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14 pages, 2599 KB  
Article
Self-Reported Late Effects, Information Needs, and Preferences for Long-Term Follow-Up Care Among Survivors of Childhood Cancer: A Nationwide Survivor-Led Survey from Germany
by Jette Luedersen, Bjoern Hessing, Marie Alfes, Franziska E. Marquard and Eva-Maria Wild
Cancers 2026, 18(18), 2951; https://doi.org/10.3390/cancers18182951 - 12 Sep 2026
Viewed by 138
Abstract
Background: Rising survival rates have created a growing population of childhood cancer survivors (CCSs) who have an increased risk of late effects and require long-term follow-up (LTFU) care. Existing services are often fragmented and may not reflect survivors’ priorities; optimizing such care [...] Read more.
Background: Rising survival rates have created a growing population of childhood cancer survivors (CCSs) who have an increased risk of late effects and require long-term follow-up (LTFU) care. Existing services are often fragmented and may not reflect survivors’ priorities; optimizing such care requires understanding not only the self-reported burden of late effects and their impact on daily lives but also survivors’ information status and their preferences for future care. Methods: Survivor Deutschland e.V. conducted a nationwide cross-sectional online survey assessing the current late effects, daily-life impairments, subjective information statuses, current follow-up structures, and preferences for future LTFU care. A total of 339 CCSs were included, covering all childhood cancer entities, most frequently leukemia (30.7%), central nervous system tumors (18.3%), and lymphoma (16.5%). Data were analyzed descriptively and supplemented by paired non-parametric analyses. Results: Overall, 74.3% (252/339) reported at least one late effect. Self-rated limitations in daily life had a median of five (Q1–Q3 3–7) on a 1–10 scale, which increased with the number of reported late effects. The most frequently affected domains were endocrine (36.3%, n = 123), fertility (33.6%), psychological (30.4%, n = 103), neurocognitive (26.0%, n = 88), and orthopedic (24.8%, n = 84) problems. A majority (69.3%, n = 235) knew that late effects existed yet felt insufficiently informed, and 4.4% only learned of these through the survey. Among 172 survivors in adult follow-up care, only 26.8% (46/172) reported access to structured, specialized LTFU care, whereas 56.4% (97/172) preferred this model. Survivors rated the importance of LTFU care highly (median 9/10) but rated satisfaction with their current care as much lower (median 3/10). The most valued components were the coverage of follow-up costs, sufficient consultation time, a dedicated contact person, and clear communication of results. Psychological support was a notable gap (5.8%, 10/172 current access vs. 17.9% 31/172 preferred), and 84.1% were willing to travel up to two hours or more for high-quality care. Conclusions: German CCSs report a high late-effect burden, meaningful impairment of their daily lives, a pronounced information gap, and substantial unmet care needs. These patient-centered findings support structured, risk-adapted LTFU with proactive information, integrated psychological support, and sustainable financing at specialized LTFU centers. Full article
(This article belongs to the Special Issue Survivorship Following Childhood, Adolescent, and Young Adult Cancer)
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15 pages, 543 KB  
Article
Association of Receipt of Human Papillomavirus Vaccination and Personal History of Cancer Diagnosis in the United States: A Cross-Sectional Study Using NHIS Data
by Manali Desai, Shreela V. Sharma, Joël Fokom Domgue, Robert Yu, Wenyaw Chan, Charles Darkoh and Sanjay Shete
Cancers 2026, 18(18), 2945; https://doi.org/10.3390/cancers18182945 - 11 Sep 2026
Viewed by 213
Abstract
Background: Cancer survivors are at increased risk for developing subsequent cancers, including HPV-associated cancers, compared to the general population. However, evidence regarding the receipt of HPV vaccination and cancer diagnosis status is limited. Methods: We analyzed 2019 and 2022 National Health [...] Read more.
