Objective: To compare the rate of anastomotic leakage in patients treated with posterior pelvic exenteration for advanced ovarian cancer, regardless of whether or not a systematic ileostomy was performed.. Secondary objectives include surgical and oncologic outcomes. Method: This is an observational retrospective, multicenter study comparing two cohorts of patients managed for advanced stage ovarian cancer in two French cancer centers, from January 2019 to February 2023. All patients underwent cytoreductive surgery with colorectal resection and immediate colorectal anastomosis. Protective ileostomy could be performed in a center (center A) whereas it was never done in the other one (center B). Results: A total of 122 patients were included (54 patients in center A and 68 patients in center B). Protective ileostomy was performed in 64,9% of cases in center A. All seven anastomotic leakage concerned center B (10.3%; p=0.017). Occurrence of complications between center A and center B are similar (p=0.65). Grade 3 complications were more frequent in center B. We observed higher rate of incomplete cytoreduction in center A (p=0.04). Survival analyses do not show significative difference between center A group and center B group, for OS (p=0,32) and DFS (p=0,41). Conclusion: Performing a protective ileostomy is an effective way to prevent anastomotic leakage in cytoreduction surgery of advanced ovarian cancer. However, there is no clear evidence in term of long-term oncologic outcome and a broad policy of this procedure exposes to specific morbidity that can negatively affect the patient’s prognostic.

Background: Breast cancer, as one of the most common malignant tumors among women worldwide, its heterogeneity, invasiveness and drug resistance pose great challenges to clinical treatment. Lactylation, as an emerging post-translational modification of proteins, has been proven to play an important role in tumor biology, especially in the regulation of the tumor microenvironment (TME) and immune microenvironment. However, the role of lactylation in breast cancer is not yet fully understood. Methods: Download the RNA-seq data and clinical data of breast cancer from TCGA, GEO and Metabric databases. Use Cox regression analysis and LASSO analysis to build a risk prediction model, and use Kaplan - Meier survival analysis and ROC curve to verify the accuracy of the model. In addition, use the consensus clustering method to determine the relevant clusters of breast cancer patients and verify the clinical predictive significance of the lactylation model genes again. We also conduct a detailed exploration of the potential mechanisms by which the lactylation model genes lead to poor prognosis in patients through single-cell and spatial transcriptomics (ST). Results: Six lactylation-related breast cancer prognosis models with prognostic value for patients were constructed, and these six genes were all risk factors for breast cancer patients. Through the consensus clustering method, it was found that these six lactylation-related DEGs (LRDEGs) could also be used to classify breast cancer patients, and the subtypes with poor prognosis had high expression of these genes. Then, through immune analysis, obvious immune heterogeneity was found among patients of different subtypes. In order to explore the potential mechanism of poor prognosis, single-cell and ST analysis revealed that CORO6+Epi might be the lactylation-related subtypes leading to poor prognosis in breast cancer. SCENIC transcription factor analysis identified that E2F3 might drive the formation of the malignant phenotype of CORO6+Epi. Finally, through cell communication analysis, it was found that CORO6+Epi might be regulated by POSTN fibroblasts through the THBS2 - SDC4 axis to promote tumor progression. Conclusion: A new lactylation-related gene prediction model was successfully constructed, which can accurately predict breast cancer patients with poor prognosis. It was also found that this might be related to the transcription factor E2F3 and the THBS2 - SDC4 axis between CORO6+Epi and POSTN fibroblasts, providing new therapeutic targets for the precision treatment of breast cancer.

