Pub Date : 2025-12-11DOI: 10.1016/j.ctarc.2025.101070
Juhua Dai , Xinping Sun , Bozhi Lin, Yujing Sun, Liyuan Chen
Background
This study examines whether the pan-immune inflammation value (PIV) is linked to all-cause, cardiovascular disease (CVD), and cancer-specific mortality in individuals with a history of cancer. Data from the National Health and Nutrition Examination Survey (NHANES) were analyzed to further explore the potential mediating influence of estimated glomerular filtration rate (eGFR) on the PIV–mortality relationship.
Methods
We included 3773 cancer survivors from NHANES (2003–2018). Mortality follow-up was conducted via linkage to the National Death Index. Associations between PIV and mortality outcomes were assessed using restricted cubic spline curves and weighted multivariable Cox regression. Mediation analysis evaluated whether eGFR partly explains the effect of PIV on mortality.
Results
Over a median follow-up of 84.75 months, 1137 deaths occurred (all-cause: 30.14 %; CVD: 8.32 %; cancer: 9.09 %). Using an optimal cutoff of 344.63, participants were classified into low (n = 2335) and high PIV (n = 1438) groups. In fully adjusted models, high PIV was associated with increased risks of all-cause mortality (HR 1.36, 95 % CI 1.18–1.56) and cancer-related mortality (HR 1.42, 95 % CI 1.10–1.82). eGFR mediated 9.10 % of the association between PIV and all-cause mortality and 11.47 % for CVD mortality, but not significantly for cancer mortality.
Conclusion
Elevated PIV independently predicts higher all-cause and cancer-specific mortality in cancer survivors. The findings suggest that PIV may serve as a practical prognostic marker, with renal function partially accounting for its link to mortality.
本研究探讨了泛免疫炎症值（PIV）是否与有癌症病史的个体的全因、心血管疾病（CVD）和癌症特异性死亡率相关。我们分析了来自国家健康与营养调查（NHANES）的数据，以进一步探讨估算的肾小球滤过率（eGFR）对piv -死亡率关系的潜在中介影响。方法我们纳入了来自NHANES（2003-2018）的3773名癌症幸存者。通过与国家死亡指数的联系进行死亡率随访。使用限制性三次样条曲线和加权多变量Cox回归评估PIV与死亡率之间的关系。中介分析评估eGFR是否部分解释了PIV对死亡率的影响。结果在84.75个月的中位随访中，共发生1137例死亡（全因：30.14%；心血管疾病：8.32%；癌症：9.09%）。采用最佳截断值344.63，将参与者分为低PIV组（n = 2335）和高PIV组（n = 1438）。在完全调整的模型中，高PIV与全因死亡率（HR 1.36, 95% CI 1.18-1.56）和癌症相关死亡率（HR 1.42, 95% CI 1.10-1.82）增加相关。eGFR介导了PIV与全因死亡率之间9.10%的相关性和CVD死亡率之间11.47%的相关性，但对癌症死亡率的相关性不显著。结论PIV升高独立预测了癌症幸存者更高的全因死亡率和癌症特异性死亡率。研究结果表明PIV可以作为一种实用的预后标志物，肾功能与死亡率的联系部分解释。
{"title":"Pan-immune-inflammation value is associated with all-cause and cause-specific mortality among individuals with cancer survivors: a population-based longitudinal cohort study","authors":"Juhua Dai , Xinping Sun , Bozhi Lin, Yujing Sun, Liyuan Chen","doi":"10.1016/j.ctarc.2025.101070","DOIUrl":"10.1016/j.ctarc.2025.101070","url":null,"abstract":"<div><h3>Background</h3><div>This study examines whether the pan-immune inflammation value (PIV) is linked to all-cause, cardiovascular disease (CVD), and cancer-specific mortality in individuals with a history of cancer. Data from the National Health and Nutrition Examination Survey (NHANES) were analyzed to further explore the potential mediating influence of estimated glomerular filtration rate (eGFR) on the PIV–mortality relationship.</div></div><div><h3>Methods</h3><div>We included 3773 cancer survivors from NHANES (2003–2018). Mortality follow-up was conducted via linkage to the National Death Index. Associations between PIV and mortality outcomes were assessed using restricted cubic spline curves and weighted multivariable Cox regression. Mediation analysis evaluated whether eGFR partly explains the effect of PIV on mortality.</div></div><div><h3>Results</h3><div>Over a median follow-up of 84.75 months, 1137 deaths occurred (all-cause: 30.14 %; CVD: 8.32 %; cancer: 9.09 %). Using an optimal cutoff of 344.63, participants were classified into low (<em>n</em> = 2335) and high PIV (<em>n</em> = 1438) groups. In fully adjusted models, high PIV was associated with increased risks of all-cause mortality (HR 1.36, 95 % CI 1.18–1.56) and cancer-related mortality (HR 1.42, 95 % CI 1.10–1.82). eGFR mediated 9.10 % of the association between PIV and all-cause mortality and 11.47 % for CVD mortality, but not significantly for cancer mortality.</div></div><div><h3>Conclusion</h3><div>Elevated PIV independently predicts higher all-cause and cancer-specific mortality in cancer survivors. The findings suggest that PIV may serve as a practical prognostic marker, with renal function partially accounting for its link to mortality.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101070"},"PeriodicalIF":2.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-11DOI: 10.1016/j.ctarc.2025.101071
Bjarn-Ove Tetzlaff , Alexander Rühle , Justus Domschikowski , Maike Trommer , Simone Ferdinandus , Jan-Niklas Becker , Georg Wurschi , Simon Böke , Christoph A. Grott , Lukas Käsmann , Melanie Schneider , Elodie Bockelmann , David Krug , Nils H. Nicolay , Alexander Fabian , Mathias Sonnhoff
Introduction
Financial toxicity, defined as the financial burden and distress caused by cancer treatment, has emerged as a critical issue in oncology care. While most research originates from the U.S., data from countries with publicly funded healthcare systems remain limited, particularly regarding breast cancer patients receiving radiotherapy. This study investigates financial toxicity in radiation-treated breast cancer patients in the German healthcare system.