Background: Cancer survivors are at increased risk for developing subsequent cancers, including HPV-associated cancers, compared to the general population. However, evidence regarding the receipt of HPV vaccination and cancer diagnosis status is limited. Methods: We analyzed 2019 and 2022 National Health Interview Survey data, focusing on adults aged 18–45 years who were eligible for HPV vaccination. We performed descriptive statistics and evaluated associations using survey-weighted bivariable and multivariable logistic regression to assess the association between a personal history of any cancer diagnosis and receipt of HPV vaccination, adjusting for sociodemographic and behavioral factors. Results: Among 20,917 participants (mean [SD] age (years): 31.41 [13.58]), 489 (2.0%) were cancer survivors; 99 (19.3%) received HPV vaccination. Among 20,423 adults without a cancer diagnosis, 5317 (27.8%) had received HPV vaccination. Five participants had missing data on cancer history. Cancer survivors had significantly lower odds of HPV vaccination compared to adults without a personal cancer history (Adjusted Odds Ratio [aOR]: 0.67, 95% CI: 0.52–0.87, p = 0.003). Living in non-metro areas (aOR: 0.77, 95% CI: 0.66–0.89, p < 0.001), smokers [current (aOR: 0.82, 95% CI: 0.71–0.94, p = 0.005), and former (aOR: 0.75, 95% CI: 0.67–0.84, p < 0.001)], non-US-born (aOR: 0.54, 95% CI: 0.47–0.61, p < 0.001), uninsured (aOR: 0.60, 95% CI: 0.52–0.69, p < 0.001) had significantly lower odds of receiving HPV vaccination. Those who were 18–26 years (aOR: 5.49, 95% CI: 4.73–6.37, p < 0.001), non-Hispanic others (aOR: 1.40, 95% CI: 1.11–1.75, p = 0.004), females (aOR: 3.18, 95% CI: 2.84–3.56, p < 0.001), higher education [some college/bachelor’s education (aOR: 1.57, 95% CI: 1.41–1.74, p < 0.001), and graduate degree/professional scholar (aOR: 1.91, 95% CI: 1.65–2.22, p < 0.001)], living in rented housing (aOR: 1.18, 95% CI: 1.08–1.29, p < 0.001) had significantly higher odds of receiving HPV vaccination. Conclusions: HPV vaccination uptake is low among cancer survivors. Targeted interventions such as strong oncologists’ recommendations, patient reminders, and care coordination between oncology and primary care professionals are needed to increase HPV vaccination uptake in this population. Full article
(This article belongs to the Section Cancer Epidemiology and Prevention)
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33 pages, 3558 KB  
Review
Aprepitant, a Neurokinin-1 Receptor Antagonist, as a Disruptive Drug for the Treatment of Pediatric Cancer
by Marisa Rosso, Carlos Alcaide and Miguel Muñoz
J. Clin. Med. 2026, 15(18), 7004; https://doi.org/10.3390/jcm15187004 - 10 Sep 2026
Viewed by 236
Abstract
Although advances in pediatric oncology have resulted in cure rates exceeding 80% among children with cancer, progress in survival outcomes has begun to plateau in recent years. Mortality in this population remains largely associated with aggressive disease features, particularly tumor resistance to chemotherapy [...] Read more.
Although advances in pediatric oncology have resulted in cure rates exceeding 80% among children with cancer, progress in survival outcomes has begun to plateau in recent years. Mortality in this population remains largely associated with aggressive disease features, particularly tumor resistance to chemotherapy and metastatic spread. At the same time, the growing population of childhood cancer survivors has drawn increasing attention to the persistent and potentially serious late effects associated with conventional chemotherapy. Thus, it is crucial to discover drugs with specific antitumor action, effective and safe drugs that, combined with chemotherapy or radiotherapy, could chemosensitize or radiosensitize the tumor and reduce the severe side effects of both. Substance P (SP) peptide and its Neurokinin-1 receptor (NK-1R) are known to be involved in pediatric cancer, promotion and progression. Pediatric cancer overexpresses SP/NK-1R and NK-1R is essential for viability of cancer cells and is not essential for normal non-tumor cells. SP induces mitogenesis, exerts anti-apoptotic effects, and promotes angiogenesis, invasion and migration for metastasis in cancer cells and produces inflammation. Conversely, NK-1R antagonists, such as aprepitant and similar drugs, inhibit mitogenesis and induce apoptosis in pediatric cancer cells in a concentration-dependent manner. They also inhibit angiogenesis, invasion, and migration in pediatric cancer cells and have an anti-inflammatory effect. Moreover, aprepitant in combination with chemotherapy or radiotherapy can produce chemosensitization or radiosensitisation and decreases the severe side effects of both. This review updates the role of the SP/NK-1R axis in pediatric cancers and analyzes its potential as a therapeutic target. It highlights NK-1R antagonists, particularly aprepitant, and their potential as drugs for the treatment of pediatric cancer. Full article
(This article belongs to the Section Oncology)
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29 pages, 2077 KB  
Review
Dental Implants After Head and Neck Radiotherapy: From Chronological Waiting Rules to Implant-Bed-Specific Risk Stratification
by Erkan Topkan, Efsun Somay, Sibel Bascil and Ugur Selek
Healthcare 2026, 14(18), 2889; https://doi.org/10.3390/healthcare14182889 - 8 Sep 2026
Viewed by 123
Abstract
Dental implant-supported rehabilitation is a key component of functional survivorship care for patients with head and neck cancer (HNC) treated with radiotherapy (RT). Despite its importance, implant outcomes in this population are frequently interpreted through simplified paradigms such as irradiated versus non-irradiated status, [...] Read more.
