ABSTRACT Background This study aimed to evaluate the impact of HPV vaccination at the time of treatment of cervical intraepithelial neoplasia (CIN) 2+ on recurrence/persistence. Research design and methods Unvaccinated women with genital high-grade lesion(s) were offered vaccination (Gardasil 9®) at the time of treatment. Those with CIN2 or 3 were compared with a historical control group of unvaccinated women. Results Vaccination was accepted by 99.6% of women (267/268); 170 satisfied the inclusion criteria. CIN2+ recurrence/persistence rate up to 24 months in the vaccine group was 3.0% (5/164) vs. 7.1% (21/295) in the control group, p = 0.091. There were no differences in the time until diagnosis. Positive margins (HR [hazard ratio] 8.28; 95% CI 4.08 to 16.77, p < 0.001) and age > 45 years (HR 2.99; 95% IC 1.56 to 5.74, p < 0.001) were associated with increased risk of persistence/recurrence. There was no reduction in HPV detection at 6 months, but vaccinated women were more likely to become HPV negative (HR 0.689; CI 95% 0.54 to 0.89; p = 0.003) and earlier. Conclusion There was a non-significant trend toward lower risk of recurrence/persistence of CIN2+ after treatment in vaccinated women; vaccination did not impact the short-term HPV detection but increased the likelihood of becoming undetectable.

The role of WNT10B expression in the prognosis of colorectal cancer: A retrospective study based on TCGA database and clinical data.

Treatment of early-stage oral cavity squamous cell carcinoma at low-volume facilities impacts surgical margins and survival: an analysis of 22,258 patients from the NCDB.

Detection of margin positivity in breast cancer using fluorescence and diffuse reflectance imaging.

Clinical protocol for the K-3 trial: a single-center, patient-blinded, randomized clinical trial addressing anesthesiologic, oncological and patient recovery outcomes of standard flank approach vs supine approach for robot-assisted partial nephrectomy.

To report the minimum 18-month follow-up oncological results of the first preliminary descriptive series of robot-assisted radical prostatectomy (RARP) using Versius Robotic Surgical System (VRSS). Data of patients were collected from two Italian centres. Data on demographic variables, surgical results, pre- and postoperative prostatic specific antigen (PSA), needed for post-operative radiotherapy were extracted from the common database. Sixty patients underwent RARP performed by two surgeons at two different centres. Median follow-up time was 29.5 (IQR 23-35) months. Twenty-one (35%) patients had reported positive surgical margins and 18 (30%) presented extracapsular invasion in the final pathology report. Fifty-five (91.7%) patients had undetectable PSA (≤0.05ng/mL) at 40days follow-up after surgery. Thirteen (21.7%) patients underwent post-operative radiotherapy during our follow-up. Results of our experience with RARP suggest that performing RARP using VRSS oncologic results are comparable with other case studies using other robotic platforms.

Vulvar high-grade squamous intraepithelial lesion (vHSIL) is a premalignant condition caused by persistent infection with high-risk human papillomavirus (HPV), with approximately 10% of cases progressing to vulvar carcinoma within ten years. This systematic review evaluates the effectiveness of surgical excision, CO2 laser ablation, and imiquimod cream in terms of complete response (CR) and recurrence rates. A systematic review was performed following PRISMA guidelines, with literature searches conducted in Medline, Embase, and Web of Science (PROSPERO: CRD42024578702). Eligible studies included adult women (≥18years) with histopathologically confirmed vHSIL requiring treatment. Two independent reviewers performed study selection and data extraction, and risk of bias was assessed using the Cochrane tools. Due to substantial study heterogeneity, a formal meta-analysis was not performed. Instead, pooled CR and recurrence rates were calculated using weighted averages, with 95% confidence intervals. Statistical heterogeneity was assessed with the I2 statistic and Chi2 test. 26 studies involving 1,705 patients were included. Pooled CR rates ranged from 55 to 100% for excision, 44-85% for CO2 laser, and 25-81% for imiquimod. Recurrence rates varied from 0 to 83%, with the lowest recurrence observed in HPV-negative patients treated with imiquimod. Excision resulted in rapid CR but had high recurrence rates, particularly with positive surgical margins. Imiquimod caused local adverse effects (burning, erythema, irritation), but preserved anatomy, as did CO2 laser ablation, which lacked histological control. No single treatment modality proved superior, with all showing high recurrence rates. These results emphasize the importance of individualized treatment strategies and further research to reduce recurrence.