Methods
A retrospective, multicenter, cross-sectional study was conducted with 279 breast cancer patients from 11 certified German breast cancer centers. Data were collected via self-report questionnaires assessing financial distress, treatment-related costs, income loss, psychosocial distress, and global quality of life at the end of radiotherapy. Ordinal regression and moderation analyses were used to identify predictors and interactions. Group comparisons were performed using chi-square and Mann-Whitney U tests.
Results
106 of 271 participants (39.1 %) reported financial toxicity, mostly at mild levels. Significant predictors included lower household income, higher direct treatment costs, and income loss. Income did not moderate the relationship between costs/income loss and financial toxicity. Patients with financial toxicity reported global lower quality of life and higher psychosocial distress. No differences were found by insurance and employment status, radiotherapy regimen, or concurrent systemic therapy.
Discussion and conclusion
Despite universal healthcare coverage and treatment in certified centers, a substantial proportion of breast cancer patients experienced financial toxicity. The findings suggest that socioeconomic consequences of treatment remain under-addressed in structured cancer care. Broader interventions are needed to mitigate financial distress in breast cancer patients undergoing radiation therapy.
{"title":"Financial toxicity in breast cancer patients during radiotherapy – A German multicenter analysis","authors":"Bjarn-Ove Tetzlaff , Alexander Rühle , Justus Domschikowski , Maike Trommer , Simone Ferdinandus , Jan-Niklas Becker , Georg Wurschi , Simon Böke , Christoph A. Grott , Lukas Käsmann , Melanie Schneider , Elodie Bockelmann , David Krug , Nils H. Nicolay , Alexander Fabian , Mathias Sonnhoff","doi":"10.1016/j.ctarc.2025.101071","DOIUrl":"10.1016/j.ctarc.2025.101071","url":null,"abstract":"<div><h3>Introduction</h3><div>Financial toxicity, defined as the financial burden and distress caused by cancer treatment, has emerged as a critical issue in oncology care. While most research originates from the U.S., data from countries with publicly funded healthcare systems remain limited, particularly regarding breast cancer patients receiving radiotherapy. This study investigates financial toxicity in radiation-treated breast cancer patients in the German healthcare system.</div></div><div><h3>Methods</h3><div>A retrospective, multicenter, cross-sectional study was conducted with 279 breast cancer patients from 11 certified German breast cancer centers. Data were collected via self-report questionnaires assessing financial distress, treatment-related costs, income loss, psychosocial distress, and global quality of life at the end of radiotherapy. Ordinal regression and moderation analyses were used to identify predictors and interactions. Group comparisons were performed using chi-square and Mann-Whitney U tests.</div></div><div><h3>Results</h3><div>106 of 271 participants (39.1 %) reported financial toxicity, mostly at mild levels. Significant predictors included lower household income, higher direct treatment costs, and income loss. Income did not moderate the relationship between costs/income loss and financial toxicity. Patients with financial toxicity reported global lower quality of life and higher psychosocial distress. No differences were found by insurance and employment status, radiotherapy regimen, or concurrent systemic therapy.</div></div><div><h3>Discussion and conclusion</h3><div>Despite universal healthcare coverage and treatment in certified centers, a substantial proportion of breast cancer patients experienced financial toxicity. The findings suggest that socioeconomic consequences of treatment remain under-addressed in structured cancer care. Broader interventions are needed to mitigate financial distress in breast cancer patients undergoing radiation therapy.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101071"},"PeriodicalIF":2.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-09DOI: 10.1016/j.ctarc.2025.101068
Florent Stasiak , Elena Pappafava , Clara Jolly , Sylvain Baillot , Arthur Streit , Joëlle Siat , Stéphane Renaud , Joseph Seitlinger
Background
Thoracotomy is still required for major lung resections, though minimally invasive approaches are increasing. Postoperative pain and respiratory issues remain challenges, and current analgesia like epidurals have limitations. Intercostal nerves cryoanalgesia has emerged as a promising alternative, but its clinical and economic impact in thoracotomy remains underexplored.
