Recurrence Time Research Articles

Clinical Study of Ibrutinib Combined with Venetoclax Regimen in the Treatment of Relapsed/Refractory Diffuse Large B-Cell Lymphoma

To investigate the clinical efficacy of ibrutinib combined with venetoclax in the treatment of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL), and to analyze the factors affecting efficacy and prognosis. Clinical data of 62 R/R DLBCL patients admitted to our hospital from August 2017 to July 2022 were retrospectively analyzed. All patients were treated with ibrutinib combined with venetoclax. The clinical efficacy and drug safety were evaluated. The effects of clinical features on short-term efficacy and overall survival (OS) were analyzed. The objective response rate (ORR) of 62 patients was 48.39%. The extranodal lesions, intermediate-high/high risk of NCCN-IPI, intermediate-high/high risk of IPI, progression or recurrence time <12 months were the risk factors affecting the short-term efficacy of chemotherapy in R/R DLBCL patients (all P < 0.05). The most common adverse effect was neutropenia (75.19%), and the incidence of grade Ⅲ-Ⅳ neutropenia was 52.71%. The 1-year and 2-year OS rates of 62 patients were 48.51% and 31.56%, respectively, and the median OS time was 12 months. Multivariate analysis showed that objective remission after chemotherapy [HR =0.080 (95%CI: 0.028-0.235)] was a protective factor for OS in R/R DLBCL patients, and intermediate-high/high risk of NCCN-IPI [HR =4.828 (95%CI : 1.546-15.080)] was an independent risk factor affecting the prognosis of R/R DLBCL patients. Ibrutinib combined with venetoclax can be used as an effective treatment regimen for R/R DLBCL, and NCCN-IPI can be used as a prognostic indicator. Objective remission after chemotherapy is beneficial for R/R DLBCL patients to achieve better OS.

The application of photodynamic therapy in recurrent genital herpes

BackgroundFrequently recurrence of genital herpes imposes significant physical and psychological burdens on patients, while existing treatments are often ineffective in preventing recurrence. Previous studies have indicated that photodynamic therapy (PDT) showed promising outcomes in the treatment of labial herpes simplex virus (HSV) infections; however, its efficacy for genital herpes remained unclear. MethodThe study screened patients with genital herpes at Daping Hospital from July 2020 to May 2024. Patients were divided into two groups based on whether they received PDT treatment. Over a one-year follow-up period, patients' healing time and recurrence rates were compared between the two groups. The cumulative incidence of recurrence and restricted mean survival time (RMST) were used to assess outcomes. Propensity score matching (PSM) was employed to minimize bias. ResultA total of 41 patients enrolled in our study, with 8 (19.5%) received PDT. The non-PDT group exhibited a slower skin lesion healing time, averaging at 7.2 days compared to 5.4 days in the PDT group. A significant difference was observed in the cumulative incidence of recurrence between the PDT and non-PDT groups (37.5% versus 71.4%) after PSM. The RMST in the PDT group was 9.94 days, compared to 5.13 days in the non-PDT group before PSM, and 4.14 after PSM. ConclusionOur study demonstrated that the PDT effectively reduced lesion recovery time and delayed recurrences of genital herpes. We recommend considering PDT as a potential treatment option for patients with recurrent genital herpes.

Linearithmic Mean and Standard Deviation Sorting Method (LMDSM): Efficient and Stable Algorithm

Sorting algorithms have significance in the field of big data and high-performance computing, where effective data processing is of major significance. This paper presents the Linearithmic Mean and Standard Deviation Sorting Method (LMDSM), a new sorting method designed to handle enormous datasets and complex computational environments. Further this paper present a comprehensive comparative analysis of LMDSM with conventional sorting algorithms like Merge Sort and Quick Sort, emphasizing its efficiency and stability in different scenarios. LMDSM consistently outperforms other sorting algorithms in terms of sorting time when tested on arrays of 850,292 data in various orders. Furthermore, paper provide a rigorous theoretical analysis of LMDSM, encompassing its recurrence relation and time complexity derivation. Our research highlights the importance of LMDSM as an effective option for organizing jobs in current computing environments, providing significant importance in speed and reliability.

