Cm In Size Research Articles

Nonvisualized Ovaries on Ultrasound: Correlation With Surgical Pathology.

The risk of malignancy in nonvisualized ovaries on pelvic ultrasound is presumed to be close to zero per imaging correlation; the goal of this manuscript is to define the risk of malignancy in nonvisualized ovaries on pelvic ultrasound as defined by surgical pathology. Records for patients with pelvic ultrasound and surgical pathology containing the word "ovary" or "ovaries" performed at our institution between 10/1/2015 and 9/30/2021 were reviewed. Data for ovarian visualization were extracted from the radiology report and correlated with surgical pathology results within each ovary. Eighty-seven ovaries in 71 patients out of 422 ovaries (20.6%) in 215 eligible patients were not visualized on ultrasound. Twenty ovaries were excluded because imaging showed large pelvic mass, and 19 ovaries were excluded because surgical pathology for the ovary of interest was not available. A total of 48 ovaries in 37 patients were nonvisualized and had available surgical pathology. Out of 48 nonvisualized ovaries, 31 were normal on surgical pathology and 17 had abnormalities, with 15 benign lesions (12 of which were ≤1 cm in size). Two ovaries in 1 patient contained malignant lesions; although the ovaries were not visualized on ultrasound, the scan demonstrated peritoneal carcinomatosis. In conclusion, a high proportion of ovaries (20.6%, 87/422) are not visualized on pelvic ultrasound, and surgical pathology reveals ovarian lesions in 35.4% (17/48) of nonvisualized ovaries on pelvic ultrasound, with the majority being subcentimeter benign lesions. In the absence of peritoneal carcinomatosis, nonvisualized ovaries had no malignant lesions.

Radial Sclerosing Lesion (Radial Scar): Radiologic-Pathologic Correlation.

Radial sclerosing lesions (RS, also referred to as "radial scars") and complex sclerosing lesions (CSL) are uncommon breast lesions often grouped together as a single entity in practice. RS/CSL have an incidence of <0.1% to 1% at core needle biopsy (CNB). When detected on CNB, imaging and pathology features must be carefully evaluated to determine appropriate surgical management or imaging follow-up due to potential for malignant upgrade at surgery. Detection of RS/CSL has increased with the advent of tomosynthesis, in which an RS/CSL is typically detected as architectural distortion with or without associated mass with spiculated margins. On US, an RS/CSL is most often occult or manifests as subtle distortion with adjacent cysts. Imaging findings cannot distinguish benign RS/CSL from those upgraded to malignancy at surgery, although larger lesion size may be associated with higher upgrade rates. Histologically, an RS has a central fibroelastotic nidus with entrapped-appearing ducts and proliferative changes at the periphery appearing to radiate from the center; CSL are larger than RS, more disorganized, and typically include multiple patterns of epithelial proliferations, including sclerosing adenosis, sclerosing papillomas, usual ductal hyperplasia, and cysts. RS/CSL with associated atypia at CNB have a 16%to 29% rate of upgrade to malignancy on surgical excision, thus rendering surgical excision essential. Conversely, an RS/CSL without associated atypia, particularly when ≤1 cm in size, has <3% rate of upgrade to malignancy at surgery, allowing consideration of imaging follow-up in lieu of excision. Here, we review recent literature as well as radiology and pathology findings of RS/CSL.

Pertumbuhan Ikan Komet (Carassius auratus) pada Sistem Vertiqua dengan Menggunakan Biofikal Filter

The growth of comet fish (Carassius auratus) in the vertiqua system using a biofical filter is motivated by limited land and water which can cause low water quality to affect the growth rate of fish. The utilization of technology needs to be done to overcome these problems and the technology used is vertiqua. Previous research showed that comet fish in the vertiqua system produced slow growth rates and had high ammonia levels. Therefore, vertiqua was modified in the filter section to become a biofical filter. The purpose of this research is to test the effectiveness of comet fish growth in the vertiqua system using a biofical filter. The benefits of this research are that the vertiqua system using a biofical filter can be a solution to overcome the problem of limited land and water, become a support for system cultivation innovation, and become a reference for further research. This research method uses descriptive methods, observation and interviews. The comet fish used in the study were 3-4 cm in size. The results of this study indicate that the vertiqua system using a biofical filter is still not effective in supporting fish growth. The growth rate of comet fish in the vertiqua system is significantly different from that in the soil pond and the growth rate of comet fish in the vertiqua system is lower than that of comet fish in the soil pond. Ammonia value is relatively high from the quality standard (&gt;0.05). However, this system is able to maintain good fish survival and good water quality, especially in temperature, pH, and DO.

