Pub Date : 2025-12-13DOI: 10.1016/j.ctarc.2025.101072
Yanran Wu , Yu Deng , Yuhan Wang , Jinxiao Li , Guangtao Pan
This review systematically summarizes the research progress on the regulation of microRNAs (miRNAs) by traditional Chinese medicine (TCM) in the prevention and treatment of hepatocellular carcinoma (HCC). As one of the most prevalent and lethal malignancies worldwide, the efficacy of current therapeutic strategies for HCC remains limited due to tumor heterogeneity and drug resistance, necessitating the exploration of novel treatment approaches. TCM, with its multi-target regulatory advantages, has demonstrated unique potential in influencing HCC progression by modulating miRNA expression, thereby affecting tumor cell proliferation, apoptosis, and invasion. This review provides an in-depth discussion of the biological pathways involved in TCM-mediated miRNA regulation, including transmembrane transport, targeted modulation, and bio-carrier-mediated delivery mechanisms. The dual role of miRNAs in HCC as either tumor suppressors or oncogenes is extensively analyzed. Moreover, we highlight the key mechanisms by which TCM modulates miRNA expression, such as epigenetic regulation, signal transduction pathway intervention, and anti-inflammatory and immunoregulatory effects, ultimately influencing HCC progression. Additionally, the clinical significance of serum miRNAs in HCC diagnosis, prognosis assessment, and correlation with pathological characteristics is discussed. Finally, we explore the challenges and future directions in HBV-associated HCC treatment via miRNA modulation, providing new insights into HCC prevention and therapeutic strategies.
{"title":"Research progress on the regulation of microRNAs by traditional Chinese medicine in the prevention and treatment of hepatocellular carcinoma","authors":"Yanran Wu , Yu Deng , Yuhan Wang , Jinxiao Li , Guangtao Pan","doi":"10.1016/j.ctarc.2025.101072","DOIUrl":"10.1016/j.ctarc.2025.101072","url":null,"abstract":"<div><div>This review systematically summarizes the research progress on the regulation of microRNAs (miRNAs) by traditional Chinese medicine (TCM) in the prevention and treatment of hepatocellular carcinoma (HCC). As one of the most prevalent and lethal malignancies worldwide, the efficacy of current therapeutic strategies for HCC remains limited due to tumor heterogeneity and drug resistance, necessitating the exploration of novel treatment approaches. TCM, with its multi-target regulatory advantages, has demonstrated unique potential in influencing HCC progression by modulating miRNA expression, thereby affecting tumor cell proliferation, apoptosis, and invasion. This review provides an in-depth discussion of the biological pathways involved in TCM-mediated miRNA regulation, including transmembrane transport, targeted modulation, and bio-carrier-mediated delivery mechanisms. The dual role of miRNAs in HCC as either tumor suppressors or oncogenes is extensively analyzed. Moreover, we highlight the key mechanisms by which TCM modulates miRNA expression, such as epigenetic regulation, signal transduction pathway intervention, and anti-inflammatory and immunoregulatory effects, ultimately influencing HCC progression. Additionally, the clinical significance of serum miRNAs in HCC diagnosis, prognosis assessment, and correlation with pathological characteristics is discussed. Finally, we explore the challenges and future directions in HBV-associated HCC treatment via miRNA modulation, providing new insights into HCC prevention and therapeutic strategies.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101072"},"PeriodicalIF":2.4,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780056","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 : 2025-12-13DOI: 10.1016/j.ctarc.2025.101077
Bader Alshamsan
Background
Breast cancer is the leading cancer among women worldwide. Long-term national data from Saudi Arabia are limited; this study analyzed 21 years of registry data to describe incidence patterns and trends.
Methods
Data from the nationwide Saudi Cancer Registry (2002–2022), which ensures comprehensive coverage and high data quality, were analyzed. Age-standardized incidence rates (ASR), histology, and stage were extracted and summarized descriptively. Temporal trends were assessed using the Joinpoint Regression Program to estimate annual percent change (APC) and average annual percent change (AAPC) with 95 % confidence intervals.
