ACSL4 coordinates metabolic and cell cycle reprogramming to promote endometrial cancer progression.

Immunotherapy has revolutionized treatment for advanced gastric/gastroesophageal junction adenocarcinoma (G/GEJC). However, identifying convenient biomarkers for predicting therapeutic efficacy remains challenging. This study investigated the association between clinicopathological characteristics and baseline peripheral blood lymphocyte subsets with efficacy of first-line chemotherapy combined with immune checkpoint inhibitors (ICIs) in proficient mismatch repair (pMMR) human epidermal growth factor receptor 2 (HER2)-negative advanced G/GEJC. This retrospective study enrolled 97 patients with pMMR HER2-negative advanced G/GEJC receiving first-line chemotherapy combined with ICIs. Clinicopathological characteristics and peripheral blood lymphocyte subsets were collected. Overall survival (OS) and progression-free survival (PFS) were used to evaluate efficacy. The univariate and multivariate analyses were conducted using Cox regression analysis. Median PFS and OS were 5.9 and 15.2 months, respectively. Tumor location, Lauren classification, tumor differentiation, peritoneal metastases, neutrophil to lymphocyte ratio (NLR), and regulatory T cells (Tregs) as significantly associated with PFS. Well-differentiated tumor and higher Tregs independently predicted longer PFS. For OS, only higher NLR was an independent risk factor. Optimal cut-offs for NLR (3.5) and Tregs (10.1) stratified patients with significantly different PFS. A nomogram combining Tregs, NLR, peritoneal metastases, and tumor differentiation achieved superior predictive performance compared to PD-L1 CPS alone, with PFS AUC of 0.68-0.77 and OS AUC of 0.69-0.75. Clinicopathological characteristics and baseline peripheral lymphocyte subsets were significantly associated with efficacy of first-line chemotherapy combined with ICIs in pMMR HER2-negative advanced G/GEJC, highlighting the potential utility of integrating these accessible parameters for efficacy prediction.

Differentiation of ex-vivo intracranial tumors based on frequency band segmentation integrated in linear discriminant analysis (FBS-LDA) of impedance-derived dielectric spectra

Immunohistochemistry combined with Alcian Blue-Periodic Acid Schiff (AB-PAS) staining in the differentiation of ovarian seromucinous borderline tumors and mucinous borderline tumors.

Bioheat transfer simulations of cryoablation and their comparison with different optimization techniques for patient specific segmented liver tumor tissue

ABSTRACTIntraoperative frozen section (FS) analysis is critical in surgical pathology, but conventional hematoxylin and eosin (H&E) staining has limitations in poorly differentiated neoplasms and resection margins. Immunohistochemistry (IHC) provides higher diagnostic specificity, yet has traditionally been too time‐consuming for intraoperative urgency. This study aimed to optimize, validate, and evaluate Fast Frozen Rapid Automated Immunohistochemistry (FFRA‐IHC) using the Q‐Stain X Autostainer to improve surgical diagnostics. After optimization with antibodies CKAE, CK5, CK7, CD45, and Synaptophysin, 44 tissue samples from patients undergoing surgery at Rigshospitalet, Copenhagen, were analyzed by FS H&E, FFRA‐IHC, and standard formalin‐fixed paraffin‐embedded (FFPE) methods. Automated FFRA‐IHC showed high diagnostic accuracy and supported immediate clinical decision‐making: of 37 tumors not classifiable by FS H&E alone, 25 (68%) were classified into specific tumor types, and all five ambiguous resection margins were resolved. A cost–benefit analysis indicated efficiency gains with reduced hands‐on time compared to manual IHC. In conclusion, FFRA‐IHC demonstrated promising results for enhancing intraoperative diagnostics, leading to its implementation in the daily workflow at our department. Future studies should expand antibody panels and assess the broader clinical impact to further improve intra‐ and perioperative care.

