Survival Outcomes In Patients Research Articles

Prognostic significance of three lymph node staging systems in pancreatic cancer with ≤ 12 and > 12 retrieved lymph nodes.

This study aimed to evaluate and compare the predictive performance of negative lymph nodes (NLN), lymph node ratio (LNR), and N stage in pancreatic ductal adenocarcinoma (PDAC) among patients with ≤ 12 retrieved lymph nodes and those with > 12 retrieved lymph nodes. Moreover, the association between the three nodal staging systems and survival was also explored. Clinical data on patients diagnosed with PDAC between 2004 and 2020 were downloaded from the Surveillance, Epidemiology, and End Results (SEER) database. Cox regression was performed to identify independent predictors of cancer specific survival (CSS) and overall survival (OS). Survival probability was calculated and compared by the Kaplan-Meier method and log rank test. Akaike information criterion (AIC) and Harrell's C-index were used to evaluate the prognostic ability of each nodal staging system. All three lymph node staging systems were independent predictors of CSS and OS. A higher NLN, a lower N stage, and a lower LNR were associated with improved survival. Compared with N stage, LNR staging performed better with a lower AIC and higher C-index for predicting the prognosis regardless of the sufficiency of retrieved lymph nodes, while NLN staging performed poorly in both the training and validation set. Subgroup analyses showed that the NLN successfully predicted survival outcomes in both lymph node-positive and node-negative patients. LNR demonstrated better predictive performance in PDAC patients regardless of the sufficiency of retrieved lymph nodes. Notably, for stage N0 disease, NLN was a more important prognostic predictor. The combination of LNR and NLN may offer more precise information on lymph node staging than the current staging system.

Prognostic impact of subcutaneous fat quality and sarcopenia on the survival outcomes in patients with colorectal cancer.

This study aimed to evaluate the relationship between the quantity and quality of subcutaneous fat and prognosis following colorectal cancer resection. We conducted a retrospective analysis of the clinical data of 399 patients who underwent curative resection for stage 2 or 3 colorectal cancer between January 2013 and March 2019. This study examined the correlation between sarcopenia and various fat parameters, including fat area and density, and assessed their impact on the prognosis. Sarcopenia was associated with a lower subcutaneous and visceral fat area, higher Hounsfield unit value in subcutaneous fat, and reduced modified intramuscular adipose tissue content in the multifidus, erector spinae, and psoas muscles. A low modified intramuscular adipose tissue content in the multifidus and erector spinae muscles was an independent prognostic factor for overall survival (hazard ratio, 2.28; p = 0.0329) and recurrence-free survival (hazard ratio: 2.32, p = 0.0233). Additionally, subcutaneous fat with a high Hounsfield unit was an independent predictor of a recurrence-free survival (hazard ratio, 2.68; p = 0.0142). Subcutaneous fat quality is correlated with sarcopenia and it thus serves as a prognostic factor for recurrence after stage 2 or 3 colorectal cancer resection.

A novel machine learning-based immune prognostic signature for improving clinical outcomes and guiding therapy in colorectal cancer: an integrated bioinformatics and experimental study

Immune cells are pivotal components in the tumor microenvironment (TME), which can interact with tumor cells and significantly influence cancer progression and therapeutic outcomes. Therefore, classifying cancer patients based on the status of immune cells within the TME is increasingly recognized as an effective approach to identify prognostic biomarkers, paving the way for more effective and personalized cancer treatments. Considering the high incidence and mortality of colorectal cancer (CRC), in this study, an integrated machine learning survival framework incorporating 93 different algorithmic combinations was utilized to determine the optimal strategy for developing an immune-related prognostic signature (IRPS) based on the average C-index across the four CRC cohorts. Notably, IRPS was demonstrated to be an independent risk factor for predicting the survival outcomes of CRC patients, showing superior performance compared to traditional clinical features and 63 published signatures in both training and validation cohorts. Furthermore, CRC patients classified in the low-risk group according to the IRPS showed higher sensitivity to immunotherapy than those in the high-risk group, suggesting that low-risk patients are more likely to benefit from immunotherapy. Through in silico screening of potential compounds, dasatinib, vinblastine, and YM-155 were identified as potential therapeutic agents for high-risk CRC patients. In vitro studies demonstrated that knockdown of APCDD1, a key component of the IRPS, inhibited the proliferation, migration and invasion of HT-29 cells and promoted their apoptosis. Thus, the IRPS serve as a powerful tool for predicting patient prognosis, immunotherapy response and candidate drugs, thereby enhancing clinical decision-making and treatment evaluation of CRC.

