Despite growing adoption of the Heidelberg TRIANGLE operation for pancreatic head/body tumors, comprehensive analysis of its safety and outcomes remains lacking.

This meta-analysis aimed to evaluate the association between distinct KRAS mutations and overall survival (OS) in pancreatic ductal adenocarcinoma (PDAC) patients.

Ultrasound (US) can be used as a reliable and early predictor of pathological response to neoadjuvant chemotherapy (NAC) in breast cancer (BC). However, existing studies have reported inconsistent results, which highlights the need for a thorough evaluation of evidence.

Dioxins, are highly potent environmental carcinogens. Their toxic effects are mediated primarily by the Aryl Hydrocarbon Receptor (AhR). A comprehensive understanding of how AhR-induced genetic and epigenetic alterations drive carcinogenesis, especially through effects on cancer stem cells (CSCs), epithelial-mesenchymal transition (EMT) and transgenerational inheritance, remains imperative.

Human Papillomavirus (HPV) E6/E7 mRNA testing has been proposed as a potential improvement over HPV DNA testing for predicting cervical lesion progression. This systematic review and meta-analysis evaluated the diagnostic performance of HPV E6/E7 mRNA testing across various clinical scenarios.

Despite the availability of several validated therapies, the optimal second-line regimen for EGFR-mutant non-small cell lung cancer (NSCLC) after tyrosine kinase inhibitor (TKI) failure remains uncertain.

Metabolomic dysregulation contributes to prostate cancer (PCa) pathogenesis, and studies suggest that circulating metabolites have strong potential to act as clinical biomarkers. However, evidence of associations between circulating metabolites with overall and clinically significant PCa risk has not been quantitively aggregated.

Surveillance imaging aims to detect tumour relapse before symptoms develop, but it's unclear whether earlier detection of relapse leads to better outcomes in children and young people (CYP) with medulloblastoma and ependymoma. This systematic review aims to identify relevant literature to determine the efficacy of surveillance magnetic resonance imaging (MRI) for CYP with medulloblastoma and ependymoma compared to symptomatic detection. 11 databases and 2 trial registries were searched in March 2025. Studies evaluating MRI surveillance imaging in CYP with medulloblastoma and ependymoma were included. The primary outcome of interest was overall survival (OS) from diagnosis. Studies were screened independently. Data extraction/quality assessment (using QUIPs) were conducted by one reviewer and checked by a second. Narrative synthesis and post-hoc meta-analyses of the proportion of relapses detected by surveillance imaging were conducted. Of 9,575 records screened, seven studies including 196 CYP with medulloblastoma and 309 with ependymoma were eligible. All were deemed moderate/high risk of bias in at least one domain. Single-proportion meta-analysis showed most relapses were detected by surveillance imaging in medulloblastoma (66.7%; 95% CI:60.1-73.2%) and ependymoma (72.6%; 95% CI:67.6-77.7%). Data on OS from diagnosis by method of relapse detection was reported in two studies: neither provide conclusive evidence that earlier detection improves survival. We conclude that while surveillance imaging detects relapses more frequently than symptomatic detection, there is limited high-quality evidence that earlier detection improves survival. Future prospective research should be conducted and should provide more granular reporting of patient characteristics and survival outcomes from diagnosis/end of treatment.

Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related mortality worldwide. Although chemotherapy remains a cornerstone in the treatment of advanced NSCLC, local ablative strategies such as microwave ablation (MWA) have emerged as promising adjunctive therapies. However, the survival benefits of combining MWA with chemotherapy remain uncertain. This meta-analysis aims to evaluate the efficacy and safety of microwave ablation combined with chemotherapy compared to chemotherapy alone in patients with advanced NSCLC. A comprehensive search was conducted in MEDLINE, EMBASE, and Cochrane Library through January 2025. Eligible studies included randomized controlled trials or observational studies comparing MWA associated with chemotherapy versus chemotherapy alone in patients with advanced NSCLC. The primary outcome was progression-free survival (PFS); secondary outcomes included partial remission (PR) rate and adverse events (AE). Hazard ratios (HR) and risk ratios (RR) with 95% confidence intervals (CI) were pooled using random-effects models. Individual patient data (IPD) were reconstructed from Kaplan-Meier curves to perform a one-stage survival meta-analysis. Four studies comprising 483 patients were included. MWA associated with chemotherapy significantly improved PFS (HR 0.408; 95% CI 0.24-0.49; p < 0.001; I2 = 53.3%). No significant differences were found for PR (RR 0.74; 95% CI 0.37-1.50; p = 0.41) or AE (RR 1.08; 95% CI 0.86-1.36; p = 0.49). Sensitivity analyses confirmed the robustness of the findings. MWA combined with chemotherapy significantly improves PFS in advanced NSCLC without increasing toxicity.

