The optimal size of circular staplers for esophagojejunostomy remains a subject of debate, with concerns that smaller staplers may increase the risk of postoperative complications and impair quality of life (QoL). The purpose of this study was to evaluate the impact of circular stapler size and anastomotic lumen diameter, measured via postoperative computed tomography (CT) imaging, on patient-reported quality of life following esophagojejunostomy. This prospective observational cohort study included patients who underwent esophagojejunostomy using circular staplers. Anastomotic lumen diameter was measured using postoperative CT imaging. Quality of life was assessed at a 6-month follow-up using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-STO22 and Eastern Cooperative Oncology Group (ECOG) performance status scales. Outcomes were compared across stapler sizes and corresponding lumen diameters. No statistically significant differences in EORTC QLQ-STO22 or ECOG scores were observed between stapler size groups. Additionally, anastomotic lumen diameter showed no correlation with quality-of-life outcomes. Smaller circular staplers, often used due to intraoperative anatomical limitations, do not adversely affect postoperative quality of life. These findings suggest that insisting on larger stapler sizes may be unnecessary and that smaller staplers can be used safely when indicated.

SABR Versus Radiofrequency Ablation and Cryoablation for Primary Renal Cell Carcinoma: An Economic Evaluation of the FASTRACK II Trial.

In the EORTC 62961-ESHO 95 randomized trial (European Organization for Research and Treatment 62961-European Society of Hyperthermia Oncology 95; ClinicalTrials.gov identifier NCT00003052), neoadjuvant chemotherapy (NAC) combined with regional hyperthermia (RHT) improved survival in patients with soft tissue sarcoma (tumor size >5 cm, grade 2 or 3, deep location). This study investigated the survival benefit of NAC+RHT in a subgroup of patients who had extremity soft tissue sarcoma (ESTS) according to risk predictions using the Sarculator nomogram. Overall survival (OS) was predicted with the Sarculator nomogram using baseline prognostic parameters. Kaplan-Meier analysis was used to estimate observed OS. A bivariable Cox model including the Sarculator score, treatment, and their interaction was fitted. Hazard ratios for OS were calculated for each decile of the Sarculator risk distribution. Of 143 patients with ESTS, 135 were analyzed (NAC, n=70; NAC+RHT, n=65) with a median follow-up of 136 months (interquartile range, 110-183 months). Survival in the NAC+RHT group exceeded Sarculator predictions and improved compared with the group that received NAC alone (hazard ratio, 0.67; 95% confidence interval, 0.39-1.17; p=.081), with an absolute 5-year OS difference of 15.6% (95% confidence interval, 0.0%-31.4%). Risk stratification suggested greater benefit of NAC+RHT as predicted OS decreased. However, the interaction between Sarculator score and treatment was not significant (p=.495). This analysis of ESTS from a randomized trial confirmed the previously reported OS benefit by adding RHT to NAC. Although patients with higher predicted risk seemed to benefit more from the combined treatment, these findings do not suggest that treatment decisions should be based on risk estimates alone, supporting the use of RHT combined with chemotherapy in patients who have primary ESTS.