Epidemiologic trends in cutaneous squamous cell carcinoma from 2011 to 2021 at All Africa Leprosy, Tuberculosis, and Rehabilitation Training Center (ALERT) in Addis Ababa, Ethiopia

Cutaneous squamous cell carcinoma (cSCC) is the most common keratinocyte carcinoma in dark-skinned ethnic groups. Available studies are primarily focused on white populations, with fewer data available for black Africans, including Ethiopians. Therefore, less priority may be given to treatment and prevention in this population. To determine the prevalence and risk factors of cSCC among patients presenting to All Africa Leprosy, Tuberculosis, and Rehabilitation Training Center , Addis Ababa, Ethiopia. A literature review was performed to determine existing knowledge. A retrospective descriptive cross-sectional study was then conducted based on stored data of confirmed cases of cSCC from 2011 to 2021 at ALERT. Demographics, other parameters related to cSCC (size, anatomic location, degree of differentiation, metastasis, and recurrence), and potential risk factors including scars, burns, HIV status, xeroderma pigmentosum, and leprosy were collected and entered on a prepared data extraction sheet and analyzed using SPSS version 25 manufactured by IBM. Among 15,075 total pathologic samples reviewed, 3.8% (n=570) were reported histopathologically as invasive cSCC (n=437), keratoacanthoma, or (squamous cell carcinoma in-situ (Bowen disease). 50.3% (n=287) occurred in female, and the mean age of affected patients was 50.1years (SD 17.2). Nearly 70% were reported after >1year of symptoms, including morphologic change, ulceration, and nonhealing wound. HIV status was not universally screened but was positive in 9.8% (46/437). Cases were commonly found to occur on the lower extremities (X2=2.7196, Pr=0.099) and >4cm in size (46.3%). Among 274 cases with adequate histologic description, 82.5% (n=226) were well-differentiated. Loco-regional metastases comprised 6.0% (n=34) and 46.7% (n=266) had ulceration. The biologic significance of ulceration in this population is unclear. Ulceration may indicate chronic wounds or Marjolin's ulcers. High rates of metastasis call for a better understanding of risk factors, preventive measures, and early diagnosis. This model of research may serve as a foundation for future nationwide investigations through the Federal Ministry of Health of Ethiopia's Disease Prevention and Control Directorate.

Correlation Between the Number of Pathological Risk Factors and Postoperative Prognosis in Patients with Stage I Lung Adenocarcinoma.

Although visceral pleural invasion, lymphovascular invasion, tumor spread through air spaces, and poor differentiation are pathological risk factors associated with unfavorable prognosis in patients with lung adenocarcinoma, the cumulative impact of these factors on prognosis remains unclear. We enrolled 1532 patients with stage I lung adenocarcinoma. Patients were divided according to the number of risk factors as follows: Group A (without risk factors), Group B (one risk factor), and Group C (multiple risk factors). Moreover, we stratified patients into two subgroups based on tumor size (≤ 3cm, 3-4cm). Kaplan-Meier analysis was used to evaluate 5-year disease-free survival (DFS) and overall survival (OS). Overall, 949, 404, and 179 patients were included in Groups A, B, and C, respectively. Group C had a larger tumor size and more cases of extrathoracic recurrence than the other groups. The 5-year DFS and OS gradually decreased across Groups A to C (DFS: 94.3%, 80.6%, and 64.3%, respectively, p < 0.001; OS: 97.2%, 92.7%, and 77%, respectively, p < 0.001). A similar trend was observed for tumors ≤ 3cm in size (DFS: 95.2%, 83.2%, and 68.5%, respectively, p < 0.001; OS: 97.6%, 94.1%, and 79.6%, respectively, p < 0.001), but a less pronounced trend was observed for tumors between 3 and 4 cm in size (DFS: 72.1, 60.8, and 43.3%, respectively, p = 0.054; OS: 85.7, 82.1, and 64.7%, respectively, p = 0.16). Postoperative survival worsened with increasing pathological risk factors in patients with stage I lung adenocarcinoma, especially those with tumor size ≤ 3cm.