Background: Secondary acute myeloid leukemia (s-AML) is a subtype of acute myeloid leukemia AML that arises in the bone marrow and primarily affects white blood cells. It is associated with prior exposure to cytotoxic agents, including chemotherapy and radiotherapy. The risk of the disease increases with age and treatment intensity. Although s-AML represents 25–30% of all AML cases, its occurrence following radiotherapy is relatively rare. Diagnosis is confirmed via bone marrow biopsy, with differential diagnoses including other leukemias, lymphomas, and myelodysplastic syndromes. Prognosis is generally poor. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the most effective curative option, though elderly patients often have limited eligibility due to comorbidities and poor performance status. Case: Five years after treatment for stage IIA rectal cancer, including radiotherapy, chemotherapy, and surgery, a 77-year-old male smoker presented with fatigue, weight loss, progressive dyspnea, headache, dizziness, blurred vision, and melena. Physical examination revealed pallor, purpura, skin crusts, and pustules. Laboratory findings showed anemia, thrombocytopenia, and circulating blasts. Bone marrow biopsy confirmed lymphoid infiltration. He was diagnosed with secondary acute myeloid leukemia (s-AML), likely therapy-related. Despite receiving three cycles of azacitidine, he died of septic shock seven months later. Conclusion: This case presents a rare and multifactorial association between prior chemotherapy, radiation therapy, and the development of therapy-related acute myeloid leukemia (t-AML). It highlights the importance of long-term hematologic surveillance in cancer survivors, particularly those exposed to alkylating agents and radiation, given their increased risk for secondary hematologic malignancies.

Aim:Understanding the perspectives of stakeholders, functional requirements, and recommendations regarding a mini-program designed for home nutrition management after gastric cancer. Design:The present study employs a descriptive qualitative research methodology. Methods:Using a descriptive qualitative research design, a purposive sampling method was employed to select 10 postoperative gastric cancer patients, 6 patient caregivers, and 8 healthcare professionals from a tertiary hospital in Suzhou City for semi-structured interviews conducted between March and July 2023. Results:Three key themes emerged from the analysis: (1) The majority of respondents expressed eager anticipation for the development of WeChat mini-programs focused on home management; (2) They emphasized the importance of comprehensive dietary management information within a home nutrition management mini-program, including basic information, precise information on dietary management, and reliable nutritional component queries. Additionally, they highlighted the need for features such as personalized dietary advice, nutritional data detection, dietary record keeping and analysis, as well as professional self-management guidance on diet encompassing individual menu formulation, online shopping convenience, and access to medical care at home; (3) Respondents also stressed the significance of an easy-to-use interface in order to facilitate user adoption and learning. Patient or Public Contribution :Understanding the attitudes and needs of stakeholders towards WeChat mini-program in facilitating post-gastric cancer surgery home nutrition management is crucial. Given the high prevalence of malnutrition among patients after gastric cancer surgery, it becomes imperative to develop sophisticated, user-friendly, and efficient tools for managing home nutrition that can effectively mitigate this occurrence. The willingness, functional requirements, and suggestions provided by stakeholders during the development and utilization process significantly impact the subsequent adoption rate of WeChat mini-program and influence the implementation of internet-based home nutrition management.

Breast cancer is a heterogeneous disease and a prevalent form of aggressive tumors in females. It remains a leading cause of mortality among adult and older women worldwide, with therapeutic resistance leading to a barrier for reliable clinical outcomes. Many studies are exploring the relationship between epigenetic dysregulation and autophagy, driving therapy resistance, tumor progression, and metabolic changes. Sudden modifications in histone tails, non-coding RNAs, and DNA methylation patterns directly modify autophagic genes, while dysregulated autophagy conversely alters the epigenetic landscape under therapeutic stress. Recent studies have shown that molecular mechanisms link epigenetic alterations with autophagy regulation in breast cancer. This literature review systematically selected studies highlighting the molecular mechanism of autophagy dysregulation and its role in chemotherapy, endocrine, and targeted therapy resistance in breast cancer. This article briefly discusses the clinical implications of epigenetic biomarkers for early detection and treatment response prediction. Furthermore, we discussed new therapeutic methods combining autophagy inhibitors and epigenetic modulators, emphasizing the role of advanced medicine approaches powered by AI-driven drug discovery. The main idea of this literature review is to provide an in-depth insight into the epigenetic autophagy link in breast cancer and shed light on promising therapeutic outcomes overcoming chemotherapeutic resistance.

