The Clock and the Scalpel: Does delayed Robot-assisted radical prostatectomy affect pathological progression and upgrading in prostate cancer?

Introduction: We investigated whether surgical delay may be associated with histological progression in patients treated with robotic-assisted radical prostatectomy (RARP) for prostate cancer (PCa).

Materials And Methods: Patients diagnosed with localized (cT1-2cN0cM0) PCa who underwent RARP between 2011 and 2022 were retrospectively reviewed. Surgical delay was categorized into four groups based on the time from biopsy to RARP: 0-3, 4-6, 7-12, and >12 months.

Strategies to evaluate treatment effects in clinical trials for emerging infectious diseases.

Background: Swift regulatory approval of therapeutic interventions is crucial during emerging infectious disease outbreaks. However, variability in treatment effects based on disease severity or subgroups complicates trial design and endpoint selection. Prioritized composite endpoints can capture treatment effects across diverse clinical courses; however, their performance under heterogeneous treatment effects remains uncertain.

[A Case of Successful Combination of Immune Checkpoint Inhibitors and Radiotherapy for MLH1 Gene-Deficient Colon Cancer].

A 77-year-old woman was diagnosed with advanced transverse colon cancer(poorly differentiated adenocarcinoma)cT3N3H0P0, cStage Ⅲc and underwent extended left hemicolectomy in April 2020. The tumor tissue revealed RAS: wild type, BRAF: mutant type, dMMR(MLH1 deficiency)by immunochemical staining, and MSI-H by CDx. She received CAPOX as adjuvant chemotherapy after surgery.

Intraoperative Blood Loss Predicts Local Recurrence After Curative Resection for Stage I-III Colorectal Cancer.

Background: To identify the predictors of local recurrence and distant metastasis after radical surgery for stage I-III colorectal cancer.

Materials And Methods: Patient and tumor characteristics, clinicopathological stages, perioperative factors, and postoperative outcomes, including local and distant recurrence, of patients who underwent primary colorectal resection were evaluated in this multicenter retrospective analysis. Univariate and multivariate regression analyses were performed to identify the risk factors for local and distant recurrences, with a focus on the intraoperative blood loss (IBL) ratio [IBL (mL)/total blood volume (mL)] and postoperative complications.

Inflammatory and Coagulation Marker Changes in PMX-DHP-Treated COVID-19 Patients.

Introduction Direct hemoperfusion using polymyxin B-immobilized polystyrene fiber column (PMX-DHP) removes endotoxin and inflammatory mediators from the blood. This study aimed to evaluate the changes in the levels of cytokines, coagulation factors, and a microbiota-derived proapoptotic peptide in COVID-19 patients treated with PMX-DHP. Methods We conducted a multicenter, prospective, single-arm interventional study of 21 oxygen-requiring patients with COVID-19 admitted between September 28, 2020, and March 31, 2022.

Multivisceral resection as a key indicator of recurrence in locally advanced colorectal cancers with pathologic T3 tumors.

Purpose: This study aimed to elucidate the clinical outcomes of patients with pathologic T3 (pT3) and pathologic T4 (pT4) tumors who underwent radical resection with multivisceral resection (MVR) and to assess the prognostic significance of MVR in locally advanced colorectal cancers (CRCs) in pT3 and pT4 tumors.

Methods: This multicenter retrospective analysis evaluated the characteristics, clinicopathologic stages, perioperative factors, and clinical outcomes of patients who underwent primary colorectal resection. Patients were divided into 4 groups: those with a pT3 tumor who did not undergo MVR (pT3 - MVR; n = 1108), those with a pT3 tumor who underwent MVR (pT3 + MVR; n = 56), those with a pT4 tumor who did not undergo MVR (pT4 - MVR; n = 306), and those with a pT4 tumor who did underwent MVR (pT4 + MVR; n = 123).

Operating characteristics of unequal allocation ratios in platform trials with the staggered addition of drugs using binary endpoints.

