Background: Thyroid cancer constitutes 92% of all endocrine malignancies, and ranks as the eighth most prevalent cancer in females. Methods: This descriptive cross-sectional study was conducted to determine the frequency and histopathological features of thyroid cancers in thyroidectomy specimens, at the Department of Histopathology, Dow University of Health Sciences, Ojha campus, Karachi. Histopathological data of 350 specimens was collected during the course of research, from June 2021 to June 2022. Results: Of the 350 thyroidectomies, benign thyroid lesions were diagnosed in 281 (80.3%), low-risk neoplasms in 8 (2.3%) and thyroid cancer in 61 (17.4%) cases. Neck swelling was the most common presentation, followed by solitary thyroid nodule. Total thyroidectomy was the preferred type of surgery for malignant cases and benign cases with compressive symptoms. Female-to-male ratio was 6:1. Papillary thyroid carcinoma was the most frequent malignant neoplasm, diagnosed in 42 thyroidectomies (68.9%), followed by follicular and medullary carcinomas, 5 cases each (8.2%). Poorly differentiated thyroid carcinoma was documented in 2 cases and only one case of anaplastic carcinoma was reported. Most of the thyroid cancers were pathological stage T3. Conclusion: Thyroid cancers accounted for 17.4% of all thyroidectomy cases with a strong female predominance. Papillary thyroid carcinoma was the most common type and most cases presented at pT3 stage. This emphasizes the need for thorough clinical and radiological evaluation of neck swellings to enable timely diagnosis.

BackgroundThere is no consensus on whether a thorough mediastinal lymph node dissection (MLND) is necessary for stage I lung adenocarcinoma (AD) patients who require lobectomy. This study aimed to evaluate the survival impact of MLND in patients with T1 stage lung AD undergoing lobectomy.MethodsWe conducted a retrospective cohort study of 5,398 patients diagnosed with lung AD (tumor diameter 1–29 mm) from 2004 to 2015, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) program. Patients were treated with either lobectomy only or lobectomy with MLND. The primary endpoint was overall survival (OS), analyzed using Kaplan-Meier survival analysis, Chi-squared testing, and Cox regression analysis.ResultsAt a median follow-up of 97 months, the median survival duration for patients with T1a lung AD who underwent lobectomy with MLND was significantly longer (143 months), compared to those who underwent lobectomy alone (79 months, P<0.001). Similar survival benefits were found for T1b and T1c lung AD. Multivariate analysis revealed that lobectomy with MLND was an independent prognostic factor for patients with T1 stage lung AD [hazard ratio (HR) =0.731; 95% confidence interval (CI): 0.639–0.837; P<0.001]. Other significant prognostic factors included gender, age, N stage, and treatment modalities.ConclusionsOur findings suggest that MLND significantly improves survival in patients with T1 stage lung AD, highlighting its importance as a surgical strategy. Further prospective randomized controlled trials are needed to confirm these findings.

To explore the prognostic factors affecting over 80 years of age patients of esophageal cancer with other cancers through the SEER database and provide a scientific basis for the treatment of specific groups of esophageal cancer patients. A total of 2244 patients over 80 years of esophageal cancer with other cancers were selected from the SEER database. Through univariate and multivariate Cox regression analyses, variables were screened to determine independent prognostic risk factors for patients. Patients were divided into Group A and Group B according to sequence number. Propensity score matching (PSM) was performed to adjust for baseline differences between the two groups. Cancer-specific survival (CSS) and overall survival (OS) was calculated using the Kaplan-Meier method and compared using the log-rank test. Subgroup and Multiple Imputation analyses were conducted. This study included 2244 patients over 80 years old of esophageal cancer with other cancers. Cox multivariate analysis revealed that sequence number of primary tumours, surgery and chemotherapy were independent factors for CSS and OS. Age and T stage were an independent prognostic factor for OS but not CSS. Patients were divided into Group A (1st of 2 or more primaries patients) and Group B (2nd of 2 or more primaries, 3rd of 3 or more primaries and ≥ 4th or more primaries patients). There were significant differences in the baseline characteristic of two groups, we performed PSM analyses at a 1:1 ratio to erase significant difference of each variable. After PSM, the median CSS of Group A (31 months, 95% CI 23-47) was significantly better than that of Group B (13 months, 95% CI 10-17) (P < 0.05), the median OS of Group A (19 months, 95% CI 14-25) was significantly better than that of Group B (10 months, 95% CI 7-12) (P < 0.05). Death analysis of 2244 patients revealed that 74.51% (n = 1558) died from disease progression, 8.27% (n = 173) from other malignant tumours, 12.82% (n = 268) from non-tumour diseases, and 4.40% (n = 92) from other causes. Age, T stage, sequence number of primary tumours, surgery and chemotherapy were independent factors affecting the survival of over 80 years of age patients of esophageal cancer with other cancers. Esophageal cancer as the first primary cancer demonstrating markedly better prognosis compared to those with non-first primary esophageal cancers, especially for patients with aged 80-84 years and T1 stage independent of treatments. This study highlight the value of prognosis for over 80 years patients of esophageal cancer with other cancers. Further research is needed to explore the prognostic prediction and treatment.