：Apocrine carcinoma is a rare malignant sweat gland tumor. We report an exceedingly rare case of low-differentiated apocrine adenosquamous carcinoma with sarcomatoid differentiation presenting on the right face of an 86-year-old female. The tumor was managed with a two-stage surgical approach: first-stage wide local excision followed by second-stage wound reconstruction with skin grafting. Pathological examination confirmed deep adipose invasion with negative margins. This case highlights the clinical challenges, pathological features, and multidisciplinary management of this aggressive cutaneous malignancy.

Background: Thrombocytopenia-absent radius (TAR) syndrome is a rare congenital disorder characterized by bilateral radial aplasia with preserved thumbs and early-onset thrombocytopenia. While hematologic and skeletal abnormalities are hallmarks of the condition, its association with hematologic malignancies is exceedingly rare, with only a few reported cases of leukemia. Juvenile myelomonocytic leukemia (JMML) is an uncommon pediatric myelodysplastic/myeloproliferative neoplasm frequently linked to RAS pathway mutations. The co-occurrence of JMML in a patient with TAR syndrome has not been previously documented. Case Presentation: We report the case of a male infant diagnosed with TAR syndrome based on clinical features and molecular confirmation of a homozygous RBM8A c.-21G>A mutation. The patient presented initially with persistent thrombocytopenia, skeletal deformities, and neonatal sepsis-like symptoms. At two years of age, he developed pancytopenia and progressive splenomegaly. Bone marrow examination and molecular studies confirmed JMML with a pathogenic NF1 mutation. He underwent successful haploidentical hematopoietic stem cell transplantation (HSCT) from a sibling donor, following a conditioning regimen of melphalan, treosulfan, cyclophosphamide, and anti-thymocyte globulin. The patient achieved full donor chimerism and hematologic remission with stable engraftment. Conclusion: This case represents, to our knowledge, one of the very few—if not the first—reported instances of successful HSCT for JMML in a patient with TAR syndrome. It underscores the importance of vigilant surveillance in TAR patients for potential malignant transformation and demonstrates the curative potential of HSCT in complex congenital and hematologic overlap syndromes.

Background: Familial adenomatous polyposis (FAP) is an autosomal dominant genetic disorder that carries an almost 100% risk of developing colorectal cancer by the age of 40. The genes primarily mutated in FAP are APC and MUTYH, with approximately 70% to 90% of FAP cases involving mutations in the APC gene, some of which may be associated with thyroid cancer. Case: We describe a case of a 30-year-old female patient with a history of papillary thyroid carcinoma who presented with abdominal pain. Gastrointestinal endoscopy revealed multiple polyps in the stomach and colon, along with liver and lung metastases from colon cancer. Further genetic testing revealed a mutation in the APC gene in this patient. Conclusion: Mutations in the APC gene lead to FAP, which subsequently results in colon cancer, and may also contribute to the development of thyroid cancer. Therefore, we recommend that young thyroid cancer patients should carefully inquire about their family history of genetic diseases, while also considering gastrointestinal endoscopy screening and ophthalmic examinations, and even molecular genetic testing. Additionally, when multiple polyps are found in the stomach and colon, the possibility of APC or MUTYH gene mutations should be considered.