Introduction: Magnetic resonance imaging (MRI) is one of the main techniques used in the diagnosis of gliomas, but it has limitations in tumor differentiation and in predicting molecular markers. Artificial intelligence (AI) has emerged as a complementary tool, capable of increasing diagnostic accuracy and supporting clinical decisions. Method: A systematic review of articles published between 2015 and 2025 in the PubMed, MEDLINE, and SciELO databases was conducted. Methodological quality was assessed using the AMSTAR-2 tool. Results: DL and ML-based models showed promising performance, with accuracy exceeding 95% in some cases, especially convolutional neural networks (CNNs). Hybrid models integrating radiomic and clinical-molecular data showed better sensitivity and specificity in differentiating between low- and high-grade gliomas. However, limitations such as methodological heterogeneity, lack of standardization of imaging protocols, risk of overfitting, and lack of robust external validation still restrict large-scale clinical application. Discussion: AI has shown promise in automating complex image analyses, reducing subjective biases, and offering greater diagnostic accuracy. However, challenges persist regarding the standardization of protocols, the difficulty of compatibility between systems, and the transparency of algorithms, which are factors that hinder its clinical incorporation. Conclusion: The integration of AI in MRI represents a milestone in oncological neuroimaging, with great revolutionary potential in the diagnosis of gliomas. To safely include these techniques in clinical practice, multicenter studies, interpretable models, and policies that ensure ethical validation, reproducibility, and equitable accessibility are necessary.

Patients who have previously received radiation therapy for primary prostate cancer (PPC) face an elevated risk of developing secondary rectal cancer (SRC). However, the clinical presentation, surgical outcomes, and oncological results of SRC in this context remain poorly characterized. This study aims to compare the clinical and pathological features, as well as treatment outcomes, of patients with primary rectal cancer (PRC) and those with SRC following radiation for prostate cancer. Retrospective cohort study using univariate and propensity-matched analyses. Data extracted from electronic medical records at a single tertiary institution [2001-2021]. Male patients with rectal cancer (RC) who underwent oncological resection with or without a prior history of prostate cancer radiation. Patients with a <3-year interval between radiotherapy and RC diagnosis were excluded. The main outcome measures were pathological analysis, postoperative complications and overall survival. Out of 1,755 patients with RC, 50 cases (2.9%) had SRC. Forty-three out of the 50 patients were included in the analysis. The median time from radiotherapy to SRC diagnosis was 8 ± 4 years (IQR). Patients with SRC were older, with a mean age of 73.7 ± 8.5 versus 61.1 ± 13 years in the control group (p < 0.001), and a higher American Society of Anaesthesiologists (ASA) score (p = 0.006). Most SRCs were distal with a median distance from the anal verge of 4.25 cm (IQR 9.5 cm). Only seven patients (16.3%) in the SRC group received neoadjuvant radiation therapy versus 764 (44.8%) of PRC (p = 0.001). SRC patients required more extensive surgical interventions, including abdominoperineal resection (46.5% vs. 29.9%), pelvic exenteration (4.7% vs. 0.4%), and fewer sphincter-preserving procedures, including low anterior resection (48.8% vs. 68.2%) and transanal resection (0% vs. 1.5%) (p = 0.02). Propensity score matching with a 1:2 ratio matching for age, body mass index (BMI), ASA score, type of surgery, and pathological staging revealed no differences between the groups regarding tumour differentiation, staging, or postoperative complications. Survival analysis at 6 years showed no significant difference in overall survival between the SRC (53.2%, 95% CI: 35%-71%) and PRC (50.3%, 95% CI: 36%-64%) groups (p = 0.61). Retrospective design and reliance on electronic medical records from a single institution. Patients with PPC developed SRC up to 10 years after radiation therapy. Patients with SRC were typically older with more comorbidities. Fewer patients with SRC underwent neoadjuvant therapy, and as a group, required more extensive surgeries with a lower rate of sphincter preservation compared to patients with PRC. Despite these differences, patients with SRC had similar pathological outcomes and overall survival compared to patients with PRC.

Pancreatic ductal adenocarcinoma (PDAC) remains challenging to diagnose in its early stages. Capitalizing on the established overexpression of plectin-1 in PDAC, we developed a novel plectin-1-targeted positron emission tomography (PET) radiotracer, [68Ga]Ga-NOTA-PTP, for precise PDAC imaging. The NOTA-PTP conjugate was synthesized, characterized, and efficiently radiolabeled with 68Ga, achieving high radiochemical purity (>99%). The radiotracer displayed a strong binding affinity for plectin-1 (IC50 = 12.8 nM) and exhibited time-dependent accumulation in PDAC cells. In murine PDAC xenografts, PET imaging demonstrated the rapid and specific tumor uptake of [68Ga]Ga-NOTA-PTP, enabling the visualization of peritoneal metastases. Targeting specificity was further verified by both the significant reduction in tumor uptake upon preadministration of the unlabeled compound and the positive correlation between tracer accumulation and plectin-1 expression levels. Collectively, this work introduces the first plectin-1-targeted PET probe for specific and sensitive detection of PDAC and metastatic lesions through efficient plectin-1 engagement.

