Search Results (3,618)

Background/Objectives: Minimally invasive approaches are increasingly used in right colectomy for colon cancer; however, comparative data, including open, laparoscopic, and robotic techniques, remain limited, particularly regarding postoperative recovery and oncological outcomes. Methods: This retrospective monocentric study included 89 patients undergoing elective right colectomy for colon cancer between July 2018 and December 2022. Of these, 30 patients underwent open, 29 laparoscopic, and 30 robotic-assisted surgery. The primary endpoint was postoperative recovery, defined as the time to first bowel movement. Secondary endpoints included length of hospital stay, complete mesocolic excision (CME) quality, lymph node yield, C-reactive protein (CRP) on postoperative day one, operative time, overall survival (OS), and disease-free survival (DFS). Multivariable regression analyses were performed adjusting for age, sex, BMI, ASA score, UICC stage, and tumor size. Results: Time to first bowel movement was shorter after minimally invasive surgery (median robotic 3.5, laparoscopic 4 vs. open 5 days) and length of hospital stay was numerically shorter (mean 9.1 vs. 10.1 days). CME quality and lymph node yield did not differ significantly between the approaches, and postoperative day-one CRP was numerically lower after robotic (median 4.9 mg/dL) and laparoscopic (5.1 mg/dL) than after open surgery (7.1 mg/dL), without reaching statistical significance after adjustment. Operative time was significantly longer with minimally invasive surgery (robotic +50 min; laparoscopic +43 min vs. open; both p < 0.001). Disease-free (open 51.6%, laparoscopic 66.5%, robotic 66.9%) and overall survival did not differ significantly after adjustment (robotic HR 1.16; laparoscopic HR 1.01 vs. open). Conclusions: No statistically significant difference in surgical quality between the approaches was detected, while operative time was significantly longer after minimally invasive surgery. No statistically significant independent association between the surgical approach and postoperative recovery or three-year oncological outcomes was detected; given the limited precision of the estimates, clinically important differences cannot be excluded. Full article

Objective: Subcostal uniportal robot-assisted thoracic surgery (URATS) using the da Vinci Single-Port (SP) system avoids intercostal placement of the main robotic access. This prespecified secondary analysis of a prospective trial characterized chronic postsurgical pain and health-related quality of life (HRQOL) as primary patient-reported outcomes after subcostal URATS for early-stage lung cancer, with mid-term oncological outcomes as an exploratory endpoint. Methods: Patients from the parent trial (NCT05535712) undergoing subcostal URATS were assessed at 3, 6, and 12 months by structured telephone interviews. Chronic postsurgical pain was defined by the ICD-11 criterion (Numerical Rating Scale [NRS] > 0 on any of four activity-specific items). Neuropathic features were assessed with the painDETECT Questionnaire (PDQ), and HRQOL with EORTC QLQ-C30 summary score and selected domains. Results: In 33 patients, chronic postsurgical pain declined from 33.3% at 3 months to 6.1% at 12 months (p = 0.004), was mild among symptomatic patients (median NRS 1), and showed no PDQ-defined neuropathic features. Two patients received a 7-day course of gabapentin at 3 months. Baseline HRQOL (median QLQ-C30 summary score 91.5) increased at all postoperative time points (p < 0.001). At a median 40-month follow-up, one patient had bilateral pulmonary recurrence at 13 months, all remained alive, and no delayed hernia or other access-related complication was identified. Conclusions: Subcostal URATS was feasible in this prospective cohort. Chronic postsurgical pain was mild and decreased over time, HRQOL remained well preserved, although data on mid-term oncological outcomes were preliminary. Full article