Papillary microcarcinoma of the thyroid gland: Evaluation of TERT and BRAFV-600E expression and their relationship with clinicopathological findings

Papillary microcarcinomas (PMCs) are papillary carcinomas ≤1 cm in size, with an increasing incidence. Although generally indolent, some cases exhibit aggressive behavior. Recently, active surveillance has been recommended to avoid surgical treatment. Identifying molecular changes that predict aggressiveness in PMCs has gained importance, but studies are limited. We aimed to demonstrate TERT expression and BRAF V600E positivity immunohistochemically in PMCs and correlate them with histomorphological features, subtypes, and clinicopathological findings. We included 95 PMC cases diagnosed between 2010 and 2019 at the Department of Pathology, Faculty of Medicine, XXX University. We investigated TERT expression using RT-PCR. We evaluated BRAF V600E mutation immunohistochemically. We evaluated the relationship between genetic, histomorphological, and clinicopathological findings. In patients with multifocality and those with a tumor size ≥0.5 cm, the frequency of lymph node metastasis was significantly higher. A positive correlation was shown between BRAF V600E positivity and lymph node metastasis, lymphovascular invasion, advanced disease stage, and classical subtype by univariate analyses. We detected TERT expression in 18 of 95 patients (7.8 %). No relationship could be detected between TERT expression alone or combined with BRAF positivity and clinicopathological features. Although TERT mutations are associated with aggressiveness in thyroid cancers, this association was absent in PMCs. The presence of TERT expression was demonstrated in some cases. However, TERT expression could not be associated with clinicopathological findings, which is consistent with the literature suggesting that TERT plays a role in advanced stages of carcinogenesis.

Single-Incision Retroperitoneal Laparoscopic Resection of Adrenal Tumors in Children

BackgroundWe describe our experience with single-incision retroperitoneal laparoscopic (SIRL) for resection of adrenal tumors in pediatric patients and discuss the technique's clinical value. MethodsWe retrospectively analyzed clinical data of 27 pediatric patients who underwent SIRL between January 2020 and September 2023. Patients with tumors >5 cm in size and those requiring vascular skeletonization surgery or extensive lymph node dissection were excluded. Demographic, perioperative, and prognostic data were collected, and computed tomography (CT) and magnetic resonance imaging were used for preoperative tumor assessment. ResultsOf 27 patients, 16 were male and 11 were female; mean age 54 ± 45 months and mean body mass index 17.2 ± 3.6 kg/m2. Mean tumor length, width, and height were 4.1 ± 1.8 cm, 3.3 ± 2.1 cm, and 2.9 ± 1.7 cm, respectively. One patient experienced a diaphragmatic tear, three patients incurred peritoneal damage, and one patient developed postoperative renal artery injury, leading to thrombosis and renal atrophy. No surgery was converted to open surgery, and no intraoperative or postoperative blood transfusions were required. Operative time, blood loss, and postoperative dietary recovery time were satisfactory. No local recurrence or distant metastases were detected during the 6–48 months of follow-up involving outpatient and telephone assessments. ConclusionsApplication of SIRL in pediatric patients with adrenal tumors achieved favorable clinical outcomes with an effective, minimally invasive surgical option for treating children with adrenal tumors. This technique demands a high level of surgical expertise, specialized instruments and experienced surgeons. Our findings indicate that SIRL is safe and provides significant postoperative benefits in pediatric patients. Level of EvidenceLevel IV.

Swollen speech: a case study of tongue abscess detected via imaging technology

BackgroundA tongue abscess is a rare but serious condition marked by a localized accumulation of pus within the tongue’s tissues. Despite the tongue’s frequent exposure to trauma, bites, and foreign objects, it typically resists infections. However, an acute lingual abscess can be life-threatening due to the risk of airway obstruction from tongue swelling. Common symptoms include increasing pain, fever, swelling, immobility, edema, and redness of the tongue. The case report aimed to highlight the unusual clinical presentation and location of a deep-seated abscess in the anterior third of the tongue, as well as the radiographic approach to diagnosing the lesion.Case presentationA 30-year-old female patient presented with sudden onset tongue pain and swelling persisting for 4–5 days. Clinical examination revealed a solitary diffuse swelling in the anterior two-thirds of the tongue, approximately 3 × 2 cm in size. Diagnostic imaging, including a plain radiograph, ultrasound (USG), and MRI, was conducted. The patient was hospitalized for incision and drainage of the abscess, followed by a 5-day course of intravenous antibiotics.ConclusionsA tongue abscess, though rare, is a serious condition indicated by tongue swelling, pain, fever, dysphagia, and dyspnea. Diagnosis involves physical examinations and imaging studies like ultrasound or MRI. Immediate treatment includes maintaining airway patency, draining the abscess, and administering broad-spectrum antibiotics. Prompt recognition and treatment are essential to prevent severe complications such as airway obstruction and sepsis. Regular follow-up ensures complete resolution and prevents recurrence.