Factors associated with the feasibility and margin quality of sublobar resection for peripheral small-sized non-small cell lung cancer.

Breast-conserving surgery (BCS) for non-palpable lesions is technically demanding, often performed by surgical trainees under supervision. Despite extensive literature evaluating localization techniques, only few studies have directly examined the role of surgeon seniority in determining surgical performance in this specific setting. We conducted a retrospective multicenter analysis (LOCALIZATION01 study, NCT05942105) including 3,195 patients who underwent BCS for non-palpable breast lesions between 2016 and 2024 across 12 Breast Units. Four localization techniques were used: wire-guided (WGL), radioguided occult lesion localization (ROLL), magnetic seed localization (MSL), carbon localization (CL). Outcomes included margin status, calculated resection ratio (CRR), operative time, and complications, stratified by surgeon seniority (attending vs resident). Most procedures were performed by attending surgeons (89.3%, n=2,855) compared to residents (10.7%, n=340). Margin positivity rates didn't differ significantly across localization techniques (e.g., ROLL 3.7% vs 2.3%, p=0.30; MSL 9.4% vs 4.4%, p=0.11, WGL 2.7% vs 5.9 p=0.16, CL 0% vs 9.6% p=0.10). Residents achieved better CRR in ROLL procedures (2.0, IQR 3, [1-47] vs 2.8, IQR 5, [1-78], p=0.006), but had longer operative times, particularly with SLNB (e.g., MSL 60min, IQR 31, [37-98] vs 55min, IQR 20, [18-180], p=0.02). Complication rates were low and comparable between groups. In a supervised setting, surgeon seniority doesn't significantly impact margin status, complication rates, or overall oncologic safety in BCS for non-palpable breast lesions. Localization methods with high reproducibility, such as ROLL and MSL, may mitigate the influence of surgical inexperience. These findings support the safe involvement of trainees in BCS under adequate supervision.

Introduction: This study evaluated the diagnostic accuracy of colposcopic assessment and the effectiveness of large loop excision of the transformation zone (LLETZ) in the management of cervical intraepithelial neoplasia (CIN) within a tertiary UK centre. Methodology: A retrospective review was conducted of 284 consecutive women who underwent colposcopy and LLETZ at Addenbrooke’s Hospital, Cambridge, between 1 January and 31 December 2023. Primary outcomes included adequacy of excision depth, histological margin status, and Test-of-Cure (TOC) outcomes. Depth adequacy was defined according to transformation zone (TZ) type (TZ1 ≥7 mm, TZ2 ≥10 mm, TZ3 ≥15 mm). Demographic and clinical characteristics were recorded. Results: Of the 284 LLETZ procedures, 87.7% were performed as a single excisional specimen, meeting national quality standards. TOC success was achieved in 89% of cases. The positive predictive value of colposcopy for detecting high-grade histology was 82.5% among women referred with highgrade cytology and 69% overall. Adequate excision depth was achieved in 59% of cases, with the highest adequacy observed in Type 1 transformation zones (64%). Complete excision with negative margins was achieved in 61.4% of cases, with lower rates observed in Type 2 and Type 3 transformation zones. Margin positivity was more frequent among younger women aged 25–34 years. Conclusion: Colposcopy and LLETZ demonstrated high diagnostic accuracy and effective disease clearance in this tertiary centre. While overall outcomes aligned with national standards, achieving adequate excision depth and negative margins-particularly in Type 3 transformation zones-remains challenging. A cautious, individualised surgical approach may help balance oncological safety with fertility preservation while maintaining high TOC success.

