaplan–Meier survival analysis, and generalized estimating equations. Results: We included 108 patients (median age at first diagnosis, 73 years; 52% male) with 418 BCCs; the median follow-up duration was 84 months. Superficial BCC was the most common subtype among lesions with available histological subtype information (56%). The head and neck region was the most frequent anatomical site in this group (51%). Multiple BCCs were present in 62% of patients. Longer follow-up was independently associated with the presence of multiple BCCs. A history of actinic keratoses showed a positive but statistically nonsignificant association with multiple BCCs. Recurrence was observed in 15 lesions (3.6%). Female sex and H-zone involvement showed higher odds of recurrence. Conclusions: In this elderly cohort, multiple BCC tumors may reflect longer follow-up and cumulative actinic damage. Recurrence was relatively infrequent but associated with clinically relevant features, including H-zone involvement and female sex. These findings support an individualized, multifactorial approach to treatment and follow-up, taking into account age, sex, lesion burden, anatomical location, and histological subtype. Full article
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19 pages, 674 KB  
Article
The Impact of Comorbidity on Severe Procedure-Coded Inpatient Events in Head and Neck Cancer and Thyroid Cancer Hospitalizations in Germany: A Nationwide DRG Analysis, 2005–2021
by Lisa-Marie Müller-Anderski, Mussab Kouka, Peter Schlattmann and Orlando Guntinas-Lichius
Cancers 2026, 18(17), 2860; https://doi.org/10.3390/cancers18172860 - 4 Sep 2026
Abstract
Background: Comorbidity is an important determinant of treatment selection and in-hospital complications in patients with head and neck cancer (HNC) and thyroid cancer (TC), yet population-based evidence on this relationship remains limited. Methods: We analyzed nationwide Diagnosis-Related Groups (DRG) data from 1,552,028 inpatient [...] Read more.
Background: Comorbidity is an important determinant of treatment selection and in-hospital complications in patients with head and neck cancer (HNC) and thyroid cancer (TC), yet population-based evidence on this relationship remains limited. Methods: We analyzed nationwide Diagnosis-Related Groups (DRG) data from 1,552,028 inpatient HNC and TC treatments of patients aged ≥30 years in Germany between 2005 and 2021. The aim was to characterize the association of comorbidity and severe treatment-related procedure-coded inpatient events (IEs) with gender, age, tumor subsite, and treatment type. Results: The largest proportion of treatments occurred in patients aged 60–69 years (33.5%). The most frequent tumor subsites were the oropharynx, thyroid gland, oral cavity, larynx, and hypopharynx, with 35.52, 33.84, 33.60, 26.12, and 15.76 treatments per 100,000 population per year, respectively. Overall, 38% of cases had a Charlson Comorbidity Index (CCI) ≥ 1, with the highest mean CCI observed for C14 (other sites of the lip, oral cavity and pharynx) and C12 (piriform sinus). IEs requiring additional in-hospital treatment occurred in 19.3% of cases. After adjustment for age, tumor location, and treatment type, men had a lower risk of IEs than women (OR 0.929; CI 0.919–0.939; p < 0.001). Increasing comorbidity was associated with a higher IE risk, reaching a plateau at CCI ≥ 4 (OR 2.135; CI 2.029–2.246; p < 0.001). IE risk was high during chemotherapy/immunotherapy (OR 29.527; CI 28.897–30.170; p < 0.001), followed by surgery (OR 3.465; CI 3.433–3.498; p < 0.001), whereas radiotherapy showed the lowest risk (OR 1.339; CI 1.313–1.366; p < 0.001). Conclusions: These findings highlight substantial heterogeneity in comorbidity and IE risk among patients with HNC or TC. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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14 pages, 247 KB  
Article
Disseminated Aspergillosis with Central Nervous System Involvement Among Patients with Hematologic Malignancies: A 30-Year Institutional Cohort of Clinical Features, Management, and Outcomes
by Saliba Wehbe, Ray Hachem, Anne-Marie Chaftari, Amir Melek, Joanne Arvelaez Pascucci, Ying Jiang and Issam Raad
J. Fungi 2026, 12(9), 667; https://doi.org/10.3390/jof12090667 - 4 Sep 2026
Abstract
Background: Disseminated invasive aspergillosis (IA) is an uncommon but devastating manifestation of disease, particularly when the central nervous system (CNS) is involved. The clinical features and outcomes of CNS dissemination, compared with isolated invasive pulmonary aspergillosis (IPA) and other disseminated forms, remain poorly [...] Read more.
