This study aims to identify core genes closely associated with the diagnosis and prognosis of colorectal cancer (CRC) using transcriptome-based meta-analysis approach and machine learning algorithms. Nine CRC datasets from the GEO database were integrated for differential gene expression analysis and WGCNA to identify key genes. Ninety-six combinations of machine learning algorithms were employed to further refine the selection of core genes and validate their diagnostic performance. Functional enrichment, molecular pathways, and associations with the immune microenvironment of core genes were analyzed using GSEA, CIBERSORT, and ssGSEA. Drug sensitivity predictions were performed to evaluate the impact of core genes on CRC drug response, and molecular docking simulations were used to identify candidate compounds targeting the core genes. A total of 26 core genes were identified, among which the high expression of the SACS gene was significantly associated with poor prognosis, advanced stage, and specific pathological subtypes in CRC patients. GSEA revealed that high SACS expression prominently activates cell cycle regulatory pathways and immune pathways while suppressing metabolic pathways. Furthermore, in vitro experiments demonstrated that SACS is highly expressed in CRC cells and that its knockdown significantly inhibits CRC cell proliferation, suggesting its functional role in tumor growth. Immune analysis showed that high SACS expression was positively correlated with activated NK cells but negatively correlated with Tregs and resting NK cells. Drug sensitivity analysis indicated that high SACS expression reduces sensitivity to oxaliplatin. Molecular docking identified coumestrol and quercetin as potential compounds targeting SACS. SACS promotes CRC progression by regulating cell cycle pathways, the immune microenvironment, and metabolic pathways. And it may serve as a potential therapeutic target for CRC.

Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) represents a challenging clinical scenario with poor prognosis. This study aimed to evaluate the efficacy and safety of combining locoregional therapy with targeted therapy and immunotherapy (triple therapy) in unresectable HCC with PVTT. We conducted a Bayesian network meta-analysis of ten studies involving 1,241 HCC-PVTT patients, comparing triple therapy with targeted therapy plus immunotherapy in terms of overall survival (OS), progression-free survival (PFS), tumor response, and treatment-related adverse events. The results demonstrated that triple therapy significantly improved OS and PFS compared to targeted therapy plus immunotherapy alone. For OS, hepatic arterial infusion chemotherapy (HAIC)-based combination showed the greatest benefit (HR 0.48, 95% CI 0.32-0.74), followed by radiotherapy-based (HR 0.53, 95% CI 0.30-0.91) and transarterial chemoembolization-based combinations (HR 0.65, 95% CI 0.45-0.94). For PFS, radiotherapy-based triple therapy demonstrated the most pronounced benefit (HR 0.43, 95% CI 0.30-0.63), followed by HAIC-based combination (HR 0.49, 95% CI 0.34-0.72). While the addition of locoregional therapies increased the incidence of grade 3-4 adverse events (73.5% vs. 39.4%, p < 0.001), the safety profile remained clinically manageable. In conclusion, triple combination therapies represent a promising approach for unresectable HCC with PVTT that requires validation through large-scale randomized controlled trials to establish optimal treatment regimens.

Post-operative radiation therapy (PORT) following breast-conserving surgery (BCS) has become a conventional care for early-stage breast cancer (EBC). This meta-analysis aimed to compare overall survival (OS) between patients receiving PORT and those not receiving PORT and to identify clinicopathologic features of low-risk patients with EBC who may be suitable for PORT omission after BCS with respect to OS. Comparative studies investigating PORT versus non-PORT in EBC patients after BCS were included, focusing on hazard ratio (HRs) for OS. Medline, Embase, and the Cochrane Central Library were searched from First January 2014 to First January 2025. A meta-analysis was performed to determine the HR for OS between PORT and non-PORT groups. Subgroup analyses were conducted to identify potential clinicopathologic features associated with low-risk patients suitable for PORT omission. A total of 28 studies (2 randomized controlled trials and 26 retrospective cohort studies) with 589,508 patients were included in the final analysis. According to the meta-analysis, patients with EBC derived an OS benefit from PORT (pooled HR = 0.60 [95% CI, 0.55-0.65]). Subgroup analyses identified clinicopathologic features associated with low-risk patients suitable for PORT omission. This systematic review and meta-analysis demonstrated that PORT is associated with improved OS in patients with EBC following BCS. However, certain clinicopathologic features, including age 65-70 years, progesterone receptor (-), luminal B subtype, triple-negative breast cancer, and low-risk 21-gene recurrence score, were identified as potential low-risk factors in patients who may be considered for PORT omission.