Background: The tumor microenvironment (TME), composed of diverse immune and stromal cells, plays a key role in cancer progression. Among its components, tumor-associated neutrophils (TANs) and the desmoplastic reaction (DR) have emerged as important modulators of tumor behavior. While each has been extensively studied, their interrelationship and association with tumor grade and clinicopathological parameters remain unclear. Aim: This hypothesis-generating study aimed to explore the relationship between the presence of TANs, various types of DR, the grade of tumor malignancy, and other fundamental clinicopathological characteristics commonly studied in daily clinical practice. Materials and Methods: The study included a cohort of 65 cancer patients (N = 65). The average number of TANs was recorded. In hematoxylin and eosin (H&amp;E)-stained sections, “hot spots” representing areas with the highest neutrophil density were first identified. The tumor-associated polymorphonuclear neutrophils were then counted in ten consecutive high-power fields (HPFs). In the same specimens, the DR was assessed and classified according to stromal texture. Results: TANs did not follow a normal distribution across any clinicopathological category (p &lt; 0.05). Significant differences in TAN levels were observed among DR types (Kruskal–Wallis H = 9.890, p = 0.007), with higher counts in myxoid compared to mature stroma (Mean Rank = 41.58 vs. 24.80, p = 0.006). TAN levels also varied significantly with tumor grade (H = 22.384, p &lt; 0.001), increasing from Grade 1 to Grade 3 (p &lt; 0.013–0.001). Higher TAN counts were associated with cellular erythroblastic oncogene B2 (c-erbB2) positivity (H = 6.547, p = 0.038), perineural invasion (Mann–Whitney U = 179.5, p &lt; 0.001), and ER/PR negativity (p = 0.016 and p = 0.044, respectively). No significant association was found with necrosis (p = 0.083). A near-significant relationship was identified between DR type and tumor differentiation grade (χ2 = 9.448, p = 0.051), with mature stroma most common in Grade 1 tumors, keloid-like stroma in Grade 2, and myxoid stroma in Grade 3. Conclusions: High TAN levels were linked to aggressive tumor features and specific DR patterns. The association of myxoid stroma with elevated TAN infiltration may reflect a highly aggressive TME. These preliminary results warrant validation in larger, prospective studies.

Rab24 is an unusual member of the Rab family of small GTPases, implicated in autophagy, endocytosis and cell division. In order to elucidate possible organ and age-specific roles of Rab24, we investigated tissue-specific levels of Rab24 in mice by western blotting and immunohistochemistry from postnatal day one to 9months of age. In adult mice, the highest protein levels were found in the brain followed by the kidney, whereas lower levels were detected in the pancreas, spleen, liver, lung, heart, and skeletal muscle. Dynamic changes in Rab24 levels were observed during early postnatal development, with a sharp increase in the brain at postnatal day 14, after which the level remained high into adulthood. In the heart, skeletal muscle, pancreas and liver, higher Rab24 levels were observed during the first two postnatal weeks, after which the levels dropped and stayed low until adulthood. The age-dependent changes suggest age- and organ-specific regulation of Rab24 protein levels and possible organ-specific roles for Rab24 in development and maturation. Immunohistochemistry of the brain revealed that Rab24 was mostly present in neuronal cells in 1-month-old and older mice. Also, epithelial cells in several tissues showed high Rab24 levels. These results suggest possible roles for Rab24 in neuronal and epithelial maintenance. We further analysed immunohistochemical staining for RAB24 in human cancers and normal tissues. RAB24 staining in cancers of the breast and skin was higher than in the corresponding normal tissues, while it was reduced in cancers of the digestive system and the urinary tract. We also observed elevated RAB24 staining in medulloblastoma and neuroblastoma, two paediatric cancers of neuronal origin. In pancreatic neuroendocrine tumours that originate from islet cells, RAB24 levels were lower than in normal pancreatic islet cells. Collectively, our findings provide a comprehensive overview of RAB24 protein levels across mouse tissues and a wide spectrum of human cancers. The observed differences in RAB24 levels between cancer types and between malignant and normal tissues, suggest that RAB24 may serve as a potential diagnostic or differentiation marker in specific tumour types.