To assess the feasibility and safety of early unclamping of the renal artery during laparoscopic partial nephrectomy (LPN) for localized renal tumors, by comparing the perioperative outcomes of early versus standard unclamping techniques in a tertiary care center in Lebanon. This retrospective study included patients who underwent pure or hand-assisted LPN between 2017 and 2020. Patients were categorized into early unclamping (EUC)-where the renal artery was unclamped after placement of the initial sutures on the tumor bed-and standard unclamping (SUC)-where clamping was maintained until renorrhaphy was complete. Perioperative parameters, tumor characteristics, kidney function, complication rates, and pathological outcomes were compared. Multivariable analysis, sensitivity analysis, and stratification were conducted to explore predictors of warm ischemia time (WIT), complications, and other outcomes. Forty-nine patients were included (37 SUC, 12 EUC). EUC was associated with a significantly shorter warm ischemia time compared with SUC (15 min vs 25 min, p < 0.001), with a trend toward shorter operative time. Complication rates, transfusion requirements, and positive surgical margins did not differ significantly between groups. Multivariable analysis suggested that EUC was independently associated with shorter warm ischemia time, while tumor size appeared to be the main predictor of complications. Sensitivity analysis also indicated an association between tumor size and complications, and stratified analysis suggested that complications tended to occur more frequently in complex tumors. Early unclamping in LPN is a feasible and safe technique that reduces WIT without compromising visibility during tumor resection or renorrhaphy. This strategy theoretically supports favorable functional and oncologic outcomes, though definitive evidence is limited by the lack of long-term follow-up. Larger prospective studies are needed to confirm these potential benefits.

To evaluate survival outcomes, complication rates, and prognostic factors for dogs and cats with urothelial carcinoma (UC) treated with partial cystectomy. Medical records of client-owned dogs and cats with UC treated with partial cystectomy between January 2010 and December 2024 were retrospectively reviewed. Data regarding signalment, tumor and surgical characteristics, adjuvant therapy, and outcomes were collected. Disease-free interval and median survival time (MST) were estimated via the Kaplan-Meier method. Prognostic factors were identified with log-rank tests and Cox proportional hazards modeling. 30 animals were included (20 dogs, 10 cats). Overall MST for 27 patients was 512 days and disease-free interval was 255 days. Mean survival time was 498 days for dogs and 730 days for cats. Complete surgical margins were associated with longer MST on univariate analysis. On multivariate analysis, complete surgical margins (hazard ratio, 0.27) and adjuvant chemotherapy (hazard ratio, 0.24) were independent positive prognostic factors. Postoperative complications occurred in 16 of 30 patients (53%). Local recurrence was documented in 12 patients (40%) and distant metastasis in 5 patients (17%). Partial cystectomy, as part of a multimodal treatment plan including adjuvant medical therapy, can be associated with prolonged survival in select dogs and cats with nontrigonal UC. The achievement of complete surgical margins is a critical predictor of outcome. The procedure carries a substantial risk of complications and eventual disease progression, underscoring the importance of careful case selection and comprehensive client counseling regarding the palliative intent of therapy.

Surgical resection remains the first-line treatment for breast cancer, underscoring the need for precision tools for intraoperative margin delineation. Due to high heterogeneity, accurate identification of tumor margins poses a significant challenge in breast cancer. Herein, we report a rapid-clearance near-infrared fluorescent probe, Cy-JW (λab = 775 nm, λem = 808 nm, compatible with current clinical intraoperative fluorescence imaging devices), which can target the tumor-overexpressed enzyme KIAA1363. Cy-JW exhibited high aqueous solubility and potent affinity for KIAA1363 (IC50 = 36.90 nM) and enabled clear visualization in three representative breast cancer cell lines. In mouse xenograft models, both intratumoral and intravenous administration yielded high tumor-to-background ratios (TBR > 5), supporting complete and precise tumor resection. Biodistribution and safety evaluations indicated rapid plasma clearance (t1/2 < 0.5 h) and predominant renal excretion within 48 h, suggesting a favorable safety profile with a reduced risk of systemic toxicity. Furthermore, preclinical assessment of freshly resected specimens from breast cancer patients (across three subtypes) using a clinical fluorescence imaging device showed strong agreement between fluorescence-guided demarcation and histopathological analysis. Collectively, these results establish Cy-JW as a promising agent for fluorescence-guided surgery (FGS) applications across diverse breast cancer subtypes.