United States has high incarceration rate, with documented racial and socioeconomic disparities in incarceration. Cancer is the leading cause of death in prisons, accounting for nearly one-third of deaths. Prior studies suggest incarcerated patients may present with more advanced disease and worse cancer-specific outcomes. We aimed to assess the association between incarceration status and stage at presentation in bladder cancer. We used the Michigan Cancer Surveillance Program, a statewide, population-based registry. We included patients diagnosed with bladder cancer between 2004 and 2019. Advanced stage was defined as pathological T stage ≥2, nodal involvement (N+), or distant metastasis (M+). Demographic and clinicopathological variables included were age, sex, race/ethnicity, year of diagnosis, smoking history, histological grade, and tumor stage. Patients were stratified by incarceration status. Univariable and Multivariable logistic regression analyses were performed to assess the association between incarceration status and advanced disease at the diagnosis, after adjusting for relevant covariates. Among 29,429 patients with bladder cancer, 31 (0.1%) were incarcerated at diagnosis. Incarcerated patients were younger (median age 58 vs. 72 years, p<0.001), more frequently Black (16.1% vs. 6.2%), and had a higher proportion of ≥T2 stage disease (32.3% vs. 20.4%). In unadjusted analysis, incarceration was not significantly associated with advanced disease (OR 1.82, 95% CI 0.82-3.77; p=0.12). However, in multivariable analysis adjusting for age, sex, race, smoking and grade, incarceration was associated with higher odds of advanced stage at presentation (OR 2.46, 95% CI 1.01-5.82; p=0.04). Female sex, Black race, smoking status and high-grade tumors were also independently associated with advanced disease. Incarceration at the time of diagnosis was independently associated with higher odds of presenting with advanced-stage bladder cancer. These findings highlight incarceration status as a marker of clinical vulnerability, not fully explained by known risk factors such as smoking or race. Addressing this disparity will require both preventive strategies targeting modifiable risk factors and structural interventions to ensure timely access to cancer diagnosis and care within correctional settings.

Immunoglobulin A nephropathy is the most prevalent primary glomerular disease worldwide; however, its heterogenous clinical course complicates prognostic prediction. Podometrics, a quantitative assessment of podocytes based on the recently proposed "podocyte depletion hypothesis," has been suggested as a potential predictor of renal outcomes in various glomerular diseases. Nevertheless, its correlation with the Oxford classification or the pre-biopsy estimated glomerular filtration rate slope remains unclear. This study aimed to investigate the association between podometrics and MEST-C scores and identify podometric parameters associated with the pre-biopsy estimated glomerular filtration rate slope. Kidney biopsy specimens from 101 patients diagnosed with immunoglobulin A nephropathy at our institution between 2019 and 2022 were evaluated using the Oxford classification and podometrics. Patients were categorized into "decline" and "non-decline" groups based on their pre-biopsy estimated glomerular filtration rate slope. Urinary mRNA levels of podocyte markers (NPHS1 and NPHS2) were measured in 94 patients. Independent factors associated with the "decline" group were identified via multivariate nominal logistic regression analysis. Patients with stage S1 or T1/2 exhibited significantly lower podocyte densities and numbers compared with those with stage S0 or T0, respectively. Elevated urinary podocyte marker levels were associated with E1 and C1/C2 lesions. The "decline" group exhibited significantly lower podocyte density and number and larger mean podocyte volume compared with the "non-decline" group. In the multivariate analysis, a lower podocyte number was the only independent factor associated with the "decline" group. The podocyte number at the time of kidney biopsy was associated with the pre-biopsy estimated glomerular filtration rate decline slope in patients with immunoglobulin A nephropathy. Furthermore, elevated urinary podocyte mRNA levels suggested the presence of E and C lesions. Podometrics may serve as a potentially less invasive marker for monitoring disease activity and guiding treatment strategies.