Wilms tumour is the most common kidney tumour in children. Owing to global collaboration and advances in clinical care, 90% of affected children, including those with metastatic disease, can now be cured. Further improvements in this outstanding outcome will depend on implementing strategies to prevent treatment-related mortality and gaining insights into the molecular and clinical drivers of Wilms tumour to introduce tailored therapies. The main treatments for Wilms tumour are nephrectomy and chemotherapy, with radiotherapy used selectively. Wilms tumour therapies can lead to long-term chronic health conditions, such as chronic kidney disease, infertility, second primary neoplasms and cardiovascular disease, despite the use of risk-adapted protocols to optimize the therapeutic index. Research into therapy de-escalation has been enhanced by survivor cohort studies investigating the chronic health conditions associated with specific Wilms tumour therapies. Understanding these relationships and which patients are most susceptible to specific toxic effects is crucial for counselling Wilms tumour survivors and their health-care providers on survivorship care planning. A classification framework could stratify survivors by their risk of treatment-related long-term morbidity, to tailor long-term follow-up monitoring and care.

Antibody-drug conjugates (ADC) offer a targeted cancer treatment approach by delivering cytotoxic payloads directly to tumor cells. However, resistance mechanisms, poor tumor penetration, and off-target toxicity often limit clinical efficacy. Vartumab targets oncofetal chondroitin sulfate (ofCS), a pan-cancer target present on tumor cells and in the malignant stroma, with low expression in normal tissues. As part of transitioning Vartumab to clinical evaluation, two linker-payloads known to mediate bystander effects, valine-citrulline (vc)-monomethyl auristatin E (MMAE) and glycine-glycine-phenylalanine-glycine (ggfg)-Deruxtecan (DXd), were investigated for design of Vartumab ADCs. We show that the ADCs maintain specificity to ofCS proteoglycans, cancer cells, and tissue biopsies, exhibiting specific binding to a wide range of malignant and metastatic tissues. Biodistribution assessment of Vartumab ADCs in mice shows strong and specific tumor uptake, with minimal accumulation in other organs. Both ADCs induced bystander killing of antigen-negative cells in the presence of antigen-positive cells and displayed potent anti-tumor activities in a cell-derived xenograft melanoma model. Furthermore, we show that Vartumab conjugates with bystander-capable linker-payloads exhibit greater in vivo potency compared to those with payloads lacking significant bystander effect. Finally, toxicity assessment in rats indicates that the ADC-MMAE is well-tolerated upon repeated doses, with similar dose-limiting toxicities as reported for clinically approved MMAE-conjugated ADCs. Our data support further clinical development of Vartumab-based ADCs.

Background: Lentiviral vectors (LVs) show promise as gene therapy tools for brain tumors, but optimal envelope protein choices for different tumor types have not been determined. Methodology: This study evaluated three pseudotyped LV variants—VSV-GP, FuG-B2, and LCMV-GP—across diverse brain tumor cell lines including glioblastoma (GBM), diffuse intrinsic pontine glioma (DIPG), medulloblastoma, and metastatic brain cancers. Results: VSV-GP and FuG-B2 pseudotypes significantly outperformed LCMV-GP across most tumor types. Both VSV-GP and FuG-B2 demonstrated high transduction efficiency in GBM and DIPG cells, though some cell lines displayed selective preferences for one pseudotype over the other. Medulloblastoma cells were challenging to transduce, with only VSV-GP achieving substantial efficacy. Metastatic brain cancers showed distinct tropism patterns: melanoma metastases were preferentially transduced by the FuG-B2 pseudotype, while lung metastases showed preference for the VSV-GP pseudotype. Conclusions: These findings suggest envelope protein selection should be tailored to specific brain tumor types. VSV-GP appears most suitable for medulloblastoma and lung metastases, FuG-B2 for melanoma metastases, and both for GBM and DIPG gene therapy applications. The study provides crucial guidance for translating lentiviral gene therapy to clinical applications, supporting personalized treatment strategies based on tumor-specific vector tropism profiles.

