Langerhans cell histiocytosis (LCH) is characterized by inflammatory lesions featuring clonal infiltration. The BRAF mutation stands out as the most prevalent. Vemurafenib has emerged as a therapeutic option. The off-label use of VMF persists in Brazil. We will delineate the cases of two Brazilian children suffering from LCH with a positive response to VMF. Case Report I: The patient underwent standard therapy, but bone marrow infiltration persisted. After confirming a BRAF V600E mutation through testing, VMF was initiated, resulting in significant improvements. Case Report II: The patient initiated VMF and showed a positive response. After several months, maintenance therapy was introduced. However, skin lesions recurred upon discontinuation of VMF. She has been on VMF for a total of 31 months, maintaining remission. The cases presented represent the first reported instances of off-label VMF use in Brazil for the treatment of LCH, and both patients have demonstrated excellent responses to the medication.

Background: To evaluate the predictive value of a nomogram with Ki-67 in overall and disease-free survival in glioma patients. Methods: A total of 76 patients diagnosed with glioma were enrolled. The baseline data and followups were retrospectively collected from medical records. The associations between Ki-67 and survival status were examined using log-rank test, univariate and multivariate Cox proportional hazard regression models. Calibrations were performed to validate the established nomograms. Results: Ki-67 negative group showed a longer OS survival time and a longer PFS survival time with log-rank test (x2=16.101, P<0.001 and x2=16.961, P<0.001). Age older than 50 years (HR=2.074, 95% CI: 1.097-3.923), abnormal treatment (HR=2.932, 95% CI: 1.343-6.403) and Ki-67 positive (HR=2.722, 95% CI: 1.097-6.755) were the independent predictive factors of death. High grade pathology (HR=2.453, 95% CI: 1.010-5.956) and Ki-67 positive (HR=2.200, 95% CI: 1.043-4.639) were the independent predictive factors of recurrence. The C-index for the nomogram of OS and PFS were 0.745 and 0.723, respectively. The calibration results showed that the nomogram could predict the overall and disease-free 1-year survival of glioma patients. Conclusion: The nomograms with Ki-67 as independent risk factor for OS and PFS could provide clinical consultation in the treatment and follow-up of malignant glioma.

Background: Recent data suggest that a subset of early stage melanoma patients may benefit from adjuvant immunotherapy. Objective: To identify findings in biopsy or surgical pathology reports associated with poor prognosis in patients diagnosed with stage I and II cutaneous melanoma. Methods: This was a retrospective cohort study of 68 stage I and II cutaneous melanoma patients treated at our institution from 2010 to 2022. Inclusion criteria were patients with stage I or II melanoma with both a biopsy and surgical pathology report. The primary outcome of the study was the prognostic value of biopsy findings on progression free survival (PFS). Kaplan-Meier and Cox-proportional hazards models were used to evaluate risk factors for progression. Results: Patients with ulceration on biopsy had a 16.1x greater risk of progression than those without ulceration [HR 16.1, 95% CI: 2.60-99.5]. Patients with absent lymphocytes on biopsy had a 9.5x greater risk of progressing compared to those with lymphocytes present [HR 9.45, 95% CI: 1.99-44.8]. Ulceration or absent TILs were associated with significantly worse PFS. Conclusions: Ulceration and absence of TILs on biopsy are associated with increased risk of progression in stage I and II melanoma patients.