Definitive limitation of orbit prediction error for laser-based debris removal

We present an analytical formula to definitively restrict the orbit prediction error. In low earth orbit, millions of pieces of space debris are below 10 cm in size. One promising active debris removal (ADR) method for “lethal nontrackable (LNT)” objects is laser-based method. The recoil of laser ablation changes the orbit of the debris object. The laser must be precisely focused on the surface of the debris object. Because the relative speed of a debris object can reach 15 km/s, accurate orbit prediction is required. Our formula ensures that the laser is focused on the debris surface at the correct time and direction. We also evaluate the parameters in the formula, achieving an orbit prediction error of less than 1 cm 10 s after detecting a debris object. This formula can be used to design a specific laser ADR system for LNT.

A Prediction Model for Assessing the Efficacy of Thermal Ablation in Treating Benign Thyroid Nodules ≥ 2 cm: A Multi-Center Retrospective Study

ObjectivesTo develop and validate a prediction model utilizing clinical and ultrasound (US) data for preoperative assessment of efficacy following US-guided thermal ablation (TA) in patients with benign thyroid nodules (BTNs) ≥ 2 cm. Materials and methodsWe retrospectively assessed 962 patients with 1011 BTNs who underwent TA at four tertiary centers between May 2018 and July 2022. Ablation efficacy was categorized into therapeutic success (volume reduction rate [VRR] > 50%) and non-therapeutic success (VRR ≤ 50%). We identified independent factors influencing the ablation efficacy of BTNs ≥ 2 cm in the training set using multivariate logistic regression. On this basis, a prediction model was established. The performance of model was further evaluated by discrimination (area under the curve [AUC]) in the validation set. ResultsOf the 1011 nodules included, 952 (94.2%) achieved therapeutic success at the 12-month follow-up after TA. Independent factors influencing VRR > 50% included sex, nodular composition, calcification, volume, and largest diameter (all p < 0.05). The prediction equation was established as follows: p = 1/1 + Exp∑[8.113 −2.720 × (if predominantly solid) −2.790 × (if solid) −1.275 × (if 10 mL < volume ≤ 30mL) −1.743 × (if volume > 30 mL) −1.268 × (if with calcification) −2.859 × (if largest diameter > 3 cm) +1.143 × (if female)]. This model showed great discrimination, with AUC of 0.908 (95% confidence interval [CI]: 0.868–0.947) and 0.850 (95% CI: 0.748–0.952) in the training and validation sets, respectively. ConclusionsA clinical prediction model was successfully developed to preoperatively predict the therapeutic success of BTNs larger than 2 cm in size following US-guided TA. This model aids physicians in evaluating treatment efficacy and devising personalized prognostic plans.

Routine colonoscopy with a surprise in the cecum: It's a giant appendicolith! A Case report and review of the literature.

Giant appendicoliths (defined as appendiceal stones larger than 2 cm in size) are rare findings, with less than 20 well-documented reported cases. Appendicoliths, in general, are linked to an increased risk of appendicitis and associated complications. However, little information is available on the clinical impact of giant appendicoliths. We present a case of a giant appendicolith accidentally discovered during screening colonoscopy. With more than 4 cm, this appendicolith is one of the largest of the few reported so far. In contrast to all other cases of giant appendicoliths, the patient did not exhibit any symptoms. Additionally, we provide an overview of giant appendicolith cases, discussing their clinical features, diagnosis, and treatment.