Materials and methods
We conducted a retrospective, observational, single-center study comparing two groups: a standard of care group (SOC, n = 54) and a cryoanalgesia group (CRYO, n = 29). All patients underwent thoracotomy with major lung resection. The CRYO group additionally received intercostal nerves cryoanalgesia. We analyzed postoperative complications, pain levels, ICU and hospital length of stay, morphine consumption, and direct hospitalization costs.
Results
Cryoanalgesia significantly reduced overall postoperative complications (24.1 % vs 50.0 %, p = 0.034), particularly respiratory complications (10.3 % vs 37 %, p = 0.035). ICU stay was shorter in the CRYO group (2 (IQR = 1) vs 3 (IQR = 1) days, p = 0.001), while total hospital stay showed no significant difference. Pain scores and morphine use were similar in both groups. The cost analysis showed lower ICU-related costs in the CRYO group, as well as a financial benefit for the French public health system.
Conclusion
Intercostal nerves cryoanalgesia during thoracotomy is associated with reduced postoperative and respiratory complications and a shorter ICU stay, while pain levels remain similar. These benefits may improve patient outcomes and reduce ICU burden, suggesting a medico-economic benefit for cryoanalgesia in thoracic surgery.
背景：尽管微创入路越来越多，但大肺切除术仍然需要开胸手术。术后疼痛和呼吸问题仍然是挑战，目前的硬膜外镇痛有局限性。肋间神经冷冻镇痛已成为一种很有前途的替代方法，但其在开胸手术中的临床和经济影响仍未得到充分探讨。材料和方法：我们进行了一项回顾性、观察性、单中心研究，比较两组：标准护理组（SOC, n = 54）和低温镇痛组（CRYO, n = 29）。所有患者均行开胸大肺切除术。CRYO组在对照组基础上给予肋间神经冷冻镇痛。我们分析了术后并发症、疼痛程度、ICU和住院时间、吗啡用量和直接住院费用。结果：低温镇痛显著降低了术后并发症（24.1% vs 50.0%, p = 0.034），特别是呼吸系统并发症（10.3% vs 37%, p = 0.035）。CRYO组ICU住院时间较短(2 (IQR = 1) vs 3 (IQR = 1) d, p = 0.001)，总住院时间差异无统计学意义。两组的疼痛评分和吗啡使用情况相似。成本分析显示，低温冷冻组的重症监护相关成本较低，同时也为法国公共卫生系统带来了经济效益。结论：开胸术中肋间神经冷冻镇痛可减少术后和呼吸系统并发症，缩短ICU住院时间，且疼痛水平保持不变。这些益处可能改善患者预后并减轻ICU负担，提示胸外科冷冻镇痛具有医学-经济效益。
{"title":"Intercostal nerves cryoanalgesia and open thoracotomy for major lung resection: evaluation of perioperative outcomes and medico-economic analysis","authors":"Florent Stasiak , Elena Pappafava , Clara Jolly , Sylvain Baillot , Arthur Streit , Joëlle Siat , Stéphane Renaud , Joseph Seitlinger","doi":"10.1016/j.ctarc.2025.101068","DOIUrl":"10.1016/j.ctarc.2025.101068","url":null,"abstract":"<div><h3>Background</h3><div>Thoracotomy is still required for major lung resections, though minimally invasive approaches are increasing. Postoperative pain and respiratory issues remain challenges, and current analgesia like epidurals have limitations. Intercostal nerves cryoanalgesia has emerged as a promising alternative, but its clinical and economic impact in thoracotomy remains underexplored.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective, observational, single-center study comparing two groups: a standard of care group (SOC, n = 54) and a cryoanalgesia group (CRYO, n = 29). All patients underwent thoracotomy with major lung resection. The CRYO group additionally received intercostal nerves cryoanalgesia. We analyzed postoperative complications, pain levels, ICU and hospital length of stay, morphine consumption, and direct hospitalization costs.</div></div><div><h3>Results</h3><div>Cryoanalgesia significantly reduced overall postoperative complications (24.1 % vs 50.0 %, <em>p</em> = 0.034), particularly respiratory complications (10.3 % vs 37 %, <em>p</em> = 0.035). ICU stay was shorter in the CRYO group (2 (IQR = 1) vs 3 (IQR = 1) days, <em>p</em> = 0.001), while total hospital stay showed no significant difference. Pain scores and morphine use were similar in both groups. The cost analysis showed lower ICU-related costs in the CRYO group, as well as a financial benefit for the French public health system.</div></div><div><h3>Conclusion</h3><div>Intercostal nerves cryoanalgesia during thoracotomy is associated with reduced postoperative and respiratory complications and a shorter ICU stay, while pain levels remain similar. These benefits may improve patient outcomes and reduce ICU burden, suggesting a medico-economic benefit for cryoanalgesia in thoracic surgery.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101068"},"PeriodicalIF":2.4,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-08DOI: 10.1016/j.ctarc.2025.101066
Saeid Safiri , Kamaleddin Hassanzadeh , Ali Shamekh , Fateme Tahmasbi , Nima Naghdi-Sedeh , Asra Fazlollahi , Mark J.M. Sullman , Mortaza Raeisi , Zohreh Sanaat , Ali-Asghar Kolahi
Background
Bladder cancer (BC), as the most common malignancy of the urinary system, imposes a substantial epidemiological and economic burden worldwide. Due to its wide range of pathological properties, this disease requires various management methods, making it a challenging malignancy to control.