BACKGROUND AND OBJECTIVES: Mucinous gastric adenocarcinoma (MGC) is historically linked to poor prognosis, yet literature inconsistencies necessitate systematic evaluation. This meta-analysis aims to compare clinicopathological features and survival outcomes between MGC and non-mucinous gastric adenocarcinoma (NMGC). METHODS: A systematic search (PubMed/Embase/Web of Science, up to April 2024) identified cohort/case-control studies. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated via random-effects models. Subgroup analyses stratified by TNM stage, sample size, geographic region, and T stage were conducted. Heterogeneity, publication bias (Begg’s/Egger’s tests), and sensitivity analyses were assessed. Study quality was appraised using the Newcastle-Ottawa Scale. RESULTS: Twenty-nine studies (163,116 patients; 4,900 MGC) revealed worse univariate overall survival for MGC (HR=1.73, 95%CI=1.48, 2.01), but significance vanished after multivariable adjustment (HR=1.09, 95%CI=0.95, 1.25). Subgroup analyses demonstrated heterogeneity: early-stage MGC (TNM I) had poorer prognosis (HR=1.53, 95%CI=1.07, 2.18), while larger cohorts (>2,000 patients) showed attenuated risk (HR=1.33 vs. 1.75 in smaller studies). MGC exhibited larger tumors, advanced T stage, and higher risks of metastasis (lymphatic, vascular, peritoneal). CONCLUSION: MGC’s prognostic impact depends on tumor stage and cofactors, not histology alone. Clinical assessment should integrate TNM stage and tumor characteristics, particularly in early-stage disease.

Background: Evidence indicates that beta-2 microglobulin (β2M) plays a prognostic role in patients with diffuse large B-cell lymphoma (DLBCL). Aim: However, due to controversies among previous studies, this meta-analysis was conducted to evaluate the prognostic role of β2M in DLBCL patients. Materials and Methods: Relevant studies were identified through a systematic search using specific keywords in PubMed/Medline, Scopus, and Web of Science databases. Studies that provided complete information on the Hazard ratio with a 95% confidence interval for β2M with respect to overall survival (OS) and progression-free survival (PFS) in multivariate models were included in the meta-analysis. Results: A total of 30 studies, encompassing 25,128 patients, were included in this meta-analysis. The pooled analysis demonstrated a significant association between elevated β2M levels and poor OS in DLBCL patients (HR Pooled: 1.65, 95% CI: 1.45–1.88, P < 0.01). Similarly, increased β2M levels were significantly associated with lower PFS in DLBCL patients (HR Pooled: 1.54, 95% CI: 1.39–1.70, P < 0.01). Conclusion: The available evidence suggests that β2M serves as an independent prognostic marker with significant effects on OS and PFS in DLBCL patients. Elevated serum β2M levels are associated with poor prognosis and worse OS and PFS outcomes in DLBCL patients.

Background: Surgical resection is an important treatment for early rectal cancer; however, postoperative anastomotic stenosis remains a challenging issue for surgeons worldwide. The endoscopic approach is usually first-choice treatment for patients with rectal cancer. Balloon dilatation, stent implantation, and endoscopic radial incision are common surgical approaches, with most patients obtaining satisfactory treatment results. However, these methods are ineffective for some patients, resulting in the need for repeated endoscopic balloon dilatation, surgical resection of anastomotic stenosis, or even permanent enterostomy. At present, there are no effective and non-recurrent interventions for these patients. For the patient described in this report, we used the technique of endoscopic balloon dilatation followed by an injection of fluorouracil (5-Fu), which successfully improved the clinical symptoms in this patient. Case Summary: Herein, we report on a case of a 67-year-old man who underwent a laparoscopic radical resection for the treatment of rectal cancer. However, the patient began having recurrent abdominal pain, bloating, and dyschezia at 1 year after the operation. His colonoscopy revealed a strictured rectal anastomosis. Endoscopic balloon dilatation was repeated more than 10 times, but anastomotic stenosis still worsened. Because the patient wanted to preserve the anus, a rectal anastomosis resection was not performed, and an endoscopic balloon dilatation combined with an injection of 5-Fu was performed instead. At day 1 after the surgery, the patient was able to defecate spontaneously, and rectal stricture was relieved. The patient was followed up for 21 months post-surgery. His symptoms of abdominal pain and distension did not recur, and there were no symptoms of defecation difficulty. Conclusion: Endoscopic balloon dilatation combined with an injection of 5-Fu is a satisfactory method for the treatment of anastomotic stenosis after rectal surgery.