Dental implant-supported rehabilitation is a key component of functional survivorship care for patients with head and neck cancer (HNC) treated with radiotherapy (RT). Despite its importance, implant outcomes in this population are frequently interpreted through simplified paradigms such as irradiated versus non-irradiated status, prescribed tumor dose, pre-RT versus post-RT placement, and arbitrary post-RT waiting intervals. This narrative review proposes a radiobiology-informed, implant-bed-specific framework for assessing implant viability following HNC RT. The biologically relevant exposure is best defined as the localized radiation dose delivered to the implant bed, considered in conjunction with fractionation, equivalent dose in 2-Gy fractions, recipient substrate, soft-tissue condition, prosthetic loading, systemic host factors, and late toxicity risk. Distinctions among early osseointegration, implant survival, implant success, prosthetic rehabilitation, and patient-centered functional benefit are essential, as retained implants do not necessarily equate to durable or meaningful rehabilitation. Post-RT timing should be understood as a contextual variable rather than a universal chronological determinant, since longer intervals do not inherently indicate progressive biological recovery and may be confounded by survivor and clinician selection. Future research should prioritize implant-bed-specific dosimetry, continuous modeling of dose and timing, standardized outcome measures, cluster-adjusted statistical approaches, time-to-event analyses, and explicit reporting of osteoradionecrosis as a distinct implant-relevant late toxicity endpoint. Shifting from chronological waiting rules to implant-bed-specific risk stratification may enhance the safety, interpretability, and clinical relevance of dental implant rehabilitation following HNC RT. Full article
(This article belongs to the Topic Advances in Dental Health, 2nd Edition)
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17 pages, 1405 KB  
Article
Early-Stage Evaluation of a Novel Sexual Health Care Model for Breast Cancer Survivors Undergoing Endocrine Therapy: A Case Series
by Wakako Yachi
Nurs. Rep. 2026, 16(9), 324; https://doi.org/10.3390/nursrep16090324 - 6 Sep 2026
Viewed by 158
Abstract
Background/Objectives: Women undergoing endocrine therapy after breast cancer often experience sexual-health concerns, but opportunities for individualized nursing support are limited. This case series implemented and preliminarily evaluated a novel sexual health-care model for women undergoing endocrine therapy after breast-cancer treatment. Methods: A care [...] Read more.
Background/Objectives: Women undergoing endocrine therapy after breast cancer often experience sexual-health concerns, but opportunities for individualized nursing support are limited. This case series implemented and preliminarily evaluated a novel sexual health-care model for women undergoing endocrine therapy after breast-cancer treatment. Methods: A care model was developed from Comfort Theory, a literature review, and clinical experience and underwent content-validity review by experts, including one nurse with lived experience of breast cancer. It was implemented individually for 6 months in five premenopausal women receiving endocrine therapy after breast-conserving surgery or total mastectomy. Data included baseline characteristics, care records, final interviews, and Self-affirmation Scale scores. Nursing goal attainment and final interviews were evaluated qualitatively. Results: All nursing goals appeared to have been achieved based on provider assessment and participants’ narratives. Participants gradually expressed distress, questions, and sexual health needs related to bodily and sexual changes, developed greater understanding of treatment-related changes, identified individualized coping strategies, and showed greater self-worth and self-care. Self-affirmation scores were descriptively higher after care. Phenomenological analysis identified four constituents: having a place to discuss a body marked by breast and fertility loss; sharing with a midwife who accepted them as they were; reconnecting with their changed bodies; and discovering new meaning in life with altered fertility and bodily integrity. Conclusions: The care model may provide a safe, individualized space for women undergoing endocrine therapy after breast cancer to express concerns, understand bodily changes, and reconstruct meaning. The findings are preliminary and represent provider-assessed observations rather than evidence of effectiveness. Full article
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22 pages, 2834 KB  
Article
Resistance Exercise Training Selectively Modulates Tumor Suppressor and Muscle-Regulatory MicroRNAs in Breast Cancer Survivors and Healthy Postmenopausal Women: An Exploratory Study
by Macarena Artigas-Arias, Josefa Bonicioli, Nolberto Huard, Luis A. Salazar, Jorge Sapunar, Luis Peñailillo, Denisse Valladares-Ide, Rui Curi and Gabriel Nasri Marzuca-Nassr
Int. J. Mol. Sci. 2026, 27(17), 7900; https://doi.org/10.3390/ijms27177900 - 4 Sep 2026
Viewed by 296
Abstract
Progressive resistance exercise training (RET) enhances skeletal muscle mass in healthy postmenopausal women (HEAs) and breast cancer survivors (BCSs) undergoing endocrine therapy. MicroRNAs (miRNAs) are recognized as key epigenetic regulators of exercise-induced adaptations, functioning as tumor suppressors, oncomiRs, and modulators of skeletal muscle [...] Read more.