Non-Surgical Treatment of Residual Cyst in Maxillary Anterior Region of an 11-year-old Patient: A Case Report

We aim to report a case of residual cyst in an 11-year-old male patient, which was treated by marsupialization as a conservative alternative to surgical enucleation. An 11-year-old male patient reported to our department with a painless swelling of approximately 1.5x1 cm in size intraorally, both in the maxillary right buccal and palatal region for about 1 month. On fine needle aspiration, a yellow-coloured highly viscous fluid was observed which on histopathological examination revealed an infected cyst. This along with the clinical examination and history confirmed the diagnosis of a residual cyst. Marsupialization was chosen as a conservative treatment due to the size of the cyst and the age of the patient. Weekly follow-up and dressing change were carried out for 6 months which lead to a complete resolution of the cyst with continuous normal development of the occlusion. No adverse effects such as fever, infection, or pus discharge were seen at any time during treatment. We have been able to design a treatment protocol which has provided us with a nonsurgical solution for large cystic lesions in growing patients without adverse effects for the complete duration of treatment. Marsupialization should be considered as a treatment option for large residual cysts, especially in pediatric patients. Key Words - Marsupialization, Maxilla, Mixed dentition, Residual cyst

Management of renal artery aneurysms: A retrospective study.

Although renal artery aneurysms (RAAs) are rare and often asymptomatic with slow growth, their natural progression and optimal management are not well understood. Treatment recommendations for RAAs do exist; however, they are supported by limited data. A retrospective cohort study was conducted to explore the management of patients diagnosed with an RAA at our institution from January 1st, 2013, to December 31st, 2020. Patients were identified through a search of our radiological database, followed by a comprehensive chart review for further assessment. Data collection encompassed patient and aneurysm characteristics, the rationale for initial imaging, treatment, surveillance, and all-cause mortality. One hundred eighty-five patients were diagnosed with or treated for RAAs at our center during this timeframe, with most aneurysms having been discovered incidentally. Average aneurysm size was 1.40cm (±0.05). Of those treated, the mean size was 2.38cm (±0.24). Among aneurysms larger than 3cm in size, comprising 3.24% of the total cases, 83.3% underwent treatment procedures. Only 20% of women of childbearing age received treatment for their aneurysms. There was one instance of aneurysm rupture, with no associated mortality or significant morbidity. Our institution's management of RAAs over the period of the study generally aligned with guidelines. One potential area of improvement is more proactive intervention for women of childbearing age.

Past, present, and future perspectives of ultrasound-guided ablation of liver tumors: Where could artificial intelligence lead interventional oncology?

The first ablation procedures for small hepatocellular carcinomas were percutaneous ethanol injection under ultrasound (US) guidance. Later, radiofrequency ablation was shown to achieve larger coagulation areas than percutaneous ethanol injection and became the most used ablation technique worldwide. In the past decade, microwave ablation systems have achieved larger ablation areas than radiofrequency ablation, suggesting that the 3-cm barrier could be broken in the treatment of liver tumors. Likewise, US techniques to guide percutaneous ablation have seen important progress. Contrast-enhanced US (CEUS) can define and target the tumor better than US and can assess the size of the ablation area after the procedure, which allows immediate retreatment of the residual tumor foci. Furthermore, fusion imaging fuses real-time US images with computed tomography or magnetic resonance imaging with significant improvements in detecting and targeting lesions with low conspicuity on CEUS. Recently, software powered by artificial intelligence has been developed to allow three-dimensional segmentation and reconstruction of the anatomical structures, aiding in procedure planning, assessing ablation completeness, and targeting the residual viable foci with greater precision than CEUS. Hopefully, this could lead to the ablation of tumors up to 5-7 cm in size.

A rare case of giant peritoneal loose body: A case report

Peritoneal loose bodies (PLBs) are uncommon abdominal lesions, typically asymptomatic and discovered incidentally during surgery. Giant PLBs, exceeding 5 cm in size, are even rarer and can present with clinical symptoms mimicking other abdominal pathologies. We present a 57-year-old male with a giant PLB presenting as intermittent abdominal pain, distention, and rectal bleeding. Imaging studies suggested colo-colic intussusception due to a colonic lipoma. The patient underwent an exploratory laparotomy revealing a segment of the descending colon containing multiple lipomas, one causing intussusception. In addition, a separate giant PLB 6 × 5.5 cm with central calcification was identified. A segmental colectomy with primary anastomosis and resection of the PLB was performed. The patient recovered well and reported complete resolution of symptoms at follow-up. Pathology confirmed a benign lipoma and a giant PLB. This case highlights the potential for giant PLBs to cause clinical symptoms and emphasizes the importance of including them in the differential diagnosis of abdominal complaints, even in the absence of a classic presentation. Exploratory laparotomy remains a definitive approach for diagnosis and management in such cases.

