Comprehensive epidemiology of melanoma at all sites: insights from Japan's National Cancer Registry, 2016-2017.

Background: Melanoma is a highly malignant cancer responsible for 55 000 deaths worldwide annually. Despite its severity, its epidemiology in Japan remains understudied owing to its rarity among Asians. This study aimed to determine the incidence of melanoma in Japan using data from the National Cancer Registry.

A multicenter study on TROP2 as a potential targeted therapy for extramammary Paget disease in Japan.

Extramammary Paget disease (EMPD) is a rare skin cancer that typically occurs in the anogenital area of older people. Since efficacy of treatments for metastatic or unresectable EMPD remains poor, development of a novel therapeutic approach is strongly desired. However, the lack of EMPD models has hampered investigation of EMPD.

AI-based visualization of loose connective tissue as a dissectable layer in gastrointestinal surgery.

We aimed to develop an AI model that recognizes and displays loose connective tissue as a dissectable layer in real-time during gastrointestinal surgery and to evaluate its performance, including feasibility for clinical application. Training data were created under the supervision of gastrointestinal surgeons. Test images and videos were randomly sampled and model performance was evaluated visually by 10 external gastrointestinal surgeons.

Cost-effectiveness of systematic chemotherapy for metastatic pancreatic cancer: a retrospective study using Japanese clinical data.

We compared the cost-effectiveness of gemcitabine plus nab-paclitaxel (GnP) and modified FOLFIRINOX (mFFX)-standard first-line treatments for metastatic pancreatic cancer in Japan. This retrospective cohort study included patients with metastatic pancreatic cancer treated at the National Cancer Center Hospital East in Japan between December 2013 and February 2017. A partitioned survival model, featuring five mutually exclusive health states, was developed.

A Phase II, Open Label, Single-Arm Study on the Efficacy of Cabozantinib in Patients With Advanced/Metastatic Nonsmall Cell Lung Cancer Harboring MET Exon 14 Alterations who Developed Acquired Resistance to Tepotinib or Capmatinib (CAPTURE Trial).

Background: MET gene exon 14 skipping was identified as a potential driver mutation that occurs in approximately 3%-4% of patients with nonsmall cell lung cancer (NSCLC), typically in the absence of other driver mutations. Capmatinib and tepotinib were the first MET- tyrosine kinase inhibitors (MET-TKIs) approved by the FDA and PMDA, specifically for patients with metastatic NSCLC. Several studies have reported acquired resistance after MET-TKI treatment for MET mutation-positive NSCLC.

Molecular subtype changes after acquiring resistance to tarlatamab in small cell lung cancer.

Tarlatamab, a novel bispecific T-cell engager, has demonstrated unprecedented efficacy in patients with small cell lung cancer. However, there is no known mechanism of resistance to tarlatamab. This study suggests that a transcriptional expression shift might be associated with acquired resistance to tarlatamab.

Prediction and Monitoring of Adaptive Radiation Therapy Timing Using Two-dimensional X-ray Image-based Water Equivalent Thickness.

Background/aim: This study aimed to predict the optimal timing for adaptive radiation therapy (ART) using two-dimensional X-ray image-based water equivalent thickness (2DWET).

Patients And Methods: Forty patients with oropharyngeal and hypopharyngeal cancer underwent Computed Tomography (CT) rescanning during treatment. An adaptive score (AS) was proposed to guide ART decisions based on changes in four dose indices: target coverage, spinal cord dose, parotid gland dose, and over-dose volume.

Optimal lymph node dissection area for pancreatic neuroendocrine neoplasms by tumor location, size, and grade.

Background: Lymph node dissection is required for many pancreatic neuroendocrine neoplasms. However, the need for such dissection has rarely been examined in detail by the tumor size, tumor location, or World Health Organization grading. The objective is to determine which characteristics of pancreatic neuroendocrine neoplasms require lymph node dissection, and to what extent lymph node dissection should be performed.

Neoadjuvant gemcitabine and S-1 in pancreatic ductal adenocarcinoma: Effects on nutritional status and pancreaticoduodenectomy outcomes.

Background: With the advent of improved chemotherapy options, neoadjuvant chemotherapy has gained acceptance as a multidisciplinary treatment approach for localized pancreatic ductal adenocarcinoma. This study aimed to clarify whether neoadjuvant chemotherapy with gemcitabine and S-1 influences preoperative nutritional status and postoperative outcomes, particularly in patients undergoing highly invasive pancreatic resection.