To present clinical presentations, histological-pathological patterns, clinical T stage, divergent treating methods, and outcomes of primary adenoid cystic carcinoma (ACC) of the lacrimal gland in a Chinese population. This case series included patients with primary lacrimal gland adenoid cystic carcinoma treated at a Chinese hospital between 2003 and 2014. An exploratory multivariate Cox regression analysis was performed to evaluate the prognostic impact of clinical T-stage. Subsequently, Kaplan-Meier survival analysis was conducted, stratifying patients by T-stage (T4 vs. T1-T3) and by surgical approach among T4 patients, to assess the influence of tumor stage and surgical management on disease-free survival outcomes. A total of 38 patients included 16 men and 22 women with a median age of 46.3 years were enrolled. Sixteen patients (42.11%) had local recurrence, while nineteen patients (50%) had distant metastasis at the time of presentation. Twelve patients (31.58%) were in T1-T3 stage and twenty-six (68.42%) were in T4 stage. Nineteen patients (73.08%) in the T4 stage exhibited a predominantly solid-basaloid pattern, and only three (25%) in T1-T3 stage had a predominantly solid-basaloid pattern histological pattern. Median DFS for the entire cohort was 29.0 months (95% CI, 19.0-39.0), and median survival after metastasis was 7.0 months (95% CI, 3.0-9.0). After adjustment for covariates, T4 stage remained independently associated with significantly shorter DFS (HR = 4.46, 95% CI: 1.40-14.21, P = 0.011). A significant difference in DFS was observed between the T1-T3 and T4 groups (log-rank P = 0.003). Meanwhile, no significant difference in disease-free survival was observed between T4 patients undergoing globe-preserving surgery and eye-sparing approaches (log-rank P = 0.297). In this Chinese cohort, the solid-basaloid pattern correlated strongly with advanced T4 disease and aggressive behavior. Kaplan-Meier and multivariate Cox analyses consistently demonstrated that T4 stage was independently associated with significantly poorer DFS. For T4 patients, DFS did not differ significantly between exenteration and globe-preserving surgery when combined with radiotherapy, suggesting that eye-sparing approaches may be viable in advanced cases.

Most cutaneous malignant melanomas (CMMs) are thin (≤1.0 mm, stage T1) with an expected 10-year melanoma-specific survival of 93%-97%. The incidence of CMM is higher in groups with high socioeconomic status (SES). We aimed to assess overall survival (OS) and detailed characteristics in individuals with thin CMM as compared to the general population matched on age, sex, and county of residence. Matched cohort study comprising patients diagnosed between 2001 and 2018 with thin CMM (cases) and melanoma-free comparators from the general population. Patients and comparators were identified in the Malignant Melanoma Data Base Sweden. Multivariable Cox regression analyses were applied to compare the mortality risk for cases and comparators with adjustments for SES and comorbidities. We identified 25,843 cases and 127,383 comparators. Cases had higher SES and less comorbidity. No significant differences in OS were found. However, in the T1a subgroup, comprising 16,941 cases, the 5-year OS was significantly better than in comparators (n = 83,510) (92.5% (95% CI 92.1%-93.0%) versus 91.1% (95% CI 90.8%-91.3%), p <.001). The adjusted mortality risk was slightly higher for the whole T1 group (HR 1.05, 95% CI 1.01-1.09), while no difference was found for the T1a subgroup. Deaths attributed to cardiovascular disease, dementia, and chronic obstructive pulmonary disease were less common in CMM patients. Patients diagnosed with thin CMM have an OS similar to or even better than the general population since they are at a lower risk of death from other diseases, likely reflecting socioeconomic and lifestyle factors.