Methods
This study utilised data from the Global Burden of Disease 2021 study to detail the incidence, deaths and disability-adjusted life years (DALYs) attributable to bladder cancer, presented as counts and age-standardised rates with 95 % uncertainty intervals.
Results
In 2021, BC accounted for an age-standardised incidence of 8.2 per 100,000 (95 % UI: 6.9 to 10.0). This disease was also responsible for an age-standardised death rate of 3.2 (95 % UI: 2.8 % to 3.9 %) per 100,000. Furthermore, BC imposed an age-standardised DALY rate of 66.3 (95 % UI: 13.9 to 24.9) per 100,000 population. However, these three parameters have not changed significantly since 1990. Iraq, Kuwait, and Iran were the only countries that had large rises in their age-standardised incidence rates from 1990 to 2021, while Qatar and Bahrain showed significant declines in their age-standardised death and DALY rates.
Conclusions
The burden of bladder cancer increased in the region between 1990 and 2021, although this increase was not statistically significant. This observation may change as further evidence becomes available, particularly with larger sample sizes and longer periods of observation. Furthermore, these findings may also reflect advances in healthcare systems and diagnostic capabilities. As the population continues to grow and age, there is an increasing urgency for more effective preventive strategies to address the risk factors associated with bladder cancer.
{"title":"The burden of bladder cancer in the MENA region: a 3-decade analysis","authors":"Saeid Safiri , Kamaleddin Hassanzadeh , Ali Shamekh , Fateme Tahmasbi , Nima Naghdi-Sedeh , Asra Fazlollahi , Mark J.M. Sullman , Mortaza Raeisi , Zohreh Sanaat , Ali-Asghar Kolahi","doi":"10.1016/j.ctarc.2025.101066","DOIUrl":"10.1016/j.ctarc.2025.101066","url":null,"abstract":"<div><h3>Background</h3><div>Bladder cancer (BC), as the most common malignancy of the urinary system, imposes a substantial epidemiological and economic burden worldwide. Due to its wide range of pathological properties, this disease requires various management methods, making it a challenging malignancy to control.</div></div><div><h3>Methods</h3><div>This study utilised data from the Global Burden of Disease 2021 study to detail the incidence, deaths and disability-adjusted life years (DALYs) attributable to bladder cancer, presented as counts and age-standardised rates with 95 % uncertainty intervals.</div></div><div><h3>Results</h3><div>In 2021, BC accounted for an age-standardised incidence of 8.2 per 100,000 (95 % UI: 6.9 to 10.0). This disease was also responsible for an age-standardised death rate of 3.2 (95 % UI: 2.8 % to 3.9 %) per 100,000. Furthermore, BC imposed an age-standardised DALY rate of 66.3 (95 % UI: 13.9 to 24.9) per 100,000 population. However, these three parameters have not changed significantly since 1990. Iraq, Kuwait, and Iran were the only countries that had large rises in their age-standardised incidence rates from 1990 to 2021, while Qatar and Bahrain showed significant declines in their age-standardised death and DALY rates.</div></div><div><h3>Conclusions</h3><div>The burden of bladder cancer increased in the region between 1990 and 2021, although this increase was not statistically significant. This observation may change as further evidence becomes available, particularly with larger sample sizes and longer periods of observation. Furthermore, these findings may also reflect advances in healthcare systems and diagnostic capabilities. As the population continues to grow and age, there is an increasing urgency for more effective preventive strategies to address the risk factors associated with bladder cancer.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101066"},"PeriodicalIF":2.4,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-04DOI: 10.1016/j.ctarc.2025.101059
Song Wang , Jiahua He , Yuanbin Liao , Weihao Li , Weili Zhang , Da Kang , Weifeng Wang , Ruowei Wang , Chi Zhou , Junzhong Lin , Leen Liao , Jianhong Peng , Yuguang Lin
Background
: Colorectal liver oligometastasis (CLO) represents an intermediate state between localized and widely disseminated disease. Transforming growth factor-beta 1 (TGF-β1) plays a stage-dependent role in the tumorigenesis of colorectal cancer. However, its prognostic value and impact on the immune microenvironment in CLO remain poorly understood.
Methods
: We retrospectively analyzed 95 CLO patients who underwent curative resection of primary tumors and liver metastases. TGF-β1 expression was assessed by immunohistochemistry (IHC) in matched tumor and liver metastasis samples. Multiplex IHC and multispectral imaging were used to quantify CD3⁺, CD8⁺, and Foxp3⁺ T-cell infiltration in intratumoral and peritumoral compartments. Survival outcomes were compared using Kaplan–Meier analysis and Cox proportional hazards model. Associations with immune infiltration were subsequently validated through the analysis of TCGA colon adenocarcinoma datasets utilizing the TIMER2.0 platform.