Introduction Laparoscopic hepatectomy (LH) for hepatocellular carcinoma (HCC) has been well-known for its advantages in the past 10 years, but little is known regarding its oncologic outcomes while the technique is being developed at an institution. This study aimed to evaluate the safety and effectiveness of LH for patients with primary HCC at favorable locations during the development period. Methods We retrospectively reviewed patients diagnosed with primary HCC that underwent hepatectomy between January 2013 and December 2019 at Hualien Tzu Chi Hospital. Patients with HCC at favorable locations (anterolateral segments) were collected and divided into laparoscopic and open hepatectomy (OH) groups. Long-term oncologic outcomes, including overall, and disease-free survival and postoperative short-term outcomes were analysed. Results The review included 159 patients, and among which 42 and 44 patients with HCC in favorable locations were underwent open and laparoscopic hepatectomies. There were no significant differences in intraoperative blood loss, major complication rate, and 90-day mortality rate. The laparoscopic group had a shorter postoperative hospital stay, and lower 90-day readmission rate. There were no significant differences in overall survival and disease-free survival. Conclusion LH for favorably located HCC can stabilize the short-term outcome and long-term outcome during the development period.

Background Multiple Myeloma (MM) is more often characterized by clonal plasma cell proliferation restricted to the bone marrow. However, a small percentage of patients with MM develops extramedullary disease (EMD): this type of localization is found in 1.7-4.5% of the newly diagnosed MM (ND/MM) and in 3.4-10% of patients with relapsed or refractory disease (RR/MM) and seems to have a bad prognostic impact. In the present report, we describe a very rare case of splenic involvement in a patient with ND/MM. Case A 72 years old female was referred in June 2022 with asthenia and abdominal pain. At physical examination, spleen enlargement was detected, with anemia (Hb 10.5 g/dL) and thrombocythopenia (48 x 109/L). Abdominal echography confirmed spleen enlargement (20 cm of longitudinal diameter). Blood tests showed free light chain alteration with a λ/κ ratio of 800. Marrow aspiration showed 60% of λ-restricted immature plasma cells: p53 expression was present in 91% of elements. PET CT scan revealed multiple focal areas of bone increased metabolic activity and a widespread positivity of the spleen with focal areas of higher uptake. Diagnosis of MM with splenic EMD was done and Dara-VMP regimen was started. After the first cycle of therapy, a marked reduction of the spleen size was observed with increase of both Hb level and platelet count. After the 2nd cycle of therapy, however, there was evolution in plasma cells leukemia: Vd-PACE regimen was thus started, but after the 2nd cycle she died in October 2022 from septic shock and multiorgan failure. Conclusions Our very rare case of ND/MM with spleen involvement confirms the aggressive behaviour of EMD, with negative prognostic factors (p53 mutation) and failure to frontline highly effective therapy. In the other few cases of spleen involvement reported, however, there were only scarce details about response: as a consequence, collection of similar cases is warranted to fully understand clinical features and possible alternative approaches for these extremely rare patients.

Despite the considerable progress achieved in the field of cancer immunotherapy over the past few years, a large number of patients fail to benefit from these therapies due to insufficient alteration of the immunosuppressive tumor microenvironment (TME), which facilitates the evasion of anti-tumor immunotherapy. Metabolic reprogramming is emerging as an important hallmark of tumorigenesis and has a major effect on remodeling the tumor immune microenvironment and the response to cancer immunotherapy. However, only a limited number of studies have summarized the research trends and hotspots in metabolic reprogramming from the perspective of tumors and immune cells. Therefore, we aimed to comprehensively explore current research status and hot topics in TME-related metabolic reprogramming over a 20-year period using a bibliometric approach. Studies focusing on metabolic reprogramming and the TME were searched from the WOSCC database. Bibliometric and visual analyses of the included articles and reviews were performed using Bibliometrix (R-Tool in R-Studio), VOSviewer, and CiteSpace. A total of 4726 articles published between 2003 and 2022 were selected. The quantity of publications and citations exhibited an annual growth. Cooperation network analysis indicated that the United States holds the foremost position in the field of metabolic reprogramming and TME research, having the highest volume of publications and citations, thus exerting the greatest influence. Among the institutions, Fudan University displayed the highest level of productivity. Regarding publications in this field, Frontiers in Immunology emerged as the journal with the most extensive number of contributions. Ho Ping-Chih made the most article contributions; Pearce Edward J., was the most co-cited author. Four clusters were obtained after clustering analysis of the authors’ keywords with tumor microenvironment and immunotherapy, metabolic reprogramming and glycolysis, immunometabolism and gut microbiota, and immune and extracellular vesicles being the main topics. Immunometabolism, glycolysis, immune cells, and tumor-associated macrophages are relatively recent burst keywords that have attracted increasing attention.A comprehensive landscape of advancements in metabolic reprogramming and the TME was studied, which can provide crucial information for scholars to further advance this promising field. Further research should explore new topics related to immunometabolism in the TME using a transdisciplinary approach.