Progressive resistance exercise training (RET) enhances skeletal muscle mass in healthy postmenopausal women (HEAs) and breast cancer survivors (BCSs) undergoing endocrine therapy. MicroRNAs (miRNAs) are recognized as key epigenetic regulators of exercise-induced adaptations, functioning as tumor suppressors, oncomiRs, and modulators of skeletal muscle homeostasis. Nevertheless, the impact of RET on circulating miRNA profiles in this population remains largely unexplored. This study aimed to explore the effects of a 12-week progressive RET program on plasma miRNAs associated with tumor biology and skeletal muscle regulation in HEAs and BCSs. Five HEAs and five BCSs undergoing endocrine therapy completed a 12-week supervised progressive RET program (3 sessions/week, 60–80% 1RM). Plasma samples were collected before and after intervention, and candidate miRNA expression was quantified by qRT-PCR, normalized to hsa-miR-16-5p, and analyzed using the 2−ΔΔCt method. At baseline, no significant differences were observed between HEA and BCS in tumor suppressor miRNAs (miR-let-7f-5p, miR-125a-5p, miR-342-3p), oncomiRs (miR-21-5p, miR-155-5p, miR-221-3p), or skeletal muscle–related miRNAs (miR-206-3p, miR-486-5p) (p > 0.05). The only exception was miR-375-3p, which showed increased expression in HEA vs BCS (p = 0.037). After 12 weeks of RET, The BCS group showed increases in miR-125a-5p (p = 0.050) and miR-342-3p (p = 0.048) with significant group × time interactions that remained significant after Benjamini–Hochberg False Discovery Rate (BH-FDR) correction (FDR-adjusted p = 0.042 for both). Both groups displayed a nominal increase in miR-375-3p (p = 0.042), which did not remain significant after FDR correction. No significant changes were detected for miR-let-7f-5p or the analyzed oncomiRs in either group. Both miR-206-3p and miR-486-5p exhibited upward trends in the BCS group (p > 0.05). In this exploratory study, 12-week RET program was associated with selective changes in plasma miRNA expression in the HEA and BCS groups, suggesting that this training regimen may act as an epigenetic modulator of circulating miRNAs involved in tumor suppression and skeletal muscle homeostasis. Full article
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20 pages, 295 KB  
Article
Perceived Facilitators and Barriers Inform Young Adult Cancer Survivors’ Preferences for Physical Activity and Diet Interventions: A Qualitative Study
by Rashida K. Jones, Aasha I. Hoogland, Bihe Hu, Xiaoyin Li, Carley Geiss, Melinda L. Maconi, Rebecca Blackwell, Yvelise Rodriguez, Crystal Bryant, Nathaly Irizarry-Arroyo, Laura B. Oswald, Brian D. Gonzalez, Brent J. Small, Andrew Galligan, Heather S. L. Jim, Marilyn Stern and Sylvia L. Crowder
Nutrients 2026, 18(17), 2896; https://doi.org/10.3390/nu18172896 - 3 Sep 2026
Viewed by 278
Abstract
Purpose: Young adult cancer survivors aged 20–30 years are at increased risk for chronic health conditions, influenced by modifiable lifestyle behaviors. Many do not meet the American Cancer Society’s guidelines for physical activity and healthy eating. Guided by Social Cognitive Theory, this qualitative [...] Read more.
Purpose: Young adult cancer survivors aged 20–30 years are at increased risk for chronic health conditions, influenced by modifiable lifestyle behaviors. Many do not meet the American Cancer Society’s guidelines for physical activity and healthy eating. Guided by Social Cognitive Theory, this qualitative study explored the facilitators and barriers to healthy lifestyle behaviors among a racially and ethnically diverse sample of young adult cancer survivors aged 20–30 years to inform tailored interventions. Methods: Participants were recruited through the Adolescent and Young Adult Oncology Program at Moffitt Cancer Center in Florida, USA. Semi-structured interviews were conducted and analyzed using applied thematic analysis. Transcripts were coded in NVivo 12 Plus and organized into themes reflecting Social Cognitive Theory constructs and intervention preferences. Demographic information was collected via pre-interview surveys. Results: Participants (N = 30) were an average of 26 years (SD = 2.4). Most identified as non-Hispanic (60%), White (60%), unmarried (83%), women (83%), and with annual household income ≥$40,000 (67%). The most common diagnoses were thyroid cancer (20%), lymphoid (17%), and sarcoma (13%). Interviews lasted 30–88 min (M = 52). Five themes emerged: (1) competing demands and time constraints; (2) symptom burden and desire for credible, flexible support; (3) previous habits, self-efficacy, and community building; (4) dual role of social support; and (5) cancer as a catalyst for behavior change. Conclusions: Findings identified facilitators and barriers to physical activity and healthy eating, and intervention preferences among young adult cancer survivors, which can inform the timing, content, and modality of tailored interventions. Implications for Cancer Survivors: Findings can inform tailored, survivor-centered interventions for young adult cancer survivors. Full article
(This article belongs to the Section Nutrition and Neuro Sciences)
93 pages, 13944 KB  
Review
Nutritional Prevention of Oxidative Stress-Induced Cardiotoxicity in Pediatric Cardio-Oncology: Molecular Mechanisms and Translational Perspectives—A Narrative Review
by Karmen Stankov, Bojan Stanimirov, Aleksandar Ninković, Maja Đanić, Slavica Lazarević, Dragana Zaklan and Nebojša Pavlović
Int. J. Mol. Sci. 2026, 27(17), 7863; https://doi.org/10.3390/ijms27177863 - 2 Sep 2026
Viewed by 256
Abstract
Cancer therapy-related cardiotoxicity has emerged as a major challenge in contemporary oncology, particularly in long-term survivors of childhood malignancies. Oxidative stress (OS)-induced cardiotoxicity represents a key mechanistic pathway underlying myocardial injury caused by numerous anti-neoplastic drugs, most notably anthracycline-based chemotherapy, while OS also [...] Read more.