Background: Persistent human papillomavirus (HPV) can cause low- or high-grade cervical lesions, which may progress to cervical cancer. This prospective, multicenter, real-world study assessed the effectiveness, tolerability and safety of a Coriolus versicolor-based vaginal gel for the regression of HPV-related low-grade cervical lesions in routine Greek practice. Methods: PAPILOBS-GR is a multicenter, open-label, non-interventional, prospective observational, non-comparative study conducted across 45 sites in Greece. Women aged ≥18 years with ASCUS/LSIL cytology and concordant colposcopy were enrolled. Participants received Coriolus versicolor-based vaginal gel for six months. A second 6-month cycle was offered if needed. The primary endpoint was lesion regression. Secondary endpoints included HPV clearance, patient satisfaction, biopsy evolution, tolerability, and safety. Results: Of 524 enrolled patients (mean age: 34.4 ± 10.0 years; 40.5% HR-HPV), 494 (94.3%) completed the study. Overall, 75.9% achieved lesion regression (72.1% at 6 months and 34.0% at 12 months). HPV clearance occurred in 72.0% overall (68.1% at 6 months and 50.0% at 12 months). Exploratory comparisons showed generally consistent effectiveness across subgroups, including women with HR-HPV, those aged >40 years, and vaccinated participants. No significant differences in clinical endpoints were observed in association with age or vaccination status. Among 22 patients with baseline and 12-month biopsies, 59.1% showed histological improvement. Satisfaction scores exceeded 8/10 at 6- and 12-month follow-ups. Only two non-serious possibly product-related adverse events were reported. Conclusions: Coriolus versicolor-based vaginal gel was associated with high rates of lesion regression and excellent tolerability, reinforcing previous clinical findings and supporting its potential role as an adjunctive approach during watchful waiting for HPV-positive low-grade cervical lesions. Full article

Background/Objectives: Vacuum-assisted breast biopsy (VABB) is widely used for the diagnosis of nonpalpable breast cancer but is not considered definitive treatment because microscopic residual disease may persist within or around the biopsy cavity. The ARTHE phase I trial evaluated a cavity-targeted radionuclide strategy based on same-session sequential intralesional administration of avidin followed by [⁹⁰Y]Y-DOTA-biotin after VABB. Methods: Eighteen women with nonpalpable breast cancer measuring ≤15 mm and a skin-to-cavity distance ≥ 13 mm were treated in three sequential activity-escalation cohorts. The primary objective was to assess acute local and systemic safety, including dose-limiting toxicity. The protocol-specified co-primary objective was to evaluate preliminary antitumor activity, assessed as breast-only pathologic complete response (pCR) at surgery. Given the phase I single-arm design, pCR was analyzed descriptively. The protocol-specified secondary objective was patient-specific dosimetry. Additional exploratory assessments included post-injection biodistribution and integration with subsequent breast-conserving surgery. Results: No dose-limiting toxicities, grade ≥ 3 adverse events, clinically relevant hematologic toxicity, treatment discontinuations, hospitalizations, or treatment-related surgical delays were observed. Local toxicity was limited to grade 1 injection-site pain and/or erythema. Post-injection imaging consistently demonstrated focal intralesional localization without clinically relevant extra-lesional uptake. All patients underwent breast-conserving surgery 4–7 weeks after treatment. No residual tumor cellularity (RTC), from either invasive or in situ carcinoma, was identified in the breast surgical specimen in 5/18 patients (27.8%). However, because diagnostic VABB may have removed part or all of the malignant lesion, the absence of residual carcinoma at surgery cannot be attributed specifically to the radionuclide treatment. Conclusions: The intralesional avidin-mediated local trapping strategy using [⁹⁰Y]Y-DOTA-biotin after VABB was feasible, showed favorable acute and short-term tolerability, was associated with early focal localization on post-injection imaging, and was compatible with standard breast-conserving surgery. Controlled studies are warranted to determine the therapeutic contribution of this post-biopsy cavity-targeted strategy, optimize administered activity, and refine patient selection. Full article

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

Background: Gastroesophageal adenocarcinoma is predominantly a disease of older adults. However, older adults are underrepresented in randomised controlled trials (RCTs), and outcomes specific to this subgroup are underreported. Clinicians therefore extrapolate data from younger, fitter trial populations, which can lead to over- and undertreatment of older cancer patients. This study examines the inclusion and completeness of outcome reporting for older patients in practice-changing trials in gastroesophageal cancer. Methods: RCTs were identified from United States Food and Drug Administration (accelerated) approvals between 2010 and 2024. The primary study report, clinicaltrial.gov repository and all relevant secondary publications were assessed for the level of reporting of outcomes. Efficacy outcomes were reported as complete, partial, qualitative or quantitative based on availability of sample size, effect size and measures of precision. Baseline characteristics, toxicity outcomes and health-related quality of life (HRQOL) outcomes were assessed using minimum data thresholds. Results: In total, 13 trials, 53 publications and 13 repository webpages were assessed. A total of 9320 patients were included, of which 40.1% were classified as older adults. Among the patients, 42.2% had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) of 0, with all but one trial excluding patients with an ECOG PS of 2 (n = 63). Baseline characteristics and toxicity outcomes for older adults were fully reported in only two trials (15.4%). Reporting of HRQOL outcomes (25.0%), secondary (20.0%) and primary endpoints (66.7%) was more complete. Overall survival (76.9%) and progression-free survival (67.0%) were the most commonly reported primary or secondary endpoints. Conclusions: This study highlights deficits in the outcome reporting of older cancer patients in GOA trials. Simultaneously, this subgroup also remains heavily underrepresented in GOA trials compared to the real-world patient population. These findings highlight the need for improvements in both trial design and outcome reporting standards for older adults. Full article