Objective: To explore the application of the downward flap patch technique in single-port axillary endoscopic breast reconstruction with implants. Methods: A retrospective analysis was conducted on the clinical data of patients who underwent single-port axillary endoscopic breast cancer radical resection with implant-based reconstruction at the Department of Oncology Surgery, Ningxia Medical University General Hospital from August 2020 to March 2023. The patients’ postoperative drainage volume, early complications, and breast reconstruction satisfaction were analyzed using the BREAST-Q questionnaire. Results: The average total drainage volume was 235 ml on the second day after surgery. A total of 8 patients (15.38%) experienced complications, including 7 cases of incision infection, 5 cases of incision dehiscence, and 2 cases of flap necrosis. There were also 2 cases of local flap ischemic necrosis. Seven patients had wound infections, including 3 cases of simple infection, 2 cases of flap necrosis, and 2 cases of combined incision dehiscence. All 52 patients completed the 3-month follow-up without any loss to follow-up. During the follow-up period, no adverse events such as recurrence, metastasis, or death occurred in any of the patients. The BREAST-Q scores of patients who experienced complications were significantly lower than those who did not. Patients with higher postoperative drainage volumes were more likely to develop wound infections. The incidence of flap necrosis and incision dehiscence was not related to postoperative compression dressing or TNM staging, while the incidence of wound infection was related to compression dressing and regional lymph node metastasis. The breast reconstruction satisfaction score was not related to TNM staging. Conclusion: Single-port axillary endoscopic breast cancer radical resection with implant-based reconstruction achieved good results in breast cancer treatment and shaping. The downward flap patch technique is simple to operate, has good implant coverage, and can achieve good breast reconstruction satisfaction.

Objective: To explore the relationship between tumor budding and clinical pathological characteristics and prognosis of cervical cancer; Methods: By searching Pubmed, Embase, Cochren, CNKI and CBM databases, the research studies on the relationship between tumor budding and prognosis or clinic-pathological characteristics of cervical cancer were included. The quality of researches included was evaluated according the Castle Ottawa Scale (NOS) and statistically analyzed by Stata 12.0. Result: A total of 10 studies were included, including 11 cohorts. Including 2017 patients, the NOS score of these studies is more than 6 points. Tumor budding is related to age and tumor size of cervical cancer. In part of pathological characteristics, squamous cell carcinoma, higher stage, lymph node metastasis, distant metastasis, high WHO grade, deep interstitial invasion, Lymphatic vessel vascular space invasion, nerve invasion and para uterine invasion are more likely to occur tumor budding, occurrence of tumor sprouting in C-type cervical adenocarcinoma is higher than that in A/B type; In univariate analysis, there was a significant correlation between cervical cancer tumor sprouting and disease-free survival in patients (RR=6.511,P=0.000), in multivariate analysis, there was also a significant correlation between those (HR=3.358,P=0.001); Subgroup analysis of univariate analysis showed that Asian (RR=1.879, P=0.000), sample size ≤ 300 (RR=1.875, P=0.000), inclusion of squamous cell carcinoma (RR=1.884, P=0.000), staging criteria (FIGO and TNM), and tumor staging (I-II and mixed staging) all had an impact on DFS.Conclusion: The clinical application of tumor budding as a prognostic factor of cervical cancer can be considered.