Cancer therapy-related cardiotoxicity has emerged as a major challenge in contemporary oncology, particularly in long-term survivors of childhood malignancies. Oxidative stress (OS)-induced cardiotoxicity represents a key mechanistic pathway underlying myocardial injury caused by numerous anti-neoplastic drugs, most notably anthracycline-based chemotherapy, while OS also critically contributes to radiotherapy-induced cardiotoxicity. Excessive reactive oxygen and nitrogen species generation promotes mitochondrial dysfunction, impaired calcium homeostasis, lipid peroxidation, endothelial injury, inflammatory activation, and cardiomyocyte apoptosis, ultimately leading to progressive cardiac remodeling and ventricular dysfunction. These processes are of particular concern in pediatric cancer survivors, especially children treated for leukemia, who face a substantially elevated lifetime risk of cardiovascular disease following treatment exposure. Increasing attention has, therefore, been directed toward nutritional strategies capable of modulating redox homeostasis and attenuating treatment-associated myocardial injury. Experimental and translational evidence suggests that selected dietary compounds and nutraceuticals, including polyphenols, omega-3 fatty acids, coenzyme Q10, selenium, antioxidant vitamins, nutrition-based epigenetic interventions and intestinal microbiota composition modulations may exert cardioprotective effects through preservation of mitochondrial integrity, enhancement of endogenous antioxidant defenses, and suppression of oxidative and inflammatory signaling pathways. Nevertheless, clinical implementation remains limited by insufficient standardization, heterogeneous study designs, and incomplete understanding of long-term efficacy and safety. This narrative review critically examines the molecular basis of the OS-induced cardiotoxicity and radiotherapy-induced cardiotoxicity and evaluates current evidence supporting nutrition-based cardioprotective interventions, with particular emphasis on pediatric leukemia survivors and the prevention of long-term cardiovascular complications following anticancer therapy. Full article
(This article belongs to the Special Issue Recent Advances in Nutrients and Oxidative Stress)
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20 pages, 986 KB  
Review
Metabolic Outcome and CV Risk in Breast Cancer Patients
by Francesco Carlo Felicetti, Gloria Mittica, Chiara Cavallin, Ester Campus, Elena Laura Salerno, Filippo Gatti, Alessandra Beano, Umberto Ricardi, Emanuela Arvat and Nicoletta Fortunati
Endocrines 2026, 7(3), 50; https://doi.org/10.3390/endocrines7030050 - 1 Sep 2026
Viewed by 298
Abstract
Breast cancer [BC] is the most diagnosed cancer among women worldwide. Thanks to advancements in early detection, systemic therapies, and supportive care, survival rates have significantly improved. As more patients survive BC, cardiovascular disease [CVD] has emerged as a leading cause of long-term [...] Read more.
Breast cancer [BC] is the most diagnosed cancer among women worldwide. Thanks to advancements in early detection, systemic therapies, and supportive care, survival rates have significantly improved. As more patients survive BC, cardiovascular disease [CVD] has emerged as a leading cause of long-term morbidity and mortality in this population. This is largely due to a combination of shared risk factors, such as obesity, diabetes and metabolic syndrome, combined to cardiotoxic effects of certain anticancer therapies, particularly anthracyclines, HER2-targeted therapies and radiotherapy. This review explores the cardiovascular [CV] implications of modern breast cancer treatments, including chemotherapy, endocrine therapy, targeted agents, radiotherapy, and emerging modalities such as immunotherapy. It also highlights the impact of patient-specific factors—such as diabetes, lipid profile, and treatment duration—on CVD risk. Current data suggest that breast cancer survivors are at increased risk of CVD compared to the general population, and that risk persists for years after treatment completion. CVD risk profile of each patient is different because of patient age, previous risk factors, and type of oncological treatment, and must be carefully delineated and keep well in mind during and after cancer treatment. Full article
(This article belongs to the Section Endocrine Oncology)
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16 pages, 650 KB  
Article
Health-Related Quality of Life, Comorbidities, and Lifestyle Behaviors Among Survivors of Obesity-Related and Non-Obesity-Related Cancer Types
by William Hernández, Génesis Rodríguez-Ortiz, Lorena González-Sepúlveda, Cynthia M. Pérez, Marievelisse Soto-Salgado and Carola T. Sánchez-Díaz
Cancers 2026, 18(17), 2817; https://doi.org/10.3390/cancers18172817 - 1 Sep 2026
Viewed by 339
Abstract
Background/Objectives: Obesity is a well-established risk factor for several cancers, yet few studies have explored survivorship outcomes among obesity-related cancer (ORC) survivors—a growing public health concern. Beyond cancer risk, obesity is associated with poorer health-related quality of life (HRQoL), greater comorbidity burden, [...] Read more.