Results
: The median IHC score for both primary tumors and liver metastases was 6. The consistency rate of TGF-β1 expression in primary tumors and liver metastases was 70 %. High TGF-β1 expression (≥6) in liver oligometastases was independently associated with poorer recurrence-free survival (RFS; HR = 3.689, 95 % CI: 1.799–7.567, P < 0.001) and overall survival (OS; HR = 3.131, 95 % CI: 1.278–7.669, P = 0.013). Patients with consistently high TGF-β1 expression in the primary tumors and liver metastases were associated with the poorest prognosis (P < 0.001). High TGF-β1 expression was associated with significantly reduced intratumoral CD3⁺ and CD8⁺ T cell infiltration and increased Foxp3⁺ regulatory T cell density (P < 0.05). This association was also observed in the cohort from TCGA.
Conclusion
: High TGF-β1 expression in CLO is associated with poor prognosis and an immunosuppressive microenvironment.
{"title":"Impact of TGF-β1 on tumor immune microenvironment and prognosis in colorectal liver oligometastasis","authors":"Song Wang , Jiahua He , Yuanbin Liao , Weihao Li , Weili Zhang , Da Kang , Weifeng Wang , Ruowei Wang , Chi Zhou , Junzhong Lin , Leen Liao , Jianhong Peng , Yuguang Lin","doi":"10.1016/j.ctarc.2025.101059","DOIUrl":"10.1016/j.ctarc.2025.101059","url":null,"abstract":"<div><h3>Background</h3><div><strong>:</strong> Colorectal liver oligometastasis (CLO) represents an intermediate state between localized and widely disseminated disease. Transforming growth factor-beta 1 (TGF-β1) plays a stage-dependent role in the tumorigenesis of colorectal cancer. However, its prognostic value and impact on the immune microenvironment in CLO remain poorly understood.</div></div><div><h3>Methods</h3><div><strong>:</strong> We retrospectively analyzed 95 CLO patients who underwent curative resection of primary tumors and liver metastases. TGF-β1 expression was assessed by immunohistochemistry (IHC) in matched tumor and liver metastasis samples. Multiplex IHC and multispectral imaging were used to quantify CD3⁺, CD8⁺, and Foxp3⁺ T-cell infiltration in intratumoral and peritumoral compartments. Survival outcomes were compared using Kaplan–Meier analysis and Cox proportional hazards model. Associations with immune infiltration were subsequently validated through the analysis of TCGA colon adenocarcinoma datasets utilizing the TIMER2.0 platform.</div></div><div><h3>Results</h3><div><strong>:</strong> The median IHC score for both primary tumors and liver metastases was 6. The consistency rate of TGF-β1 expression in primary tumors and liver metastases was 70 %. High TGF-β1 expression (≥6) in liver oligometastases was independently associated with poorer recurrence-free survival (RFS; HR = 3.689, 95 % CI: 1.799–7.567, <em>P</em> < 0.001) and overall survival (OS; HR = 3.131, 95 % CI: 1.278–7.669, <em>P</em> = 0.013). Patients with consistently high TGF-β1 expression in the primary tumors and liver metastases were associated with the poorest prognosis (<em>P</em> < 0.001). High TGF-β1 expression was associated with significantly reduced intratumoral CD3⁺ and CD8⁺ T cell infiltration and increased Foxp3⁺ regulatory T cell density (<em>P</em> < 0.05). This association was also observed in the cohort from TCGA.</div></div><div><h3>Conclusion</h3><div><strong>:</strong> High TGF-β1 expression in CLO is associated with poor prognosis and an immunosuppressive microenvironment.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101059"},"PeriodicalIF":2.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.ctarc.2025.101061
R.M.G. van Vuren , N. Wolfhagen , R.A.M. Damhuis , S. Kruijff , W.Y. van der Plas , W.H. Schreurs , O.C.J. Schuurbiers , H.J.M. Smit , A.F.T.M. Verhagen , M.W. Wouters , J. Belderbos , D.J. Heineman
Introduction
The COVID-19 pandemic significantly impacted lung cancer treatment, necessitating shifts in treatment modalities. Guidelines temporarily recommended SBRT as alternative to surgery for early-stage NSCLC.
Materials and Methods
This retrospective cohort study analyzed data from the Dutch Lung Cancer Audit – Radiotherapy (DLCA-R) and Surgery (DLCA-S) registries, including patients with Stage I NSCLC treated between 2018 and 2022. Patients were categorized into historic, pandemic, and post-pandemic cohorts. The primary endpoint was the percentage of surgical and radiotherapy treatments in these cohorts; secondary endpoints included time to treatment, complications, acute toxicity, and mortality.
Results
A total of 15,072 treatment episodes were analyzed. During the pandemic, the percentage of patients with Stage I NSCLC receiving radiotherapy increased significantly from 57 % to 65 %, while the percentage of patients undergoing surgery decreased. The shift towards radiotherapy persisted post-pandemic. Time to treatment and complication rates remained stable, though pulmonary embolism rates increased during the pandemic.
Conclusions
The pandemic led to a significant increase in radiotherapy for Stage I NSCLC, aligning with prevailing ESMO guidelines. However, this shift persisted post-pandemic when surgical capacity was restored. Short-term outcomes were unchanged.