Methods: Patients with resectable pancreatic ductal adenocarcinoma who underwent pancreaticoduodenectomy as upfront surgery or after neoadjuvant chemotherapy with gemcitabine and S-1 between January 2015 and December 2022 were assessed.

Short-Term Outcomes of a Novel Hybrid Technique, Minimally Invasive Laparoscopic and Robotic Surgery (MILAR) Using the da Vinci SP System for Gastric Cancer.

Background: Robotic surgery may have shown advantages over conventional laparoscopic surgery, but the da Vinci SP system, which utilizes a single incision, has had limited use in gastric cancer surgery. This study aims to evaluate the short-term outcomes of a novel hybrid technique, minimally invasive laparoscopic and robotic surgery (MILAR), with the da Vinci SP system for gastric cancer.

Materials And Methods: This retrospective study reviewed 23 consecutive patients who underwent gastrectomy for gastric cancer using the MILAR technique with the da Vinci SP system between May and October 2024.

Impact of radiotherapy-related late toxicities of skin and soft tissue in the neck on quality of life in head and neck cancer patients: a multi-institutional observational study in Japan.

Purpose: This multi-institutional observational study aimed to assess the incidence, severity, and impact of radiotherapy-related late toxicities of the cervical skin and soft tissue in head and neck cancer patients. We also explored patient interest in fat grafting as a potential treatment for skin and soft tissue sequelae.

Methods: This study was conducted across 19 institutions in Japan.

Phase 3 Study of Talazoparib Plus Enzalutamide Versus Placebo Plus Enzalutamide as First-Line Treatment in Patients With Metastatic Castration-Resistant Prostate Cancer: TALAPRO-2 Japanese Subgroup Analysis.

Background: In TALAPRO-2, the poly(ADP-ribose) polymerase inhibitor talazoparib plus the androgen receptor-signaling inhibitor enzalutamide improved radiographic progression-free survival (rPFS) versus placebo plus enzalutamide (hazard ratio [HR] = 0.63; 95% CI, 0.51-0.

Association of Preoperative Physical Fitness With Post-Esophagectomy Pneumonia in Older With Locally Advanced Esophageal Cancer: An Exploratory Prospective Study.

Backgrounds: Currently, there is a lack of evidence of prehabilitation during neoadjuvant chemotherapy (NAC) to prevent pneumonia of older patients. This study aimed to investigate the association of preoperative physical fitness after NAC with post-esophagectomy pneumonia in older patients with locally advanced esophageal cancer (LAEC).

Methods: This single-center exploratory prospective cohort study included 80 patients aged ≥ 65 years with LAEC scheduled for curative esophagectomy after NAC between 2021 and 2023.

A simplified scoring system for predicting treatment response in limited-stage small-cell lung cancer (EAST score).

Aims: This study aimed at developing a scoring system (EAST score) to predict recurrence after chemoradiotherapy in limited-stage small-cell lung cancer (LS-SCLC).

Patients & Methods: Treatment-naïve LS-SCLC patients receiving concurrent chemoradiotherapy (CCRT) ( = 234) or sequential chemoradiotherapy ( = 53) were retrospectively reviewed. Using data from CCRT population, clinical and radiological variables associated with disease progression were identified.

Functional status, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio as prognostic factors of one-year survival rate in elderly patients with advanced-stage non-small cell lung cancer.

Background And Aim: Non-small cell lung cancer (NSCLC) is the most common lung cancer found in elderly patients. Aging and chronic inflammation are related to its pathogenesis. Functional status, lymphocyte-to-monocyte ratio and platelet-to-lymphocyte ratio describe a chronic inflammation and correlate to the survival of older adults with advanced-stage (IIIB-IV) NSCLC.

High Fracture Risk of Femoral Bone Metastasis Treated with Palliative Radiotherapy in Recent Years.

Bone-modifying agents (BMAs) have been widely used to reduce skeletal-related events, including pathological fractures. Herein, we aimed to clarify the incidence of pathological fractures caused by high-risk femoral bone metastases after palliative radiotherapy (RT) in the BMA era and evaluate the necessity of prophylactic surgical stabilization. We assessed 90 patients with high-risk femoral bone metastases, indicated by Mirels' scores ≥ 8, without pathological fractures and surgical fixations, who received palliative RT at our institution between January 2009 and December 2018.