Comparison of two alternative sequences with cabazitaxel and 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer: A retrospective multicenter study (LuCaS).

Cabazitaxel and 177Lu-PSMA-617 have been shown to improve survival in patients with metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel and androgen receptor pathway inhibitors (ARPI). we aimed to evaluate the impact of sequencing cabazitaxel and 177Lu-PSMA-617 on survival outcomes in patients with mCRPC. This is a retrospective, multicenter, cohort study which included patients with mCRPC who received sequential treatment with 177Lu-PSMA-617 and cabazitaxel between January 2015 and December 2023. Primary outcome was progression-free survival-2 (PFS-2) RESULTS: A total of 68 patients with mCRPC who received sequential 177Lu-PSMA-617 and cabazitaxel were included in the study. The primary outcome, progression-free survival-2 (PFS-2), was similar in patients treated with 177Lu-PSMA-617 first (LU-CA) and those receiving cabazitaxel (CA-LU) first (10.8 and 11.7 months, respectively; p = 0.422). The median overall survival (OS) was also similar in the LU-CA and CA-LU groups (16.6 and 19.9 months, respectively; p = 0.917). The objective response rate (ORR) for 177Lu-PSMA-617 was 23.1 % when used first and 16.1 % after cabazitaxel. ORR for cabazitaxel was 25.6 % and 31.3 % when used as the first agent and when used after 177Lu-PSMA-617, respectively. In conclusion, treatment sequencing between cabazitaxel and 177Lu-PSMA-617 did not significantly affect survival outcomes in patients with mCRPC. These findings suggest that both drugs can be effectively integrated into the mCRPC treatment paradigm without concerns about the effect of sequencing. However, prospective data are needed to optimize sequencing strategies and explore their impact on specific patient subgroups for more personalized care.

Sarcopenia and myosteatosis are associated with low survival in patients receiving lenvatinib for unresectable hepatocellular carcinoma.

To investigate the association of skeletal muscle mass and quality with survival outcomes in patients with advanced hepatocellular carcinoma (HCC) treated with lenvatinib (LEN). In this retrospective study, LEN-treated patients with HCC were enrolled. Sarcopenia and myosteatosis were evaluated on the basis of baseline skeletal muscle index and mean muscle attenuation, respectively, on computed tomography at the L3 level. Low skeletal muscle mass (LSMM) was determined on the basis of index value, and bioinformatics tools were used to determine reliable cutoff values. Myosteatosis was defined on the basis of mean Hounsfield unit values and predefined cutoff values. A logrank test and Cox proportional hazards model were used to compare overall survival (OS) and progression-free survival (PFS). A total of 81 patients were included. Patients with LSMM exhibited significantly lower PFS (p=0.003) and OS (p=0.010) than did patients without LSMM. Patients with myosteatosis exhibited significantly lower PFS (p=0.012) and OS (p<0.001) than did patients without myosteatosis. In multivariate analysis adjusted for tumor extent and liver function reserve, LSMM and myosteatosis remained independent predictors of low PFS (p=0.028, p=0.031) and OS (p=0.027, p=0.001), respectively. LSMM and myosteatosis are independent prognostic factors for PFS and OS in advanced patients with HCC who received LEN and may exert synergistic effects on these survival outcomes.

Outcomes of Immunotherapy Treatment in Sinonasal Mucosal Melanoma.