{"title":"Impact of COVID-19 pandemic on treatment patterns for stage I Non-Small Cell Lung Cancer in the Netherlands","authors":"R.M.G. van Vuren , N. Wolfhagen , R.A.M. Damhuis , S. Kruijff , W.Y. van der Plas , W.H. Schreurs , O.C.J. Schuurbiers , H.J.M. Smit , A.F.T.M. Verhagen , M.W. Wouters , J. Belderbos , D.J. Heineman","doi":"10.1016/j.ctarc.2025.101061","DOIUrl":"10.1016/j.ctarc.2025.101061","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic significantly impacted lung cancer treatment, necessitating shifts in treatment modalities. Guidelines temporarily recommended SBRT as alternative to surgery for early-stage NSCLC.</div></div><div><h3>Materials and Methods</h3><div>This retrospective cohort study analyzed data from the Dutch Lung Cancer Audit – Radiotherapy (DLCA-R) and Surgery (DLCA-S) registries, including patients with Stage I NSCLC treated between 2018 and 2022. Patients were categorized into historic, pandemic, and post-pandemic cohorts. The primary endpoint was the percentage of surgical and radiotherapy treatments in these cohorts; secondary endpoints included time to treatment, complications, acute toxicity, and mortality.</div></div><div><h3>Results</h3><div>A total of 15,072 treatment episodes were analyzed. During the pandemic, the percentage of patients with Stage I NSCLC receiving radiotherapy increased significantly from 57 % to 65 %, while the percentage of patients undergoing surgery decreased. The shift towards radiotherapy persisted post-pandemic. Time to treatment and complication rates remained stable, though pulmonary embolism rates increased during the pandemic.</div></div><div><h3>Conclusions</h3><div>The pandemic led to a significant increase in radiotherapy for Stage I NSCLC, aligning with prevailing ESMO guidelines. However, this shift persisted post-pandemic when surgical capacity was restored. Short-term outcomes were unchanged.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101061"},"PeriodicalIF":2.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastrointestinal cancer represents a substantial global health challenge, contributing to over one-third of cancer-related mortality worldwide. The progression of these malignancies involves complex molecular and physiological mechanisms, with Midkine (MDK) emerging as a critical regulator. MDK, a heparin-binding growth factor, exhibits a multifaceted role in tumorigenesis, influencing cell proliferation, metastasis, angiogenesis, and chemoresistance. Elevated MDK expression has been identified in various gastrointestinal cancers, including gastric, esophageal, and colorectal malignancies, underscoring its potential as a diagnostic biomarker and therapeutic target. This review examines MDK’s molecular and biological functions in gastrointestinal cancers, emphasizing its clinical utility in diagnosis, prognosis, and therapy. By exploring the intricate mechanisms of MDK, this study aims to advance the development of novel, personalized therapeutic strategies to improve patient outcomes.
{"title":"The multifaceted role of midkine in gastrointestinal cancer: From biomarker to treatment","authors":"Zahra Rasoulizadeh , Amir Mohammad Nezhad Salari , Arezoo Gowhari Shabgah , Ghasem Sargazi , Roghayyeh Vakili-Ghartavol , Najmeh Mohammadpour , Reza Beheshti Monfared , Jamshid Gholizadeh","doi":"10.1016/j.ctarc.2025.101058","DOIUrl":"10.1016/j.ctarc.2025.101058","url":null,"abstract":"<div><div>Gastrointestinal cancer represents a substantial global health challenge, contributing to over one-third of cancer-related mortality worldwide. The progression of these malignancies involves complex molecular and physiological mechanisms, with Midkine (MDK) emerging as a critical regulator. MDK, a heparin-binding growth factor, exhibits a multifaceted role in tumorigenesis, influencing cell proliferation, metastasis, angiogenesis, and chemoresistance. Elevated MDK expression has been identified in various gastrointestinal cancers, including gastric, esophageal, and colorectal malignancies, underscoring its potential as a diagnostic biomarker and therapeutic target. This review examines MDK’s molecular and biological functions in gastrointestinal cancers, emphasizing its clinical utility in diagnosis, prognosis, and therapy. By exploring the intricate mechanisms of MDK, this study aims to advance the development of novel, personalized therapeutic strategies to improve patient outcomes.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101058"},"PeriodicalIF":2.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.ctarc.2025.101056
Alexandra C. Preda , Rossitza Krasteva , Mihailo Stjepanović , Krassimir Koynov , Assia Konsoulova , Georgeta P. Iorga , Anghel A. Udrea , Anca Zgura , Tudor-Eliade Ciuleanu , Raluca Patru , Jeliazko Arabadjiev , Ivan Tonev , Zoran Andrić , Goran Stojanović , Mihaela Pasca-Fenesan , Edvina-Elena Pirvu , Bojidar Iliev , Ivan Kazmukov , Angel Petrov , Neda Nikolić , Michael Schenker
Background
Lung cancer is the leading cause of cancer deaths worldwide, with non-small cell lung cancer (NSCLC) being most common. This study examines how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, highlighting regional disparities and aiming to improve outcomes.