Constrictive physiology is not present in all dogs with idiopathic chylothorax.

To determine whether subtotal pericardectomy affects recurrence and long-term outcomes in dogs with idiopathic chylothorax (IC). 12 client-owned dogs diagnosed with IC between July 26, 2016, and March 23, 2023. The diagnosis of constrictive physiology (CP) was established with cardiac catheterization and defined as elevated and equal diastolic pressures in all 4 cardiac chambers. Dogs were then entered into the constrictive physiology (CP) group or non-CP (NCP) group. All dogs received at least a thoracic duct ligation (TDL). The dogs in the CP group had a subtotal pericardectomy performed in addition to TDL. Repeated surgical interventions, recurrence, long-term outcomes, and survival times were recorded. 8 dogs were entered into the CP group and underwent TDL and subtotal pericardectomy. Four dogs were entered in the NCP group and underwent only a TDL. Four dogs in the CP group and 1 in the NCP group required multiple surgeries for recurrent chylothorax. The 1-, 2-, and 3-year disease-free rates were, respectively, 100%, 100%, and 50% for the NCP group and 87.5%, 72.9%, and 72.9% for the CP group (P = .935). The 1-, 2-, and 3-year survival rates were, respectively, 100%, 100%, and 100% for the NCP group and 87.5%, 72.9%, and 72.9% for the CP group (P = .317). Constrictive physiology should be evaluated by cardiac catheterization before surgical treatment of IC in dogs. If CP is not diagnosed, subtotal pericardectomy may not be required.

Predicting recurrence of instability after a primary traumatic anterior shoulder dislocation.

The risk factors for recurrent instability (RI) following a primary traumatic anterior shoulder dislocation (PTASD) remain unclear. In this study, we aimed to determine the rate of RI in a large cohort of patients managed nonoperatively after PTASD and to develop a clinical prediction model. A total of 1,293 patients with PTASD managed nonoperatively were identified from a trauma database (mean age 23.3 years (15 to 35); 14.3% female). We assessed the prevalence of RI, and used multivariate regression modelling to evaluate which demographic- and injury-related factors were independently predictive for its occurrence. The overall rate of RI at a mean follow-up of 34.4 months (SD 47.0) was 62.8% (n = 812), with 81.0% (n = 658) experiencing their first recurrence within two years of PTASD. The median time for recurrence was 9.8 months (IQR 3.9 to 19.4). Independent predictors increasing risk of RI included male sex (p < 0.001), younger age at PTASD (p < 0.001), participation in contact sport (p < 0.001), and the presence of a bony Bankart (BB) lesion (p = 0.028). Greater tuberosity fracture (GTF) was protective (p < 0.001). However, the discriminative ability of the resulting predictive model for two-year risk of RI was poor (area under the curve (AUC) 0.672). A subset analysis excluding identifiable radiological predictors of BB and GTF worsened the predictive ability (AUC 0.646). This study clarifies the prevalence and risk factors for RI following PTASD in a large, unselected patient cohort. Although these data permitted the development of a predictive tool for RI, its discriminative ability was poor. Predicting RI remains challenging, and as-yet-undetermined risk factors may be important in determining the risk.

Repeating Nuclear Transients from Repeating Partial Tidal Disruption Events: Reproducing ASASSN-14ko and AT2020vdq

Some electromagnetic outbursts from the nuclei of distant galaxies have been found to repeat on months-to-years timescales, and each of these sources can putatively arise from the accretion flares generated through the repeated tidal stripping of a star on a bound orbit about a supermassive black hole (SMBH), i.e., a repeating partial tidal disruption event (rpTDE). Here, we test the rpTDE model through analytical estimates and hydrodynamical simulations of the interaction between a range of stars, which differ from one another in mass and age, and an SMBH. We show that higher-mass (≳1M ⊙), evolved stars can survive many (≳10−100) encounters with an SMBH while simultaneously losing few × 0.01M ⊙, resulting in accretion flares that are approximately evenly spaced in time with nearly the same amplitude, quantitatively reproducing ASASSN-14ko. We also show that the energy imparted to the star via tides can lead to a change in its orbital period that is comparable to the observed decay in the recurrence time of ASASSN-14ko’s flares, Ṗ≃−0.0026 . Contrarily, lower-mass and less-evolved stars lose progressively more mass and produce brighter accretion flares on subsequent encounters for the same pericenter distances, leading to the rapid destruction of the star and cessation of flares. Such systems cannot reproduce ASASSN-14ko-like transients, but are promising candidates for recreating events such as AT2020vdq, which displayed a second and much brighter outburst compared to the first. Our results imply that the lightcurves of repeating transients are tightly coupled with stellar type.