Sinonasal mucosal melanoma has poor survival despite multimodality treatment. While the impact of immunotherapy (IT) on metastatic cutaneous melanoma is well-defined, there are relatively little data on sinonasal mucosal melanoma. We sought to define immunotherapy outcomes in patients with sinonasal mucosal melanoma. A retrospective cohort study evaluated patients treated with IT during their overall treatment strategy for SNMM. Patient demographics, treatment, and survival outcomes were recorded. 52 patients had IT treatment for SNMM from 2000 to 2022, with an average age of 69.1 ± 11.9 years. The most common treatment was surgery with radiation and IT (n = 26, 50%). Most regimens consisted of a combination of Nivolumab and Ipilimumab (n = 17, 32.7%) or pembrolizumab (n = 14, 26.9%). 44.2% of patients experienced reported complications. Overall survival at 1-, 2-, and 5 years was 86.9%, 74.1%, and 39.1%, respectively. Approximately half of patients will have a local response following immunotherapy, but it is rare to have improvement at metastatic locations. Further research within our group will assess optimal timing and markers that are predictive of response.

Prediction of Survival Outcomes in Patients with Glioma Using Magnetic Resonance Imaging (MRI): A Systematic Review and Meta-Analysis.

Glioma is the most common malignancy in the central nervous system. Even with optimal therapies, glioblastoma (the most aggressive form of glioma) is incurable, with only 26.5% of patients having a 2-year survival rate. The present meta-analysis evaluated the association of magnetic resonance imaging (MRI)-derived parameters in glioma patients with progression-free survival (PFS) and overall survival. Eligible clinical articles on glioma patients included those that contained an evaluation of the association between MRI findings, PFS, and overall length of survival. Review of the literature included the following databases: WHO International Clinical Trials Registry Platform; Google Scholar; Web of Science; PubMed; SIGLE; NYAM; Scopus; Randomized controlled trial (RCT); Virtual Health Library (VHL); Cochrane Collaboration; EMBASE; and Clinical Trials. The current review included 20 studies, and covered 2097 patients with gliomas. There were 1310 patients with glioblastoma and 320 with astrocytoma. There were 161 patients with grade-2 gliomas and 111 patients with grade-3. Tumour necrosis, peritumoural oedema, and multiple lesions were associated with PFS, as well as tumour necrosis and peritumoural oedema with overall survival. The present meta-analysis highlighted the ability of MRI to predict PFS and overall survival in patients with gliomas. This is crucial to identify patients at risk for poor survival outcomes and for individualising the treatment plan for such patients. The PROSPERO Registration: CRD42023489535, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=489535.

Membranous Overexpression of Fibronectin Predicts Microvascular Invasion and Poor Survival Outcomes in Patients with Hepatocellular Carcinoma.

Fibronectin (FN) has recently been identified as being overexpressed in patients with hepatocellular carcinoma (HCC) and deemed a promising biomarker of vascular invasion. The aim of this study was to examine the patterns of FN expression in HCC cells and their clinicopathological significance, such as their association with vascular invasion and angiogenesis patterns. Immunohistochemical analysis of FN was conducted using tissue microarrays from 258 surgically resected HCCs and matched nontumorous liver tissues. Three distinct FN expression patterns were observed: cytoplasmic, membranous, and sinusoidal. Moderate or strong expression was considered FN-positive. Cytoplasmic or sinusoidal FN expression was significantly more common in HCC cells than in the adjacent liver tissue (p<0.001). FN expression was detected in the membranes of HCC cells and absent in nonneoplastic hepatocytes (p<0.001). Overall survival and disease-free survival in patients with HCC cells with membranous FN expression were significantly shorter than those in patients without membranous FN expression. Membranous FN expression in HCC was significantly associated with high serum alpha-fetoprotein (AFP) and protein induced by vitamin K absence-II (PIVKA-II) levels, infiltrative gross type, poor Edmondson-Steiner grade, major vessel invasion, microvascular invasion, macrotrabecular massive subtype, advanced T stage, and vessel-encapsulating tumor cluster pattern. Sinusoidal pattern of FN expression in HCC was significantly associated with high serum AFP and PIVKA-II levels, infiltrative gross type, large tumor size, microvascular invasion, macrotrabecular massive subtype, and vessel-encapsulating tumor cluster patterns. Evaluating FN expression in HCC cells may be useful for identifying aggressive cases of HCC with vascular invasion via biopsy.