BackgroundLarge cell neuroendocrine carcinoma (LCNEC) accounts for approximately 3% of lung cancers and carries a poor prognosis. For early-stage, node-negative disease classified as T1–2N0M0 by the 9th edition tumor, node, metastasis (TNM) staging system, the role of adjuvant chemotherapy following surgical resection remains controversial due to limited evidence from randomized trials. Our research aims to evaluate the effectiveness of adjuvant chemotherapy in this specific patient population using a large national database.MethodsWe sourced data of patients who were diagnosed with LCNEC at the T1–2N0M0 stage and had undergone surgery, focusing on the time frame from the start of 2004 to the end of 2015, using the Surveillance, Epidemiology, and End Results (SEER) database as our resource. In order to comprehensively evaluate the cancer-specific survival (CSS) and overall survival (OS) across different groups, we implemented a multi-faceted statistical approach, encompassing subgroup analyses, propensity score matching (PSM) techniques, and Kaplan-Meier (K-M) survival curves. Additionally, we employed the Cox Proportional-Hazards model to pinpoint standalone predictors of outcomes in LCNEC staged as T1–2N0M0.ResultsOf the 582 T1–2N0M0 LCNEC patients studied, 473 (81%) patients underwent surgery alone. Before and after applying propensity score adjustments, we found no notable variance in OS and CSS when comparing the surgery-only cohort to the group that received adjuvant chemotherapy. Exploratory subgroup analyses suggested potential heterogeneity in treatment associations, though biological plausibility was uncertain. Cox regression identified middle tumor location, segmentectomy, age ≥65 years, and zero regional nodes examined as independent prognostic factors (P<0.05).ConclusionsAccording to the 9th edition of the American Joint Committee on Cancer (AJCC) staging system, adjuvant chemotherapy does not provide significant survival benefits for the overall T1–2N0M0 LCNEC population. Exploratory subgroup analyses suggested potential heterogeneity in treatment associations; however, given the retrospective design and inherent limitations of SEER data (lacking performance status, comorbidities, recurrence data, and detailed chemotherapy information), these hypothesis-generating findings require prospective validation before informing clinical practice.

Abstract Prostate cancer (PCA) is the second leading cause of cancer-related death among men in the US. Early-onset prostate cancer (EOPCa) accounts for ∼10% of all PCA diagnoses, with an ∼58,694 new cases reported worldwide in 2021. Although EOPCa accounts for a growing proportion of cases, it remains underexplored. Younger patients often present with distinct clinical features, hereditary predispositions, and long-term survivorship challenges. Hispanic/Latino men, particularly those from Puerto Rico, experience disparities in incidence and outcomes, yet remain underrepresented in PCA research. A better understanding of the epidemiological, clinical, and germline genetic profile of Puerto Rican men with EOPCa is essential to guide risk stratification and inform precision medicine strategies. This study retrospectively identified 80 cases of EOPCa of 9,393 patients treated for PCA between 2020–2025 in a tertiary hospital in southern PR. Demographic, clinicopathological variables were collected, including age, PSA, BMI, Gleason score (GS), tumor stage, family history, lifestyle factors, and treatments. Germline genetic testing results were analyzed and variants classified as pathogenic, variants of uncertain significance (VUS), or benign. Frequencies of recurrent alterations were calculated. Eighty patients were identified; 39 met the inclusion criteria. Age ranged 37–49 years (mean 45.7). PSA at diagnosis ranged 1.7–25.4 ng/mL (mean 6.2). Nearly half (48.7%) were obese (BMI ≥30). At biopsy, GS 6 was most frequent (56.4%); following prostatectomy (87.2% of cases), GS 6 remained most common (50.0%), followed by GS 8 (23.5%). Stage T2 (55.9%) and T3 (23.5%) predominated. Family history of PCA was reported by 38.0%. Most patients consumed alcohol (76.9%) but denied smoking (71.8%). Germline testing identified 10.3% pathogenic variants, 35.9% VUS, and 5.1% carriers, with the remainder negative. In total, 21 alterations were detected: 15 VUS, 5 pathogenic, and 1 benign. Alterations were distributed across 15 genes, with recurrent findings in RECQL4 (n=3), POLD1 (n=3), ATM (n=2), and TMEM127 (n=2). This study provides the first characterization of the epidemiological, clinical, and germline genetic profile of EOPCa in Puerto Rico. Findings highlight a notable burden of germline alterations and underscore the importance of incorporating genetic testing into clinical management. Expanding research among underrepresented populations is critical to guide early detection, refine prognostication, and reduce PCA disparities. Citation Format: Gustavo Alayon-Rosario, Natalia Yordan-Fernandez, Juliana Melendez-Ojeda, Gabriela Castro-Morales, Lenin Godoy-Munoz, Carmen Ortiz-Sanchez, Gilberto Ruiz-Deya. Genetic and clinical profiles of early-onset prostate cancer in Puerto Rican men: A preliminary characterization [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr B007.