Background: Right-sided metastatic colon cancer represents a clinically distinct subgroup with inferior outcomes and uncertain optimal biologic treatment selection, even among patients with RAS wild-type disease. Real-world data focusing specifically on right-sided RAS wild-type metastatic colon cancer remain limited. This study aimed to describe clinicopathologic characteristics, metastatic patterns, treatment approaches, and survival outcomes in this population using a national multicenter registry. Methods: This retrospective multicenter cohort study was conducted using data from the ONKO-KOLON Türkiye registry. Patients with pathologically confirmed KRAS/NRAS wild-type metastatic colorectal cancer and available primary tumor localization were evaluated. The main analytic cohort included patients with right-sided metastatic colon cancer, defined as right colon or transverse colon tumors. Left-sided colon cancer patients were used as a contextual comparator, while rectal cancer patients were excluded from sidedness-based colon comparisons. Survival outcomes were estimated using the Kaplan–Meier method, and prognostic factors were evaluated using Cox regression analyses. Results: Among 1079 patients in the source cohort, primary tumor localization was available in 1065 patients. Of these, 213 had right-sided colon cancer, 464 had left-sided colon cancer, and 388 had rectal cancer. In the right-sided cohort, median age was 61.5 years, 64.3% were male, and 66.7% had synchronous/de novo metastatic disease. Liver metastasis was the most common metastatic site (63.4%), followed by lymph node (31.0%), lung (21.1%), and peritoneal metastases (15.5%). First-line anti-VEGF-based treatment was used in 46.0% of patients, while anti-EGFR-based treatment was used in 40.8%. Among evaluable patients, the objective response rate was 46.8% and the disease control rate was 79.2%. Median progression-free survival was 10.0 months, and median overall survival was 24.0 months. In unadjusted exploratory analysis, median OS was 27.0 months with anti-EGFR-based treatment and 17.0 months with anti-VEGF-based treatment (log-rank p = 0.022), whereas median PFS was 10.0 months in both groups. In an extended covariate-adjusted multiple-imputation sensitivity model, the anti-EGFR OS estimate did not meet statistical significance (adjusted HR 0.66, 95% CI 0.43–1.00; p = 0.051). In a secondary contextual comparison, median overall survival was shorter in the right-sided than in the left-sided colon cancer group (24.0 vs. 28.0 months; HR 1.47, 95% CI 1.19–1.82; p < 0.001), whereas progression-free survival did not differ significantly. Conclusions: This study provides a descriptive account of metastatic patterns, treatment approaches, and outcomes in a dedicated right-sided RAS wild-type metastatic colon cancer cohort. The unadjusted OS difference between biological treatment groups was not confirmed after measured covariate adjustment and should not be interpreted as evidence of comparative treatment effectiveness. Because molecular profiling was incomplete, this study cannot identify biomarker-defined treatment subgroups. Prospective studies with complete, predefined molecular characterization are needed before molecularly informed treatment selection hypotheses can be evaluated in this population. Full article

Background/Objectives: Exercise medicine is gaining significant importance in adult oncology to improve physical activity and quality of life (QoL). However, few studies have investigated the effects of adapted physical activities in the pediatric population. The aim of this secondary analysis is to compare the movement quality of a hematological/oncological pediatric population before and after an individualized exercise program (IEP). Methods: Participants who met the inclusion criteria (aged 5–18 years, oncological/hematological diagnosis, consent) underwent an IEP delivered both in the hospital and via telemedicine at home. The subject’s movement quality was assessed before and after six months of the IEP using instrumented functional tests (i.e., 6 min walking test, Timed Up and Go, T25-FW, and turning test). To reduce the number of variables obtained, principal component analysis (PCA) was performed, and the resulting scores were then compared. Results: A total of 18 subjects (median age 12 years; eight females) were included in the analysis. Through the PCA, four dimensions were identified: Gait Efficiency, Gait Quality, Dynamic Balance, and Functional Abilities. The pre–post comparison showed significant improvements (p = 0.002) in Dynamic Balance and a trend (p = 0.05) in Gait Efficiency. Conclusions: The presented results indicate the crucial Principal Components (PCs) of movement in children treated for cancer. Moreover, in our setting, under the IEP we observed a significant improvement in Dynamic Balance. The results are consistent with those observed in previous studies. However, the limited number of subjects and the study design preclude definitive conclusions. Full article