Rosai-Dorfman disease (RDD) is a rare histiocytic disorder that most commonly affects lymph nodes but can also present in extranodal sites. Involvement of the male breast is rare and may clinically and radiologically mimic malignancy. A comprehensive review will be valuable for histologic assessment and treatment of similar cases. We report a case of extranodal RDD in a 65-year-old man, who presented with a 48 × 40 × 25 mm left breast mass. The mass was excised with clear surgical margins. Histopathologic examination showed sheets and clusters of large histiocytes with emperipolesis on a background of lymphoplasmacytic inflammation. Immunohistochemistry showed that the lesional cells were positive for S100 and CD68, and negative for CD1a. The morphology and immunohistochemistry confirmed the diagnosis of extranodal RDD limited to the subcutaneous tissue of the breast. The literature review yielded 13 cases of extranodal RDD of the male breast. Four cases lacked sufficient details to be included in the synthesis. All patients presented with unilateral palpable breast masses. Radiologic evaluation was suspicious for malignancy in all 7 patients with imaging reported. Microscopy revealed sheets of large histiocytes with emperipolesis, which were positive for S100 and CD68 and negative for CD1a. No evidence of systemic disease was found. All patients were treated conservatively, with 2 recurrences at 24 months of follow-up. Extranodal RDD of the male breast is exceedingly rare and can mimic carcinoma both clinically and radiologically. Accurate diagnosis requires histologic and immunohistochemical confirmation. Awareness of this entity is critical to avoid overtreatment.

This study analyzed the profitability of taro farming in North Central, Nigeria. A simple random sampling design was used to select 220 taro farmers based on a well-structured questionnaire. The data were analyzed using descriptive statistics, farm budgetary technique, and depreciation of assets, financial analysis, multiple regression analysis, and Kendall’s coefficient of concordance. The average age and farm experience of taro farmers were 42 and 10 years, respectively. The results show that the mean total cost of taro production per hectare was 410.442$, while the mean total revenue was 1066.67$ indicating a substantial positive margin. The calculated t-value of (112.14) was greater than the tabulated t-value (1.96) at 5% level of significance, this implies that taro production was profitable in the study area. The profitability analysis further shows a gross margin of 827.25$ and a net farm income of 656.22$, reflecting a rate of return on investment (ROI) of 1.596. Despite the high profitability, variation in returns SD = 87,602 relative to cost SD = 42,594 suggest disparities in the efficiency and access to productive resources. Age, experience, education, and farm size were significant factors influencing the net farm income of taro farmers. These findings underscore the economic potential of taro as a food security and income generating crop in Nigeria. The study recommends strengthening agricultural input support programs through access to inputs, use of resistant varieties, enhancing extension service delivery system and improving market infrastructure, value addition to sustain profitability among taro farmers.

Tumour-free margins ( >5 mm) in head and neck malignancies improve prognosis, possibly impacting the need for adjuvant treatment. In this phase II prospective, non-randomised trial (NCT05499065), we investigate the use of fluorescence imaging using the tumour targeting fluorescent tracer cetuximab-IRDye800CW combined with fresh frozen sectioning to identify inadequate margins intraoperatively in patients with oral squamous cell carcinoma. Primary objectives of our study are intraoperative detection of inadequate margins and additional resections, and feasibility of implementing fluorescence-guided fresh frozen sectioning (FG-FFS) into the clinical workflow. In this study, 10 out of 20 patients show inadequate margins after initial surgery; FG-FFS correctly classifies margin in 19 patients. Additional resections increase tumour-free margin rates from 50% to 85%, where anatomical boundaries limit further improvement in one patient. Intraoperative margin adjustment reduces the need for adjuvant treatment in seven patients. These findings demonstrate that FG-FFS is a reliable and feasible method for intraoperative margin assessment without delaying surgery.