Background Due to the high mortality rate of oral squamous cell carcinoma (OSCC), early detection of the disease is critical. Despite previous research on potential diagnostic biomarkers, there is no consensus regarding the role and validity of specific biomarkers for OSCC. Aims The purpose of this study was to explore and verify diagnostic biomarkers for OSCC. Methods and Results mRNA expression data of 57 oral tissues from OSCC patients and 22 from individuals without OSCC was analyzed using a moderated t-test to determine potential biomarkers. Statistical analysis revealed 163 differentially expressed genes between OSCC and normal tissues, 68 of which were upregulated in OSCC tissue. The 11 most significantly upregulated genes were determined to be MMP1, MMP3, MMP10, CXCL10, IL8, CXCL11, MMP12, CXCL9, GBP5, RPS4Y1, and MMP13. Conclusions This study suggests that MMPs are especially promising diagnostic biomarkers and therapeutic targets for OSCC and identifies 68 upregulated genes for further research.

Cancer as a terrible disease ranks among the most important healthcare issues confronting humanity, necessitating a proactive approach to treatment. Numerous signaling cascades are involved in the complex process of carcinogenesis. Despite its success, chemotherapy has had some undesirable side effects. Plants offer a rich source of novel substances and represent an exciting new option for cancer research. Plants and plant-derived products are revolutionizing themselves because they are less poisonous, quicker, cheaper, safer, and simpler than standard treatment procedures. Natural products are viewed as viable candidates for the creation of anticancer medicines because of their pleiotropic effects on target events in a variety of ways. The actions of plant-derived products are selective; they damage cancer cells and have no significant effect on healthy cells. Several researches are being conducted on the production of potential candidates from these plant-derived products that can stop or inhibit cancer cell proliferation without causing adverse effects. Numerous plant-derived products and the analogs from which they were derived have been identified as potential anticancer therapeutic possibilities. In this review, we summarize research on botanical products with significant and active anticancer activity and their anticancer constituents, with a focus on breast cancer. This review sought to highlight the most recent advances and key successes in plant-derived products and cancer therapies focusing on nuclear and cellular structures. Furthermore, cancer drugs and their problems are discussed.

Background: There has been no construction of nomograms specifically geared towards pblueicting the prognosis of older patients with rectal cancer. Our objective was to create a nomogram that can accurately pblueict the chances of cancer-specific survival (CSS) and overall survival (OS) for older patients with rectal cancer,stratifying them into distinct risk groups. Methods: Data of older than 65 years with rectal cancer from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020 were extracted. Results: A total of 12,780 patients were collected in order to identify the independent prognostic factors for cancer-specific survival (CSS) and overall survival (OS) and construct nomograms. The factors included age, sex, race,year of diagnos, marital status, grade, tumor size, CEA, T classification, N classification, Months from diagnosis to treatment, surgery, chemotherapy, and radiation. LASSO regression was used for this purpose. The results showed that grade, chemotherapy, and months from diagnosis to treatment were identified as independent prognostic factors for OS, while grade, chemotherapy, and tumor size were identified as independent prognostic factors for CSS. The concordance index of the CSS nomogram was 0.609 (95% confidence interval [CI], 0.598-0.619) in the training cohort and 0.682 (95%CI, 0.665-0.698) in the validation cohort. The concordance index of the OS nomogram was 0.697 (95%CI, 0.686-0.708) in the training cohort and 0.605 (95%CI, 0.589-0.621) in the validation cohort. Conclusion: Caution should be taken when administering adjuvant therapy after surgery in older patients with rectal cancer,as we have developed and validated a new pblueictive nomogram for CSS and OS.