In the context of stomatology and head and neck surgery, ameloblastoma plays a prominent role. Although defined by the World Health Organization (WHO) as a benign entity, it exhibits biologically aggressive behavior, characterized by an infiltrative growth pattern and high recurrence rates, which demands an in-depth understanding of its pathogenic and clinical aspects to achieve a favorable prognosis. Ameloblastoma is an odontogenic neoplasm of epithelial lineage that, despite being histologically benign according to the WHO, displays a biological phenotype marked by aggressive medullary infiltration, progressive expansion, and elevated recurrence rates. The complexity of clinical management lies in the dichotomy between complete eradication of tumor margins and preservation of the functional and aesthetic integrity of the stomatognathic system. The analysis of contemporary therapeutic modalities indicates that the transition between conservative interventions and radical resections should be based on rigorous mapping of the histopathological subtype and the cortical extent of the lesion. In parallel, the integration of molecular biomarkers and immediate prosthetic reconstruction techniques redefines prognosis, enabling an approach that goes beyond strict oncological control. Clinical resolution and mitigation of tumor recurrence depend on individualized management, with particular attention to patient age and specific tumor biology. It is imperative that therapeutic outcomes be supported by longitudinal surveillance protocols and multidisciplinary rehabilitation, ensuring morphofunctional restoration and long-term preservation of quality of life.

Neuroendocrine tumors of unknown primary (NET-UPs) represent a diagnostically and therapeutically challenging subset of neuroendocrine neoplasms. Despite advances in imaging and molecular profiling, up to 13% of metastatic NETs lack an identifiable origin at presentation. This review examines the multimodal diagnostic strategies for NET-UPs, highlighting the integration of cross-sectional imaging, receptor-based PET imaging, immunohistochemistry, and surgical exploration. While 68Ga-DOTATATE PET/CT remains the preferred imaging modality for well-differentiated tumors, intraoperative small bowel palpation offers the highest diagnostic yield when imaging is inconclusive. Immunohistochemical markers, including second generation neuroendocrine stains and transcription factor profiles, aid in classifying tumor origin and differentiation. Management of NET-UPs is largely guided by tumor grade and somatostatin receptor status. Well-differentiated, receptor-positive tumors are treated with somatostatin analogues, with peptide receptor radionuclide therapy used in progressive disease. Despite therapeutic advancements, optimal sequencing and combination strategies remain areas of ongoing investigation. Given the clinical heterogeneity of NET-UPs, sustained multidisciplinary collaboration is critical to optimizing outcomes in this complex and increasingly prevalent disease.

Trace metals, including copper (Cu) and zinc, are associated with the development and prognosis of hepatocellular carcinoma (HCC). However, their interference with magnetic resonance imaging (MRI) limits their use as potential biomarkers. This study investigated the usefulness of Synchrotron Radiation-excited X-ray Fluorescence (SR-XRF) imaging in studying the distribution of trace metals in HCC. This case-control study analyzed 33 specimens from 32 patients with HCC who underwent surgical resection (n = 29) or biopsy (n = 3) at Kobe University Hospital between December 1999 and November 2002. The findings of SR-XRF were compared with those of MRI and histopathology. SR-XRF provided two-dimensional mapping of trace metal distribution with high spatial resolution (1.0 µm). The mean tumor-to-liver ratio (TLR) of Cu content was significantly higher in well-differentiated HCCs than in moderately and poorly differentiated HCCs (p < 0.05). Moreover, the mean TLRs of Cu content were significantly higher in high-intensity lesions than in iso- or low-intensity lesions on T1-weighted imaging (p < 0.05). This study supports previous evidence of the involvement of Cu in HCC development, suggesting its potential as a clinical biomarker for diagnosis and disease progression. Additionally, the results demonstrate that SR-XRF has potential for clinical application due to its ability to map trace metal distribution at high resolution. These findings suggest, rather than demonstrate, the association among Cu accumulation, tumor differentiation, and MRI signal characteristics.