Background: Disseminated invasive aspergillosis (IA) is an uncommon but devastating manifestation of disease, particularly when the central nervous system (CNS) is involved. The clinical features and outcomes of CNS dissemination, compared with isolated invasive pulmonary aspergillosis (IPA) and other disseminated forms, remain poorly characterized. Methods: Using an institutional database of 1157 cancer patients diagnosed with IA between 1993 and 2024, we identified 43 patients with disseminated IA, defined as infection involving ≥2 non-contiguous organ systems, including 8 with CNS involvement. Patients with disseminated IA were matched 1:3 to patients with IPA based on year of diagnosis. We compared clinical features, antifungal treatment, and outcomes between: (1) CNS-disseminated IA and IPA, and (2) CNS-disseminated IA and other forms of disseminated IA. Results: Baseline characteristics, including hematologic malignancy subtype, hematopoietic stem cell transplantation status, neutropenia, and antifungal prophylaxis, were similar across groups. Aspergillus fumigatus was the predominant species in all cohorts. No patients with CNS-disseminated IA achieved clinical response at end of therapy, versus 35% with IPA (p = 0.05) and 30% with other disseminated IA (p = 0.17). Twelve-week IA-associated mortality was significantly higher in CNS-disseminated IA than in IPA (88% vs. 45%, p = 0.028) and was higher than in other disseminated IA (88% vs. 46%, p = 0.05). Combination antifungal therapy was more frequently used in CNS-disseminated IA than in IPA (63% vs. 31%) and other disseminated IA (63% vs. 43%), while rates of ICU admission and mechanical ventilation were similar across groups. Conclusions: CNS involvement in disseminated IA defines a distinct, high-risk phenotype, with profoundly reduced treatment response and survival despite comparable baseline characteristics. Given the small number of CNS cases and the predominance of cases diagnosed during earlier study periods, these findings should be interpreted with caution. Although combination antifungal therapy was used more frequently in CNS-disseminated IA, no significant outcome benefit was observed, underscoring the need for improved therapeutic approaches for CNS aspergillosis in immunocompromised hosts. Full article
(This article belongs to the Section Fungal Pathogenesis and Disease Control)
73 pages, 1145 KB  
Review
Deep Learning in Multimodal Breast Cancer Imaging: From Image Reconstruction and Segmentation to Diagnosis and Treatment Response Prediction
by Dorota Bartusik-Aebisher, Sara Czech, Jakub Szpara, Avijit Paul, Marvin Xavierselvan and David Aebisher
Appl. Sci. 2026, 16(17), 8771; https://doi.org/10.3390/app16178771 - 3 Sep 2026
Abstract
Breast cancer imaging is central to screening, diagnosis, staging, treatment monitoring, and post-treatment surveillance, but image interpretation remains limited by variable image quality, interobserver variability, false-positive findings and heterogeneous tumor biology. This narrative review summarizes current applications of deep learning in multimodal breast [...] Read more.
Breast cancer imaging is central to screening, diagnosis, staging, treatment monitoring, and post-treatment surveillance, but image interpretation remains limited by variable image quality, interobserver variability, false-positive findings and heterogeneous tumor biology. This narrative review summarizes current applications of deep learning in multimodal breast cancer imaging, with emphasis on image reconstruction, image enhancement, lesion detection, segmentation, classification, biomarker prediction, treatment response assessment, prognosis and clinical implementation. A structured literature search was performed across major biomedical and technical databases, focusing on studies involving mammography, digital breast tomosynthesis, ultrasound, MRI, PET/CT, digital pathology and multimodal fusion approaches. Current evidence indicates that deep learning can support image denoising; super-resolution, low-dose, and accelerated reconstruction; lesion localization; tumor segmentation; benign–malignant classification; and molecular or biomarker-related prediction. Multimodal models integrating radiological imaging, histopathology, clinical variables, and molecular markers show particular promise for treatment response prediction, recurrence risk estimation, and personalized decision support. However, clinical translation remains limited by retrospective study designs, small and imbalanced datasets, domain shift, inconsistent annotations, limited explainability, bias, lack of prospective validation, and regulatory challenges. Deep learning should therefore be viewed as a decision-support framework that may improve breast cancer imaging workflows if validated in diverse, prospective, and clinically representative settings. Full article
(This article belongs to the Special Issue Digital Innovations in Healthcare—2nd Edition)
15 pages, 821 KB  
Article
The Prognostic Role of the Lung Immune Prognostic Index in Neuroendocrine Prostate Cancer: A Multicenter Retrospective Study
by Merve Turan, Mehmet Nuri Baser, Fatima Ozkaya Kutluay, Ahmet Unlu, Ozlem Kutlu, Umut Cakıroglu, Asim Armagan Aydin, Olcun Umit Unal, Gamze Gokoz Dogu and Esin Oktay
Diagnostics 2026, 16(17), 2839; https://doi.org/10.3390/diagnostics16172839 - 3 Sep 2026
Abstract
Background: Neuroendocrine prostate cancer (NEPC) is a rare and aggressive malignancy with limited prognostic tools. The Lung Immune Prognostic Index (LIPI), derived from dNLR and lactate dehydrogenase, has demonstrated prognostic value in small-cell lung cancer but has not been evaluated in NEPC. [...] Read more.