Lung cancer remains the leading cause of cancer-related death globally. While lobectomy is the standard treatment for early-stage disease, trials have shown that segmentectomy offers comparable survival outcomes for small (≤2 cm) peripheral tumours. Robotic-assisted thoracic surgery (RATS) has gained popularity due to enhanced precision compared with video-assisted thoracic surgery (VATS). However, comparative outcomes of RATS vs VATS segmentectomy remain unclear. This study, therefore, aimed to compare short-term and long-term outcomes in patients undergoing VATS and RATS segmentectomy for non-small cell lung cancer (NSCLC). We retrospectively reviewed consecutive patients undergoing RATS or VATS segmentectomy for NSCLC between July 2015 and December 2021. Primary outcomes were overall survival (OS), disease-free survival (DFS), and recurrence. Secondary outcomes included complications, length of stay, length of drainage, and lymph-node stations harvested. A total of 144 patients were included (RATS n = 86; VATS n = 58). Baseline characteristics were comparable across groups. RATS was associated with a significantly greater number of lymph-node stations harvested and wider tumour-free margins. Short-term outcomes, including complications, length of stay, drainage duration, conversion rates, and operative time, were similar. Long-term outcomes favoured the robotic approach, with significantly improved OS, DFS, and lower recurrence rates, although multivariable analysis showed no significant difference in hazard ratios between approaches. RATS segmentectomy demonstrated improved survival metrics and reduced recurrence compared with VATS while maintaining comparable perioperative outcomes. The robotic platform facilitated more extensive lymphadenectomy and wider resection margins, which may underlie the observed oncologic advantages.

Phyllodes tumours (PTs) are infrequent fibroepithelial neoplasms that account for <1% of all primary breast tumours. Local recurrence (LR) rates and distant metastasis vary depending on tumour histology. In this case report, the patient developed a painful growing tumour in the nipple after nipple-sparing mastectomy 17 years before. Local excision was performed with a final diagnosis of borderline PT after 205 months disease-free.The management of surgical margins of PT remains under discussion due to the high risk of LR. Breast-conserving surgery, when feasible, is considered the surgical approach of choice; however, immediate breast reconstruction after mastectomy is a balanced option when the tumour's characteristics are not suitable for conservative surgery. When performing nipple-sparing mastectomy, nipple recurrence is extremely rare but a complication to consider during the patient's follow-up.

Transoral laser microsurgery for glottic cancer: landmark 24-year single-institution experience with 661 patients and validation of the isoprognostic zone system.

Currently, the Test of Cure after conization consists of two elements, namely human papillomavirus (HPV) testing and cytology. Given the high sensitivity of HPV testing and its modest resource requirements, we will explore its potential as a stand-alone test for identifying persistent/recurrent cervical intraepithelial neoplasia (CIN) during follow-up after conization, including women at increased risk, such as those with involved resection margins. This retrospective study examined 473 women who underwent conization in Funen, Denmark, between January 1, 2020, and December 31, 2024. During the post-conization follow-up period, data were manually extracted from patients' medical records and PatoBank. At the follow-up, cervical intraepithelial neoplasia grade 1 or worse (CIN1+) persistent/recurrence was experienced by 55 women (11.6%) (median age of 42 years (range 22-87 years)). Among those with involved margins, 30.3% (40/132) experienced persistent/recurrent CIN1+ compared to 3.6% (7/193) with free margins; and 66.4% (314/473) tested negative for high-risk HPV after conization, and only four of them developed persistent/recurrent CIN1+. HPV testing alone predicted the risk of CIN1+ persistence/recurrence with 93% sensitivity and 98.7% negative predictive value (NPV). Combining negative HPV test results with free resection margins yielded a sensitivity and NPV of 100%. Co-testing combined with free margins also provided a sensitivity and NPV of 100%. Using HPV testing as a stand-alone test after conization demonstrates an NPV nearly equal to that of the Test of Cure. Adding free margins to HPV testing further enhanced sensitivity and NPV for detecting CIN1+ persistence or relapse during follow-up. Our results indicate that HPV testing alone can be used as post-conization follow-up for women with negative margins.