Expression Characteristics of SYPL1 in Oral Squamous Cell Carcinoma and Its Correlation With Prognosis

Abstract Purpose: The study aimed to evaluate the response to neoadjuvant chemoradiation (CRT) in early onset (EO) rectal cancer (RC) patients in a large national dataset. Methods: The National Cancer Database (NCDB) is a large hospital-based oncology registry that captures case-level data on approximately 70% of newly diagnosed cancers in the United States. A cohort of locally advanced RC patients, stage II-III, who were treated with CRT prior to surgical resection was identified using the 2022 participant user file, covering 2004-2022. The cohort was divided into EO (&amp;lt;40 years of age) RC and later onset (LO) RC. Downstaging was defined as decreased stage from initial clinical to final pathologic staging. Continuous variables were compared using Wilcoxon rank sum tests and categorical variables were compared using Chi-square and Fisher’s Exact Tests. Logistic regression models were used to assess the associations of pathologic complete response (pCR) and downstaging with reference to age as a 6-level categorical variable (18-39, 40-49, 50-59, 60-69, 70-79, 80+) while adjusting for possible confounders including stage, Charlson-Deyo Comorbidity Classification (CDCC), sex, race, ethnicity, year of diagnosis, insurance status and income. All analysis was conducted in SAS 9.4 and R 4.4.2. Results: 37,508 patients were identified, including 1,722 EORC patients. EO patients were more commonly female, Black, Asian or Hispanic (p&amp;lt;0.001). EO patients also had lower CDCC scores (e.g. 93% vs 77% CDCC 0; p&amp;lt;0.001) and higher-grade tumors (e.g. 12% vs 9.2% poorly differentiated; p&amp;lt;0.001). Examining clinical staging, EO patients exhibited slightly increased frequency of T2 staging [6.6% vs 4.9%] and decreased T3 staging [81.5% vs 83.7%] (p=0.007) with more advanced lymph node (LN) staging [N1:49.4% vs 44.4%; N2:23.3% vs 13.2%] (p&amp;lt;0.001). On univariate analysis, EO patients had higher numbers of examined LNs (median 17 vs 14; p&amp;lt;0.001) and positive LNs (mean 1.60 vs 0.93, p&amp;lt;0.001). While the rate of pathologic complete response did not differ by age, EO patients had less downstaging of the primary tumor (47.6% vs 50.9%, p=0.007). EO also had more N downstaging and N upstaging (Downstaging: 46.3% vs 39.8%; Upstaging: 15.4% vs 12.6%, p&amp;lt;0.001). On adjusted analysis, probability of pCR was greatest at age 70-79 (OR 1.24, p=0.03). All age groups 50 and above were associated with increased LN downstaging (ORs 1.20-1.42; p values &amp;lt;0.01). Also, higher T stage correlated with greater odds of LN downstaging (e.g. cT4 OR 2.24, p&amp;lt;0.001). Odds of primary T downstaging increased for ages 60-69 (OR 1.13, p=0.014) and 70-79 (OR 1.20, p=0.001). Also, these odds decreased with greater N stage (N1: OR 0.73, p&amp;lt;0.001; N2: OR 0.68, p&amp;lt;0.001). Conclusions: EORC patients presented with higher grade tumors and more aggressive LN staging than LORC. Generally, pathological response after CRT was stronger with increased age, including pCR, LN and primary T downstaging. Additional analysis is needed to understand the differing rates of clinical LN involvement and downstaging in EO patients. Citation Format: Joshua E. Meyer, Jordan Fredette, Christopher G. Cann. Disparate response to chemoradiation in early onset vs late onset rectal cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: The Rise in Early-Onset Cancers—Knowledge Gaps and Research Opportunities; 2025 Dec 10-13; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(23_Suppl):Abstract nr C026.

Patterns of treatment and survival in borderline resectable and locally advanced pancreatic cancer.