Subcutaneous adipose tissue radiodensity as a predictor of poor prognosis in advanced biliary tract cancer.

High subcutaneous adipose tissue radiodensity (SATr), an indirect surrogate marker of adipose tissue quality, was associated with poor prognosis in various cancers. The present study aimed to assess the association of SATr with survival outcomes in patients with advanced biliary tract cancer (BTC). This retrospective, single-center study included patients with unresectable or recurrent BTC who underwent chemotherapy/chemoradiotherapy. Overall survival (OS) and progression-free survival (PFS) were assessed using the log-rank test and the Cox proportional hazards model according to the SATr status. The study cohort included 234 patients, including 38 and 196 patients with high and non-high SATr, respectively. The median OS durations were 10.5 and 17.4 months (HR = 1.72, 95% CI: 1.19-2.49, p < .01) and the median PFS durations were 4.9 and 8.0 months (HR = 1.52, 95% CI: 1.05-2.20, p = .03) in patients with high and non-high SATr, respectively. By multivariate analysis, high SATr, neutrophil/lymphocyte ratio >5, modified Glasgow prognostic score 1-2, and serum carcinoembryonic antigen >5.0 ng/mL were predictors for OS (HR, 1.66, 2.42, 2.00, and 1.56, respectively; p < .05). By multivariate analysis, metastatic disease status, high SATr, neutrophil/lymphocyte ratio >5, and modified Glasgow prognostic score 1-2 were independent risk factors for worse PFS (HR, 1.56, 1.56, 1.81, and 1.57, respectively; p < .05). High SATr was associated with risk of tumor progression and poor prognosis in patients with advanced BTC treated by palliative chemotherapy/chemoradiotherapy.

Efficacy and safety of neoadjuvant therapy for hepatocellular carcinoma with portal vein thrombosis: A meta‑analysis.

Hepatocellular carcinoma (HCC) with coexisting portal vein tumor thrombus (PVTT) is associated with poor patient outcomes. The efficacy and safety of neoadjuvant therapy in patients with HCC with PVTT remain a subject of debate. In the present study, a comprehensive search of electronic databases, including PubMed, Web of Science, Embase and the Cochrane Library, was conducted to identify studies evaluating the outcomes of neoadjuvant therapy in patients with HCC and PVTT. The primary outcomes assessed were overall survival (OS) and relapse-free survival (RFS), with complication rates as a secondary outcome. A total of six studies comprising 750 patients were included in the present meta-analysis. The neoadjuvant therapy group exhibited significantly superior OS [hazard ratio (HR), 0.39; P<0.001] and RFS (HR, 0.31; P<0.001) compared with the primary hepatectomy control group. Compared with the control group, neoadjuvant radiotherapy improved OS (HR, 0.34; P<0.001) and RFS (HR, 0.24; P=0.004). While the neoadjuvant intervention subgroup exhibited an improved OS compared with controls (HR, 0.37; P=0.001), no significant difference in RFS was observed (HR, 0.11; P=0.095). Geographical analysis revealed that the Chinese subgroup demonstrated a significantly improved OS and RFS (HR, 0.41 for both; P<0.001), compared with the control group. However, the Japanese and Korean subgroups showed no improvement in OS (HR, 0.25; P=0.057) compared with the control group, and the results did not reach statistical significance. There were no significant differences between the groups in terms of blood transfusion, blood loss, operation time, bile leakage, ascites, peritoneal infection, postoperative bleeding, complications or mortality (all P>0.05). Overall, neoadjuvant therapy significantly improved survival outcomes in patients with HCC and PVTT without increasing complication rates, supporting its efficacy and manageable safety profile.

Survival and toxicity outcomes of hypofractionated conformal radiotherapy compared to conventionally fractionated radiotherapy in the treatment of diffuse intrinsic pontine gliomas.