BACKGROUND Laparoscopic anterior resection for colorectal cancer often necessitates a temporary protective stoma to mitigate anastomotic-leak risk, yet stoma reversal is frequently delayed by postoperative ileus. Western medicine offers limited pro-motility options, while traditional Chinese medicine (TCM) has shown promise within enhanced-recovery protocols. Modified Da-Cheng-Qi decoction (mDCQD), a purgative- and qi-moving formula, has demonstrated intestinal motility benefits, but its specific impact on stoma-reversal timing remains unexamined. We undertook a retrospective study to determine whether mDCQD accelerates stoma closure and reduces postoperative ileus after laparoscopic colorectal resection with protective stoma. AIM To investigate the effect of mDCQD on stoma reversal time and incidence of postoperative ileus after laparoscopic anterior resection for colorectal cancer. METHODS A retrospective analysis was conducted on 283 patients who underwent laparoscopic anterior resection for colorectal cancer with prophylactic stoma at our hospital from January 2022 to August 2024. According to whether mDCQD was used postoperatively, patients were divided into observation group (132 cases) and control group (151 cases). The control group received conventional treatment postoperatively, while the observation group received oral mDCQD (raw rhubarb 12 g, mirabilite 10 g, immature bitter orange 15 g, magnolia bark 15 g, radish seed 15 g, aucklandia root 10 g, areca seed 10 g, cannabis seed 15 g) starting from postoperative day 2-3 (the day of gastric tube removal) in addition to conventional treatment, twice daily, 150 mL each time, continued until anal gas passage and defecation. Observation indicators included stoma reversal time, incidence of postoperative ileus, time to first anal gas passage, time to first defecation, time to bowel sound recovery, TCM symptom scores, quality of life scores European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30), gastrointestinal hormone levels [motilin (MTL), gastrin (GAS), vasoactive intestinal peptide (VIP)], and inflammatory and nutritional indicators [C-reactive protein (CRP), procalcitonin (PCT), albumin (ALB), prealbumin (PA)]. Kaplan-Meier method and Cox proportional hazards regression model were used to analyze factors affecting stoma reversal time. RESULTS The stoma reversal time in the observation group was 118.5 ± 23.7 days, shorter than 142.8 ± 28.4 days in the control group (t = 7.623, P < 0.001). The incidence of postoperative ileus in the observation group was 6.1% (8/132), lower than 18.5% (28/151) in the control group (χ 2 = 10.245, P = 0.001). The time to first anal gas passage (52.3 ± 10.8 hours vs 68.7 ± 14.2 hours), time to first defecation (78.6 ± 15.3 hours vs 96.4 ± 18.7 hours), and time to bowel sound recovery (38.2 ± 8.5 hours vs 51.6 ± 11.3 hours) in the observation group were all shorter than those in the control group (P < 0.001). On postoperative days 5 and 7, TCM symptom scores in the observation group were lower than those in the control group (P < 0.001). At 3 months after stoma surgery, the EORTC QLQ-C30 overall health status score in the observation group was 68.5 ± 11.7 points, higher than 62.3 ± 13.2 points in the control group (t = 4.19, P < 0.001). On postoperative days 5 and 7, MTL and GAS levels in the observation group were higher than those in the control group, while VIP levels were lower (P < 0.001); CRP and PCT levels in the observation group were lower than those in the control group, while ALB and PA levels were higher (P < 0.05). Multivariate Cox regression analysis showed that the use of mDCQD was an independent factor for shortening stoma reversal time (hazard ratio = 2.147, 95% confidence interval: 1.658-2.781, P < 0.001). CONCLUSION mDCQD can shorten stoma reversal time after laparoscopic anterior resection for colorectal cancer, reduce the incidence of postoperative ileus, promote intestinal function recovery, and improve patients’ quality of life. It is a safe and effective integrated traditional Chinese and Western medicine treatment method.

Abstract Background This study aimed to evaluate the short‐term influence of preoperative educational materials on the quality of life in patients with newly diagnosed urinary cancer before surgery. Methods Patients with urinary cancer were retrospectively enrolled from April 2020 to March 2021. Quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐Core 30 version 3.0 on the day of admission and after patients read the education materials. Propensity score matching was applied to match baseline characteristics in subgroup analyses. Results A total of 180 patients were enrolled. Most of them were male with renal cancer. Sleep disturbance ( p = 0.004), appetite loss ( p = 0.013), fatigue ( p = 0.002), constipation ( p = 0.029), and physical function ( p = 0.006) showed statistically significant differences post‐intervention. Subgroup analyses suggested that improvements in sleep disturbance, fatigue, and physical function persisted in the younger group (≤ 60 years old), while bladder cancer patients showed improvements in physical function and cognitive function. Conclusion Preoperative educational materials were associated with short‐term improvements in specific quality of life domains among patients with urinary cancer. Younger age and bladder cancer diagnosis appeared to be potential effect modifiers.

Background: An estimated 4.4 million people in Europe require palliative care annually, a number expected to rise with population aging. Telepalliative care (TPC) has been practiced in various settings over the past two decades. The Telepal program was developed to provide individualized palliative care, aiming to improve health-related quality of life (HRQoL) and enhance access to health care professionals. Objective: This study examined whether the Telepal program influenced HRQoL, symptom burden, perceived health, and patients’ sense of security among patients receiving specialized palliative care (SPC). We hypothesized that Telepal would improve HRQoL and sense of security compared with standard SPC. Method: In this randomized controlled trial conducted in Denmark, 182 patients referred to SPC were followed for up to 26 weeks. The control group (CG) received routine SPC, while the intervention group (TPG) received routine SPC plus TPC. HRQoL and symptom burden were assessed weekly using the European Organization for Research and Treatment of Cancer Quality of life Questionnaire–Core 15–Palliative Care and at weeks 1 and 4 using the EuroQol Five-Dimension Five-Level Questionnaire, including the Visual Analog Scale for perceived health. Sense of security was assessed twice weekly using a Likert scale. Results: HRQoL, symptom burden, and sense of security worsened over time in both groups, with no significant group differences. The TPG reported consistently higher pain, while perceived health declined in the CG but remained stable in the TPG. Conclusion: Telepal did not prevent declines in HRQoL or sense of security; however, perceived health remained more stable in the TPG. Telepal may serve as a complementary component of palliative care, particularly for patients facing barriers to in-person visits.