In advanced laryngeal (LSCC) and hypopharyngeal squamous cell carcinoma (HPSCC), concurrent chemoradiation is the standard approach for organ preservation. However, in T4a disease, upfront surgery followed by adjuvant radio(chemo)therapy is recommended due to suboptimal outcomes with non-surgical treatment. Since cartilage invasion is the principal determinant of T4 staging, its accurate detection is essential for optimal treatment selection. The comparative diagnostic performance of CT, MRI, and FDG-PET in this setting remains uncertain. This retrospective study included 204 patients with LSCC or HPSCC treated between 2010 and 2019 at a tertiary cancer center. All patients underwent pre-therapeutic hybrid FDG-PET combined with CT and/or MRI. Demographic, clinical, and imaging data were collected. Diagnostic accuracy for cartilage invasion was assessed against histopathological findings, and the prevalence of imaging artifacts was analyzed. The study included 204 patients. CT demonstrated higher specificity than MRI for detecting cartilage invasion (86.7% vs. 70.0%), whereas MRI showed greater sensitivity than CT (80.0% vs. 77.1%) but was limited by motion artifacts in 20% of cases. FDG-PET–based metabolic assessment revealed that elevated tumoral SUVmax correlated with cartilage invasion in upfront surgery cases (p = 0.043) but not in salvage surgery cases (p = 0.90). CT is more reliable than MRI for detecting cartilage invasion in LSCC and HPSCC, particularly in patients prone to motion artifacts. FDG-PET adds diagnostic value in upfront surgery candidates, supporting the combined use of CT and PET as the preferred preoperative imaging strategy.

The surgical approach for papillary thyroid cancer (PTC) by either lobectomy or total thyroidectomy (TT) has long been a topic of debate, especially for patients with intermediate-risk PTC, such as T1 and T2 stage patients with more than five positive lymph node metastases (LNM). This study analyzed a population-based retrospective cohort of T1 and T2 PTC patients with more than five positive LNM from the SEER database (2004-2017), comparing clinicopathologic features and survival outcomes between those undergoing lobectomy and TT. Cox proportional hazards regression analysis to explore prognostic factors of survival. Propensity score matching (PSM) was used to balance covariates. The study included 5,610 patients, with 5,322 (94.87%) receiving TT and 288 (5.13%) undergoing lobectomy. Patients in the TT group had higher rates of N1b stage diagnoses, multifocal lesions, and more lymph nodes examined and more lymph nodes positive. Survival analysis showed no difference in overall survival (OS) between the groups (p = 0.177), but a significant difference in cancer-specific survival (CSS) (p < 0.001). After 1:1 PSM, there were no significant difference in OS (p = 0.089) and CSS (p = 0.350). Additionally, stratified analysis showed no significant difference in OS and CSS between patients treated with TT plus radioactive iodine (RAI) ablation and those who underwent lobectomy (both p > 0.05). This cohort study suggests that T1 and T2 PTC patients with more than five positive LNM have no additional survival benefit of TT over lobectomy. If RAI ablation is not planned, lobectomy may be an effective alternative.

This study aims to comprehensively evaluate surgical efficiency and quality of life (QoL) differences among Conventional open thyroidectomy (COT), gasless endoscopic thyroidectomy trans-axillary approach (GETTA), transoral endoscopic thyroidectomy vestibular approach (TOETVA), and endoscopic thyroidectomy via bilateral-areolar approach (ETBAA) in T1 papillary thyroid carcinoma (T1-PTC) patients. Prospective observational cohort study. Tertiary academic center. 463 female patients with T1-PTC were stratified into four cohorts: GETTA (n = 122), TOETVA (n = 108), COT (n = 128), and ETBAA (n = 105). Perioperative time periods were divided into five parts for analysis. Level VI lymph node dissection was routinely performed, and the yield is reported. QoL was assessed using Voice Impairment Score (VIS), Swallowing Impairment Score (SIS), Scar Cosmesis Assessment and Rating (SCAR-Q), European Organization for Research and Treatment of Cancer QoL Questionnaire-Core 30 (EORTC QLQ-C30), and Symptom Checklist-90 (SCL-90). Longitudinal QoL trends were evaluated during postoperative recovery. Significant intergroup disparities were observed in surgical efficiency (P < 0.001); COT demonstrated superior time efficiency. All cohorts experienced transient postoperative QoL declines, with endoscopic groups showing accelerated recovery trajectories in physical, psychological, and cosmetic domains (P < 0.001). Four techniques are safe and effective. COT remains the most time-efficient approach, while TOETVA excels in cosmesis. GETTA and ETBAA offer intermediate advantages, combining reasonable efficiency with enhanced recovery profiles. Clinical decision-making should prioritize patient-specific factors, including cosmetic preferences and recovery priorities.

Missed Adjuvant Therapy After Resection of Intermediate and High-Risk Oral Cavity Cancer: A Multi-institutional Study.