Diffuse intrinsic pontine gliomas are associated with dismal survival outcomes. Conventional fractionation radiation to a dose of 60Gy is the standard of treatment. This retrospective review aims to compare survival and toxicity outcomes of patients treated with conventional fractionation (CF) and hypofractionation (HF) radiotherapy. Treatment-naïve diffuse intrinsic pontine glioma patients undergoing radical radiation were analyzed. CF was delivered to a dose of 50-60Gy in 25-30 fractions, while HF was delivered as 38-40Gy in 12-15 fractions. All patients were planned via the volumetric modulated arc therapy (VMAT) technique. A total of 64 patients were eligible for analysis. The median age of presentation was 10years. Motor deficit was the most common presenting complaint in 51.6% of the patients, with a median symptom duration of 2months. The pons was the most frequent site of disease epicenter in 71.8% of the patients. After a median follow-up of 9.45months (range 0.23-72.63months), 23 patients died, and 28 patients experienced disease progression. The unadjusted hazard ratio (HR) for death in patients treated with HF as compared to CF was 1.330 (95% CI 0.522-3.386) (p-value 0.550, by Cox regression analysis). The median OS for the entire cohort was 13.9months, while it was 9.7months (95% CI 5.65-13.74) and 15.1months (95% CI 9.02-21.18) (p-value = 0.547) with CF and HF, respectively. On multivariate analysis, disease epicenter in the pons was the only significant factor associated with PFS. Hypofractionation was associated with a significantly higher aspiration rate and Ryle's tube requirement (p-value 0.027). Hypofractionated radiation can be considered for diffuse intrinsic pontine glioma with optimum supportive care.

Laryngeal Cancer in the West of Scotland 2014-2020: Trends and Survival in a Cohort of 867 Patients.

Laryngeal squamous cell cancer (LSCC) accounts for around one-third of head and neck cancers, with smoking and alcohol as major risk factors. Despite advances in organ preservation, survival rates have stagnated globally over recent decades. The impact of socioeconomic deprivation on LSCC outcomes in the West of Scotland remains underexplored. We hypothesized that survival outcomes in the West of Scotland are poorer than cohorts from other developed nations. To evaluate characteristics and survival outcomes for LSCC patients in the West of Scotland and identify predictors of survival. A retrospective cohort study of 867 LSCC patients in the West of Scotland (2014-2020) analyzed demographics, tumor staging, performance status, treatments, and socioeconomic status (Scottish Index of Multiple Deprivation, SIMD). Subgroup differences were assessed using chi-squared tests. Survival analysis was performed with Kaplan-Meier curves, log-rank tests, and Cox proportional hazards modeling. The cohort had a male-to-female ratio of 3.2:1, with a mean age of 65.5 years, with 56% presenting with advanced disease. Most patients (70.7%) lived in the most deprived areas. Supraglottic cancers were the most common subsite (51%). Five-year overall survival (OS) was 46%, with a median OS of 52 months. Glottic cancers had better outcomes (64% OS) compared to supraglottic cancers (36%). Predictors of survival included age, subsite, performance status, alcohol use, treatment modality, and deprivation. LSCC survival in the West of Scotland is lower than in other European nations, influenced by advanced-stage presentation, deprivation, and frailty. Addressing these factors is vital to improving outcomes. III Laryngoscope, 2025.

The analysis of gene co-expression network and immune infiltration revealed biomarkers between triple-negative and non-triple negative breast cancer.