BACKGROUND Patients with hepatocellular carcinoma (HCC) often experience considerable psychological distress that affects their quality of life (QoL). AIM To investigate the effects of drug-eluting microsphere - transcatheter arterial chemoembolization (DEM-TACE) combined with lenvatinib on anxiety, depression, and QoL. METHODS This prospective study enrolled 126 patients with primary HCC treated with DEM-TACE combined with lenvatinib from October 2022 to October 2025. Anxiety and depression assessment with the Hospital Anxiety and Depression Scale (HADS) and QoL evaluation with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) and HCC-specific module were conducted at baseline and at 3-, 6-, and 12-month. Clinical outcomes, including overall survival, progression-free survival, and adverse events (AEs), were recorded. RESULTS Overall, 58.7% and 61.1% of patients exhibited anxiety and depression at baseline, respectively. After treatment, both psychological status and QoL significantly improved. At 12 months, the prevalence rates of anxiety and depression decreased to 31.0% and 28.6%, respectively (both P < 0.001). The EORTC QLQ-C30 global health status score increased from 52.3 ± 15.7 to 71.2 ± 14.3 (P < 0.001). Physical, role, and emotional functioning scores also significantly improved (all P < 0.001). Treatment-related AEs were generally manageable. Multivariate analysis showed that baseline HADS score, Barcelona Clinic Liver Cancer stage, and tumor response were independent predictors of QoL outcomes (P < 0.05). CONCLUSION DEM-TACE combined with lenvatinib shows an acceptable safety profile and favorable efficacy in improving anxiety, depression, and QoL in patients with HCC. Early psychological assessment and intervention may optimize outcomes.

Survival has improved substantially for patients with Hodgkin lymphoma (HL), but long-term quality of life (QoL) remains incompletely understood. This was a Danish, nationwide, cross-sectional study of QoL among persons with a diagnosis of HL matched 1:10 to general population comparators. Questionnaires included the HeartQoL, the European Organization for Research and Treatment of Cancer Quality of Life Core-30 (QLQ-C30), the Short Form-36 (SF-36), and the EuroQoL Health Questionnaire (EQ-5D). Mean differences (MD) were estimated using linear regression adjusted for sex and age, and stratified by time since diagnosis (0-5, > 5-10, and > 10 years). Overall, 1777 patients with HL (42% of 4156 invited) and 6166 matched comparators (14% of 41 558 invited) responded, and median age was similar (HL: 59, comparators: 61). Most had classical HL (92%). HL groups had consistently and significantly lower QoL than their respective comparators, with 0-5, > 5-10, and > 10 years post-diagnosis MDs of -0.27, -0.28, and -0.24 for the HeartQoL, -7.4, -7.6, and -5.6 points for the QLQ-C30 summary score, -4.5, -4.9, and -4.2 points for the SF-36 physical component summary, and -0.05, -0.05, and -0.04 for the EQ-5D index. The relative difference between the HL group and comparators decreased from baseline to > 10 years post-diagnosis, but differences remained clinically important. The most pronounced symptoms were fatigue and dyspnea. To summarize, persons with HL experience reductions in QoL compared with the general population, even > 10 years post-diagnosis. The observed differences were clinically relevant within several domains and emphasize the need for a multidisciplinary approach to survivorship care.