Background: Paclitaxel is a cornerstone chemotherapeutic agent widely used in breast cancer treatment, primarily through the stabilization of microtubule dynamics. Beyond its canonical tubulin-targeting activity, increasing evidence suggests that paclitaxel may engage additional molecular targets, contributing to its complex pharmacological profile. In this study, an integrated computational workflow was applied to evaluate the structural compatibility between paclitaxel and the neurokinin-2 receptor (NK2R), a G protein-coupled receptor involved in tumor-associated inflammatory and proliferative signaling pathways. Physicochemical profiling and target prediction were performed using SwissADME and SwissTargetPrediction, followed by molecular docking and molecular dynamics simulations using AutoDock Vina and GROMACS 2024.1. Paclitaxel exhibited physicochemical properties consistent with transient interactions in hydrophobic transmembrane environments. Docking analysis identified a plausible binding mode within the NK2R transmembrane cavity, primarily stabilized by hydrophobic contacts. Molecular dynamics simulations over 100 ns revealed stable ligand occupancy and overall complex stability, while MM-PBSA calculations indicated a favorable transient association. The predicted interaction is consistent with secondary or non-canonical receptor engagement. While NK2R is not established as a pharmacological target of paclitaxel, the results support the structural feasibility of a previously uncharacterized receptor interaction and provide a reproducible computational framework for exploring GPCR-associated effects of cytotoxic agents. Full article

Background: This study evaluated temporal changes in stage distribution, registry-recorded primary-site surgery, survival outcomes, and exploratory short-term mortality prediction among patients with early-onset testicular germ cell tumors, defined in this study as tumors diagnosed in patients aged 15–49 years, across the study periods. Materials and Methods: This retrospective cohort study used Incidence-SEER Research Data, 17 Registries, November 2025 Submission. Male patients aged 15–49 years diagnosed with malignant testicular germ cell tumors between 2018 and 2023 were included. Diagnosis periods were categorized as the pre-COVID-19 period (2018–2019), COVID-19 period (2020–2021), and 2022–2023 period. Logistic Regression was used to assess factors associated with regional or distant-stage disease. Overall survival was evaluated using Cox regression, while testicular cancer-specific death was additionally evaluated using Aalen–Johansen cumulative incidence estimates and Fine–Gray competing-risk regression. Follow-up was also restricted to 12 months in sensitivity analyses. Machine learning models were developed as an exploratory secondary analysis of 12-month all-cause mortality. Results: A total of 13,303 patients were included. Among patients with known stage, regional or distant-stage disease increased from 31.2% before the pandemic to 33.5% during the COVID-19 period and 34.4% during the 2022–2023 period. In adjusted analysis, COVID-19 (OR = 1.11, 95% CI: 1.02–1.22) and diagnoses during the 2022–2023 period (OR = 1.16, 95% CI: 1.06–1.28) were associated with higher odds of regional or distant-stage disease. In full follow-up analyses, diagnosis during the 2022–2023 period was associated with higher all-cause mortality (HR = 1.29, 95% CI: 1.01–1.65) and testicular cancer-specific death in both cause-specific Cox (HR = 1.49, 95% CI: 1.12–2.00) and Fine–Gray models (sHR = 1.45, 95% CI: 1.09–1.93). In 12-month analyses, the overall survival association was attenuated, whereas the association with testicular cancer-specific death remained significant in the Fine–Gray model (sHR = 1.46, 95% CI: 1.03–2.07). Conclusions: Early-onset testicular germ cell tumors diagnosed during the COVID-19 period and in 2022–2023 showed a modest shift toward regional or distant-stage presentation, while diagnosis in 2022–2023 was associated with higher testicular cancer-specific mortality in competing-risk analyses. Full article