To explore whether the Human Papillomavirus (HPV) status plays a role in the selection of treatments for hypopharyngeal squamous cell carcinoma (HSCC), we compared the survival outcomes of patients with different HPV statuses who underwent surgery combined with chemoradiotherapy and chemoradiotherapy alone. Patient's data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM), multivariate Cox regression analysis, and Kaplan‒Meier analysis were conducted. 591 patients were obtained from the SEER database. The study revealed that HPV-positive HSCC patients had better cancer specific survival (CSS) (P = 0.009) and overall survival (OS) (P < 0.001). These findings were also supported by Multivariate Cox regression analysis. Kaplan‒Meier analysis revealed that surgery significantly improved CSS (P = 0.023) and OS (P = 0.004) in HPV-negative HSCC patients. However, for HPV-positive patients, there was no significant improvement in CSS (P = 0.565) or OS (P = 0.863). Similar results were obtained after PSM. We further analyzed that among HPV-negative patients with stage T3 disease, surgery significantly improved the 5-year OS rate (12.17% vs. 62.06%; P = 0.002) and CSS rate (25.90% vs. 68.15%; P = 0.019). For stage N2-3 HPV-negative HSCC patients, the 5-year OS and CSS of the surgery group and no surgery group were 62.31% vs. 29.76% (P = 0.011) and 65.59% vs. 44.39% (P = 0.104), respectively. However, for HPV-positive patients with different T stages and N stages, there was no significant survival difference. Surgery combined with chemoradiotherapy is more suitable for HPV-negative patients with stage T3 and stage N2-3 disease.

Objective: To construct and validate a prognostic prediction model for patients with ovarian metastases from colorectal cancer after radical resection. Methods: A retrospective case series analysis was conducted on the clinical and pathological data of 81 patients with colorectal cancer and ovarian metastases who underwent radical resection for ovarian metastases at the Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, between January 2014 and December 2023. The patients were all female, with an age (M(IQR)) of 49(13) years (range: 22 to 79 years). The primary tumor was located in the colon in 60 cases (74.1%) and in the rectum in 21 cases (25.9%). Univariate and multivariate Cox regression analyses were used to identify independent risk factors affecting prognosis. A risk scoring system was constructed, and patients were assigned to high-risk and low-risk groups based on their risk scores. The predictive performance of the scoring system was assessed, and 5-fold cross-validation was performed to evaluate the model's stability on the internal dataset. Results: Among the 81 patients with ovarian metastases, a high proportion had T4 stage (58 cases, 71.6%), lymph node positivity (68 cases, 84.0%), and colon cancer (60 cases, 74.1%). Preoperative imaging suggested unilateral ovarian metastasis in 15 patients (23.4%), but pathological examination after bilateral oophorectomy confirmed bilateral ovarian metastases. Among the 17 patients who initially underwent unilateral oophorectomy, 11 developed contralateral ovarian metastases at varying times postoperatively. Univariate Cox proportional hazards regression analysis revealed that positive lymph node ratio (HR=2.68,95%CI:1.41 to 5.09,P=0.003), N stage (HR=2.07,95%CI:1.08 to 3.95, P=0.028),maximum diameter of metastatic tumors (HR=2.27,95%CI:1.04 to 4.96, P=0.040),and peritoneal metastasis or ascites at the time of ovarian metastasis (HR=2.04,95%CI:1.02 to 4.08, P=0.043) were significantly associated with overall survival in patients with ovarian metastasis from colorectal cancer. Multivariate regression analysis identified that positive lymph node ratio (HR=3.34,95%CI:1.08 to 10.34, P=0.037) and maximum diameter of metastatic tumors (HR=2.65,95%CI:1.19 to 5.88, P=0.017) were independent prognostic factors for overall survival following radical oophorectomy in patients with ovarian metastasis from colorectal cancer. Based on the regression coefficients from the multivariate analysis for variables (ovarian metastatic tumor diameter ≥6 cm, positive lymph node ratio ≥0.3,and presence of peritoneal metastasis or ascites), a risk scoring system was developed. Using the optimal cutoff value (154 points) for the risk score,patients were divided into high-risk (19 cases) and low-risk (62 cases) groups. Kaplan-Meier survival curves demonstrated that the high-risk group had significantly lower median overall survival (27 months) and median disease-free survival (22 months) compared to the low-risk group (median overall survival 90 months,median disease-free survival not reached; both P<0.01). Receiver operating characteristic curve analysis showed that the area under the curve(AUC) for predicting 1-,3-,and 5-year overall survival was 0.731(95%CI:0.563 to 0.899), 0.703(95%CI:0.573 to 0.833), and 0.776(95%CI: 0.657 to 0.894), respectively. The AUC for predicting 1-,3-, and 5-year disease-free survival was 0.724(95%CI:0.397 to 0.993),0.710(95%CI:0.514 to 0.906),and 0.688(95%CI:0.478 to 0.898),respectively,indicating good performance of the model.The decision curve analysis showed that the model has good clinical net benefit and the results of the 5-fold cross-validation showed that the model demonstrated stability in the internal dataset. Conclusions: When performing radical resection for ovarian metastasis from colorectal cancer,bilateral oophorectomy should be considered to minimize the risk of postoperative recurrence. Patients with ovarian metastasis from colorectal cancer,characterized by a metastatic tumor diameter ≥6 cm,a positive lymph node ratio ≥0.3,and the presence of peritoneal metastasis or ascites, tend to have a poorer prognosis. Based on these findings,a clinical prognostic scoring system for radical resection of ovarian metastasis from colorectal cancer has been developed to stratify patients into different risk groups and may assist in postoperative risk assessment and management.