Cancer-related fatigue (CRF) is a frequent, subjective, and difficult-to-manage symptom, for which few interventions have proven effective. Recent evidence suggests that electroacupuncture (EA) can reduce fatigue, although specific studies on this technique remain scarce. To evaluate the efficacy of EA in treating CRF in cancer patients. A systematic review registered in PROSPERO was conducted, including clinical trials assessing the effects of EA in patients with CRF. Searches were performed in the PubMed, Embase, Virtual Health Library, Scopus, and CAPES databases, with no restrictions on date, language, sex, ethnicity, or type of cancer. We assessed the methodological quality using the PEDro scale and evaluated the risk of bias using the RoB-2 tool. A total of 2,110 studies were identified. After applying inclusion criteria, five trials were included: three randomized, one non-randomized, and one single-arm clinical trial. In total, 251 patients were analyzed, 132 of whom received EA treatment. Interventions varied from two to three weekly sessions, each lasting 20 to 30 minutes, over a period of four to eight weeks. Acupuncture points and electrical frequencies (0.2-25 Hz) differed between studies. Outcomes were measured by the Brief Fatigue Inventory, Functional Assessment of Cancer Therapy - Fatigue, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Despite the potential benefits observed in EA-treated groups, the findings remain inconsistent. EA shows promising therapeutic potential for managing CRF. However, the small number of studies, methodological heterogeneity, and small sample sizes limit generalizability. Multicenter clinical trials with larger samples and standardized protocols are needed to confirm efficacy.

The health-related quality of life (HRQoL) of patients with differentiated thyroid carcinoma (DTC), especially their mental health, can be compromised by various factors beyond disease prognosis and treatment stage. However, predictors of poor emotional functioning (EF) in DTC patients have not been thoroughly studied. To inform targeted interventions that could improve or preserve HRQoL in patients with DTC, this study aimed to identify predictors of impaired EF, and particularly modifiable factors. Data analyzed were from the phase IV international validation study of the European Organization for Research and Treatment of Cancer thyroid cancer-specific HRQoL questionnaire (QLQ-THY34). Patients (n = 196) were assessed at three timepoints before treatment (t1), 6 weeks after the start of treatment (t2), and 6 months after t2 (t3). Multilevel, multivariable logistic regression models were used to assess the likelihood of impaired EF at t3 according to predefined potential predictors at t1 and t2. Impaired EF at t1 or t2 predicted impaired EF at t3. Exhaustion, head and neck discomfort and body image issues were significantly associated with poor EF at t3. More specifically, temporal changes of these three variables from t1 to t2 were independent predictors of poor EF at t3 with an odds ratio of 1.04 (p < 0.001), 1.01 (p = 0.04), and 1.01 (p = 0.001) per score point, respectively. There was no evidence that worry about important others, lacking social support, sex, stage, or Karnofsky performance score are associated with EF at t3. Exhaustion, head and neck discomfort, and body image concerns emerged as modifiable factors that predict future impaired EF in patients with DTC undergoing treatment. These factors could be targeted in prehabilitation, rehabilitation or other interventional programs to potentially improve or preserve patients' EF.

Invasive Fungal Infections Following Bruton Tyrosine Kinase Inhibitor Treatment: A Systematic Review and Meta-analysis.

Background/Objectives: Patients with breast cancer show substantial heterogeneity in terms of psychological adjustment following diagnosis. We aimed to characterize longitudinal trajectories of quality of life (QoL) and depressive symptoms during the first 18 months post-diagnosis and to identify robust clinical, psychosocial, and behavioral predictors associated with distinct adjustment pathways. Methods: Women (N = 538; mean age 55.4 years; range 40-70) with operable breast cancer (stages I-III) were drawn from the multicenter BOUNCE cohort. QoL (Global Health Status/QoL scale of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30) and depressive symptoms (depression subscale of the Hospital Anxiety and Depression Scale) were assessed at baseline and months 3, 6, 9, 12, 15 and 18. Latent class growth analysis and growth mixture modeling identified distinct trajectory classes. Associations between early predictors and trajectory membership were examined using logistic regression combined with elastic net regularization. Results: Depression trajectories demonstrated heterogeneity, with groups characterized by persistent resilience (59.7%), stable moderate/high (25.3%), delayed onset (5.0%), and recovery (10.0%). QoL trajectories ranged from stable excellent (13.2%) and stable high (40.7%) to moderate (31.4%) and persistent low/deteriorating (6.9%), as well as a distinct recovering trajectory (7.8%). Trajectory differentiation was primarily driven by psychological resources, symptom burden, functional status, and coping processes, alongside specific contributions from clinical factors. Conclusions: Distinct subgroups of women with breast cancer follow divergent adjustment pathways. These findings highlight the multidimensional nature of resilience and support the need for tailored interventions that promote long-term well-being beyond simple risk reduction.

Empowering the next generation of clinical cancer researchers: Structure, activities, and vision of the European Organisation for Research and Treatment of Cancer (EORTC) Young and EarlyCareer Investigator (Y-ECI) network.