Objective To perform an epidemiological and survival analysis on a cohort of HB-NENs patients using the latest data. Method In this cohort study, 390 patients diagnosed with HB-NENs between January 1, 1975, and December 31, 2020, were identified from the Surveillance, Epidemiology, and End Results Program. Related data were used for epidemiologic and survival analysis, as well as the development and validation of a nomogram to predict the overall survival probability of individual HB-NENs patients. The study cutoff date was December 31, 2020, and statistical analysis was performed from May 1 to July 31, 2023. Result The age-adjusted incidence rate of HB-NENs increased 1.76-fold from 1992 to 2020 (annual percentage change [APC], 2.73; 95% CI, 1.86-3.65; P < 0.05). Furthermore, the incidence of HB-NENs in the extrahepatic bile duct increased most significantly (APC, 3.73; 95% CI, 2.03-5.46; P < 0.05), gallbladder also increased most significantly (APC, 3.51; 95% CI, 1.97-5.08; P < 0.05), whereas patients with HB-NENs in the liver had no significant difference. As for tumor type, the incidence increased in HB-NECs (APC, 2.93; 95% CI, 1.34-4.53; P < 0.05) but the incidence was stable in HB-NETs. On multivariable analyses, age at diagnosis, race, tumor size, grade, tumor type, tumor stage, and surgery were significantly associated with overall survival for HB-NENs patients. Furthermore, a nomogram based on associated factors was constructed to predict the 6-month, 1-year and 2-year survival probability, with the concordance indexes of 0.829 (95% CI, 0.800-0.857) for the internal validations and 0.801 (95% CI, 0.745-0.857) for the external validations. Conclusion In this study, the occurrence and prevalence of HB-NENs have exhibited a persistent upward trend over nearly two decades. Furthermore, this study proposes that a nomogram comprising eight prognostic parameters can effectively quantify the mortality risk in HB-NENs patients.

Hepatosplenic T Cell lymphoma (HSTCL) is a rare form of peripheral T cell lymphoma with an aggressive course and a poor prognosis. It affects primarily young adult males, many of them with a history of immunosuppression and autoimmune diseases. We describe a case of a 27-year-old male, previously treated with azathioprine, presenting with pancytopenia, the bone marrow was aplastic and partly infiltrated with gamma-delta T-lymphocytes (Tγδ). The diagnosis was confirmed by a liver biopsy. The patient received induction chemotherapy with a total of 3 cycles of ifosfamide, carboplatin, etoposide (ICE protocol) without ever reaching hematological regeneration, so eventually followed by allogeneic transplantation. In the 60-month surveillance, the patient still shows complete remission.

Background/Objectives: Non-melanoma skin cancers (NMSC) are the most frequent cutaneous tumors globally. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) represent the most frequently encountered representatives of this group and may represent a diagnosis challenge in some circumstances of hard to differentiate tumors. The aim of this study was to determine the factors that influence the diagnosis of NMSC and their impact. Methods: A single center, descriptive, retrospective study was performed, with a total of 866 cases from 678 patients from 2016-2022. Cases were then analyzed based on their histological diagnosis and characteristics and the available clinical data. Results: From the 866 cases, 709 were histologically diagnosed as BCC and 157 as SCC. The clinical accuracy for BCCs was 95% whereas for SCCs was 62% with both having large variations among attending dermatologists. Clinical factors that were found to influence the diagnosis were: advanced age (p<0.001), a biopsy beforehand (p=0.009), and multiple diagnosis or uncertainty (p=0.005) were predictive for a final diagnosis of SCC. Factors predicting BCCs were: the presence of multiple lesions (p=0.032), presence of ulcerations (p<0.001), age under 50 (p=0.002). BCCs were more likely to be correctly diagnosed than SCC (p<0.001). Cases with multiple BCCs were thinner compared to single-lesion excisions (p<0.001). A tumor reduction was observed after the 2020 the SARS-CoV-2 (p=0.023). Conclusions: Differentiating NMSC can be challenging, but several trends have been observed which may aide in further improving the diagnosis rates especially for SCCs.