Less is more: The use of a single biodegradable stenting to treat biliary anastomotic strictures in pediatric liver transplantation.

To report our experience of using biodegradable biliary stents for anastomotic biliary strictures in pediatric liver transplant patients. Analysis of a retrospective data collection from January 2014 to January 2023, including all pediatric liver transplant recipients in our center treated for anastomotic biliary strictures with biodegradable biliary stents (BBS). In phase 1 (2014-2019), there was an initial percutaneous transhepatic cholangiography (PTC) with anastomotic dilatation followed two weeks after by a second PTC with BBS insertion. In phase 2 (2019-2023), the BDS were placed shortly after anastomotic biliary strictures dilatation, requiring only one PTC. All patients were followed up with routine tests and ultrasound. Forty-six anastomotic biliary strictures were diagnosed in 43 pediatric liver transplant recipients with a median of 6.7 months post-liver transplantation (0.1-246.8 months). Eight out of 46 anastomotic biliary strictures (17.4%) treated with biodegradable biliary stents relapsed (median recurrence time: 6.5 months; 1.6-17.0 months). Four resolved with further BBS placement; only four needed surgical revision (8.7%) after a median follow-up time of 43.9 months (0.3-106.3). There were no differences in anastomotic biliary strictures recurrence rate, time between stent placement and recurrence, or the presence of cholangitis based on whether the BBS was deployed in one or two steps. Patients with end-to-end anastomosis had a higher anastomotic biliary strictures recurrence (or 10.8; 1.4-81.3, p=0.008) than those with bilioenteric anastomosis. The use of biodegradable stents stents could be good option for treating anastomotic biliary strictures in pediatric liver transplant patients, with our series showing a success rate of over 90% and an average follow-up of 43.9 months.

The Accelerating Decline of the Mass Transfer Rate in the Recurrent Nova T Pyxidis* * Based on observations made with the NASA/ESA Hubble Space Telescope, obtained from the data archive at the Space Telescope Science Institute. STScI is operated by the Association of University for Research in Astronomy, Inc. under NASA contract NAS 5-26555.

The recurrent nova T Pyxidis (T Pyx) has erupted six times since 1890, with its last outburst in 2011, and the relatively short recurrence time between classical nova explosions indicates that T Pyx must have a massive white dwarf (WD) accreting at a high rate. It is believed that, since its outburst in 1890, the mass transfer rate in T Pyx was very large due to a feedback loop where the secondary is heated by the hot WD. The feedback loop has been slowly shutting off, reducing the mass transfer rate, and thereby explaining the magnitude decline of T Pyx from ∼13.8 (before 1890) to 15.7 just before the 2011 eruption. We present an analysis of the latest Hubble Space Telescope far-ultraviolet and optical spectra, obtained 12 yr after the 2011 outburst, showing that the mass transfer rate has been steadily declining and is now below its preoutburst level by about 40%: Ṁ∼1−3×10−7M⊙ yr−1 for a WD mass of ∼1.0–1.4 M ⊙, an inclination of 50°–60°, reddening of E(B − V) = 0.30 ± 0.05, and a Gaia Data Release 3 distance of 2860−471+816 pc. This steady decrease in the mass transfer rate in the ∼decade after the 2011 outburst is in sharp contrast with the more constant preoutburst ultraviolet continuum flux level from archival International Ultraviolet Explorer spectra. The flux (i.e., Ṁ ) decline rate is 29 times faster now in the last ∼decade than observed since 1890 to ∼2010. The feedback loop shut off seems to be accelerating, at least in the decade following its 2011 outburst. In all eventualities, our analysis confirms that T Pyx is going through an unusually peculiar short-lived phase.