To evaluate the prognostic value of osteoprotegerin (OPG), receptor activator of nuclear factor-κB (RANK) and RANK ligand (RANKL) of the RANK signalling in patients with breast cancer.

IntroductionChemotherapy is used frequently in the neoadjuvant setting for breast cancers, most commonly triple negative and human epidermal growth factor receptor 2 (HER-2) positive breast cancer. Certain hormone positive HER-2 negative cancers known as luminal B have shown response to adjuvant chemotherapy and can be considered in the neoadjuvant setting. This meta-analysis reviews survival outcomes in neoadjuvant chemotherapy in comparison to adjuvant in luminal B breast cancer.MethodsPubMed, Medline, and Embase were accessed on the 31st of January 2024 to complete this systematic review and meta-analysis. All study types were included. Studies included compared survival rates in luminal B breast cancer patients in the neoadjuvant and adjuvant setting. All regimens of chemotherapy were included. Studies were included if they had at least median of 48 months follow up. Studies were excluded if they were non-comparative or did not report survival rates.ResultsTwo retrospective analyses comparing neoadjuvant and adjuvant chemotherapy were found from this systematic review, with a total of 4575 patients included. Of the 4575 patients, 679 received neoadjuvant chemotherapy (14.84%). Meta-analysis of these studies identified a non-significant trend of increased overall survival in the adjuvant chemotherapy arm with a hazard ratio of 1.85, confidence interval 0.98 - 3.48, (P value 0.058).DiscussionThis meta-analysis revealed a paucity of data in the comparison of neoadjuvant to adjuvant chemotherapy in luminal B breast cancer patients. Both studies identified were of a retrospective nature, and further research in this field should be considered.

AimTo ascertain the safety and feasibility of robotic simultaneous resection of synchronous colorectal cancer and liver metastases.MethodsA PRISMA-compliant systematic review with proportion meta-analysis was conducted. All retrospective or prospective observational studies including patients aged ≥ 18 with synchronous colorectal cancer and liver metastases undergoing robotic simultaneous resection were eligible. The outcomes included conversion to open, operative time, intraoperative blood loss, Clavien-Dindo ≥ III complications, 30-day mortality, anastomotic leak, R0 resection, and length of hospital stay.ResultsSeven eligible studies including 165 patients were identified. The mean age was 62.8 years (95% CI: 60.5-65.2), mean body mass index was 26.5 (95% CI: 24.6-28.4), and 52.0% (95% CI: 37.9-66.1) were male. The mean operative time was 406.5 min (95% CI: 358.2-454.7) and mean intraoperative blood loss was 150.0 mL (95% CI: 124.5-175.6). Conversion to open occurred in 3.9% (95% CI: 1.0-6.8), Clavien-Dindo ≥ III complications in 9.3% (95% CI: 4.7-13.8), 30-day mortality in 0.9% (95% CI: 0.0-2.4), and anastomotic leak in 4.3% (95% CI: 0.9-7.6). R0 resection was achieved in 99.0% (95% CI: 97.5-100), and the mean length of hospital stay was 6.7 days (95% CI: 5.5-7.9).ConclusionsSingle-arm meta-analysis suggests that robotic simultaneous resection of synchronous colorectal cancer and liver metastases may not only be feasible and safe but also may be advantageous in terms of conversion avoidance, complexity handling, and perioperative recovery. More studies with larger sample size are required to inform long-term oncological outcomes and selection criteria and to provide comparative evidence.