Pancreatic neuroendocrine carcinoma (PNEC) is a rare and aggressive malignancy with poor prognosis. However, large-scale studies on the prognostic factors of PNEC remain limited. We retrospectively extracted clinical data of patients diagnosed with PNEC between 2004 and 2021 from the surveillance, epidemiology, and end results (SEER) database. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using Kaplan–Meier method and compared by log-rank test. Univariate and multivariate Cox proportional-hazards regression models were employed to identify independent prognostic factors. Among 2089 included patients with PNEC, the median age was 61 years (range: 11–90 years). The median OS was 13.0 months, with 1-, 3-, and 5-year OS rates of 51.3%, 29.1%, and 20.1%, respectively. The median CSS was 14.0 months, with corresponding 1-, 3-, and 5-year CSS rates of 53.0%, 31.2%, and 21.9%, respectively. Multivariate analysis identified that advanced age (HR = 1.02, 95% CI: 1.01–1.03, P < .001), poor histological differentiation (HR = 1.35, 95% CI: 1.12–1.63, P = .002), primary tumor located in the head (HR = 1.28, 95% CI: 1.09–1.51, P = .003) or body (HR = 1.42, 95% CI: 1.15–1.75, P = .001) of the pancreas, regional lymph node metastasis (HR = 1.32, 95% CI: 1.14–1.53, P < .001), absence of primary site surgery (HR = 2.15, 95% CI: 1.82–2.54, P < .001), and absence of chemotherapy (HR = 1.87, 95% CI: 1.63–2.15, P < .001) were independent prognostic factors associated with worse OS and CSS. Patients with PNEC have poor prognosis with median survival of approximately 13 months. Several clinicopathological factors including age, tumor differentiation, tumor location, lymph node status, and treatment modalities were identified as independent prognostic indicators. These findings provide valuable insights for prognostic stratification and treatment decision-making in patients with PNEC.

Rationale:Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm that can arise in various anatomical locations, while IMT originating from the broad ligament is exceptionally rare. Anaplastic lymphoma kinase (ALK) is a highly specific diagnostic biomarker for IMT. However, no standardized therapeutic algorithm has been established for ALK-negative IMT, largely due to the unclear risk of distant metastasis and recurrence. In cases with undefined tumor differentiation and no detectable molecular targets, close surveillance and individualized therapeutic strategies should be guided by the tumor’s biological behavior and patient-specific risk factors.Patient concerns:We present the case of a 21-year-old unmarried, nulliparous woman who reported a palpable abdominal mass, ultimately found to originate from the broad ligament.Diagnoses:Exploratory laparotomy revealed a mass arising from the posterior leaf of the broad ligament along the posterior uterine wall. Histopathological analysis favored a diagnosis of ALK-negative IMT, although the origin and differentiation trajectory of the tumor remained undetermined.Interventions:The patient did not undergo any adjuvant therapy, such as chemotherapy. Instead, a regimen of routine follow-up was implemented to monitor for disease progression or recurrence.Outcomes:At the 10-month follow-up, no clinical or radiological signs of recurrence or malignant transformation were observed.Lessons:To date, surgical resection remains the mainstay of treatment for IMT. For ALK-negative IMT cases, molecular profiling to identify targetable genomic alterations may assist in selecting individualized targeted therapies.

BackgroundThe prognosis for patients with stage II-III colorectal cancer (CRC) is heterogeneous, with only a subset benefiting from adjuvant chemotherapy. Currently, prognostic models that effectively integrate clinicopathological and genetic factors remain limited. This study aimed to develop a predictive model that accurately forecasts survival and guides personalized treatment decisions.MethodsData from 322 CRC patients were analyzed. Significant prognostic factors were selected using univariate Cox regression analysis. Subsequently, the least absolute shrinkage and selection operator (LASSO) regression algorithm, coupled with the Cox proportional hazards model, was applied to identify the most parsimonious set of predictors. A nomogram was constructed based on a multivariable Cox regression model to estimate 3- and 5-year overall survival (OS). Predictive performance was assessed using the concordance index (C-index), receiver operating characteristic (ROC) curve analysis, and calibration plots. Decision curve analysis (DCA) was performed to assess the clinical utility of the nomogram.ResultsMultivariate analysis identified tumor stage, tumor differentiation grade, lymphovascular invasion, BRAF mutation, and adjuvant chemotherapy as independent predictors of OS. The developed nomogram demonstrated good discrimination, with a C-index of 0.712 and 0.726 for the training and testing cohorts, respectively. Calibration plots showed excellent agreement between predicted and observed 3- and 5-year OS. DCA confirmed that the nomogram provided clinical net benefits.ConclusionThe nomogram, integrating clinicopathological and genetic factors, provides a robust tool for predicting outcomes in patients with stage II-III CRC. It can aid in personalized treatment planning and improve patient management.