Triple-negative breast cancer (TNBC) is a heterogeneous disease with a worse prognosis. Despite ongoing efforts, existing therapeutic approaches show limited success in improving early recurrence and survival outcomes for TNBC patients. Therefore, there is an urgent need to discover novel and targeted therapeutic strategies, particularly those focusing on the immune infiltrate in TNBC, to enhance diagnosis and prognosis for affected individuals. The gene co-expression network and gene ontology analyses were used to identify the differential modules and their functions based on the GEO dataset of GSE76275. The Weighted Gene Co-Expression Network Analysis (WGCNA) was used to describe the correlation patterns among genes across multiple samples. Subsequently, we identified key genes in TNBC by assessing genes with an absolute correlation coefficient greater than 0.80 within the eigengene of the enriched module that were significantly associated with breast cancer subtypes. The diagnostic potential of these key genes was evaluated using receiver operating characteristic (ROC) curve analysis with three-fold cross-validation. Furthermore, to gain insights into the prognostic implications of these key genes, we performed relapse-free survival (RFS) analysis using the Kaplan-Meier plotter online tool. CIBERSORT analysis was used to characterize the composition of immune cells within complex tissues based on gene expression data, typically derived from bulk RNA sequencing or microarray datasets. Therefore, we explored the immune microenvironment differences between TNBC and non-TNBC by leveraging the CIBERSORT algorithm. This enabled us to estimate the immune cell compositions in the breast cancer tissue of the two subtypes. Lastly, we identified key transcription factors involved in macrophage infiltration and polarization in breast cancer using transcription factor enrichment analysis integrated with orthogonal omics. The gene co-expression network and gene ontology analyses revealed 19 modules identified using the dataset GSE76275. Of these, modules 5, 11, and 12 showed significant differences between in breast cancer tissue between TNBC and non-TNBC. Notably, module 11 showed significant enrichment in the WNT signaling pathway, while module 12 demonstrated enrichment in lipid/fatty acid metabolism pathways. Subsequently, we identified SHC4/KCNK5 and ABCC11/ABCA12 as key genes in module 11 and module 12, respectively. These key genes proved to be crucial in accurately distinguishing between TNBC and non-TNBC, as evidenced by the promising average AUC value of 0.963 obtained from the logistic regression model based on their combinations. Furthermore, we found compelling evidence indicating the prognostic significance of three key genes, KCNK5, ABCC11, and ABCA12, in TNBC. Finally, we also identified the immune cell compositions in breast cancer tissue between TNBC and non-TNBC. Our findings revealed a notable increase in M0 and M1 macrophages in TNBC compared to non-TNBC, while M2 macrophages exhibited a significant reduction in TNBC. Particularly intriguing discovery emerged with respect to the transcription factor FOXM1, which demonstrated a significant regulatory role in genes positively correlated with the proportions of M0 and M1 macrophages, while displaying a negative correlation with the proportion of M2 macrophages in breast cancer tissue. Our research provides new insight into the biomarkers and immune infiltration of TNBC, which could be useful for clinical diagnosis of TNBC.

Changing Landscape of Head and Neck Squamous Cell Carcinoma and Nasopharyngeal Carcinoma Treatment and Survival Trends in Thailand: A 13-Year Multicenter Retrospective Study of Patients.

The incidence and survival rates of head and neck squamous cell carcinoma (HNSCC) and nasopharyngeal carcinoma (NPC) vary globally, influenced by factors such as ethnicity, lifestyle, and health care systems. A retrospective analysis was conducted on patients with HNSCC treated between 2008 and 2020 in four major Thai academic cancer centers, using a multidisciplinary multicenter database. The study focused on the evolution of patient characteristics, survival changes, and treatment landscape alterations over time. Among 6,319 patients, the most common primary sites were nasopharynx (33%), oral cavity (23%), oropharynx (17%), larynx (15%), and hypopharynx (8%). An increase in human papillomavirus-related oropharyngeal carcinoma was noted, from 13% in 2008 to 42% in 2019-2020. The majority of patients presented with locally advanced (LA) stages (IVa/b: 50%, III: 26%). Chemoradiotherapy (54%) and surgery (24%) were the main treatments, with cisplatin (79%) being most commonly used in chemoradiation. Overall survival (OS) improved annually across all subsites, correlating with an increase in intensity-modulated radiotherapy (IMRT) use, from 25% in 2008 to 90% in 2019-2020. The median follow-up duration was 4.59 years, with a minimum of 2.75 years. Patients treated with IMRT had significantly longer OS compared with those treated with non-IMRT techniques, in both NPC and non-NPC HNSCC (P < .001). To our knowledge, this is the largest study in Thailand that demonstrates increasing survival outcomes in patients with HNSCC and NPC, despite commonly presenting with LA stages. The increasing use of IMRT may be contributing to improved survival outcomes in both patients with NPC and non-NPC HNSCC patients.