Background: One recommendation for the allocation ratio between multiple drugs and a shared placebo control group in platform trials (PTs) is to use a :1 allocation ratio for the placebo group relative to the drug group, where is the number of drug groups with ongoing patient enrollment during the trials. However, the practical utility of such unequal allocation ratios in PTs lacks adequate study.

Methods: We compared the performances of equal and unequal allocation ratios through simulations to imitate practical PTs using only concurrent controls and binary endpoints for hospitalized patients with infectious diseases.

Cryo-EM structure of the bacterial intramembrane metalloprotease RseP in the substrate-bound state.

Site-2 proteases (S2Ps), conserved intramembrane metalloproteases that maintain cellular homeostasis, are associated with chronic infection and persistence leading to multidrug resistance in bacterial pathogens. A structural model of how S2Ps discriminate and accommodate substrates could help us develop selective antimicrobial agents. We previously proposed that the S2P RseP unwinds helical substrate segments before cleavage, but the mechanism for accommodating a full-length membrane-spanning substrate remained unclear.

LC16m8 for Pre-exposure Prophylaxis against Mpox in a High-Risk Population: An Open-Label Randomized Trial.

Background: This randomized controlled trial provided LC16m8 pre-exposure prophylaxis to high-risk individuals to assess its efficacy for mpox prevention, safety, and immunogenicity.

Methods: This multicenter, randomized, open-label trial enrolled men and women aged ≥18 years at high risk of mpox. Participants were randomly assigned 1:1 to early- or late-vaccination groups.

[Retroperitoneoscopic Resection of Para-Aortic Lymph Node Metastasis in Colorectal Cancer].

Para-aortic lymph node metastasis(PALNM)is classified as distant metastasis in colorectal cancer(CRC). Although the benefit of para-aortic lymph node dissection(PALND)for the CRC patients with PALNM suspected radiologically remains controversial, some reports have shown that the survival benefit for PALND in CRC patients with PALNM. Moreover, the report evaluating the extent of PALND showed that the patients treated with radical lymphadenectomy had better prognosis compared to those treated with targeted lymphadenectomy defined as the dissection of only swollen lymph nodes.

Planning and Implementing Master Protocol Trials in Japan: Key Considerations of the Japanese Guideline.

The importance of master protocol trials, which encompass basket, umbrella, and platform trials, has been increasingly recognized worldwide for their efficiency in evaluating multiple drugs or diseases within a single trial. While the US Food and Drug Administration and European regulatory bodies have issued guidelines to facilitate such trials, Japan only recently introduced its own set of guidelines to address the unique challenges and opportunities within its regulatory and healthcare landscape. Our study elaborates on these newly issued Japanese guidelines, which were developed through a collaborative effort involving biostatisticians, physicians, clinical trialists, regulatory authorities, and industry representatives.

Transmembrane serine protease 4 expression in the prognosis of radical resection for biliary tract cancer.

Background: Recent advancements in biliary tract cancer (BTC) treatment have expanded beyond surgery to include adjuvant therapy, yet the prognosis remains poor. Identifying prognostic biomarkers could enhance the assessment of patients who have undergone radical resection for BTC.

Aim: To determine transmembrane serine protease 4 (TMPRSS4) utility as a prognostic biomarker of radical resection for BTC.

Treatment of intractable isolated bile leakage occurring after right anterior sectionectomy for hepatocellular carcinoma: Right hepatico-jejunostomy.

Introduction: An isolated bile leakage is a relatively rare type of postoperative bile leakage. Most isolated bile leakages require invasive procedures such as surgical approaches.

Presentation Of Cases: The right hepatic duct was intraoperatively injured during right anterior sectionectomy.

Efficacy of first-line immune checkpoint inhibitor and anti-angiogenic agent combination therapy for Kirsten rat sarcoma viral antigen-mutant advanced non-small-cell lung cancer: a systematic review and network meta-analysis.