Discovery of SRGA J144459.2−604207 with the SRG/ART-XC telescope: A well-tempered bursting accreting millisecond X-ray pulsar

We report the discovery of the new accreting millisecond X-ray pulsar SRGA J144459.2−604207 using data of the SRG/ART-XC. The source was observed twice in February 2024 during the declining phase of the outburst. The timing analysis revealed a coherent signal near 447.9 Hz modulated by the Doppler effect due to the orbital motion. The derived parameters for the binary system are consistent with a circular orbit with a period of ∼5.2 h. The pulse profiles of the persistent emission, showing a sine-like part during half a period with a plateau in between, can be well modeled by emission from two circular spots that are partially eclipsed by the accretion disk. Additionally, during our observations with an exposure of 133 ks, we detected 19 thermonuclear X-ray bursts. All bursts have similar shapes and energetics, and none show any signs of an expanding photospheric radius. The burst recurrence times decreases linearly from ∼1.6 h at the beginning of observations to ∼2.2 h at the end and anticorrelate with the persistent flux. The spectral evolution during the bursts is consistent with the models of the neutron star atmospheres that are heated by accretion and implies a neutron star radius of 11–12 km and a distance to the source of 8–9 kpc. We also detected coherent pulsations during the bursts and showed that the pulse profiles differ substantially from those observed in the persistent emission. However, we could not find a simple physical model explaining the pulse profiles detected during the bursts.

Nature and management of melanoma recurrences following adjuvant anti-PD-1 based therapy

IntroductionApproximately 50 % of resected stage II-IV melanoma patients develop recurrent disease by 5 years despite adjuvant anti-PD-1 therapy. Data to define best management of recurrences is lacking. MethodsThis was a multicentre, international, retrospective cohort study. Patients with resected stage II-IV melanoma who commenced adjuvant anti-PD-1-based therapy before January 2022 and later recurred were identified. Data on demographics, disease characteristics, recurrence patterns, management and outcomes were collected. Results711 patients from 17 sites were included. Median age was 60 [range 16–92], 64 % were male, 2 % stage II, 91 % were stage III, 7 % stage IV. Median time to recurrence was 6.2 months (0–68.5) and median follow up time from recurrence was 19.8 months (range 0.2–73.1). 63 % recurred on anti-PD-1 therapy, 36 % off therapy [3 % < 6 months, 33 % > 6 months]. Initial recurrences were locoregional (LR) alone in 44 %, distant alone (DR) in 43 %, and 11 % in both sites. LR recurrences were managed with local therapy, alone (62 %) or with “second adjuvant” anti-PD-1 (14 %) or BRAF/MEK therapy (23 %); 12 m RFS2 was 25 %, 29 % and 69 % respectively (p = 0.0045). Definitive systemic therapy at first recurrence was given in 16 % LR and 86 % DR, with best outcomes for anti-CTLA4 + anti-PD-1 and trial combinations (24 m PFS 63 % and 69 %, respectively). The 24 m OS for the entire cohort was 65 %. ConclusionMost recurrences following adjuvant anti-PD-1 based therapy occur early and while still on drug. Outcomes are poor, regardless of site, timing of recurrence, and subsequent treatment.

Evaluation of serum fibronectin levels and fibronectin gene polymorphism in patients receiving intravesical BCG therapy for non-muscle invasive bladder cancer and its prognostic value