There is ongoing debate on the relative safety and effectiveness of robot-assisted partial nephrectomy (RAPN) and percutaneous thermal ablation (PTA) in the treatment of cT1 renal cancers. The purpose of this study was to compare the oncological, functional, and perioperative results of these two approaches. Web of Science, PubMed, Cochrane Library, and EMBASE were used in a systematic review to find English-language research that was published before to August 2025. Review Manager 5.4 was used to do a meta-analysis, combining five trials with 773 patients (398 treated with PTA and 375 with RAPN). Weighted mean differences (WMD) were utilized for continuous variables, while odds ratios (OR) were used for dichotomous variables. PROSPERO registered the study (ID: CRD420251125197). PTA was associated to a reduced postoperative glomerular filtration rate (WMD: -14.14; 95% CI: -23.77 to -4.15; P = 0.004), a higher local recurrence rate (OR: 4.14; 95% CI: 1.63-10.53; P = 0.003), and a significantly shorter operative time (WMD: -86.41 min; 95% CI: -143.58 to -29.24; P = 0.003) when compared to RAPN. The duration of hospital stays, the rate of postoperative glomerular filtration rate drop, serious complications (Clavien-Dindo grade ≥ III), the risk of metastases, and 5-year overall survival (OS) did not, however, differ significantly between the two groups. According to our research, PTA and RAPN are both safe and efficient ways to treat cT1 renal tumors while maintaining a similar level of renal function. For individuals with pre-existing renal impairment or poor overall health, PTA could be a better option.

This study aims to compare the efficacy and safety of secondary cytoreductive surgery (SCS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) versus SCS alone in the management of platinum-sensitive recurrent ovarian cancer (PSROC) through a systematic review and meta-analysis.

This study aimed to assess perioperative safety and long-term survival after hepatopancreatoduodenectomy (HPD) by performing a systematic review and single-arm meta-analysis of studies published since 2005. The HPD procedure is a high-risk but potentially curative treatment for advanced bile duct and gallbladder cancers. Although perioperative outcomes have improved over time, an updated synthesis of contemporary evidence remains limited.

Immune checkpoint inhibitors (ICIs) targeting programmed cell death protein-1/programmed death-ligand 1 (PD-1/PD-L1) have revolutionized non-small cell lung cancer (NSCLC) treatment. Atezolizumab, a promising PD-L1 inhibitor, has unknown effectiveness and safety in patients with different PD-L1 expression statuses. This study aimed to evaluate the effectiveness and safety of atezolizumab compared with docetaxel in patients with NSCLC.

Blinded independent central review (BICR) mitigates assessment bias in oncology trials but imposes significant operational burdens. Its value in hematologic malignancies-where multimodal response criteria reduce reliance on subjective imaging assessments compared to solid tumors-remains unestablished. This meta-analysis evaluates BICR-investigator concordance specifically in hematology trials.

Studies were meticulously selected based on a literature search conducted across multiple databases. Data on overall survival (OS), progression-free survival (PFS), and clinicopathological characteristics were extracted. Heterogeneity was assessed among studies for reliability. Sensitivity analysis confirmed result stability, and Egger's test checked for publication bias. Ten studies with 1761 cases were analyzed. Patients with high TK1a level had a significantly higher risk of poor OS (HR 1.80; 95% CI, 1.35-2.41, Z = 3.99, P < .05) compared to those with low TK1a level. Similar finding is revealed in PFS analysis. The overall heterogeneity in the analysis was substantial. After regression analysis, sample type likely caused it. We performed an analysis to indicate that high TK1a level linked to negative ER status (OR: 0.651, 95% CI, 0.43-0.985, P < .001) but not other factors. Funnel plot test showed no publication bias in the included articles. Assessing TK1a level may offer supportive insights into the prognosis of breast cancer patients. This biomarker could potentially aid in evaluating patient outcomes and gauging the effectiveness of treatment strategies in clinical interventions.

This study aimed to evaluate the diagnostic accuracy of the apparent diffusion coefficient (ADC) derived from diffusion weighted imaging (DWI) for detecting lymph node metastasis in breast cancer.

