Non-blood liquid biopsy specimens represent an emerging frontier in cancer diagnostics, offering anatomically relevant alternatives to traditional blood-based analyses. These specimens provide unique advantages including proximity to tumor sites and potentially higher concentrations of tumor-derived biomarkers.

Salvage vesiculectomy has been proposed by several experts to deal with isolated seminal vesicle recurrence (ISVR). Although initial research has shown that the salvage vesiculectomy is successful, there is still disagreement over its clinical efficacy and safety due to the lack of strong randomized controlled trials. To support the clinical use of salvage vesiculectomy, this study intends to assess its safety, outcome and clinical impact.

Aim: Recent network meta-analyses (NMAs) in metastatic castration-sensitive prostate cancer have not adequately addressed potential treatment effect modifiers and population imbalances, which introduces bias. Although, individual-patient data (IPD) are seldom available across all trials, recent methodological advances allow adjustments using a combination of IPD and aggregate data. Materials & methods: IPD from the ARASENS trial (darolutamide + docetaxel + androgen-deprivation-therapy [ADT]) and aggregate data from a systematic review were analyzed. Two methods were used to adjust for population imbalances: multilevel network meta-regression (ML-NMR) using baseline characteristics, and network meta-interpolation (NMI) using subgroup data. Relative effects were estimated for an ARASENS-like population, with sensitivity analysis in an average trial population. Results: Twelve studies, including ARASENS, were included. All studies reported baseline characteristics for ML-NMR. Sufficient subgroup data for NMI were available in 8/12 studies for overall survival (OS) and 5/12 studies for progression-free survival (PFS). Darolutamide + docetaxel + ADT showed significant benefit over docetaxel + ADT, ADT and standard-nonsteroidal-antiandrogen + ADT in all analyses. ML-NMR showed improved OS for darolutamide + docetaxel + ADT compared with abiraterone + docetaxel + ADT, apalutamide + ADT, enzalutamide + ADT and abiraterone + ADT. ML-NMR also showed improved PFS for darolutamide + docetaxel + ADT compared with apalutamide + ADT and enzalutamide + ADT. Using NMI, darolutamide + docetaxel + ADT demonstrated OS benefit over abiraterone + ADT and PFS benefit relative to abiraterone + ADT and apalutamide + ADT. Findings were consistent in an average population, although ML-NMR did not show significant OS benefit of darolutamide + docetaxel + ADT over apalutamide + ADT. Conclusion: Improved outcomes were observed with darolutamide + docetaxel + ADT compared with other therapies. By incorporating effect modifiers and addressing population imbalances, we provide clinicians with a more accurate understanding of treatment efficacy for better-informed decision-making.

At present, the prognosis for patients with extensive-stage small cell lung cancer (ES-SCLC) has remained poor. If standard treatment for ES-SCLC fails, these patients face rapid disease progression and high mortality. Thus, current treatment strategies are limited, and new treatments are urgently needed. Apatinib, a novel tyrosine kinase inhibitor (TKI) specifically targeting vascular endothelial growth factor receptor-2 (VEGFR-2), has been increasingly reported as a treatment for ES-SCLC, showing different clinical efficacy and related adverse reactions. Therefore, we performed this meta-analysis on existing studies to evaluate the efficacy and safety of apatinib in patients with ES-SCLC.

Ongoing evidence indicates increased risk of sarcopenic obesity among children and young people (CYP) with acute lymphoblastic leukemia (ALL), often beginning early in treatment, persisting into survivorship. This review evaluates current literature on body composition in CYP with ALL during and after treatment. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelinesand was registered at the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42023480732). Three databases (PubMed, MEDLINE (OVID), and CINAHL) were searched until March 2024. Studies with individuals aged 0-21 years with ALL during or after treatment were included. The Joanna Briggs Institute checklist was used to assess the bias risk. Of the 126 studies, 13 were included (eight cross-sectional and five prospective). Eight studies used dual-energy X-ray absorptiometry, three used bioelectrical impedance analysis, two used air-displacement plethysmography, and one applied the four-compartment model. Fat mass (FM) increased early (T2-T3 ≈ +1standard deviation score [SDS]), and remained elevated at treatment end, and was above reference at follow-up (T5 ≈ +0.7 SDS). Fat-free mass (FFM) declined during therapy (lowest at T4 ≈ -0.7 SDS) with partial recovery by T5 (confidence interval crossing 0). Body mass index was elevated in the ALL groups versus controls. Heterogeneity was substantial, reflecting variation in age, assessment timing, and methodology. Despite methodological limitations, this review demonstrates persistent increases in FM and a reduction in FFM during and after treatment. Large, international studies using standardized body composition methodologies and clinically relevant cut-offs are needed to define long-term risks.

First-line immunotherapy, alone or with chemotherapy, has revolutionized the treatment of metastatic non-small cell lung cancer (NSCLC). However, with multiple approved regimens, the optimal therapeutic choice is undefined due to a lack of direct comparative trials. This network meta-analysis was conducted to establish a hierarchy of efficacy for five landmark immunotherapy-based regimens to inform clinical and policy decisions.