BackgroundBladder cancer continues to be a significant health issue, leading to ongoing research into novel biomarkers and treatment strategies. This study aims to evaluate the potential of serum fibronectin levels and fibronectin gene polymorphisms as biomarkers for predicting the recurrence and treatment response in patients with NMIBC undergoing intravesical BCG therapy.MethodsBetween June 2022 and December 2022, data of 73 patients who applied to the Mersin University Urology Clinic due to NMIBC and were followed and treated in our clinic, receiving intravesical BCG treatment, when necessary, as well as 56 individuals without any malignancy, were prospectively examined. Serum fibronectin levels were measured using the enzyme-linked immunosorbent assay method. PCR testing was applied for the fibronectin gene RS10202709 and RS 35,343,655 gene polymorphisms by using Real-Time PCR.ResultsThe mean serum fibronectin level in the patient group was 76.794 ± 66.998ng/ml. Simultaneously, it was 50.486 ± 25.156ng/ml in the control group, and these differences in serum fibronectin levels were statistically significant(p = 0.003). Out of the 73 patients included in the study, recurrence of bladder cancer was observed in 53 of them. They were divided into two groups based on the recurrence times: early recurrence and late recurrence. The mean fibronectin level in the early recurrence group was 102 ± 86.1 ng/ml, while it was 44.7 ± 11.8 ng/ml in the late recurrence group. Emphasize the significance of the higher fibronectin levels in the early recurrence group by stating, patients with early recurrence exhibited significantly higher serum fibronectin levels compared to those with late recurrence (p < 0.001), suggesting a potential role for fibronectin as a prognostic biomarker.ConclusionsThe statistically higher concentrations of serum fibronectin levels in patients with bladder cancer observed in our study are a noteworthy finding. These findings suggest that serum fibronectin levels could serve as a valuable prognostic biomarker for early recurrence in NMIBC patients, although their predictive value for BCG treatment response remains limited.

First-degree family history of cancers in patients with stage I endometrial carcinoma. Prevalence and prognostic impact.

We aimed to study the impact of first-degree family history on patients with endometrial cancer. We conducted a retrospective chart review from January 1990 to June 2016, comparing stage I endometrial cancer patients with and without a sporadic family history of cancers. We collected the patients' demographic information, tumor characteristics, and treatment plans. During the follow-up period, patient information on tumor recurrence and survival was collected. The chi-square test was used to assess the associations between categorical variables. The Cox proportional hazards regression model was used to estimate multivariate-adjusted hazard ratios (95% confidence interval (CI)). Among the 1737 patients with stage I endometrial cancer, 709 had a positive first-degree family history of cancers and 1028 had negative family history (FH) of cancers. Patients with positive FH were more likely to be older, have stage IB disease, and receive adjuvant radiotherapy; however, the difference was not statistically significant. At 5years follow up, patients with a positive family history had longer time to recurrence (TTR) than their negative FH counterparts. Maternal family history of cancer was the most common, followed by a sister's history of cancer, paternal history, brother's history, and offspring history of cancer. Breast, endometrial, and colon cancers are the most common cancers among first-degree relatives. Endometrial cancer patients with sporadic first-degree FH of cancers share similar demographics and tumor characteristics compared to their counterpart with slightly increased likelihood to be older, with stage IB disease and have a longer TTR compared to their negative counterpart.

Мультидисциплинарный подход в лечении рецидива рака прямой кишки с вовлечением мочевых путей