The Human Pathology Atlas for deciphering the prognostic features of human cancers

Cancer is one of the leading causes of mortality worldwide, highlighting the urgent need for a deeper molecular understanding and the development of personalized treatments. The present study aims to establish a solid association between gene expression and patient survival outcomes to enhance the utility of the Human Pathology Atlas for cancer research. In this updated analysis, we examined the expression profiles of 6918 patients across 21 cancer types. We integrated data from 10 independent cancer cohorts, creating a cross-validated, reliable collection of prognostic genes. We applied systems biology approach to identify the association between gene expression profiles and patient survival outcomes. We further constructed prognostic regulatory networks for kidney renal clear cell carcinoma (KIRC) and liver hepatocellular carcinoma (LIHC), which elucidate the molecular underpinnings associated with patient survival in these cancers. We observed that gene expression during the transition from normal to tumorous tissue exhibited diverse shifting patterns in their original tissue locations. Significant correlations between gene expression and patient survival outcomes were identified in KIRC and LIHC among the major cancer types. Additionally, the prognostic regulatory network established for these two cancers showed the indicative capabilities of the Human Pathology Atlas and provides actionable insights for cancer research. The updated Human Pathology Atlas provides a significant foundation for precision oncology and the formulation of personalized treatment strategies. These findings deepen our understanding of cancer biology and have the potential to advance targeted therapeutic approaches in clinical practice. The Knut and Alice Wallenberg Foundation (72110), the China Scholarship Council (Grant No. 202006940003).

The Clinical Characteristics, Patterns of Recurrence, and Long-Term Survival Outcomes of Dual-Phenotype Hepatocellular Carcinoma After Curative Liver Resection.

Dual-phenotype hepatocellular carcinoma (DPHCC) is discernible from classical HCC (CHCC) in its morphology and is characterized by the co-expression of both CHCC and cholangiocyte markers. This study aimed to clarify the difference between DPHCC and CHCC after surgery. Patients with HCC after surgery were collected. The clinical characteristics, patterns of recurrence, and survival outcomes of patients with DPHCC and CHCC were compared. Multivariate analyses were used to determine the independent risk factors that influence the prognosis of patients. Patients with DPHCC (n = 141) account for 26% of the total patients (n = 541). Compared to patients with CHCC, patients with DPHCC are significantly associated with incomplete capsules, microvascular invasion, and poor differentiation (all P < 0.05). Compared to patients with CHCC, the 5-year overall survival (OS) (56% vs 43%) and recurrence-free survival (RFS) (35% vs 28%) are lower in patients with DPHCC. Meanwhile, among patients with tumor recurrence after surgery, patients with DPHCC have a higher proportion of advanced-stage tumors, and extrahepatic metastasis (all P < 0.05). Moreover, multivariate analysis showed that DPHCC is an independent risk factor for both OS (HR 1.399, 95% CI 1.061-1.845, P = 0.017) and RFS (HR 1.313, 95% CI 1.033-1.669, P = 0.026). DPHCC, an aggressive HCC subtype with poor differentiation and high invasiveness, shows inferior RFS and OS post-liver resection compared to CHCC. Clinicians' recognition and addressing of its unique challenges can improve DPHCC patients' prognosis and QoL.

The characteristics of Korean elderly multiple myeloma patients aged 80 years or over.

Multiple myeloma (MM) predominantly affects elderly individuals, but studies on older patients with MM are limited. The clinical characteristics and survival outcomes of patients with MM aged 80 years or over were retrospectively analyzed. This retrospective multicenter study was conducted to investigate the clinical characteristics, treatment patterns, and survival outcomes of patients aged 80 years or over who were newly diagnosed with MM at five academic hospitals in Daegu, Korea, between 2010 and 2019. A total of 127 patients with a median age of 83 years (range, 80-93 yr) were enrolled: 52 (40.9%) with Eastern Cooperative Oncology Group Performance Status (ECOG PS) > 2, 84 (66.1%) with International Staging System (ISS) stage III disease, and 93 (73.2%) with a Charlson comorbidity index (CCI) > 4. Chemotherapy was administered to 86 patients (67.7%). The median overall survival was 9.3 months. Overall survival was significantly associated with ECOG PS > 2 (HR 2.26, 95% CI 1.43-3.59), ISS stage III (HR 1.99, 95% CI 1.18-3.34), and chemotherapy (HR 0.34, 95% CI 0.21-0.55). There was no statistically significant difference in event-free survival according to the type of anti-myeloma chemotherapy administered. The early mortality (EM) rate was 28.3%. Even in patients with MM aged 80 years or over, chemotherapy can result in better survival outcomes than supportive care. Patients aged ≥ 80 years should not be excluded from chemotherapy based on age alone. However, reducing EM in elderly patients with newly diagnosed MM remains challenging.