Appendiceal adenocarcinomas are rare tumours with aggressive traits, most often diagnosed incidentally after routine appendectomy. Survival rates vary greatly between the different subgroups, and adenocarcinoma has the worst prognosis. Surgery is the only curative treatment, however, the long-term benefit of extended surgical resections over appendectomy has not been established. This study aimed to investigate survival outcomes in patients with appendiceal adenocarcinoma that undergo appendectomy versus right hemicolectomy (RHC).

Intra-arterial chemotherapy (IAC) has emerged as a targeted alternative to intravenous chemotherapy (IVC) for retinoblastoma; however, the comparative effectiveness and safety of these approaches remain incompletely defined. We performed a systematic review and meta-analysis to evaluate whether IAC-based regimens are associated with improved clinical outcomes compared with IVC in pediatric retinoblastoma. Twelve studies were included. Comparative studies contributed to the quantitative synthesis, whereas selected non comparative IAC series were summarized qualitatively to provide contextual evidence. Overall survival demonstrated a consistent association favoring IAC across both early and advanced disease categories, with a pooled effect estimate of OR 4.72 (95% CI 2.69-8.28). In early-stage disease, the pooled OR was 12.61 (95% CI 3.82-41.58), while advanced-stage disease showed a pooled OR of 3.56 (95% CI 1.88-6.74). Heterogeneity was negligible within subgroups (I² = 0%). Event-free survival favored IAC-based treatment overall with a pooled RR of 1.36 (95% CI 1.13-1.62). When stratified by treatment approach, IAC alone showed a pooled RR of 1.30 (95% CI 1.01-1.66) with moderate heterogeneity (I² = 61%), whereas IAC combined with IVC sequencing demonstrated a pooled RR of 1.43 (95% CI 1.10-1.86) with no heterogeneity (I² = 0%). Globe salvage outcomes were improved with IAC, with a pooled RR of 1.33 (95% CI 1.23-1.42; I² = 9%). Avoidance of enucleation also favored IAC overall, with a pooled RR of 1.69 (95% CI 1.34-2.12). Subgroup analyses indicated a modest and non-significant effect in early-stage disease (RR 1.27, 95% CI 0.89-1.80) and a clearer effect in advanced-stage disease (RR 2.08, 95% CI 1.54-2.80), with minimal heterogeneity (I² = 0%). Metastatic events were rare across studies; nevertheless, pooled analysis suggested lower odds of metastasis in IAC-based regimens compared with IVC (OR 0.42, 95% CI 0.19-0.91; I² = 0%), with no evidence of subgroup differences between IAC alone and IAC plus IVC sequencing. In conclusion, IAC-based strategies were associated with favorable outcomes in survival, disease control, globe salvage, and avoidance of enucleation compared with IVC, with consistently low heterogeneity across major endpoints and metastatic events remaining uncommon in both arms. These findings support the role of IAC as an important component of contemporary retinoblastoma management, particularly in settings with appropriate technical expertise and multidisciplinary resources.

The prognostic relevance of microscopically positive (R1) resection margins in hepatoblastoma remains uncertain. While microscopically complete (R0) resection is the gold standard and the primary surgical goal, R1 resections are occasionally accepted to avoid transplantation, partial hepatectomy with vascular replacement in advanced tumors, or re-resection in cases of unexpected positive margins.

Intravesical bacillus Calmette-Guérin (BCG) therapy remains the cornerstone for high-risk non-muscle-invasive bladder cancer (NMIBC), but up to 40% of patients experience disease recurrence or progression within 2 yr. We conducted a systematic review and meta-analysis of three phase 3 randomized trials POTOMAC, CREST, and ALBAN; n = 2590) in BCG-naïve high-risk NMIBC disease treated with a combination of BCG and an immune checkpoint inhibitor (ICI). Overall risk of bias was low for all studies. Combination therapy with BCG maintenance was associated with better event-free survival (EFS) in comparison to BCG alone (pooled hazard ratio [HR] 0.77, 95% confidence interval [CI] 0.60-0.99; Q = 3.29, p = 0.2). Using the HR for high-grade recurrence from ALBAN, the pooled estimate was directionally consistent, but not statistically significant (HR 0.78, 95% CI 0.58-1.04; Q = 3.94, p = 0.1). Overall survival was comparable between groups (HR 0.92, 95% CI 0.67-1.26). Grade ≥3 treatment-related adverse events were more frequent with combination therapy (risk ratio [RR] 3.66, 95% CI 2.56-5.24 for BCG induction only; RR 3.97, 95% CI 2.54-6.21 for BCG induction + maintenance). There was a moderate decline in patient-reported quality of life in the ICI + BCG maintenance arms. These findings are supported by moderate-certainty evidence for EFS. BCG monotherapy remains the benchmark for BCG-naïve high-risk NMIBC. ICI addition improves EFS but increases high-grade toxicity, which should prompt cautious and individualized adoption pending mature survival data.