Background: Neuroendocrine prostate cancer (NEPC) is a rare and aggressive malignancy with limited prognostic tools. The Lung Immune Prognostic Index (LIPI), derived from dNLR and lactate dehydrogenase, has demonstrated prognostic value in small-cell lung cancer but has not been evaluated in NEPC. This study assessed the prognostic role of LIPI in NEPC. Methods: This multicenter retrospective study included 34 patients with NEPC (21 secondary, 13 de novo) from four centers in Turkey. Laboratory data were collected at NEPC diagnosis (T3), initial prostate cancer diagnosis (T1), and castration-resistant prostate cancer diagnosis (T2). LIPI was scored using original fixed cut-offs. Survival analyses included Kaplan–Meier, Cox regression, and ROC methods. Results: At NEPC diagnosis, 18 patients (52.9%) had Good LIPI and 16 (47.1%) Intermediate + Poor LIPI. Intermediate + Poor LIPI was associated with significantly shorter overall survival (median 4 vs. 15 months; log-rank p = 0.001; HR 3.83, 95% CI 1.65–8.90). In multivariable analysis, albumin was an independent predictor (HR 0.37, p = 0.015), while LIPI showed a trend (HR 2.35, p = 0.091). LIPI demonstrated the highest discriminatory ability for 6-month overall survival (AUC 0.763, p = 0.009). LIPI at earlier disease stages did not predict time to transformation or castration resistance. Among secondary NEPC patients, worsening LIPI trajectory was associated with shorter survival (median 4 vs. 10 months; log-rank p = 0.031). Conclusions: LIPI at NEPC diagnosis was associated with overall survival and demonstrated the highest discriminatory ability among the inflammatory indices assessed. As a routine blood-based score, LIPI may support risk stratification at NEPC diagnosis. Prospective validation is warranted. Full article
(This article belongs to the Special Issue Prostate Cancer: Innovations in Diagnosis and Risk Stratification)
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12 pages, 396 KB  
Article
Identifying Distinct Quality-of-Life Profiles in Prostate Cancer Patients: A Latent Profile Approach
by Linan Cheng
Curr. Oncol. 2026, 33(9), 532; https://doi.org/10.3390/curroncol33090532 - 2 Sep 2026
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Abstract
Background: Prostate cancer substantially affects patients’ quality of life (QoL). However, whether distinct QoL profiles exist among patients remains unclear. Objective: This study aimed to identify latent QoL profiles among patients with prostate cancer and explore factors associated with profile membership. Methods: A [...] Read more.