Relationship between survival outcomes in patients with colorectal liver metastasis undergoing hepatectomy and significance of fibrotic markers for liver injury assessment

Relationship between survival outcomes in patients with colorectal liver metastasis undergoing hepatectomy and significance of fibrotic markers for liver injury assessment

Early Enteral Nutrition May Improve Survival in Patients With Cardiogenic Shock.

Background and Aim: International guidelines recommend early enteral nutrition (EEN) for critically ill patients. However, evidence supporting the optimal timing of EN in patients diagnosed with cardiogenic shock (CS) is lacking. As such, this study aimed to compare the clinical outcomes and safety of EEN versus delayed EN in patients diagnosed with CS. Methods: This retrospective cohort study was conducted using data from the Medical Information Mart for Intensive Care IV version 2.2 database. Patients who received EN within 2 days of admission were assigned to the EEN group. A 1:1 propensity score-matched (PSM) analysis was performed to control for bias in baseline characteristics and ensure the reliability of the results. To exclude the impact of confounders, an adjusted proportional hazards regression model was used to verify the independence between EEN and survival outcomes. Results: Of 1846 potentially eligible patients, 1398 received EEN and 448 received delayed EN. After 1:1 PSM, 818 patients were assigned to the EEN (n = 409) and delayed EN (n = 409) groups. Regarding cumulative survival, patients with CS receiving EEN experienced better 30-, 90-, and 180-day survival outcomes than the delayed EN group (hazard ratio [HR] 0.803 [95% confidence interval [CI] 0.647-0.998], p=0.045; HR 0.729 [95% CI 0.599-0.889], p=0.001; and HR 0.778 [95% CI 0.644-0.938], p=0.008, respectively). After adjusting for confounders, EEN was found to be independently associated with survival outcomes. Moreover, EEN did not increase the risk(s) for ileus, aspiration pneumonia, or gastrointestinal bleeding. Patients who received delayed EN experienced longer hospital stays than those receiving EEN (17 days [interquartile range [IQR] 10-25] versus 12 days [IQR 7-19 days], respectively; p < 0.001). Conclusion: EEN was not associated with harm, but rather with improved survival outcomes in patients diagnosed with CS. Further studies are required to verify these findings.

Identification and analysis of prognostic ion homeostasis characteristics in kidney renal clear cell carcinoma.

Kidney renal clear cell carcinoma (KIRC), a prevalent primary malignant tumor within the urinary system, is characterized by significant heterogeneity. It has been shown that ion channels are important targets for anti-tumor therapy. In this study, we screened 70 selected KIRC related ion homeostasis genes with significant differential expression. We established diagnostic and prognostic models for 15 genes (PDK4, JPH4, ATP1A3, CCL7, CYP27B1, ABCB6, TNFSF11, MCHR1, TNNI3, ANGPTL3, Ednrb, SAA1, Chrna9, TMPRSS6, CCL14) by LASSO regression in the TCGA-KIRC cohort. We also provided a nomogram based on ion homeostasis for clinicians to explore the combined effect of the risk model on clinical variables. Patients in the low-risk group have a significant survival advantage. The potential clinical benefit of our predicted 15 gene signatures in clinical strategies was validated by Calibration Curves and DCA curves. Ultimately, the immune microenvironment and enrichment pathways were analyzed among individuals categorized as high-risk and low-risk. The predictable ion homeostasis-associated 15 gene signature established in this study predicts overall survival outcomes in patients with KIRC, to some extent helping clinicians to select personalized treatment regimens.