Results
A total of 37,516 female and 639 male breast cancer cases were reported from 2002 to 2022. The ASR increased from 12.6 to 49.7 per 100,000 (AAPC 5.6 %, 95 % CI: 4.5–6.7, p < 0.0001). Incidence rose steadily with a sharp surge in 2020–2022, briefly interrupted by a COVID-19-related dip. Median age at diagnosis increased from 46 to 52 years (p = 0.003). The steepest increase occurred among women aged 70–74 (APC 8.3 %). Breast cancer increased from 21.1 % to >30 % of female cancers since 2015, while it remained rare in men (<1 %). Stage distribution shifted toward earlier detection, with localized disease rising from 26 % to 52 %.
Conclusion
Breast cancer incidence in Saudi Arabia has increased at one of the fastest rates worldwide (AAPC 5.6 % vs. 0.5–1 % in high-income countries). The increase is accompanied by stage migration and an upward shift in median age at diagnosis. With the sharpest increases in older women and rising life expectancy, prioritizing expanded mammogram screening coverage and breast-care service capacity is essential for future planning.
{"title":"Trends in breast cancer incidence, age at diagnosis, and stage in Saudi Arabia, 2002–2022: a population-based study","authors":"Bader Alshamsan","doi":"10.1016/j.ctarc.2025.101077","DOIUrl":"10.1016/j.ctarc.2025.101077","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the leading cancer among women worldwide. Long-term national data from Saudi Arabia are limited; this study analyzed 21 years of registry data to describe incidence patterns and trends.</div></div><div><h3>Methods</h3><div>Data from the nationwide Saudi Cancer Registry (2002–2022), which ensures comprehensive coverage and high data quality, were analyzed. Age-standardized incidence rates (ASR), histology, and stage were extracted and summarized descriptively. Temporal trends were assessed using the Joinpoint Regression Program to estimate annual percent change (APC) and average annual percent change (AAPC) with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>A total of 37,516 female and 639 male breast cancer cases were reported from 2002 to 2022. The ASR increased from 12.6 to 49.7 per 100,000 (AAPC 5.6 %, 95 % CI: 4.5–6.7, <em>p</em> < 0.0001). Incidence rose steadily with a sharp surge in 2020–2022, briefly interrupted by a COVID-19-related dip. Median age at diagnosis increased from 46 to 52 years (<em>p</em> = 0.003). The steepest increase occurred among women aged 70–74 (APC 8.3 %). Breast cancer increased from 21.1 % to >30 % of female cancers since 2015, while it remained rare in men (<1 %). Stage distribution shifted toward earlier detection, with localized disease rising from 26 % to 52 %.</div></div><div><h3>Conclusion</h3><div>Breast cancer incidence in Saudi Arabia has increased at one of the fastest rates worldwide (AAPC 5.6 % vs. 0.5–1 % in high-income countries). The increase is accompanied by stage migration and an upward shift in median age at diagnosis. With the sharpest increases in older women and rising life expectancy, prioritizing expanded mammogram screening coverage and breast-care service capacity is essential for future planning.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101077"},"PeriodicalIF":2.4,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780101","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}
Cosmetic interventions like Nipple-Areola Complex tattooing have been shown to improve outcomes in breast cancer survivors. Although it is a safe and well-tolerated technique that provides satisfactory aesthetic results, several research needs were acknowledged. This paper aims to briefly review the latest evidence regarding Nipple-Areola Complex tattooing for breast reconstruction proposes after oncological surgery, assessing studies' designs and the addressed outcomes, including any Patient Reported Outcome. Complete and primary published literature between 2023 and February 2025 was included. Pubmed, Embase, Cinahl, and Scopus were searched with these main keywords: Nipple, Areola*, Tattoo*, and dermopigmentation. A narrative synthesis was conducted to summarize the results. In the last two years, the amount of literature on the topic has increased, along with the technique application and its research interest. Observational designs [cross-sectional (N = 5); retrospective (N = 5); implementation project (N = 1); qualitative (N = 1)] addressed current research gaps, like quality-of-life assessment with validated instruments and organizational aspects. In line with previous literature, the Nipple-Areola Complex reconstruction's relevance, satisfaction with the cosmetic outcome, the fading phenomenon, and the factors influencing color durability were other outcomes assessed. Emotional, psychological, and sexual domains are patient-reported outcomes that benefit from Nipple-Areola Complex tattooing. Sustainability and professional training remain critical issues worthy of further comprehensive studies.