Densities of neuston often not elevated within plastic hotspots territory inside the North Pacific Garbage Patch

The North Pacific Garbage Patch, located in the eastern part of the North Pacific subtropical gyre, contains vast amounts of floating plastic debris. Research over the past decades has mainly focused on assessing the extent of plastic pollution in this oceanic region. However, the North Pacific subtropical gyre is also home to the surface-associated pelagic community known as neuston. To date, the dynamics of this ecosystem and its vulnerability towards environmental pollution and anthropogenic impacts remain poorly understood. While removing plastic debris afloat at sea can reduce negative impacts of plastic pollution on neuston and marine life in general, concerns have been raised that cleanup efforts could have an adverse effect on neuston due to potential co-accumulation of neuston and plastic at the sea surface. Here, we provide the most comprehensive assessment of neuston abundance in the eastern North Pacific Ocean and its relation to the distribution of floating plastic debris (0.05–5 cm in size) based on a first year-round survey. Our results reveal that neuston taxa inside the North Pacific Garbage Patch often show similar or lower abundances in areas with particularly high densities of floating plastic debris compared to the wider garbage patch. Targeting open-ocean cleanups on such plastic hotspot territories inside the garbage patch can therefore minimize interactions with neuston during cleanups, thus maximizing their net environmental gain. We further discover that neuston depicts substantial seasonal variability, which needs to be considered when assessing impacts on neuston.

Different clinicopathological features between young and older patients with pulmonary adenocarcinoma and ground-glass opacity

After the recommendation of computed tomography as a routine procedure for lung cancer screening, an increasing number of young adults have been diagnosed with pulmonary ground-glass opacity (GGO). Up to 63% of pulmonary nodules with a GGO component can be malignant. Since young cancer patients have limited exposure to environmental mutagens, they have special characteristics and needs. This study sought to compare the clinicopathological characteristics of young and old patients with GGO-associated lung adenocarcinoma (GGO-LUAD). Clinicopathological data from 203 patients who underwent video-assisted thoracoscopic surgery between January 2018 and April 2020 for pulmonary GGO component nodules were reviewed. Lung nonmucinous adenocarcinoma patients younger than 40 years old and older than 40 years old were enrolled: 103 patients ≤ 40 years old and 100 patients > 40 years old. The relevant clinicopathological features, including sex, smoking status, tumor size, pathological characteristics, radiographic features and prognosis of pulmonary nodules, were evaluated. Univariate analyses were applied for comparisons between groups. The differences in baseline characteristics (sex, smoking status, tumor location) between the different age groups were not significant. Young patients were more likely to have tumors < 1 cm in size, while older patients predominantly had tumors > 2 cm in size. The mean percentage of invasive adenocarcinoma was greater in the elderly group. Young and older patients seemed to have similar subtypes of adenocarcinoma (p > 0.05) but had different degrees of differentiation (p < 0.001). The 3-year overall survival (OS) and recurrence-free survival (RFS) of the young group were 100% and 99.03%, respectively, while the 3-years OS and RFS of the older group were 99% and 98%, respectively. Our work revealed that young patients with malignant pulmonary nodules and GGOs have distinct pathological subtypes. Patients with GGOs of different ages have different clinicopathological characteristics. The 3-year prognosis of young patients with malignant pulmonary nodules with GGOs is satisfactory.

A randomised controlled trial of Standard Of Care versus RadioAblaTion in Early Stage HepatoCellular Carcinoma (SOCRATES HCC)