For breast conserving mammoplasty, the persistent problem of blue staining of the skin left after blue dye injection affects the overall aesthetics of the breast after the breast conservation procedure and causes distress to patients . Herein, through a case report, we proposed that for breast tumors adjacent to the nipple areola area, a double-ring incision could be used to remove the tumor and injecting blue dye into the skin within the double-ring incision subcutaneously to mark the sentinel lymph nodes could be considered as a satisfying method, because the blue skin could be removed intraoperatively by de-epithelializing and forming a new areola border with purse-string sutures.

Background Neuroblastoma (NB) is a childhood cancer of the sympathetic nervous system, and its prognosis is poor. NB cells undergo transcriptional changes to utilize aerobic glycolysis as its primary metabolic pathway, which provides an immediate source of ATP to meet high biosynthetic demands. Alternative metabolic fuel inputs, including ketone bodies which require oxidative phosphorylation, may impact the proliferative capacity of NB. Procedure In this study, the expression of glycolytic and ketolytic genes in the context of MYCN oncogene amplification, tumour staging 1 - 4, and Kaplan-Meier survivability was investigated using the R2: Genomics analysis and visualisation platform (http://r2.amc.nl). The R2 database is a platform for gene expression and prognostic data for primary tumour samples. Three NB genomics datasets were accessed and further analysed in GraphPad Prism to investigate the relationships between glycolytic and ketolytic gene expression and prognosis. Results Glycolytic gene expression is increased in MYCN amplified, metastatic tumours, and is associated with worse event free survival. Ketolytic gene expression is lower in metastatic tumours and is associated with better event free survivability. The glycolytic gene expression profile of NB suggests that elevated levels correlate with low probability of survival. Ketolytic gene expression patterns suggest a decreased reliance for ketolytic energy, which may be exploited to slow tumorigenic growth. Conclusions This study validates the glycolytic gene expression profiles in metastatic and MYCN-amplified NB tumours and suggest the potential use of these genes in prognosis prediction. Furthermore, the study highlights the reliability and utility of the R2 database as an oncogenomic tool for NB research.

IntroductionBlastic plasmacytoid dendritic cell neoplasm (BPDCN) is one of the rare hematological malignancies. It is highly invasive, has a poor prognosis, and often has skin invasion as its first clinical manifestation. It can also involve lymph nodes, soft tissue, peripheral blood, and the bone marrow. There is no current recommended treatment for this disease. Chemotherapy designed for treating acute leukemia is often used for induction and consolidation to achieve a rapid complete response. Allogeneic hematopoietic stem cell transplantation (allo-HSCT), when appropriate, has been recommended to achieve long-term survival. We reported a case of BPDCN in our center that was treated with chemotherapy combined with UCBT, along with a review of the literature, to provide a reference for the treatment of this disease.

One of the major challenges in cancer research is identifying biomarkers involved in molecular aspects of cancer, including initiation, progression, and therapy outcomes of different cancers. Survival analysis is used to predict the impacts of alteration in gene expression of specific genes on cancer progression. Although studying the impacts of all genes would be infeasible, understanding the survival impacts of transcription factors might be useful. TCGA datasets have been widely used to do such analysis. Here, we have studied the impacts of transcription factors with a proven role in cancer (Oncofactors) on patients’ survival in 13 major TCGA datasets. We have first identified the differentially expressed genes among patients and healthy people. Next, we selected the differentially expressed oncofactors among these genes. In the next step, using clinical data, the survival analysis of each cancer type was conducted using a p-value of 0.01 as the significance level. Interestingly, different sets of TFs were significantly associated with survival for each type of cancer. Unexpectedly, our results indicate that only a limited number of oncofactors might impact on overall survival of cancer patients.