The aim of theis study was toevaluate impact of duration of neoadjuvant treatment (NAT) on surgical resection rate, resection margin, response to treatment, and survival in patients with pancreatic ductal adenocarcinoma (PDAC).

The effect of single-nucleotide polymorphisms (SNPs) in Cyclin Dependent Kinase Inhibitor 1A (CDKN1A C/A), Mouse Double Minute 2 (MDM2), 309 T/G methylenetetrahydrofolate reductase (MTHFR) 677 C/T, MTHFR 1298 A/C, and Methionine synthase (MTR) 2756 A/G has been investigated in retinoblastoma (RB) with inconsistent results. Therefore, this study aims to conduct a meta-analysis and explore the overall role of these genetic variants with retinoblastoma risk. Literature search was done using PubMed, EMBASE, Cochrane Library, Google, Dogpile, and CBM all studies evaluating the association between CDKN1A or p21 C/A, MDM2 309 T/G, MTHFR 677 C/T, MTHFR 1298 A/C, and MTR 2756 A/G polymorphism and RB risk were included. A total of 1773 patients and 2474 controls were included. To understand these polymorphisms' role in RB risk, pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random or fixed effects model. P values < 0.05 were considered statistically significant. Funnel plots were used to assess publication bias. Our meta-analysis showed a significant association between RB susceptibility to CDKN1A dominant model (OR = 1.518, 95% CI = 1.003-2.298, P = 0.048), MDM2 dominant model (OR = 0.700, 95% CI = 0.542-0.903, P = 0.006) and MTR 2756 A/G all models that is allele model (OR = 4.680, 95% CI = 1.992-10.993, P = 0.000), dominant model (OR = 2.044, 95% CI = 1.511-2.765, P = 0.000), and recessive model (OR = 0.283, 95% CI = 0.122-0.656, P = 0.003). The present meta-analysis suggested that MTR 2756 A/G, MDM2 309 T/G, and CDKN1A polymorphism are associated with the risk of RB.

Core needle biopsy (CNB) is the preferred diagnostic method for suspected soft tissue and bone sarcoma, but nondiagnostic results remain common. To clarify the role of repeat biopsy, we conducted a systematic review of studies reporting repeat CNB after an initial nondiagnostic CNB, searching MEDLINE, EMBASE and PubMed. Nine studies involving nearly 9757 initial CNBs were included. Meta-analysis showed a pooled diagnostic yield of 69% (95% CI: 0.564-0.819) for repeat CNB. Subgroup analyses demonstrated a significantly higher diagnostic yield in bone sarcoma (83.1%) compared with soft tissue sarcoma (48.5%). The repeat CNB rate following a nondiagnostic initial biopsy was 5.48%. This study represents the first systematic review and meta-analysis evaluating repeat CNB in this setting, and it highlights substantial variability in diagnostic yield between sarcoma subtypes. Further research focusing on repeat biopsy across specific sarcoma subgroups is warranted to guide clinical decision-making.

This systematic review and meta-analysis compared fibroblast activation protein inhibitor (FAPI) and 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography/computed tomography (PET/CT) regarding diagnostic efficacy in primary liver cancers, focusing on sensitivity, specificity, and clinical applicability.

Different image-enhanced endoscopy (IEE) methods have shown promise in improving colorectal lesion detection, but direct comparisons remain limited. This network meta-analysis compared the detection and diagnostic performance of various IEE modalities for colorectal lesions.

The aim of this study is to compare the efficacy of the laparoscopic pylorus-preserving gastrectomy (LPPG) and laparoscopic distal gastrectomy (LDG) for gastric cancer (GC) on postoperative complications and nutritional status.

Pancreaticoduodenectomy (PD) is the standard curative option for pancreatic head carcinoma, but R1 resections remain frequent. The superior mesenteric artery (SMA) "artery-first" approach (AFA) may improve oncologic clearance and operative safety. We conducted a systematic review and meta-analysis comparing AFA versus standard PD.

Accurate preoperative localization is essential for successful breast-conserving surgery on non-palpable breast lesions. In recent years, Magseed has emerged as a non-wired localization approach with promising outcomes due to its flexibility and precision. This meta-analysis aimed to evaluate the efficacy and safety of Magseed localization on non-palpable breast lesions.

Totally laparoscopic distal gastrectomy (TLDG) is a minimally invasive alternative to laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer. While both are widely used, it remains unclear which yields better outcomes. Therefore, this meta-analysis aimed to compare surgical outcomes and postoperative quality of life (QoL) between TLDG and LADG.

The cell surface protein TROP-2 is overexpressed in various solid tumors, making it an attractive therapeutic target. Datopotamab deruxtecan (Dato-DXd) is a novel antibody-drug conjugate (ADC) designed to selectively deliver cytotoxic agents to TROP-2-expressing cancer cells. It has recently been approved for treating unresectable or metastatic hormone receptor-positive, HER2-negative breast cancer. While preclinical and early phase clinical trials have shown promising efficacy, this meta-analysis aims to provide a comprehensive evaluation of the efficacy and safety of Dato-DXd in patients with advanced solid tumors by synthesizing the available clinical evidence.