Colorectal cancer (CRC) ranks among the top three most prevalent and lethal cancers for men and women. The overall annual CRC incidence rate has decreased Since 1985. However, despite continued overall declines, CRC is rapidly shifting to diagnosis at a younger age. Studies suggest that there were significant differences of early-onset CRC in epidemiology, etiology, molecular features, it is a heterogeneous disease. So further characterization of early-onset CRC is required to reveal the difference in clinical and pathological characteristics as well as prognosis between the 2 groups. It may help improve the treatment strategy in the future.

Design: A systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) 2020 Statement. It is registered in the Prospective Registry of International Systematic Reviews (PROSPERO) database. (Registration number: CRD42023447007).[PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang Data Knowledge Service Platform, and Chinese Scientific and Technical Journal Database (VIP) were searched from the library’s construction to August 1, 2023. Methods: After literature screening, data extraction, and evaluation of literature quality were independently performed by 2 researchers trained in evidence-based care according to the inclusion and exclusion criteria, and meta-analysis was performed using RevMan 5.4. Results: A total of 6 randomized controlled trials containing 531 patients were included. Meta-analysis showed that IVR-based interventions helped to improve anxiety symptoms [SMD=-2.06,95% CI= (-2.73,-1.40), P<0.0001], depressive symptoms [SMD=-2.31,95% CI=(-4.39,0.23), P=0.03] and fatigue symptoms [SMD=-1.94,95%CI=(-3.18,-0.71), P=0.002]; the qualitative analysis results showed that IVR technology could improve the pain and the quality of life of breast cancer patients, and the difference was statistically significant (P<0.05). Conclusions: IVR technology applied to breast cancer patients can improve their anxiety, depression, pain, fatigue, and other symptoms, and improve their quality of life, and it is interesting and worth promoting. Due to the limited number of included studies and sample size, more large-sample trials are to be conducted to explore the applicability and feasibility of IVR technology in symptom management of breast cancer patients and to validate the above results.

Purpose This study aimed to explore the correlation between morphological parameters and dosimetric parameters of the heart and spinal cord in advanced-stage esophagus cancer (EPC) to provide a reference for clinical treatment. Methods A total of 105 patients with middle- and advanced-stage EPC, who received treatment in our hospital from 2019 to 2021, were included. The morphological parameters were calculated by imaging. Intensity-modulated radiation therapy plan was executed at Raystation4.7. The prescription dose of PTV-G and PTV-C was set as 60Gy/30F and 54Gy/30F, respectively. The linear regression model was used to analyze the correlation between morphologic parameters of EPC and dosimetric parameters of the heart and spinal cord. Results In 105 cases, the total lung length was correlated with the spinal cord D2. The heart Dmean and heart V40 was correlated with PTV-G volume, PTV-G length; In middle- and upper-segment EPC cases, only the total lung volume was correlated with the spinal cord Dmean, spinal cord D2, heart Dmean, and heart V40; In middle-stage EPC cases, the heart Dmean was correlated with the PTV-G volume, PTV-G length. the total lung length was correlated with the spinal cord D2; In middle- and lower-segment EPC, only the PTV-G volume and PTV-G length were correlated with the heart Dmean. All the aforementioned values were statistically significant. Conclusions Combined with the non-segmented tumor and different locations, the organ at risk dose was comprehensively considered.

Tumor lysis syndrome (TLS) is a life-threatening condition caused by the rapid destruction of malignant cells, leading to imbalances in electrolytes and posing risks such as acute kidney injury, arrhythmia, and seizures. This retrospective study aimed to evaluate the incidence of TLS in a cohort of 94 patients with advanced-stage aggressive B-cell malignancies treated with fractionated rituximab, along with usual TLS preemptive measures such as hyperhydration and urate-lowering treatments. The study found that TLS occurred in seven patients, with one case classified as clinical TLS (cTLS) and six as laboratory TLS (lTLS). The incidence of TLS was higher in patients with Burkitt lymphoma compared to diffuse large B-cell lymphoma. TLS occurrence did not significantly influence survival outcomes in this cohort. Comparison with other datasets showed similar TLS rates in patients with high-grade B-cell lymphoma. These findings contribute to the understanding of TLS in B-cell malignancies, highlighting the potential of fractionated rituximab as a debulking approach to manage TLS risk that warrants further investigation in prospective trials.