Background/Objectives: Obesity is a well-established risk factor for several cancers, yet few studies have explored survivorship outcomes among obesity-related cancer (ORC) survivors—a growing public health concern. Beyond cancer risk, obesity is associated with poorer health-related quality of life (HRQoL), greater comorbidity burden, and adverse lifestyle behaviors during survivorship. This study examined differences in these outcomes between ORC and non-ORC survivors living in Puerto Rico. Methods: We analyzed 569 cancer survivors aged ≥21 years actively undergoing treatment from the Impact of Social Determinants of Health on the Cancer Care Continuum in Cancer Survivors in Puerto Rico Study, with survey data collected between 2023 and 2025. ORC status was classified based on the presence of a primary ORC (n = 262); all others were classified as non-ORC (n = 307). Outcomes included: (1) HRQoL, assessed using the Functional Assessment of Cancer Therapy-General overall score and domains; (2) comorbidities; and (3) lifestyle behaviors (i.e., physical activity, alcohol use, and smoking status). Poisson regression models with robust standard errors estimated adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for all outcomes except smoking status and comorbidity burden, which were analyzed using multinomial logistic regression models to estimate adjusted relative risk ratios (aRRRs). Results: ORC survivors had a higher relative risk of former smoking (vs. never smoking) than non-ORC survivors (aRRR: 1.74, 95% CI: 1.02–2.96). No other differences were observed between groups. Older ORC survivors reported better emotional (aPR = 0.59, 95% CI: 0.41–0.85) and physical (aPR = 0.74, 95% CI: 0.58–0.95) well-being than older non-ORC survivors. Among male participants, ORC survivors reported a lower prevalence of moderate/exceeded drinking than non-ORC survivors. Conclusions: Findings highlight a higher relative risk of former smoking (vs. never smoking) among ORC survivors compared with non-ORC survivors, with additional sex- and age-specific patterns in alcohol use and emotional/physical well-being. Full article
(This article belongs to the Special Issue Health-Related Quality of Life in Cancer Survivorship)
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19 pages, 1292 KB  
Article
Predictors of Early In-Hospital Mortality in Patients Aged ≥65 Years Undergoing Colorectal Cancer Surgery: A Retrospective Cohort Study
by Ivan Pesic, Ilija Golubovic, Milica Nestorovic, Marko Gmijovic, Zoran Damjanovic, Milorad Pavlovic, Vanja Pecic, Toplica Bojic, Aleksandar Pavlovic and Aleksandra Ignjatović
Surgeries 2026, 7(3), 103; https://doi.org/10.3390/surgeries7030103 - 31 Aug 2026
Viewed by 169
Abstract
Background/Objectives: Patients aged ≥65 years undergoing colorectal cancer surgery are at increased risk of postoperative complications and mortality due to advanced age, comorbidity burden, frailty, and reduced physiological reserve. The aim of this study was to evaluate perioperative predictors associated with early in-hospital [...] Read more.
Background/Objectives: Patients aged ≥65 years undergoing colorectal cancer surgery are at increased risk of postoperative complications and mortality due to advanced age, comorbidity burden, frailty, and reduced physiological reserve. The aim of this study was to evaluate perioperative predictors associated with early in-hospital mortality in patients aged ≥65 years undergoing colorectal cancer surgery. Methods: This single-center retrospective cohort study included 438 patients aged ≥65 years who underwent colorectal cancer surgery at a tertiary referral center between January 2017 and December 2018. Demographic characteristics, comorbidities, American Society of Anesthesiologists (ASA) classification, surgical urgency, perioperative laboratory parameters, and transfusion requirements were analyzed. The primary endpoint was early in-hospital mortality. Survival analysis was performed using Kaplan–Meier curves and Cox proportional hazards regression analysis. Results: The overall in-hospital mortality rate was 9.4% (41/438). Emergency surgery was associated with significantly reduced in-hospital survival compared with elective procedures (log-rank p < 0.001). Non-survivors more frequently presented with emergency surgical indications, higher ASA scores, greater comorbidity burden, anemia, nutritional impairment, elevated inflammatory markers, renal dysfunction, and increased transfusion requirements. In univariate Cox regression analysis, emergency surgery, ASA score ≥ 3, elevated creatinine, leukocyte count, and C-reactive protein levels, lower hemoglobin, albumin and total protein levels, and red blood cell transfusion were significantly associated with mortality. In multivariate analysis, elevated creatinine (HR 1.004, p = 0.030), leukocyte count (HR 1.064, p = 0.004), C-reactive protein (HR 1.009, p < 0.001), and lower hemoglobin concentration (HR 0.938, p < 0.001) remained independent predictors of in-hospital mortality. Conclusions: Early in-hospital mortality after colorectal cancer surgery in patients aged ≥65 years is associated with systemic inflammation, anemia, and renal dysfunction. Routinely available clinical and laboratory parameters may assist in identifying high-risk patients and improving perioperative risk assessment and postoperative management. Full article
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11 pages, 2235 KB  
Article
Prognostic Value of Inflammatory Indices and the Advanced Lung Cancer Inflammation Index (ALI) for Survival Outcomes in Hemodialysis Patients
by Demet Yavuz, Mehmet Derya Demirag, Enis Akca, Muhammed Ali Atasever, Mehmet Omer Bostanci and Nihal Aydemir
Medicina 2026, 62(9), 1670; https://doi.org/10.3390/medicina62091670 - 31 Aug 2026
Viewed by 278
Abstract
Background and Objectives: Chronic systemic inflammation and malnutrition drive adverse outcomes in maintenance hemodialysis (HD) patients. This study investigated the prognostic utility of four accessible inflammatory indices—systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), atherogenic index of plasma (AIP), and advanced lung cancer [...] Read more.
