To explore the role of multi-sequence magnetic resonance imaging (MRI) images in preoperative prediction of lymph node metastasis in laryngeal squamous cell carcinoma (LSCC). Patients with LSCC undergoing open surgery and lymph node dissection were enrolled (n = 224 training, n = 96 testing). Radiomic features (n = 2394) were extracted from T1-enhanced and T2-weighted images. Features were screened using least absolute shrinkage and selection operator (LASSO) regression, and the best-performing classification model was identified among Logistic Regression, Random Forest, Extreme Gradient Boosting, and Light Gradient Boosting Machine. An imaging biomarker-based nomogram integrating radiomic and clinical features was developed via logistic regression. LASSO regression identified 14 stable features (6 from T1-enhanced images, 8 from T2-weighted). The Random Forest model showed the best radiomics-only performance (area under the receiver operating characteristic curve [AUC]: 0.877 training; 0.875 testing). The combined clinical - radiomics nomogram achieved higher discrimination (AUC: 0.942 training; 0.908 testing), outperforming standalone clinical or radiomic models. The radiomic-clinical nomogram enhances preoperative prediction of cervical lymph node metastasis in LSCC, offering the potential to optimize clinical decision-making.

Small cell lung cancer (SCLC) is an aggressive malignancy with limited treatment options. While surgery is increasingly considered for early-stage disease, its prognostic implications remain poorly characterized, and validated predictive tools are lacking. This retrospective study analyzed 7718 patients from the SEER database and 237 patients from Tianjin Medical University General Hospital. Clinical variables including surgical approach, TNM stage, and adjuvant therapies were evaluated. Prognostic factors were identified through Cox regression, and a nomogram was developed from SEER data with external validation in the independent cohort. Surgical resection was associated with improved survival in stage I-IIIA patients but showed no benefit in stage IIIB-IV disease. Multivariate analysis identified TNM stage, lobectomy (versus sublobar resection), and postoperative chemotherapy as independent prognostic factors. The nomogram demonstrated strong predictive performance, with 1-, 3-, and 5-year AUC values of 0.871/0.727/0.725 in the development cohort and 0.775/0.744/0.723 in the validation cohort. Our findings support surgical consideration for early-stage SCLC and provide a validated prognostic tool for clinical decision-making. The nomogram incorporating TNM stage, surgical extent, and adjuvant therapy effectively predicts survival outcomes, offering practical guidance for treatment planning.

Familial cancer test referral rates for rare tumors are suboptimal and follow a social gradient; while cancer registries are legally mandated to collect comprehensive clinical pathological data which could be used to inform clinical practice. We aimed to investigate consumer acceptability of and preferred approach for a cancer registry-driven familial cancer testing notification pathway. A qualitative study using semi-structured interviews informed by the Theoretical Framework of Acceptability was conducted. Nineteen individuals recently disclosed to the Victorian Cancer Registry diagnosed with a cancer meeting local familial cancer testing criteria were interviewed. Participants supported being notified directly by the cancer registry to inform them about familial cancer testing, as they welcomed using existing health data in new ways to optimize health care. Key considerations included the timing, tone, language, information provided in the registry communication, and minimizing the onus on the patient. Assuring data security and verifying the legitimacy of the registry were raised. Individuals diagnosed with cancer found the service model acceptable. Participants preferred either to action the findings independently, with supporting resources, or permit the cancer registry to directly inform treating clinicians. Ongoing and consumer-informed work is required to develop processes and resources including digital options.

Although immune checkpoint inhibitor (ICI) therapy for patients with extensive-stage small cell lung cancer (ES-SCLC) has shown promising results in clinical trials, it is not as widely used as for other cancers. Thus, investigating the association between ICI therapy and overall survival and treatment patterns of patients with ES-SCLC provides a new perspective regarding the introduction of ICI. This retrospective cohort study identified patients newly diagnosed with SCLC between January 2015 and January 2023 who received first-line treatment with etoposide from a nationwide database in Japan. Patients were divided into those who received ICI and conventional chemotherapy. Overall survival was assessed with a Cox proportional hazards model weighted by the inverse propensity score. The treatment patterns were visualized using a Sankey diagram. Of the 4537 patients, 2433 received conventional chemotherapy and 2104 received ICI therapy. The hazard ratio for mortality with ICI therapy was 0.892 (95% CI, 0.797-0.998). Less than half of the patients received ICI therapy as first-line treatment. Older patients tended to receive conventional chemotherapy. Compared with conventional chemotherapy, ICI therapy was associated with increased overall survival in patients with ES-SCLC. However, clinical implementation of ICI therapy was delayed, particularly in older patients.

To review how molecular preselection and combination treatment affects overall response rate (ORR) in pediatric non-central nervous system (CNS) solid tumors treated with tyrosine kinase inhibitors (TKIs). A systematic literature review was performed to identify studies reporting ORR (till July 2023). The review was non-registered and non-meta-analytic. 53 clinical studies involving 306 molecularly preselected patients (16 studies), 513 molecularly not preselected patients on TKI monotherapy (26 studies) and 350 molecularly not preselected patients on combination therapy (15 studies) met prespecified criteria for ORR analysis. According to the MINORS score, methodological quality was moderate to poor. Molecular preselection increased median ORR to TKI monotherapy from 0% [95% CI, 0%, 6%] to 36% [95% CI, 27%, 50%], (p = 0.001). Combination treatment increased median ORR from 0% [95% CI, 0%, 6%] to 14% [95% CI, 5%, 26%] in molecularly unselected population (p = 0.003). Comprehensive molecular characterization was absent, less than 20% of studies investigated molecular aberrations beyond the mechanism of action of tested TKI. Only few studies were terminated due to safety issues. Molecular background of tumors should be taken into account when using TKIs. The current molecular pre-selection criteria are insufficient and need to be improved.

The glucose-to-lymphocyte ratio (GLR) has recently gained attention as a composite biomarker reflecting systemic inflammation and metabolic dysregulation. While its prognostic value has been reported in various malignancies, its clinical utility in endometrial cancer remains unknown. This study aimed to evaluate the prognostic relevance of GLR in surgically treated patients with endometrial cancer. We retrospectively analyzed 165 patients who underwent total abdominal hysterectomy for endometrial cancer between January 2021 and January 2025. GLR was calculated by dividing fasting glucose levels by absolute lymphocyte count. Patients were classified into GLR-high and GLR-low groups using the median value (3.70). Disease-free survival (DFS) and overall survival (OS) were compared using Kaplan - Meier curves and Cox regression analysis. The median follow-up was 17.4 months. High GLR was independently associated with shorter DFS (HR: 2.05; 95% CI: 1.08-3.89; p = 0.029). A trend toward shorter OS was also noted (HR: 2.29; p = 0.056). Additional factors linked to poorer survival included absence of adjuvant radiotherapy, high tumor grade, and advanced stage. GLR is an independent prognostic factor for DFS in endometrial cancer and may serve as a readily available, cost-effective biomarker. Further prospective studies are needed for validation.