Background:The objective of our study was to investigate the willingness to pay (WTP) per quality-adjusted life year (QALY) among people with malignancies in China, and the associated factors that significantly affect WTP/QALY ratios.Methods:We conducted a cross-sectional survey using the contingent valuation method and employed the EuroQol-5 Dimensions (EQ-5D), European Organisation for Research and Treatment of Cancer Quality of Life Utility Measure-Core 10 Dimensions (QLU-C10D), and WTP questionnaires to extract information on demographic characteristics, health utility, and WTP for full recovery from the respondents. Furthermore, we conducted stepwise regression analyses to identify factors affecting the WTP/QALY ratios.Results:We received 1012 valid questionnaires, comprising 588 patients and 424 family members. The mean age of the patients was 57.05 (11.48) years. There were 483 male patients and 529 female patients; the numbers of urban and rural patients were 576 and 436, respectively. The mean scores of health utility (standard deviation) measured by EuroQol Five-Dimensional Five-Level Questionnaire and QLU-C10D were 0.75 (0.20) and 0.74 (0.16). For the overall sample, the mean and median WTP/QALY values based on the EQ-5D instrument were 336,236 renminbi (RMB) (4.67 times gross domestic product [GDP] per capita) and 177,814 RMB (2.47 times GDP per capita), and 344,233 RMB (4.78 times GDP per capita) and 152,386 RMB (2.12 times GDP per capita) for the QLU-C10D instrument. There was no significant difference between the WTP/QALY values based on different cancers. In stepwise regression models, the WTP/QALY value was significantly correlated with health utility, income level, employment status, regular physical examination, etc.Conclusion:This paper evaluated the monetary value of QALY among people with malignancies in China. Our analysis reveals an inverse relationship between national income levels and the ratio of WTP per QALY to GDP per capita, suggesting that lower-income countries may adopt relatively higher cost-utility thresholds in proportion to their GDP per capita. Additionally, the ratios of WTP/QALY to GDP per capita for patients with malignant tumors are similar to those of the general population with life-threatening conditions; patients with non-life-threatening diseases have comparable WTP/QALY to GDP per capita ratios with the general population in a quality-of-life improvement scenario, providing empirical reference for decision-making and resource allocation in the stratified disease management. Future studies with more representative samples across a broader range of countries are warranted to enable a more comprehensive and systematic discussion.

Factors influencing quality of life over five years post-diagnosis in breast cancer survivors: Results from the E3N-Generations cohort.

Patterns of Disease Progression in Advanced Breast Cancer Patients Treated With Cyclin D Kinase 4/6 Inhibitors: Prognostic and Therapeutic Implications.

Stereotactic Body Radiation Therapy Boost Following Urgent 3D Conformal Radiation Therapy for Metastatic Epidural Spinal Cord Compression: A Phase 1 Feasibility Study.

Quality of Life of Stereotactic Versus Hypofractionated Radiation Therapy for Inoperable Stage I Non-Small Cell Lung Cancer: Results From the LUSTRE Trial.

IntroductionSurvival outcomes for early-stage breast cancer have improved substantially; however, many survivors experience persistent treatment-related toxicities that adversely affect long-term quality of life (QoL) and functional recovery. Prospective survivorship data from China remain limited. The PERSEVERE study aims to characterise longitudinal trajectories of QoL and treatment-related toxicities among Chinese women treated for stage I–III breast cancer and to identify factors associated with suboptimal recovery.Methods and analysisPERSEVERE is a prospective, multicentre, observational cohort study enrolling approximately 3000 women with newly diagnosed stage I–III invasive breast cancer across cancer centres in China. Data are collected at baseline and serially for up to 5 years, including clinical variables, a validated suite of patient-reported outcome measures collected via a centralised REDCap electronic platform and baseline biospecimens. The primary outcome is the change in the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 global health status/QoL score from baseline to 12 months. Longitudinal and time-to-event analytical approaches appropriate for observational cohort studies will be applied, with exploratory analyses planned to investigate symptom trajectories and biological correlates.Ethics and disseminationThe study protocol (ID: NCC25/629-5575) has been approved by the Independent Ethics Committee of the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences. Written informed consent will be obtained from all participants. Study findings will be disseminated through peer-reviewed open-access publications and presentations at national and international conferences, with summaries shared with clinicians and patient advocacy groups.Trial registration numberNCT07010939.

Patient-reported outcomes and qualitative interviews in patients with estrogen receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer: results from the phase III EMBER-3 trial.