EGFR, TP53, and CUL3 Triple Mutation in Non-Small Cell Lung Cancer and its Potentially Poor Prognosis: A Case Report and Database Analysis.

Concurrent mutations in tumor protein p53 (TP53) or Kelch-like ECH-associated protein 1-nuclear factor erythroid 2-related factor 2-pathway components are linked to poor outcomes in epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), but the impact of triple mutations remains unclear. We report a case of EGFR-, TP53-, and Cullin 3 (CUL3)-mutant NSCLC in a 43-year-old woman with widespread metastases at diagnosis, including those in the contralateral lung, distant lymph nodes, pericardium, liver, bones, left adrenal gland, and brain. She received osimertinib as first-line therapy, but pericardial effusion and liver metastases progressed rapidly over 3 months, and she was switched to carboplatin and pemetrexed.

WEE1 confers resistance to KRAS inhibitors in non-small cell lung cancer.

KRAS inhibitors sotorasib and adagrasib have been approved for the treatment of KRAS-mutant non-small cell lung cancer (NSCLC). However, the efficacy of single-agent treatments is limited, presumably due to multiple resistance mechanisms. To overcome these therapeutic limitations, combination strategies that potentiate the antitumor efficacy of KRAS inhibitors must be developed.

Quantification of beam size impact on intensity-modulated proton therapy with robust optimization in head and neck cancer-comparison with intensity-modulated radiation therapy.

We assessed the effect of beam size on plan robustness for intensity-modulated proton therapy (IMPT) of head and neck cancer (HNC) and compared the plan quality including robustness with that of intensity-modulated radiation therapy (IMRT). IMPT plans were generated for six HNC patients using six beam sizes (air-sigma 3-17 mm at isocenter for a 70-230 MeV) and two optimization methods for planning target volume-based non-robust optimization (NRO) and clinical target volume (CTV)-based robust optimization (RO). Worst-case dosimetric parameters and plan robustness for CTV and organs-at-risk (OARs) were assessed under different scenarios, assuming a ± 1-5 mm setup error and a ± 3% range error.

Secondary Reconstruction of Premaxilla With a π-Shaped Fibula Osteocutaneous Flap.

Midface deformities due to oncologic bony defects are often difficult to secondarily correct. The authors herein report 2 cases of secondary reconstruction of an oncological premaxillary defect using a π-shaped fibula osteocutaneous flap. The authors divided the fibula into 3 pieces and made it π-shaped to reconstruct the curvature of the premaxilla.

MOUNTAINEER-03 phase III study design: first-line mFOLFOX6 + tucatinib + trastuzumab for HER2+ metastatic colorectal cancer.

Patients diagnosed with metastatic colorectal cancer (mCRC) have a poor prognosis with survival ranging 2-3 years. The prevalence of human epidermal growth factor receptor 2 (HER2) amplification is approximately 3-4% in mCRC and increases up to 8% in patients with // wild-type (WT) CRC tumors. Tucatinib is a highly selective HER2-directed tyrosine kinase inhibitor that, in combination with trastuzumab, has demonstrated clinically meaningful activity in patients with chemotherapy-refractory, HER2-positive (HER2+), WT mCRC in the MOUNTAINEER trial.

Clinical performance of endoscopic ultrasound-guided tissue acquisition for perivascular soft-tissue cuffing suspected to be extravascular migratory metastases of pancreatic or bile duct cancer (with video).

Objectives: This study aimed to investigate the diagnostic performance and safety of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for perivascular soft-tissue cuffing (PSTC).

Methods: This single-center, retrospective study evaluated patients in whom EUS-TA was performed for PSTC in pancreatic or bile duct cancer lesions between October 2017 and March 2024. PSTC was defined as a perivascular soft-tissue area contiguous with nearby blood vessels from the suspected primary tumor.

Managing Wound Complications After Osteosarcoma Resection: Stopping Adjuvant Therapy and Performing Secondary Closure.

Purpose Adjuvant chemotherapy (AC) following limb-sparing surgery with endoprosthesis is the gold standard treatment for osteosarcoma (OS). However, AC can impair wound healing, leading to endoprosthesis exposure, making the decision to continue or pause AC important. We propose standard guidelines for managing this situation.