Background: Prostate cancer substantially affects patients’ quality of life (QoL). However, whether distinct QoL profiles exist among patients remains unclear. Objective: This study aimed to identify latent QoL profiles among patients with prostate cancer and explore factors associated with profile membership. Methods: A cross-sectional study included 200 patients with prostate cancer recruited from a tertiary hospital in China between May and December 2024. QoL was assessed using the Functional Assessment of Cancer Therapy–Prostate (FACT-P). Latent profile analysis was performed using Mplus 8.3, and the optimal model was selected according to information criteria, entropy, and likelihood ratio tests. Multivariable logistic regression was used to examine factors associated with profile membership. Results: LPA identified two distinct subgroups: low QoL (32.5%) and high QoL (67.5%). Medium and heavy economic burden significantly increased odds of low QoL (OR = 4.13, 95% CI: 1.13–15.02, p = 0.032; OR = 11.12, 95% CI:1.55–79.86, p = 0.017). Urinary continence markedly reduced odds of low QoL (OR = 0.08, 95% CI: 0.02–0.25, p < 0.001). Longer diagnosis-to-treatment intervals were associated with membership in the low-QoL profile (1–3 months: OR = 2.99, 95% CI: 1.26–7.08, p = 0.013; >3 months: OR = 3.36, 95% CI: 1.02–11.07, p = 0.046). Conclusions: This study identified two QoL profiles among patients with prostate cancer. The findings suggest that person-centered QoL assessment may facilitate early identification of patients with greater supportive care needs and contribute to more individualized survivorship care. Full article
(This article belongs to the Section Oncology Nursing)
29 pages, 361 KB  
Review
Precision Diagnostics in Prostate Cancer: Integrating Biomarkers, Imaging, Genomics, and Artificial Intelligence in Contemporary United States Practice
by Moustafa Kardjadj
Med. Sci. 2026, 14(5), 541; https://doi.org/10.3390/medsci14050541 - 2 Sep 2026
Viewed by 134
Abstract
Prostate cancer is the most commonly diagnosed non-cutaneous malignancy among men in the United States and remains a leading cause of cancer-related mortality. Its marked biological, molecular, and histopathological heterogeneity creates a central diagnostic challenge: identifying clinically significant disease while limiting unnecessary biopsy [...] Read more.
Prostate cancer is the most commonly diagnosed non-cutaneous malignancy among men in the United States and remains a leading cause of cancer-related mortality. Its marked biological, molecular, and histopathological heterogeneity creates a central diagnostic challenge: identifying clinically significant disease while limiting unnecessary biopsy and overdiagnosis of tumors unlikely to affect survival or quality of life. Although prostate-specific antigen (PSA) remains the foundation of early detection, its limited cancer specificity has driven the development of increasingly risk-adapted diagnostic pathways. Contemporary evaluation integrates clinical risk assessment and PSA-derived measures with selectively used blood- and urine-based biomarkers, multiparametric magnetic resonance imaging (mpMRI), image-guided biopsy, histopathological classification, genomic risk assessment, and molecular imaging. Biomarkers such as the Prostate Health Index, 4Kscore, IsoPSA, MiCheck, SelectMDx, and ExoDx may refine biopsy decisions in appropriately selected patients but should be interpreted according to the clinical setting, decision threshold, and surrounding diagnostic pathway. Prostate MRI and PI-RADS-based assessment have become central to pre-biopsy evaluation, while MRI-targeted biopsy improves detection of Grade Group ≥ 2 disease. Increasing use of the transperineal biopsy route offers comparable cancer detection with a lower infectious risk. Following diagnosis, Grade Group, adverse histological features, clinical risk models, and selected tissue-based genomic classifiers provide complementary prognostic information. PSMA PET/CT has further improved staging of selected patients with higher-risk disease and localization of biochemical recurrence. Precision diagnostics must also account for disease phenotypes that may not be adequately represented by conventional PSA- and imaging-based pathways, including intraductal carcinoma, cribriform architecture, ductal adenocarcinoma, and neuroendocrine prostate cancer. Emerging approaches, including artificial intelligence-assisted MRI interpretation, digital pathology, high-frequency micro-ultrasound, liquid biopsy, alternative molecular radiotracers, and multi-omic integration, show increasing potential but remain at different stages of validation and clinical adoption. This review critically examines contemporary prostate cancer diagnostics within United States clinical practice, distinguishing established guideline-supported approaches from selectively used adjuncts and emerging technologies. Particular emphasis is placed on diagnostic performance in context, clinical utility, external validation, healthcare equity, regulatory considerations, and the need to demonstrate that increasing diagnostic complexity translates into meaningful improvements in patient care. Full article
(This article belongs to the Section Cancer and Cancer-Related Research)
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24 pages, 407 KB  
Article
Impact of Post-Primary Treatment Hormone Replacement Therapy on Survival in Women with Cervical Cancer
by Hee Joong Lee and Banghyun Lee
Cancers 2026, 18(17), 2841; https://doi.org/10.3390/cancers18172841 - 2 Sep 2026
Viewed by 131
Abstract
Background/Objectives: The effects of hormone replacement therapy (HRT) after primary treatment on survival outcomes in women with cervical cancer (CC) remain unclear. This nationwide cohort study evaluated the association between post-primary treatment HRT and overall survival (OS) in women with CC. Methods [...] Read more.