Aim. To evaluate immediate and long-term oncological results ofsurgical treatment of recurrent rectal cancer involving the urinary tractsystem to show the need for a multidisciplinary treatment approach for locally advanced recurrent rectal cancer. Material and methods. Retrospective cohort analysis with prospective supported database. Analyzed 14 cases: all patients with locally advanced rectal cancer recurrence involving urinary tract system were operated at the Clinic of Coloproctology and Minimally Invasive Surgery in 2013-2022. Results. The age of the patients was 51.6 ± 13.0 years, 6 men, 8 women. The greatest recurrence number was (88%) finded in group of primary colorectal cancer of the lower and middle parts of the rectum. In 57.2% observations patients received preoperative chemotherapy or combination with radiotherapy. Approximately 64% of primary operations were performed using an open approach. Recurrence of CRC with pT3-T4 invasion was diagnosed in 72% of cases. Metastatic damage of lymphatic nodes after primary surgery were identified in 57.2% of cases. In 2 observations primary surgery was performed with R2 resection margin, relapse in that cases was detected after 11 and 13 months. One histopathological report indicated R1 resection, relapse noted after 6 months. Adjuvant chemotherapy was performed in 10 cases (71.4%), in two cases (14.3%) – postoperative radiation therapy. Average time for recurrence detecting after primary operation was 16.5 [12-28] months. Advanced combined interventions including recurrence removal with colon resection, gynecological and urological stages (RR+CR+GR+UR) amounted to 36%, recurrence removal with resection colon and urological stage (RR+CR+UR) was performed in 43% of cases, recurrence removal without the colonic stage (RR+GR+UR and RR+UR) - 3 (21%) patients. Reconstructive surgery to restore urine derivation were performed in 12 (85.7%) cases. The average duration of the procedures was 412.5[205-490] minutes, intraoperative blood loss - 275 [150-400] ml. Early postoperative complications are classified as Clavien-Dindo III. One patient with SIRS was classified as a complication Clavien-Dindo IV. The duration of the postoperative period was 25.5 [14-30] days. Postoperative mortality was 0%. According pathohistological examination R1 resection was detected in 3 (21.4%) cases. Adjuvant chemotherapy was performed 8 (57.1%) patients, in 1 case (7.1%) combination with a course of radiotherapy. During the period 24 months after surgery the mortality rate was 14.3%, repeated relapses diagnosed in 3 (21.4%) patients, one was reoperated. Distant metastases was noted in 4 (28.6%) patients, of which in 1 case with repeated recurrence. Discussion. Our urogenital bacterial diversity analysisshowed that human testicular tissue is not a microbiologically sterile environment and also presented new data associated with testicular tissue and its possible relations with male infertility. Conclusion. The main treatment method for locally advanced rectal cancer recurrence involving the urinary tract system is surgical. Multidisciplinary approach with the involvement in the surgical team urologist oncologist made it possible to perform a one-stage radical intervention for locally advanced recurrence of rectal cancer with restoration of derivation urine without the need for subsequent reconstructive procedures on the urinary system. Keywords: rectal cancer, urinary tract, multidisciplinary approach, surgical treatment, recurrence.

A computational probabilistic procedure to quantify the time of breast cancer recurrence after chemotherapy administration

We propose a random linear differential equation with jumps to model the dynamics of breast tumor growth using real patients’ data. The model considers the effect of chemotherapy administration and tumor resection. Also, the inherent randomness of the data and the model are taken into account.The model is probabilistically solved by combining two main methods belonging to Uncertainty Quantification: the principle of maximum entropy (PME) and the random variable transformation technique (RVT). The PME is applied to assign proper probability distributions to model parameters. The RVT technique is used to determine the probability density function (PDF) of the solution of the random differential equation, which is a stochastic process.We apply computational optimization techniques to determine the PDF of model parameters so that the PDF of the solution matches the ones assigned to real patients’ data.Once random tumor dynamics has been modeled, we simulate, after surgery, different adjuvant chemotherapy strategies with the aim of delaying tumor recurrence as long as possible. Results are in concordance with medical literature, and tumor relapse is delayed as more cycles of chemotherapy are administered.Although the proposed model has a common general structure, it is shown how it can be customized to patients in order to construct projections about the tumor’s growth. To better illustrate the applicability of the proposed approach, we carefully show how our model can be tailored to two real patients treated at the Hospital Clínico de Valencia (Spain). The obtained results have been overseen by doctors from this hospital.

On the kinetic temperature of a one-dimensional crystal on the long-time scale

We investigate the dynamics of the kinetic temperature of a finite one-dimensional harmonic chain, the evolution of which is initiated by a thermal shock. We demonstrate that the kinetic temperature returns arbitrarily close to its initial state (the one immediately following the thermal shock) infinitely many times, and we give an estimate for the time elapsed until the recurrence. This assertion is closely related to the Poincare recurrence theorem and we discuss their relation. To estimate the recurrence time we use its averaging along system’s trajectory and provide a rigorous mathematical definition of the mean recurrence time. It turns out that the mean recurrence time exponentially increases with the number of particles in the chain. A connection is established between this problem and the local theorems of large deviations theory.Previous studies have shown that in such a one-dimensional harmonic chain, at times of order N, a thermal echo phenomenon is observed — a sharp increase in the amplitude of kinetic temperature fluctuations. In the present work, we give a rigorous mathematical formulation to this phenomenon and estimate the amplitude of the fluctuations.The research is funded by the Ministry of Science and Higher Education of the Russian Federation within the framework of the Research Center of World-Class Program: Advanced Digital Technologies (agreement №075-15-2020-311 dated 04.20.2022).