Methods
This retrospective cohort study of stage IV NSCLC patients in Romania, Bulgaria, and Serbia analyzed the impact of patient and tumor characteristics on treatment choices, timelines for diagnosis, biomarker testing, and imaging, using regression analyses.
Results
The study included 840 stage IV NSCLC patients (mean age 64.2 years) across Romania, Bulgaria, and Serbia, with 280 patients per country. Overall, chemo–immunotherapy (CIT) was most common (38.1 %), followed by immunotherapy (31.2 %). Bulgaria and Romania favored CIT, while Serbia’s options were limited by reimbursement. Factors influencing treatment included programmed death-ligand 1 (PD-L1) status and gene mutation profile in Bulgaria, weight loss and appetite in Romania, and smoking status and symptoms in Serbia. Testing and treatment initiation times varied, with Serbia showing the shortest times. PD-L1 status and Eastern Cooperative Oncology Group performance were crucial across all countries. Common symptoms included chest pain, cough, shortness of breath, and general pain, with varying frequencies across countries.
Conclusion
This retrospective three-country real-world cohort shows marked regional differences in first-line treatment and timing for stage IV NSCLC. Beyond clinical factors, health-system elements, reimbursement, biomarker-testing availability/turnaround, and access to chemo-immunotherapy, shape care. Addressing these offers policy-level opportunities to improve equitable, guideline-concordant treatment. Initiated after the most heated phase of the COVID-19 pandemic and conducted without contingency measures, thus study highlights the need for personalized medicine and improved healthcare infrastructure to address disparities in treatment and testing times.
MicroAbstract
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer worldwide. In this retrospective cohort study we examined how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, and revealed significant regional differences in baseline characteristics, treatment preferences, and influencing factors for stage IV NSCLC in these countries.
{"title":"Impact of patient and tumor characteristics on various aspects of the non-small cell lung cancer patient journey in Romania, Bulgaria, Serbia: A multicenter, non-interventional, retrospective cohort study","authors":"Alexandra C. Preda , Rossitza Krasteva , Mihailo Stjepanović , Krassimir Koynov , Assia Konsoulova , Georgeta P. Iorga , Anghel A. Udrea , Anca Zgura , Tudor-Eliade Ciuleanu , Raluca Patru , Jeliazko Arabadjiev , Ivan Tonev , Zoran Andrić , Goran Stojanović , Mihaela Pasca-Fenesan , Edvina-Elena Pirvu , Bojidar Iliev , Ivan Kazmukov , Angel Petrov , Neda Nikolić , Michael Schenker","doi":"10.1016/j.ctarc.2025.101056","DOIUrl":"10.1016/j.ctarc.2025.101056","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is the leading cause of cancer deaths worldwide, with non-small cell lung cancer (NSCLC) being most common. This study examines how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, highlighting regional disparities and aiming to improve outcomes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study of stage IV NSCLC patients in Romania, Bulgaria, and Serbia analyzed the impact of patient and tumor characteristics on treatment choices, timelines for diagnosis, biomarker testing, and imaging, using regression analyses.</div></div><div><h3>Results</h3><div>The study included 840 stage IV NSCLC patients (mean age 64.2 years) across Romania, Bulgaria, and Serbia, with 280 patients per country. Overall, chemo–immunotherapy (CIT) was most common (38.1 %), followed by immunotherapy (31.2 %). Bulgaria and Romania favored CIT, while Serbia’s options were limited by reimbursement. Factors influencing treatment included programmed death-ligand 1 (PD-L1) status and gene mutation profile in Bulgaria, weight loss and appetite in Romania, and smoking status and symptoms in Serbia. Testing and treatment initiation times varied, with Serbia showing the shortest times. PD-L1 status and Eastern Cooperative Oncology Group performance were crucial across all countries. Common symptoms included chest pain, cough, shortness of breath, and general pain, with varying frequencies across countries.</div></div><div><h3>Conclusion</h3><div>This retrospective three-country real-world cohort shows marked regional differences in first-line treatment and timing for stage IV NSCLC. Beyond clinical factors, health-system elements, reimbursement, biomarker-testing availability/turnaround, and access to chemo-immunotherapy, shape care. Addressing these offers policy-level opportunities to improve equitable, guideline-concordant treatment. Initiated after the most heated phase of the COVID-19 pandemic and conducted without contingency measures, thus study highlights the need for personalized medicine and improved healthcare infrastructure to address disparities in treatment and testing times.</div></div><div><h3>MicroAbstract</h3><div>Non-small cell lung cancer (NSCLC) is the most common type of lung cancer worldwide. In this retrospective cohort study we examined how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, and revealed significant regional differences in baseline characteristics, treatment preferences, and influencing factors for stage IV NSCLC in these countries.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101056"},"PeriodicalIF":2.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.ctarc.2025.101054
Pasquale Rescigno , Alastair Greystoke
Next-generation sequencing (NGS) offers broad molecular profiling that reveals genetic variation, gene expression and epigenetic modifications. This information is essential for identifying actionable biomarkers, enabling informed clinical decision-making and allowing therapeutic targeting of specific genetic alterations. International guidelines recommend biomarker testing in suitable patients, as targeted therapy offers greater benefits than non-specific chemotherapy. Several factors are pivotal for maximising the clinical utility and integration biomarker testing approaches in clinical practice. While utilising genomic information from NGS is becoming part of routine oncology practice, the integration of the significant complexity of the sequencing data can be challenging. Therefore, the involvement of multidisciplinary teams in precision oncology including oncologists, pathologists, radiologists, molecular biologists/geneticists and bioinformaticians is the need of the hour. Here, we highlight the complexities of NGS techniques and reporting that guide clinical decision-making in oncology, and also provide UK expert perspectives on the integration of NGS into local treatment practices.