Background and Objectives: Chronic systemic inflammation and malnutrition drive adverse outcomes in maintenance hemodialysis (HD) patients. This study investigated the prognostic utility of four accessible inflammatory indices—systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), atherogenic index of plasma (AIP), and advanced lung cancer inflammation index (ALI)—in predicting survival. Materials and Methods: This retrospective cohort study evaluated electronic health records of 222 incident HD patients in Turkey (2014–2021), followed through December 2024. Baseline biomarkers were calculated prior to HD initiation. Survival outcomes were assessed using Kaplan–Meier curves, and independent predictors of all-cause mortality were determined via multivariable Cox proportional hazards regression models. Results: During a median follow-up of 24.9 months, 106 patients (47.7%) died. Non-survivors presented with significantly higher median SII, NLR, and AIP, and markedly lower ALI than survivors (all p < 0.001). Multivariable analysis revealed that elevated SII (HR: 1.035, 95% CI: 1.020–1.050; p < 0.001) and NLR (HR: 1.081, 95% CI: 1.042–1.122; p < 0.001) were risk factors for mortality. In contrast, higher ALI demonstrated a significant protective effect on survival (HR: 0.975, 95% CI: 0.953–0.998; p = 0.036). Kaplan–Meier analyses confirmed superior overall survival in patients with lower SII, NLR, AIP, and higher ALI. Conclusions: SII, NLR, AIP, and ALI are practical, cost-effective biomarkers for mortality risk stratification in HD patients. ALI, integrating both nutritional and inflammatory dimensions, demonstrates particularly robust prognostic value for predicting survival. Full article
(This article belongs to the Special Issue End-Stage Kidney Disease (ESKD))
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23 pages, 5563 KB  
Article
Whole-Blood Fatty Acid Phenotypes and Subsequent Quality-of-Life Changes Among Cancer Survivors
by Lin Lv, Juan Xia, Xinyu Zhu, Luxin Wang, Chen Lv, Yanyi Fu, Donghui Yu and Jinming Yu
Nutrients 2026, 18(17), 2838; https://doi.org/10.3390/nu18172838 - 28 Aug 2026
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Abstract
Background/Objectives: Whole-blood fatty acid composition provides an objective biomarker of fatty acid status, but its relationships with nutritional characteristics and subsequent quality-of-life (QoL) changes among cancer survivors remain incompletely understood. We aimed to identify whole-blood fatty acid phenotypes and examine their associations with [...] Read more.
Background/Objectives: Whole-blood fatty acid composition provides an objective biomarker of fatty acid status, but its relationships with nutritional characteristics and subsequent quality-of-life (QoL) changes among cancer survivors remain incompletely understood. We aimed to identify whole-blood fatty acid phenotypes and examine their associations with nutritional characteristics, cross-sectional QoL profiles, and subsequent QoL changes in an overlapping longitudinal subcohort. Methods: In this cohort study, the 2023 baseline investigation included 3175 community-dwelling adult cancer survivors with whole-blood fatty acid profiles and paired questionnaires. After excluding participants with substantial missing QoL data, implausible fatty acid measurements, or missing age, sex, or cancer type, 3009 participants comprised the baseline analytical sample. Among these, 423 overlapped with an independent longitudinal cohort contributing QoL data from June 2021 and June 2024, and 398 had complete covariate data for the core adjusted longitudinal analyses. Whole-blood fatty acid phenotypes were identified using principal component analysis and unsupervised clustering. Nutritional characteristics were assessed using habitual dietary intake, Diet Balance Index 2022 scores, and nutrition literacy measures. QoL was assessed using the EORTC QLQ-C30. Multivariable models examined cross-sectional QoL and annualised QoL changes. An open-source phenotype assignment tool was developed to support reproducible classification in future cohorts. Results: Among 3009 baseline participants (mean [SD] age, 64.9 [7.0] years; 2397 women [79.7%]), five whole-blood fatty acid phenotypes were identified. Phenotypes 2 and 3 were rarely observed in the available general-population reference sample and appeared enriched among survivors. Phenotype 2, a high-SFA/low-PUFA phenotype accompanied by higher red meat intake and greater DBI-22 excess scores for red meat and related animal foods, was associated with statistically significant worsening across multiple QoL domains over 12 months despite relatively favourable baseline QoL. Compared with the general-population-mapped reference pool (Phenotypes 1, 4, and 5), Phenotype 2 showed annualised declines in summary score (−4.66 [95% CI, −8.14 to −1.19]) and role functioning (−5.35 [−9.88 to −0.83]), and worsening pain (8.28 [2.58 to 13.98]), dyspnoea (6.83 [0.16 to 13.50]), and constipation (14.10 [7.30 to 20.90]). Prebaseline annualised QoL changes over the preceding 24 months did not differ significantly across phenotypes. Conclusions: Whole-blood fatty acid profiling identified distinct nutritional-metabolic phenotypes among community-dwelling cancer survivors. The high-SFA/low-PUFA phenotype, accompanied by higher red meat intake and greater DBI-22 excess scores for red meat and related animal foods, was associated with worsening across multiple QoL domains over the subsequent 12 months despite relatively favourable baseline QoL. These findings highlight whole-blood fatty acid phenotyping as a potentially informative framework for characterising nutritional-metabolic heterogeneity and subsequent QoL vulnerability among cancer survivors. The open-source phenotype assignment tool may facilitate reproducible phenotype assignment and external validation in future cohorts. Full article
(This article belongs to the Section Nutritional Epidemiology)
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18 pages, 438 KB  
Article
Fear of Cancer Recurrence and Associated Factors Among Women with Female Cancer: A Cross-Sectional Study
by Lovorka Brajković, Ivana Lozić, Dora Korać and Vanja Kopilaš
Healthcare 2026, 14(17), 2722; https://doi.org/10.3390/healthcare14172722 - 26 Aug 2026
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Abstract
Background/Objectives: The emotional impact of a cancer diagnosis may become particularly salient during survivorship, as survivors continue to face fears and concerns related to recurrence. Fear of cancer recurrence (FCR) is one of the most prevalent psychological challenges and significant unmet need [...] Read more.