Background and Objectives: Radical cystectomy (RC) is standard treatment for muscle-invasive bladder cancer, but the role of gynecologic organ preservation in women remains uncertain. We primarily evaluated the prevalence and predictors of pathological gynecologic organ involvement and secondarily assessed survival and developed a prediction model. Materials and Methods: This multicenter retrospective study included 232 women undergoing RC at 13 tertiary centers. Of the 232 women, 182 had clinical T2 disease and 50 had BCG-unresponsive or very-high-risk Ta/T1 non-muscle-invasive bladder cancer. Overall survival (OS) was the primary endpoint; CSS and RFS were secondary outcomes. Multivariable logistic regression was used to identify predictors and develop preoperative prediction models. Results: Pathological gynecologic organ involvement was identified in 26 patients (11.2%): uterine in 15 (6.5%), vaginal in 11 (4.7%), ovarian in five (2.2%), and adnexal in 21 (9.1%). The median OS was shorter in patients with involvement than in those without (19.0 vs. 48.0 months; p = 0.048). Vaginal and ovarian involvement were associated with shorter OS (both p < 0.001), whereas uterine and adnexal involvement were not. Pathological T stage was associated with organ involvement (p = 0.001), with the highest frequency in pT4 disease. Model 2 showed an AUC of 0.898 and an optimism-corrected AUC of 0.872. A risk score of 0 classified 31.0% as low risk, with an NPV of 97.2% and a sensitivity of 92.3%. Conclusions: Pathological gynecologic organ involvement was uncommon but associated with poorer survival. These findings may support preoperative risk stratification, although the oncologic safety of organ-preserving surgery cannot be established from pathological involvement data alone. Full article

Objectives: The aim of this study was to evaluate the reliability, accuracy, and morbidity of dynamic sentinel lymph node biopsy (DSNB) in patients with intermediate- and high-risk penile cancer who had clinically negative lymph nodes, with a focus on long-term follow-up outcomes. Methods: Between January 2005 and January 2024, 287 patients with histologically confirmed penile cancer underwent radioisotope-guided DSNB at the Department of Urology, University of Pécs. Patients lost to follow-up within 24 months were excluded. Of the remaining patients, 211 underwent primary DSNB and 37 secondary DSNB. Thirty-nine patients in the primary DSNB group with Tis, T1a, or G1 tumours were additionally excluded, leaving 209 patients for analysis. Variables included tumour stage and grade, sentinel lymph node (SLN) yield and histology, complications, inguinal progression, false-negative rate, and radical lymphadenectomy findings. Results: A total of 573 SLNs were removed from 209 patients, with a median of 2.7 nodes per patient. SLN metastases were identified in 31 patients, involving 37 groins. Among 178 patients with negative SLNs, three developed inguinal metastases. Sensitivity was 91% per patient and 92.5% per groin, with false-negative rates of 8% and 7.5%, respectively. All false-negative cases occurred within two years, with no later inguinal recurrences. DSNB-related complications occurred in 24 patients (11.4%); most were mild or moderate and managed on an outpatient basis. Two patients required surgery and one required hospital readmission. Conclusions: In a high-volume centre, DSNB is a safe and reliable staging procedure with low morbidity in clinically node-negative intermediate- and high-risk penile cancer. Further studies should assess radiotracer injection sites and compare one-day versus two-day protocols. Full article

Background/Objectives: Colonoscopy is the standard examination for many symptomatic patients referred for lower-gastrointestinal investigation, but it is resource-intensive and may be a burdensome experience. Colon capsule endoscopy (CCE) offers a minimally invasive, sedation-free first-line examination, although clinically important findings, inadequate cleansing or incomplete transit can generate downstream colonoscopy. DanCap aims to compare the costs and clinical consequences of a CCE-first pathway with routine conventional colonoscopy (CC). Methods: DanCap is a single-centre, cluster-allocated crossover trial at Odense University Hospital, Denmark. General practice clinics follow CCE or CC according to the parity of their pre-existing provider number, with pathways crossing after 200 consecutive CCE participants; no trial-generated random allocation sequence is used. Eight hundred symptomatic adults aged >18 years referred for expedited lower-gastrointestinal investigation are planned. CCE participants with suspected cancer, any polyp ≥6 mm, inadequate cleansing or an incomplete examination are referred for colonoscopy. The primary outcome is pathway cost. Registered secondary outcomes and prespecified process measures include polyp and colorectalcancer detection, examination quality, reinvestigation and patient-reported consequences. FIT and microbiome are registered secondary outcomes; participation in the substudy is optional and the analyses are exploratory within the CCEpathway. Primary analyses will follow the assigned pathway and account for GP clinic clustering, period and allocation sequence. Expected Results: The trial will quantify the resource use and clinical consequences of implementing CCE in routine symptomatic practice. Conclusions: DanCap is intended to inform decisions about CCE pathway implementation rather than to establish unbiased whole-cohort test sensitivity or specificity. Trial registration: ClinicalTrials.gov NCT06475560; first submitted 20 June 2024 and first posted 26 June 2024. Recruitment began on 27 November 2024; the registry listed the study as recruiting when last updated on 19 March 2026. Full article