{"title":"Illuminating the spectrum of genomic sequencing approaches in the precision oncology era: A UK perspective","authors":"Pasquale Rescigno , Alastair Greystoke","doi":"10.1016/j.ctarc.2025.101054","DOIUrl":"10.1016/j.ctarc.2025.101054","url":null,"abstract":"<div><div>Next-generation sequencing (NGS) offers broad molecular profiling that reveals genetic variation, gene expression and epigenetic modifications. This information is essential for identifying actionable biomarkers, enabling informed clinical decision-making and allowing therapeutic targeting of specific genetic alterations. International guidelines recommend biomarker testing in suitable patients, as targeted therapy offers greater benefits than non-specific chemotherapy. Several factors are pivotal for maximising the clinical utility and integration biomarker testing approaches in clinical practice. While utilising genomic information from NGS is becoming part of routine oncology practice, the integration of the significant complexity of the sequencing data can be challenging. Therefore, the involvement of multidisciplinary teams in precision oncology including oncologists, pathologists, radiologists, molecular biologists/geneticists and bioinformaticians is the need of the hour. Here, we highlight the complexities of NGS techniques and reporting that guide clinical decision-making in oncology, and also provide UK expert perspectives on the integration of NGS into local treatment practices.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101054"},"PeriodicalIF":2.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.ctarc.2025.101055
Xinglong Li, Guangsong Tang, Wenyue Wang, Chen Zhang, Yu Xue, Ning Xu, Qing fa Wu, Wei qiang Yu
Background
Lung cancer is a highly prevalent and invasive malignancy, characterized by profound metabolic reprogramming as one of its key features. The advent of single-cell RNA sequencing (scRNA-seq) has allowed us to study cellular metabolism in greater detail. In this study, we systematically explore the metabolic pathways of distinct cell types within the lung cancer tumor microenvironment using scRNA-seq data. Moreover, we identify potential biomarkers with diagnostic and prognostic significance.
Methods
We leveraged scRNA-seq data from lung cancer to map the metabolic landscape of different cell types in the tumor microenvironment. Malignant cells were classified into three distinct subgroups based on their metabolic activity: high-metabolism, intermediate-metabolism, and low-metabolism.
Results
Malignant cells exhibit significantly higher metabolic activity compared to non-malignant cell types. The low-metabolism state was strongly associated with immune signaling pathways, with FSCN1 identified as a key marker. This state revealed a distinct population of cells enriched for cancer stem cell (CSC)-like characteristics.
Conclusion
This study provides a comprehensive exploration of the metabolic characteristics of malignant cells in lung cancer at single-cell resolution. Our findings provide insights that could improve prognosis and support more targeted treatments for lung cancer patients.
{"title":"Single-cell analysis of lung cancer metabolism and its clinical implications","authors":"Xinglong Li, Guangsong Tang, Wenyue Wang, Chen Zhang, Yu Xue, Ning Xu, Qing fa Wu, Wei qiang Yu","doi":"10.1016/j.ctarc.2025.101055","DOIUrl":"10.1016/j.ctarc.2025.101055","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is a highly prevalent and invasive malignancy, characterized by profound metabolic reprogramming as one of its key features. The advent of single-cell RNA sequencing (scRNA-seq) has allowed us to study cellular metabolism in greater detail. In this study, we systematically explore the metabolic pathways of distinct cell types within the lung cancer tumor microenvironment using scRNA-seq data. Moreover, we identify potential biomarkers with diagnostic and prognostic significance.</div></div><div><h3>Methods</h3><div>We leveraged scRNA-seq data from lung cancer to map the metabolic landscape of different cell types in the tumor microenvironment. Malignant cells were classified into three distinct subgroups based on their metabolic activity: high-metabolism, intermediate-metabolism, and low-metabolism.</div></div><div><h3>Results</h3><div>Malignant cells exhibit significantly higher metabolic activity compared to non-malignant cell types. The low-metabolism state was strongly associated with immune signaling pathways, with <em>FSCN1</em> identified as a key marker. This state revealed a distinct population of cells enriched for cancer stem cell (CSC)-like characteristics.</div></div><div><h3>Conclusion</h3><div>This study provides a comprehensive exploration of the metabolic characteristics of malignant cells in lung cancer at single-cell resolution. Our findings provide insights that could improve prognosis and support more targeted treatments for lung cancer patients.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101055"},"PeriodicalIF":2.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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