The role of younger age as a prognostic factor in breast cancer remains debated. Despite its association with an aggressive clinical course, there is insufficient research on its etiology. This study aimed to analyze age-related differences in breast cancer diagnosis among Turkish women. Data from 23,594 patients in the National Breast Cancer Database (NBCD) were analyzed. The demographic, clinical, and pathological characteristics of patients aged ≤40 years were compared with those >40 years. The median age was 50 years (range 18-97). Among them, 4,535 patients (19%) were 40 years old or younger, with 84% of this subgroup being over 30 years old. Conversely, 19,059 patients (81%) were older than 40. Patients in the younger age group were less likely to have pathologic T1 disease (41% vs. 47%), N0 disease (49% vs. 55%), and Stage I disease (25% vs. 31%) compared to those over 40 (p<0.001). The rates of mastectomy (41% vs. 39%; p = 0.024) and axillary dissection (71% vs. 65%; p = 0.001) were higher among patients diagnosed at 40 years of age or younger. Multivariate analysis identified significant associations in younger patients, including invasive ductal carcinoma (95% CI, 1.06-1.43), estrogen receptor (ER) negativity (95% CI, 1.26-1.87), PR negativity (95% CI, 1.21-1.75), high histologic grade (95% CI, 1.43-1.87), multifocality/multicentricity (95% CI, 1.26-1.72), T3-T4 tumors (95% CI, 1.06-1.66), and axillary positivity (95% CI, 1.025-1.321). Breast cancer diagnosed at ≤40 years is more likely to exhibit aggressive biology, multifocality, or multicentricity presentation, and present at advanced stages. Consequently, younger patients experience higher rates of mastectomy and axillary dissection. These findings suggest a poorer prognosis, highlighting the need for more intensive therapeutic strategies in this population.

IntroductionLocally advanced rectal cancer (LARC) remains a therapeutic challenge, with significant risks of both locoregional and distant relapse. Total neoadjuvant therapy (TNT), which combines induction chemotherapy and chemoradiotherapy (CRT) prior to surgery, has emerged as a potentially more effective strategy than traditional approaches, yet data from low- and middle-income countries (LMICs) remain limited. This study evaluates the efficacy and toxicity of induction FOLFIRINOX followed by concurrent CRT in Vietnamese patients with lower–middle LARC.MethodsA retrospective analysis was conducted on adult patients (n = 72) with clinical stage T3–T4 M0 rectal adenocarcinoma. All patients received induction FOLFIRINOX for six cycles and preoperative CRT, followed by total meso-rectal excision (TME), and adjuvant chemotherapy as indicated. The primary endpoint was pathologic complete response (pCR, ypT0N0); secondary endpoints were 3-year disease-free survival (DFS) and safety. The study conforms to STROBE guidelines.ResultsPathological complete response was achieved in 25.0% of patients. The 3-year DFS reached 90.6%. Treatment feasibility was high, with 93.06% completing all 6 induction cycles; hematologic adverse events, particularly leukopenia and neutropenia, were the most common toxicities but were generally manageable with supportive care, while nonhematological toxicities were predominantly mild. R0 resection rate was 100% and sphincter-preserving surgery was 86.1%.ConclusionIn a LMIC setting, induction FOLFIRINOX followed by CRT shows promising efficacy and tolerable toxicity in LARC. These findings support early, intensified systemic therapy to enhance local control and mitigate metastatic spread.