BackgroundTherapeutic options for early-stage hepatocellular carcinoma (HCC) in individual patients can be limited by tumor and location, liver dysfunction and comorbidities. Many patients with early-stage HCC do not receive curative-intent therapies. Stereotactic ablative body radiotherapy (SABR) has emerged as an effective, non-invasive HCC treatment option, however, randomized evidence for SABR in the first line setting is lacking.MethodsTrans-Tasman Radiation Oncology Group (TROG) 21.07 SOCRATES-HCC is a phase II, prospective, randomised trial comparing SABR to other current standard of care therapies for patients with a solitary HCC ≤ 8 cm, ineligible for surgical resection or transplantation. The study is divided into 2 cohorts. Cohort 1 will compromise 118 patients with tumors ≤ 3 cm eligible for thermal ablation randomly assigned (1:1 ratio) to thermal ablation or SABR. Cohort 2 will comprise 100 patients with tumors > 3 cm up to 8 cm in size, or tumors ≤ 3 cm ineligible for thermal ablation, randomly assigned (1:1 ratio) to SABR or best other standard of care therapy including transarterial therapies. The primary objective is to determine whether SABR results in superior freedom from local progression (FFLP) at 2 years compared to thermal ablation in cohort 1 and compared to best standard of care therapy in cohort 2. Secondary endpoints include progression free survival, overall survival, adverse events, patient reported outcomes and health economic analyses.DiscussionThe SOCRATES-HCC study will provide the first randomized, multicentre evaluation of the efficacy, safety and cost effectiveness of SABR versus other standard of care therapies in the first line treatment of unresectable, early-stage HCC. It is a broad, multicentre collaboration between hepatology, interventional radiology and radiation oncology groups around Australia, coordinated by TROG Cancer Research.Trial registrationanzctr.org.au, ACTRN12621001444875, registered 21 October 2021.

Clinicopathological Study of Fibroepithelial Lesions of the Breast in a Tertiary Care Hospital in South India.

Introduction Fibroepithelial lesions of the breast mainly include fibroadenoma and phyllodes tumors with overlapping morphological features and varied clinical behavior. This study aims to determine the histopathological spectrum of fibroepithelial lesions of the breast in a tertiary care hospital. Methods This is a cross-sectional study that was carried out in the pathology department from 1stJanuary 2015 to 31stDecember 2023. Relevant data of all fibroepithelial lesions reported during the study period were retrieved from the medical records, tabulated, and analyzed. The Pearson chi-square test was used to determine the significant association between the various clinicopathological parameters of fibroepithelial lesions. A p-value of less than 0.05 was taken as statistically significant. Results Out of a total of 195 fibroepithelial lesions, 185 (95%) were fibroadenoma, 07 (3.5%) were phyllodes tumors, and three (1.5%) were fibroadenoma with tubular adenoma. The most common age group was 21 to 40 years, with the majority of phyllodes tumors being more than 5 cm in size compared to fibroadenomas. The association between the clinicopathological characteristics such as age of patients, tumor size, and histological grade was statistically insignificant in this study. Conclusions The implementation and usage of morphological diagnostic criteria will help in diagnosing and categorizing this broad group of fibroepithelial lesions, thereby facilitating appropriate treatment forpatients.

Chondrosarcoma of the Mobile Spine in the Elderly: A National Cancer Database Study

BackgroundThe current research on geriatric patients with spinal chondrosarcoma is limited. This study aimed to investigate the demographics, patterns of care, and survival of geriatric patients with chondrosarcoma of the mobile spine. MethodsThe National Cancer Database was queried from 2008 to 2018 for geriatric patients (60-89 years) with chondrosarcoma of the mobile spine. The primary outcome of this study was overall survival (OS). The secondary outcome was treatment utilization patterns. Survival analyses were conducted using log-rank tests and Cox proportional hazards regressions. Logistic regression models were utilized to assess correlations between baseline variables and treatment utilization. ResultsThe database retrieved 122 patients. While 43.7% of the patients presented with tumors exceeding 5cm in size, the incidence of regional lymph node involvement or distant metastases was relatively low, affecting only 5% of the patients. Furthermore, 22.3% of the patients had tumors graded as 3-4. The five-year OS rate was 52.9% (95% confidence interval 42-66.6). The mortality risk was significantly associated with age, tumor grade and stage, and treatment plan. Most patients (79.5%) underwent surgery, while 35.9% and 4.2% were treated with radiotherapy and chemotherapy, respectively. Age, race, comorbidities, geographical region, tumor stage, and healthcare facility type significantly correlated with treatment utilization. ConclusionSurgical resection significantly lowered the mortality risk in geriatric patients with spinal chondrosarcomas. Demographic and geographical factors significantly dictated treatment plans. Further studies are required to assess the role of radiotherapy and chemotherapy in treating these patients in the modern era.