Background/Objectives: The emotional impact of a cancer diagnosis may become particularly salient during survivorship, as survivors continue to face fears and concerns related to recurrence. Fear of cancer recurrence (FCR) is one of the most prevalent psychological challenges and significant unmet need among women with female cancer. The aim of this study was to assess the presence of FCR in predominantly breast cancer survivors, and to examine its relationship with certain demographic, clinical, and psychosocial factors. Methods: This cross-sectional study was conducted with a convenience sample of 120 women with a history of breast or gynecological cancer who were recruited over a two-month period through several cancer support associations across Croatia. Data were collected in person using a questionnaire comprising sociodemographic and clinical variables, as well as four self-reported instruments: the Fear of Cancer Recurrence Inventory–Short Form, Impact of Event Scale, Cancer Behavior Inventory–Brief Version, and Multidimensional Scale of Perceived Social Support. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient and hierarchical regression analysis. Results: In the final sample of 110 women, FCR levels were moderate, with 66.4% of participants reporting clinically significant levels. FCR was positively associated with chemotherapy (r = 0.22, p < 0.05), intrusive thoughts (r = 0.56, p < 0.01) and avoidance tendencies (r = 0.39, p < 0.01), and negatively associated with age (r = −0.26, p < 0.01) and self-efficacy for coping (r = −0.41, p < 0.01). In the final regression model, intrusive thoughts, coping self-efficacy, and chemotherapy were the only variables independently associated with fear of cancer recurrence. Conclusions: These findings indicate the presence of FCR in the period after primary treatment, particularly among breast cancer survivors, and highlight cognitive processing of cancer-related experiences and self-efficacy as potentially relevant areas for further research. Full article
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26 pages, 5103 KB  
Article
Mind–Body Intervention for Post-Surgical Breast Cancer Patients in Southern Italy: A Pilot Feasibility Study of Qigong on Patient-Reported Symptom Burden and Emotional Well-Being
by Graziella Marino, Eugenia Giglio, Martina Giuseffi, Giovanni Pace, Carlo Calabrese, Marzia Sichetti and Marisabel Mecca
Cancers 2026, 18(17), 2758; https://doi.org/10.3390/cancers18172758 - 25 Aug 2026
Viewed by 407
Abstract
Background: Post-surgical breast cancer (BC) survivors frequently experience clusters of persistent post-treatment physical and psychological symptoms, which can negatively affect their quality of life (QoL). Mind–body interventions such as Qigong may offer potential benefit, but evidence in oncology remains limited. Methods: We conducted [...] Read more.
Background: Post-surgical breast cancer (BC) survivors frequently experience clusters of persistent post-treatment physical and psychological symptoms, which can negatively affect their quality of life (QoL). Mind–body interventions such as Qigong may offer potential benefit, but evidence in oncology remains limited. Methods: We conducted a single-arm pilot feasibility study at the AMICO clinic (IRCCS-CROB, Southern Italy) to evaluate the feasibility, acceptability, safety, and exploratory pre–post symptoms associated with an 8-week Qigong programme in post-surgical BC patients. Fourteen women (aged 42–73 years; stage I–III) who reported symptom burden and emotional sensitivity attended weekly one-hour classes and were encouraged to practise at home. Feasibility outcomes included adherence, completion of post-intervention assessment, adverse events, and participant acceptability. Symptom severity was assessed at baseline and post-intervention using a 0–5 study-specific symptom questionnaire score. For the secondary descriptive prevalence analysis, scores ≥ 3 were classified as indicating moderate-to-severe symptom burden. Results: All 14 participants completed the post-intervention assessment, overall intervention adherence was 92%, and no adverse events were reported. In the secondary descriptive analysis, the prevalence of moderate-to-severe pain and mood changes decreased from 64.3% to 35.7%, fatigue from 57.1% to 28.6%, anxiety from 85.7% to 42.9%, and sleep disturbances from 35.7% to 14.3%. Hot flushes decreased from 64.3% to 42.9%. Despite the heterogeneity of individual symptom trajectories, most participants reported meaningful improvements in overall well-being. Conclusions: The 8-week programme was feasible, well tolerated, and acceptable in this small real-world cohort. Symptom burden decreased during the intervention period; however, because of the uncontrolled study design and small sample size, these changes cannot be attributed specifically to Qigong. Larger controlled studies are required to estimate treatment effects and identify potential moderators of response. Full article
(This article belongs to the Special Issue The 5th International Electronic Conference on Cancers (IECC 2026))
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