Analyzing Recurrence Rates in Pyoderma Gangrenosum

Pyoderma Gangrenosum (PG) is a rare skin disease characterized by rapid development of painful skin ulcers with violaceous borders that is often associated with inflammatory disorders.1,2 Treatment involves systemic immunosuppression alongside wound care management.2,3 Despite clinicians’ best efforts in implementing appropriate therapy, PG ulcers can recur, and there is minimal data regarding recurrence rates. We systematically reviewed Embase, MEDLINE, and Cochrane library for cases, case series, and clinical studies of confirmed PG to evaluate for recurrence rates. Recurrence was defined as the appearance of new ulcerations after complete initial healing. Our analysis found 269 studies with 351 patients. Among this cohort, 34 cases (10%) described one or more recurrence episodes. Within these 34 cases, ulcer locations were as follows: 20 (56%) on the lower extremities, 12 (33%) on the trunk, 1 (3%) on the upper extremities, 1 (3%) on the head, and 2 (5%) in unspecified areas. When analyzing the time of recurrence from initial healing, we found that 11 cases (29%) recurred in 3 months or less, 5 (14%) from 3 to 6 months, 1 (3%) from 6 to 12 months, and 7 (19%) after 12 months. 13 cases (35%) did not specify a timeline for recurrence, and 3 cases reported two recurrence episodes. In conclusion, our study investigates PG recurrence patterns and suggests that about 10% of patients with PG might experience recurrence after healing, which supports previously reported data.4 Future directions include the impact of treatment duration and treatment type (topical versus systemic) on recurrence rates.

The impact of histological subtype on postoperative recurrence pattern and timing in locally advanced esophagogastric junction cancer

PurposeThe differences in tumor behavior between adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the esophagogastric junction (EGJ) have yet to be well investigated. The purpose of this study was to gain insights that can contribute to tailored treatments and follow-up strategies by analyzing the correlation between histological subtypes and oncological outcomes.MethodsA retrospective analysis was used to determine the characteristics of the histological subtypes of EGJ cancer by comparing the appearance of postoperative recurrence. A total of 102 consecutive patients with pathological stage IIA to IVA EGJ cancer, who underwent R0 surgery in our department from 2004 to 2020, were enrolled. The recurrence pattern, timing, survival, and potential prognostic factors were compared.ResultsAfter a median follow-up time of 70.1 months, the AC group demonstrated comparable lymph node failure-free survival (P = 0.291) and significantly worse non-lymphogenous recurrence-free survival (P = 0.035) than did the SCC group. A significantly longer period from surgery to recurrence was also observed in the AC group (P = 0.029). Multivariate analysis indicated that histological subtype (P = 0.015, 95% CI 1.24–7.28) was significantly correlated with the incidence of non-lymphogenous recurrence.ConclusionsThe pattern and timing of postoperative recurrence were significantly different between the histological subtypes of EGJ cancer. Compared with EGJ SCC, EGJ AC may have a greater tendency toward non-lymphogenous progression and a greater propensity for longer surgery-to-recurrence periods.

Challenges related to clinical decision-making in hepatocellular carcinoma recurrence post-liver transplantation: Is there a hope?