{"title":"The role of nipple-areola complex tattooing in breast cancer psycho-physical rehabilitation: An updated review","authors":"Deborah Maselli , Martina Torreggiani , Valeria Soffientini , Enrica Tamagnini , Stefano Botti , Paola Ferri , Stefania Costi","doi":"10.1016/j.ctarc.2025.101075","DOIUrl":"10.1016/j.ctarc.2025.101075","url":null,"abstract":"<div><div>Cosmetic interventions like Nipple-Areola Complex tattooing have been shown to improve outcomes in breast cancer survivors. Although it is a safe and well-tolerated technique that provides satisfactory aesthetic results, several research needs were acknowledged. This paper aims to briefly review the latest evidence regarding Nipple-Areola Complex tattooing for breast reconstruction proposes after oncological surgery, assessing studies' designs and the addressed outcomes, including any Patient Reported Outcome. Complete and primary published literature between 2023 and February 2025 was included. Pubmed, Embase, Cinahl, and Scopus were searched with these main keywords: Nipple, Areola*, Tattoo*, and dermopigmentation. A narrative synthesis was conducted to summarize the results. In the last two years, the amount of literature on the topic has increased, along with the technique application and its research interest. Observational designs [cross-sectional (<em>N</em> = 5); retrospective (<em>N</em> = 5); implementation project (<em>N</em> = 1); qualitative (<em>N</em> = 1)] addressed current research gaps, like quality-of-life assessment with validated instruments and organizational aspects. In line with previous literature, the Nipple-Areola Complex reconstruction's relevance, satisfaction with the cosmetic outcome, the fading phenomenon, and the factors influencing color durability were other outcomes assessed. Emotional, psychological, and sexual domains are patient-reported outcomes that benefit from Nipple-Areola Complex tattooing. Sustainability and professional training remain critical issues worthy of further comprehensive studies.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101075"},"PeriodicalIF":2.4,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145773464","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}
Colorectal cancer (CRC) chemotherapy is based on 5-fluorouracil (5-FU) and the folate leucovorin (LV). The active metabolites of these compounds, 5-fluorodeoxyuridine monophosphate (FdUMP) and 5,10-methylenetetrahydrofolate (5,10-MeTHF), form an inhibitory complex with thymidylate synthase (TS) resulting in elevated deoxyuridine (dUr) levels. In contrast to LV, natural 5,10-MeTHF (arfolitixorin, ARF) participates directly in the complex. Pyridoxal 5′-phosphate (PLP) potentially boosts 5-FU/LV (FLV)-based chemotherapy.
Objective
The study explored the correlation between dUr levels in tumor homogenates and tumor response, and assessed the impact of LV and ARF, combined with FdUMP and optionally PLP, on dUr levels.
Patients and Methods
Sixty-seven patients with metastatic CRC receiving first-line FLV-based chemotherapy and exhibiting either tumor response or disease progression were included. Tumor homogenates were prepared from snap-frozen primary tumors, and the dUr level was analyzed using LC-MS/MS. Fit modelling was used to predict the effect of explanatory variables on tumor response.
Results
Significantly higher dUr levels were observed after the addition of ARF compared to LV. dUr levels correlated positively with ARF, but not with LV, dosage. Adding PLP to LV increased dUr levels in 43% of homogenates but levels remained lower than those achieved with ARF alone. The baseline dUr level, together with the variables tumor location, BMI, and chemotherapy regimen were predictive for tumor response.
Conclusions
The method used enables simultaneous analysis of multiple compounds within a tumor homogenate. Measuring dUr in homogenates before and after folate modulation, prior to initiation of FLV-based chemotherapy, could help predict tumor response and guide the choice between LV and ARF for optimal folate support.