Background/Objectives: The effects of hormone replacement therapy (HRT) after primary treatment on survival outcomes in women with cervical cancer (CC) remain unclear. This nationwide cohort study evaluated the association between post-primary treatment HRT and overall survival (OS) in women with CC. Methods: We identified 15,261 women aged ≤60 years with CC who received primary treatment using the Korean Health Insurance Review and Assessment Service database. HRT users were defined as women who received HRT prescriptions for ≥28 days within one year after completion of primary treatment. Stabilized inverse probability of treatment weighting (IPTW) was used to reduce baseline differences between HRT users and non-users, followed by multivariable Cox regression to further adjust for potential confounding. Landmark analyses were performed to address potential immortal time bias. Results: Among 15,261 women, 4118 (27.0%) received HRT. In IPTW-weighted analyses, HRT use was significantly associated with improved OS in both multivariable models (adjusted HR, 0.544; 95% CI, 0.502–0.590; p < 0.001 and adjusted HR, 0.653; 95% CI, 0.574–0.742; p < 0.001, respectively). This association was generally maintained in landmark analyses at 1, 3, and 5 years after diagnosis and remained significant across localized, regional, and distant disease in stage-stratified analyses. The association was most consistently observed among women with squamous cell carcinoma. Conclusions: Post-primary treatment HRT was associated with improved OS in women with CC. Further prospective studies are needed to clarify the clinical implications of this association. Full article
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14 pages, 328 KB  
Article
Male Breast Cancer: An Analysis of Clinicopathological Features, Treatment Patterns, and Survival Outcomes over 10 Years from a Tertiary Center
by Hüseyin Tepetam, Cemal Ugur Dursun, Mustafa Mert Hanilce, Solen Nasifoglu, Nursena Ciflik, Duygu Gedik, Sermin Kokten and Sule Karabulut Gul
J. Clin. Med. 2026, 15(17), 6800; https://doi.org/10.3390/jcm15176800 - 2 Sep 2026
Viewed by 152
Abstract
Background/Objectives: Male breast cancer (MBC) is a rare malignancy accounting for less than 1% of all breast cancers, and current treatment recommendations are largely extrapolated from studies in women. We aimed to evaluate the clinicopathological characteristics, treatment patterns, survival outcomes, and prognostic [...] Read more.
Background/Objectives: Male breast cancer (MBC) is a rare malignancy accounting for less than 1% of all breast cancers, and current treatment recommendations are largely extrapolated from studies in women. We aimed to evaluate the clinicopathological characteristics, treatment patterns, survival outcomes, and prognostic factors of male breast cancer patients treated at a tertiary referral center. Methods: We retrospectively reviewed 45 patients with histopathologically confirmed MBC treated between January 2015 and July 2025. Demographic, clinicopathological, treatment, and follow-up data were collected from institutional records. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan–Meier method, and potential prognostic factors were analyzed using univariate Cox proportional hazards regression. Results: The median age at diagnosis was 60 years, and invasive ductal carcinoma was the predominant histological subtype (95.6%). Estrogen and progesterone receptor positivity were observed in 93.0% and 95.2% of patients, respectively, while HER2 positivity was identified in 26.8%. Modified radical mastectomy was performed in 95.6% of patients, adjuvant endocrine therapy in 88.9%, chemotherapy in 73.3%, and radiotherapy in 64.4%. After a median follow-up of 84 months (range, 1–125 months), the estimated 5-year OS and DFS rates were 85.3% and 68.4%, respectively. No locoregional recurrence was observed in the entire cohort; all recurrences were distant metastases. None of the evaluated clinicopathological variables demonstrated a statistically significant association with OS or DFS. Conclusions: This single-center experience demonstrates favorable long-term survival and no observed locoregional recurrence in a contemporary cohort of patients with male breast cancer. These real-world findings are consistent with current treatment strategies and provide additional evidence regarding the management of this rare disease. Larger multicenter collaborative studies are needed to establish robust prognostic models and generate male-specific evidence to further optimize clinical management. Full article
(This article belongs to the Section Oncology)
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