Hepatocellular carcinoma (HCC) is a common liver malignancy and represents a serious cause of cancer-related mortality and morbidity. One of the favourable curative surgical therapeutic options for HCC is liver transplantation (LT) in selected patients fulfilling the known standard Milan/University of California San Francisco criteria which have shown better outcomes and longer-term survival. Despite careful adherence to the strict HCC selection criteria for LT in different transplant centres, the recurrence rate still occurs which could negatively affect HCC patients' survival. Hence HCC recurrence post-LT could predict patients' survival and prognosis, depending on the exact timing of recurrence after LT (early or late), and whether intra/extrahepatic HCC recurrence. Several factors may aid in such a complication, particularly tumour-related criteria including larger sizes, higher grades or poor tumour differentiation, microvascular invasion, and elevated serum alpha-fetoprotein. Therefore, managing such cases is challenging, different therapeutic options have been proposed, including curative surgical and ablative treatments that have shown better outcomes, compared to the palliative locoregional and systemic therapies, which may be helpful in those with unresectable tumour burden. To handle all these issues in our review.

Retrospective study on endoscopic treatment of recurrent esophageal cancer patients after radiotherapy.

Esophageal cancer poses a significant health burden globally. Endoscopic treatment has emerged as a viable option for patient ineligible for surgery or experiencing disease recurrence post-radiotherapy. Patients visiting the Department of Endoscopy at the Cancer Hospital of China Academy of Medical Sciences between March 2009 and March 2024 were retrospectively analyzed. Inclusion criteria encompassed patients with histologically confirmed esophageal cancer who had not undergone surgery, but received radiotherapy or CRT, and subsequently opted for endoscopic treatment. Data on demographics, treatment modalities, recurrence patterns, histopathological characteristics, and outcomes were collected. Statistical analysis was conducted using SPSS 27.0, employing Kolmogorov-Smirnov tests for data normality assessment. Out of 25 included patients, the mean age was 60.29years, with a predominance of males (88%). Most patients (64%) received chemoradiotherapy (CRT), while the rest underwent radiotherapy alone. The median follow-up duration was 50.92months, with a median recurrence time of 38.92months. Majority (56%) presented with a solitary lesion and 76% had negative margins. Histopathological analysis revealed various stages of cancer, with the most common being high-grade squamous epithelial neoplasia (64%). Survival analysis indicated a 72% overall survival rate, with 16% surviving beyond 5-year post-treatment. Approximately, 20% succumbed during the study, primarily due to non-esophageal causes (16%). Endoscopic treatment shows promise as a therapeutic option for selected esophageal cancer patients, offering favorable outcomes in terms of survival and disease control. Further prospective studies are warranted to validate these findings and optimize patient selection criteria for endoscopic interventions in esophageal cancer management.

Laparoscopic Fertility-Sparing Management of Borderline Ovarian Tumors: Surgical and Long-Term Oncological Outcomes.

Objectives: To assess the long-term oncological safety of laparoscopic fertility-sparing surgery (FSS) in borderline ovarian tumors and the impact of laparoscopic surgical factors on recurrences. Primary outcomes were the recurrence rate and time to recurrence after laparoscopic FSS. Secondary outcomes were to evaluate the recurrence rate after a second laparoscopic surgery and to assess factors associated with the risk of relapse. Methods: This is a retrospective single-center observational study in a tertiary university-affiliated hospital. Thirty-four patients diagnosed with borderline ovarian tumors who underwent laparoscopic FSS were recruited. Patients were categorized into two groups: the adnexectomy group, including patients who underwent unilateral adnexectomy, and the cystectomy group, which included patients who underwent unilateral cystectomy, bilateral cystectomy, and unilateral adnexectomy with contralateral cystectomy. Results: Eleven relapses (32.3%) were observed during a median follow-up period of 116.1 [62.5-185.4] months. The recurrence rate was similar for patients who underwent cystectomy (6/19, 31.6%) and adnexectomy (5/15, 33.3%). Cystectomy led to a shorter time to first recurrence (36-month progression-free survival rates of 66% vs. 85%) and higher rates of capsular rupture (71.4% vs. 20%, p = 0.04) compared to adnexectomy. No deaths due to progression of disease were reported. Conclusions: Laparoscopic FSS for borderline ovarian tumors is a safe, long-term oncological option. Although the recurrence rate was similar in patients undergoing adnexectomy or cystectomy, the time to recurrence was shorter in cases treated with cystectomy. Further research is needed to identify eventual laparoscopic risk factors more strongly correlated with recurrence.