背景：结直肠癌（CRC）化疗基于5-氟尿嘧啶（5-FU）和叶酸亚叶酸素（LV）。这些化合物的活性代谢物，5-氟脱氧尿苷单磷酸（FdUMP）和5,10-亚甲基四氢叶酸（5,10- methf），与胸苷酸合成酶（TS）形成抑制复合物，导致脱氧尿苷（dUr）水平升高。与LV相反，天然5,10- methf （arfolitixorin， ARF）直接参与复合物。吡哆醛5'-磷酸（PLP）可能促进基于5- fu /LV （FLV）的化疗。目的：探讨肿瘤匀浆中dUr水平与肿瘤反应的相关性，并评估LV和ARF联合FdUMP和选择性PLP对dUr水平的影响。患者和方法：67例转移性结直肠癌患者接受一线基于flv的化疗，并表现出肿瘤反应或疾病进展。从速冻原发肿瘤中制备肿瘤匀浆，采用LC-MS/MS分析dUr水平。拟合模型用于预测解释变量对肿瘤反应的影响。结果：加ARF后的dUr水平明显高于LV。dUr水平与ARF呈正相关，与LV剂量无关。在LV中加入PLP增加了43%的匀浆dUr水平，但仍低于单独使用ARF的水平。基线dUr水平、肿瘤位置、BMI和化疗方案等变量可预测肿瘤反应。结论：所采用的方法可以同时分析肿瘤匀浆中的多种化合物。在开始基于flv的化疗之前，在叶酸调节前后测量匀浆中的dUr，可以帮助预测肿瘤反应，并指导选择LV和ARF以获得最佳叶酸支持。
{"title":"Deoxyuridine as a surrogate marker of thymidylate synthase inhibition contributes to a multivariable model predicting 5-FU/LV response in metastatic colorectal cancer","authors":"Elisabeth Odin , Göran Carlsson , Bengt Gustavsson , Yvonne Wettergren","doi":"10.1016/j.ctarc.2025.101076","DOIUrl":"10.1016/j.ctarc.2025.101076","url":null,"abstract":"<div><h3>Background</h3><div>Colorectal cancer (CRC) chemotherapy is based on 5-fluorouracil (5-FU) and the folate leucovorin (LV). The active metabolites of these compounds, 5-fluorodeoxyuridine monophosphate (FdUMP) and 5,10-methylenetetrahydrofolate (5,10-MeTHF), form an inhibitory complex with thymidylate synthase (TS) resulting in elevated deoxyuridine (dUr) levels. In contrast to LV, natural 5,10-MeTHF (arfolitixorin, ARF) participates directly in the complex. Pyridoxal 5′-phosphate (PLP) potentially boosts 5-FU/LV (FLV)-based chemotherapy.</div></div><div><h3>Objective</h3><div>The study explored the correlation between dUr levels in tumor homogenates and tumor response, and assessed the impact of LV and ARF, combined with FdUMP and optionally PLP, on dUr levels.</div></div><div><h3>Patients and Methods</h3><div>Sixty-seven patients with metastatic CRC receiving first-line FLV-based chemotherapy and exhibiting either tumor response or disease progression were included. Tumor homogenates were prepared from snap-frozen primary tumors, and the dUr level was analyzed using LC-MS/MS. Fit modelling was used to predict the effect of explanatory variables on tumor response.</div></div><div><h3>Results</h3><div>Significantly higher dUr levels were observed after the addition of ARF compared to LV. dUr levels correlated positively with ARF, but not with LV, dosage. Adding PLP to LV increased dUr levels in 43% of homogenates but levels remained lower than those achieved with ARF alone. The baseline dUr level, together with the variables tumor location, BMI, and chemotherapy regimen were predictive for tumor response.</div></div><div><h3>Conclusions</h3><div>The method used enables simultaneous analysis of multiple compounds within a tumor homogenate. Measuring dUr in homogenates before and after folate modulation, prior to initiation of FLV-based chemotherapy, could help predict tumor response and guide the choice between LV and ARF for optimal folate support.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101076"},"PeriodicalIF":2.4,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779871","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.2025.101070
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}
Background: Chronic obstructive pulmonary disease (COPD) is the most prevalent comorbidity among lung cancer patients, but its clinical and prognostic relationship with KRAS-mutant non-small cell lung cancer (NSCLC) remains unclear.
Methods: This multicenter retrospective cohort study enrolled 163 histologically confirmed KRAS-mutant NSCLC patients, including 59 with COPD and 104 without COPD. Clinical data consisted of baseline characteristics, co-mutation profiles, and survival outcomes were collected and efficacy evaluations. PFS and OS were compared using the Kaplan-Meier method and log-rank test.