Introduction: Primary tracheal carcinoma is a rare and challenging disease that presents significant diagnostic and therapeutic difficulties. Delayed diagnosis due to misinterpretation of airway obstruction symptoms often leads to poorer prognoses for patients. This study aimed to explore the clinical manifestations and multidisciplinary treatment approaches for primary tracheal carcinoma in Bangladesh, with a focus on recent advancements in diagnosis and treatment. Methods: A retrospective observational study was conducted at Bangladesh Specialized Hospital Limited, involving patients aged over 30 who were diagnosed with tracheal carcinoma and underwent multidisciplinary treatment. Data were collected through patient interviews and medical record reviews. Descriptive and inferential statistical analyses were performed to examine demographic characteristics, histological variations, tumor locations, clinical signs and symptoms, treatment approaches, and outcomes. Results: Thirteen patients were included in the study, with a mean age of 49.15±10.50 years. The most common histological variations were invasive squamous cell carcinoma and adenoid cystic carcinoma. The upper trachea was the most prevalent tumor location. Dyspnea, cough, and hemoptysis were the most frequently reported symptoms. Surgical interventions, such as definitive surgery and apple coring surgery, were the primary treatment modalities. Multidisciplinary approaches including Adjuvant / definitive Radiotherapy resulted in a low rate of local recurrence, and patients with successful treatment had better survival outcomes. Conclusion: This study provides insights into the demographic and clinical characteristics of primary tracheal carcinoma in Bangladesh and highlights the importance of a multidisciplinary treatment approach. Further research with larger sample sizes is needed to validate these findings and improve diagnostic and therapeutic strategies for this rare malignancy.

Background and Objectives: The retroauricular hairline approach is increasingly being used for submandibular gland resections because of the excellent cosmetic results. A meta-analysis of studies compared the retroauricular hairline and conventional approaches for submandibular gland excision. Methods: A meta-analysis of studies identified from the PubMed, Embase, and China National Knowledge Infrastructure databases was performed. Postoperative nerve damage (temporary earlobe numbness and other signs of nerve damage), surgical durations, wound lengths, intraoperative bleeding volumes, postoperative drainage, and lengths of hospital stay were compared. Results: The retroauricular hairline approach led to greater risk of temporary earlobe numbness (OR: 7.28; 95% CI: 1.57–33.87; P = 0.01), but this resolved during the follow-up. There was no significant difference in the risk of other nerve injuries between the two approaches. The retroauricular hairline group had significantly longer operative times and wound lengths compared to the conventional resection group. There were no significant differences between the two approaches in intraoperative bleeding volumes, postoperative drainage, and lengths of hospital stay. Conclusions: The retroauricular hairline approach is a safe and efficient alternative to the conventional approach. It provides better cosmetic results and does not increase the risk of long-term neurological complications.

Background When unfolded proteins accumulate in the endoplasmic reticulum (ER), they cause ER stress and activate the pathways of unfolded protein response (UPR), constituted by a set of canonical ER stress transducing proteins. While the classical UPR is well-studied, the functions of non-canonical ER stress transducers are emerging. Findings The CREB3 (cyclic AMP responsive element binding protein 3) family, which contains five members including CREB3, CREB3L1, CREB3L2, CREB3L3, and CREB3L4, is the most important non-canonical ER stress response factor sensing and modulating unfolded protein homeostasis. As novel ER stress transducers, the CREB3 family plays important roles in regulating protein folding, modification, and secretion, contributing to biological events, including cell proliferation, differentiation, and migration in diverse contexts, especially in cancer. Conclusion This review summarized the roles of the CREB3 family in development and disease progression, with an aim to provide references for further research and clinical translation.