Background: The prognosis and disease course of medullary thyroid carcinoma (MTC) can vary widely among patients. Effective risk stratification is important for ensuring timely treatment and personalized follow-up. Biomarkers can enhance risk stratification and guide the development of targeted anticancer therapies and imaging techniques. While numerous studies have explored various immunohistochemical biomarkers in MTC, an overview is still lacking. This study aimed to provide a comprehensive overview of immunohistochemical biomarkers and their role in the prognosis of MTC patients, with a primary focus on overall survival (OS). Methods: This review was preregistered in PROSPERO (CRD42023469437). A systematic search was performed using the online medical databases Embase, MEDLINE (Ovid), and Cochrane. Quality was assessed using an adapted scoring system based on the REMARK criteria and the Quality in Prognosis Studies tool. The primary outcome was OS. Secondary outcomes included other types of survival and associations with clinicopathological risk factors and recurrence. Results: Of 2992 studies, 108 were included, investigating 170 unique biomarkers and with sample sizes ranging from 11 to 327 participants. The majority (72%) were reported in only one article. A minority of studies were rated as high quality (28%). Markers of proliferation Ki-67 (Ki-67) and programmed cell death-ligand 1 (PD-L1) were significantly associated with OS (hazard ratio [HR]: 6.67, confidence interval [CI]: 1.43-31.18 and HR: 3.34, CI: 1.18-9.51). Conclusions: Our systematic review provides a comprehensive synthesis of the literature on immunohistochemical biomarkers in MTC and highlights the need for high-quality validation studies. Our meta-analysis confirms the prognostic value of Ki-67, although with varying certainty due to large differences in study quality. Furthermore, we describe the association of PD-L1 positivity with poorer OS, increased recurrence, and more aggressive clinicopathological features, which supports the rationale for further investigating the potential of anti-PD-1/PD-L1 immunotherapy for advanced MTC.

Colorectal cancer (CRC) continues to be a leading cause of cancer-related mortality globally, and accurately predicting lymph node metastasis (LNM) in T1 and T2 lesions is vital for informing treatment strategies. This study aimed to assess the diagnostic accuracy of artificial intelligence (AI)-based models, particularly deep learning (DL) and machine learning (ML) approaches, in predicting LNM risk in CRC.

Although several studies have suggested that sarcopenia is associated with adverse outcomes in kidney cancer patients undergoing nephrectomy, the results have been inconsistent. Therefore, this meta-analysis was conducted to investigate the relationship between sarcopenia and post-nephrectomy survival in kidney cancer patients.

Previous meta-analyses have shown TAS-102's potential in metastatic colorectal cancer (mCRC). Thus, we conducted a meta-analysis to investigate the efficacy and safety of TAS-102 combined with bevacizumab versus TAS-102 monotherapy in the treatment of mCRC.

Claudin 18.2 (CLDN18.2) is a novel treatment target for patients with unresectable or stage IV gastric cancer. However, it remains unclear whether the expression of CLDN18.2 affects survival outcomes. In total, 586 patients with GC were enrolled in this study. CLDN18.2 expression in cancer cells was analyzed by immunohistochemistry. Correlations between CLDN18.2 expression and several clinicopathological factors and survival outcomes were investigated. We also performed a systematic review and a meta-analysis. CLDN18.2 expression was mainly observed in the cell membrane. The CLDN18.2 expression was not significantly correlated with any clinicopathological factor. In all patients, CLDN18.2 did not significantly affect OS. In patients with the diffuse type, the overall survival of patients with CLDN18.2-high expression was worse than that of patients with CLDN18.2-low expression, although the difference was not significant (p = 0.092). Meta-analyses revealed that CLDN18.2 was not significant prognostic factor in resected cases, although CLDN18.2 negative cases showed a trend for worse survival. In, conclusion, CLDN18.2 was not a significant prognostic factor in general, although CLDN18.2 negative cases showed a trend for worse survival. We revealed that patients with CLDN18.2 high expression showed worse survival outcomes especially in the diffuse type.

Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, often associated with poor outcomes due to metastasis and late detection. The epithelial-to-mesenchymal transition (EMT) is central to OSCC progression, but the prognostic role of EMT markers remains unclear. This systematic review and meta-analysis evaluated five key EMT markers-E-cadherin, EpCAM, Vimentin, TWIST, and SNAIL-in OSCC.

Platinum-refractory/resistant (r/r) small cell lung cancer (SCLC) is associated with poor prognosis and limited treatment options. While chemotherapy has been the standard, recent randomized controlled trials (RCTs) have investigated immunotherapy and targeted therapies. In 2025, the DeLLphi-304 trial showed tarlatamab significantly improved overall survival (OS) and progression-free survival (PFS) versus standard chemotherapy (SC). However, no network meta-analysis (NMA) has compared systemic therapies in this setting.