Background/Objectives: In Germany, women have direct access to gynaecologists without GP referral, making the GP’s role in female-specific conditions largely secondary. It has not previously been examined whether the sex of the GP is nonetheless associated with the documented prevalence of these conditions in primary care records. Methods: This retrospective cross-sectional study used data from the IQVIA™ Disease Analyzer. All women aged ≥18 years with at least one visit to one of 1183 GPs in Germany in 2025 were included. Women attending female and male GPs were matched 1:1 by propensity score on age, statutory health insurance, practice size, consultation frequency in 2025, and the van Walraven comorbidity score (excluding malignancy), yielding 661,485 women per group. Associations between GP sex and the documented prevalence of eight female-specific conditions were examined using conditional logistic regression within the age strata clinically relevant to each condition (from 18–30 to >75 years), with the age × GP-sex interaction tested in a single model per condition and E-values calculated to assess robustness to unmeasured confounding. Results: The association between GP sex and documented prevalence was strongly age-dependent, with a significant age × GP-sex interaction for seven of eight conditions (all p < 0.001). Female GP sex was associated with higher documented prevalence in mid-life, including menopausal and perimenopausal disorders (46–60 years: OR 1.37, 95% CI 1.28–1.46), endometriosis (31–45 years: OR 1.15, 1.03–1.28) and benign neoplasm of the female breast and genital organs (46–60 years: OR 1.16, 1.04–1.29); in the oldest women, the pattern attenuated or reversed (menopausal disorders > 75 years: OR 0.81, 0.72–0.90). No association was observed for breast cancer or female genital organ cancer at any age. Conclusions: In German primary care, the association between GP sex and the documented prevalence of female-specific disorders is age-dependent—most pronounced for conditions that require active clinical recognition and patient disclosure in mid-life, and absent for specialist-managed malignancies. Full article

Background/Objectives: Histopathology-correlated evidence for preoperative magnetic resonance imaging (MRI) in penile cancer remains limited. We evaluated multiparametric MRI with artificially induced erection for local and nodal staging in surgically treated penile cancer. Methods: This prospective, single-centre diagnostic accuracy study included consecutive patients who underwent preoperative multiparametric MRI between 2017 and 2024, with postoperative histopathology as the reference standard. The primary endpoint was binary local T-staging (≤T1 vs. ≥T2). Secondary endpoints were three-category T-staging (≤T1/T2/≥T3) and binary nodal staging (N0 vs. N+) in patients with pathological nodal verification. Two radiologists independently reassessed all 38 examinations in a post hoc reproducibility analysis. Results: Thirty-eight patients were included; all tumours were glans-based and treated with organ-sparing surgery. Binary local staging showed 68.4% accuracy (95% CI, 52.5–80.9%), 88.2% sensitivity, 52.4% specificity, 60.0% positive predictive value, 84.6% negative predictive value, and balanced accuracy of 0.703 (95% CI, 0.568–0.838). Overstaging predominated (10 false-positive vs. 2 false-negative classifications; p = 0.043). Three-category exact agreement was 52.6% (κ = 0.257). In the pathologically verified nodal subset (n = 30), accuracy was 83.3% (95% CI, 66.4–92.7%), sensitivity 78.6%, specificity 87.5%, and balanced accuracy 0.830 (95% CI, 0.691–0.970). Inter-reader agreement was 92.1% for binary T staging (κ = 0.837) and 97.4% for binary N staging (κ = 0.943). Conclusions: mpMRI was sensitive but insufficiently specific for ≥T2 disease and should not independently trigger treatment escalation. Nodal performance was encouraging but arose from a guideline-selected verified subset. These findings apply primarily to glans-based, organ-preserving cohorts and do not establish an incremental benefit of erection induction. Full article