Results: The COPD-LC group showed with a higher proportion of KRAS G12C mutations (47.4% vs. 26.2%, P = 0.028) and higher smoking rates (91.5% vs. 65.4%, P <0.001). Additionally, this group had a poorer baseline performance status and a higher Charlson Comorbidity Index. Chemoimmunotherapy significantly improved survival in advanced-stage NSCLC patients (mPFS: 9 vs. 6 months, HR = 0.62, P = 0.022; mOS: 24 vs. 11 months, HR = 0.53, P = 0.023), particularly those with COPD-comorbid lung cancer. Notably, within the COPD-LC subgroup, KRAS G12C-mutant patients achieved significantly longer median PFS compared to non-G12C subtypes (11.5 vs. 5 months, HR = 0.38, P = 0.009) and no significant differences in mPFS or mOS were observed between PS 0-1 and PS 2-3 groups. Co-mutations were identified in 78.6% of patients, with no significant intergroup differences.
Conclusion: COPD-comorbid KRAS-mutant NSCLC patients exhibit unique G12C subtype enrichment and distinct clinical features. Chemoimmunotherapy represents an effective first-line strategy for this population, particularly benefiting those with G12C mutations.
背景：慢性阻塞性肺疾病（COPD）是肺癌患者中最常见的合病，但其与kras突变的非小细胞肺癌（NSCLC）的临床和预后关系尚不清楚。方法：这项多中心回顾性队列研究纳入了163例组织学证实的kras突变型非小细胞肺癌患者，其中59例合并COPD， 104例未合并COPD。临床数据包括基线特征、共突变谱和生存结果的收集和疗效评估。采用Kaplan-Meier法和log-rank检验比较PFS和OS。结果：COPD-LC组KRAS G12C突变比例更高（47.4% vs. 26.2%, P = 0.028），吸烟率更高（91.5% vs. 65.4%）， P结论：copd合并KRAS突变的NSCLC患者表现出独特的G12C亚型富集和明显的临床特征。化疗免疫治疗是这一人群有效的一线治疗策略，尤其对G12C突变患者有益。
{"title":"Clinical characteristics and prognostic outcomes in KRAS-mutant non-small cell lung cancer: A real-world study with or without COPD comorbidity.","authors":"Chen Liao, Yubo Wang, Zhoukui Bi, Huawei Chen, Yu Xu, Defeng Hu, Rui Luo, Jiarui Wang, Zhi Xu, Yafei Li, Li Bai","doi":"10.1016/j.ctarc.2025.101064","DOIUrl":"https://doi.org/10.1016/j.ctarc.2025.101064","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the most prevalent comorbidity among lung cancer patients, but its clinical and prognostic relationship with KRAS-mutant non-small cell lung cancer (NSCLC) remains unclear.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study enrolled 163 histologically confirmed KRAS-mutant NSCLC patients, including 59 with COPD and 104 without COPD. Clinical data consisted of baseline characteristics, co-mutation profiles, and survival outcomes were collected and efficacy evaluations. PFS and OS were compared using the Kaplan-Meier method and log-rank test.</p><p><strong>Results: </strong>The COPD-LC group showed with a higher proportion of KRAS G12C mutations (47.4% vs. 26.2%, P = 0.028) and higher smoking rates (91.5% vs. 65.4%, P <0.001). Additionally, this group had a poorer baseline performance status and a higher Charlson Comorbidity Index. Chemoimmunotherapy significantly improved survival in advanced-stage NSCLC patients (mPFS: 9 vs. 6 months, HR = 0.62, P = 0.022; mOS: 24 vs. 11 months, HR = 0.53, P = 0.023), particularly those with COPD-comorbid lung cancer. Notably, within the COPD-LC subgroup, KRAS G12C-mutant patients achieved significantly longer median PFS compared to non-G12C subtypes (11.5 vs. 5 months, HR = 0.38, P = 0.009) and no significant differences in mPFS or mOS were observed between PS 0-1 and PS 2-3 groups. Co-mutations were identified in 78.6% of patients, with no significant intergroup differences.</p><p><strong>Conclusion: </strong>COPD-comorbid KRAS-mutant NSCLC patients exhibit unique G12C subtype enrichment and distinct clinical features. Chemoimmunotherapy represents an effective first-line strategy for this population, particularly benefiting those with G12C mutations.</p>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"101064"},"PeriodicalIF":2.4,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112586","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}
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