We performed a systematic review and meta-analysis to compare the efficacy and safety of endoscopic submucosal dissection (ESD) with those of endoscopic mucosal resection (EMR) for rectal tumors extending to the dentate line (RTDLs).

To evaluate the current diagnostic accuracy of ultrasound in evaluating inguinal lymph nodes in patients with vulvar cancer and to determine if there have been advancements since 2020.

Human epidermal growth factor receptor 2 (HER2) overexpression defines a distinct breast cancer (BC) subtype that is highly sensitive to anti-HER2 therapy. However, the predictive and prognostic value of varying HER2 expression levels-specifically immunohistochemistry (IHC) 3 + versus IHC 2+/in situ hybridization (ISH)-positive-tumors remains uncertain. This systematic review and meta-analysis compared pathological complete response (pCR) between these subgroups in early-stage HER2-positive BC treated with anti-HER2-based neoadjuvant chemotherapy (NACT).

The management of extremity soft tissue sarcomas (STS) involving major vessels presents unique challenges, historically leading to amputation. Advances in vascular reconstruction have enabled limb-sparing surgery (LSS), but outcomes and perioperative risks remain uncertain. This systematic review and meta-analysis aimed to evaluate oncologic results following LSS with vascular reconstruction in extremity STS.

Inflammatory biomarkers, such as leukocyte ratios, have emerged as promising tools for diagnosing and prognosticating brain gliomas. This study systematically reviewed and analysed the diagnostic and prognostic relevance of peripheral blood leukocyte ratios in glioma. Following the PRISMA guidelines, we conducted a systematic review and meta-analysis by searching PubMed, Web of Science, and Scopus for studies published in English. Eligible studies evaluated the sensitivity, specificity, and area under the curve (AUC) of inflammatory ratios, as well as their associations with survival outcomes. Quality was assessed using the Newcastle-Ottawa Scale. A total of 29 assessments with 13,189 observations compared the neutrophil-to-lymphocyte ratio (NLR) between glioma patients and non-glioma groups, yielding a pooled standardised mean difference (SMD) of 0.445 (95% CI: 0.280-0.609, p < 0.0001; I2 = 85.1%). When compared to healthy individuals (10 assessments, 4444 observations), glioma patients exhibited a significantly elevated NLR (SMD: 0.797, 95% CI: 0.576-1.019, p < 0.0001; I2 = 87.5%). Compared to meningioma (5 assessments, 3227 observations), glioma patients had a significantly higher NLR (SMD: 0.352, 95% CI: 0.280-0.424, p < 0.0001; I2 = 24.7%). In comparisons with brain metastasis (4 assessments, 428 observations), the difference was not significant (SMD: -0.112, p = 0.3315; I2 = 44.6%). The platelet-to-lymphocyte ratio (PLR) (25 assessments, 12,085 observations) showed no significant difference between glioma and non-glioma groups (SMD: 0.1291, p = 0.0836; I2 = 81.4%). Similarly, the derived NLR (dNLR) was significantly higher in glioma patients than in non-glioma groups (SMD: 0.2421, p < 0.0001; I2 = 49.9%). The lymphocyte-to-monocyte ratio (LMR) was significantly lower in glioma compared to meningioma (SMD: -0.2989, p < 0.0001; I2 = 0.0%). MLR analysis showed high heterogeneity (I2 = 99.5%) with non-significant findings (p = 0.4476). These findings suggest NLR and dNLR as potential biomarkers for glioma diagnosis. Peripheral blood leukocyte ratios, particularly NLR, represent valuable biomarkers for glioma diagnosis and prognosis. Further research is warranted to enhance their precision and clinical utility.

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.