Background: Recent advancements in advanced non-small-cell lung cancer (NSCLC) treatment have significantly improved primary therapy outcomes owing to the emergence of various molecular targeted therapies and immune checkpoint inhibitors (ICIs). However, for Kirsten rat sarcoma viral antigen (KRAS) mutations, molecular targeted drugs, such as sotorasib, are not applicable as first-line treatments, and the optimal primary treatment remains unclear. Therefore, we aimed to investigate the efficacy of ICI combination therapy as first-line treatment for KRAS-mutant NSCLC.

Utility of Machine Learning in the Prediction of Post-Hepatectomy Liver Failure in Liver Cancer.

Background: Posthepatectomy liver failure (PHLF) is a serious complication associated with high mortality rates. Machine learning (ML) has rapidly developed and may outperform traditional models in predicting PHLF in patients who have undergone hepatectomy. This study aimed to predict PHLF using ML and compare its performance with that of traditional scoring systems.

Blood perfusion with polymyxin B immobilized columns in patients with COVID-19 requiring oxygen therapy.

Extracorporeal blood purification with polymyxin B immobilized fiber column direct hemoperfusion (PMX-DHP), is reported to be effective in treating COVID-19 pneumonitis with oxygen demand. This multicenter prospective study evaluated the efficacy and safety of PMX-DHP in oxygen-requiring patients with COVID-19 admitted between September 28, 2020, and March 31, 2022. The primary endpoint was the percentage of clinical improvement 15 days after treatment.

Effects of thienopyridine class antiplatelets on bleeding outcomes following robot-assisted radical prostatectomy.

This study aimed to assess the effects of thienopyridine-class antiplatelet agents (including ticlopidine, clopidogrel, and prasugrel) on bleeding complications in patients who underwent robot-assisted radical prostatectomy. This cohort study used a database for robot-assisted radical prostatectomy at 23 tertiary centers nationwide between 2011 and 2022. Patients who received thienopyridines (thienopyridine group) were compared with those who received aspirin monotherapy (aspirin group).

Weekday Surgery Associated With Short-Term Outcomes in Patients With Colorectal Cancers.

Introduction: The "weekday effect" on elective surgery remains controversial. We aimed to examine the association between the day of surgery and short-term outcomes after elective surgery for stage I-III colorectal cancer (CRC).

Methods: We performed a multicenter retrospective analysis of 2574 patients who underwent primary colorectal resection for CRC between January 2017 and December 2019 at 15 institutions belonging to the Hiroshima Surgical Study Group of Clinical Oncology.

[Surgical Resection and Adjuvant Chemotherapy for Early Multiple Peritoneal Recurrence after Rejection of Hepatocellular Carcinoma-A Case Report].

Thus far, no consensus has been reached regarding the treatment of peritoneal dissemination of hepatocellular carcinoma (HCC). Here, we report a case of surgical resection and postoperative adjuvant chemotherapy for early multiple peritoneal recurrences of HCC. A 74-year-old man was found to have hepatic mass of 80 mm in size in S7 and 57 mm in S8, and was diagnosed with HCC.

[Unresectable Esophageal Cancer on the Elderly Woman Which Was Treated Effectively with Ipilimumab plus Nivolumab-A Case Report].

Until now, the standard treatment regimen was cisplatin plus 5-FU as the chemotherapy for unresectable advanced esophageal cancer. Immune checkpoint inhibitors have brought about changes to the cancer treatment. Ipilimumab plus nivolumab was approved in June 2022 for unresectable advanced esophageal cancer.

Association between social background and implementation of postoperative adjuvant chemotherapy for older patients undergoing curative resection of colorectal cancers, sub-analysis of the HiSCO-04 study.

Purpose: Adjuvant chemotherapy is recommended following colorectal cancer resection based on risk of recurrence. In older patients, treatment decisions should consider recurrence rates and tolerability, as well as functional prognosis, residual disease, and social factors. This study aims to investigate factors, including social background, influencing implementation of postoperative adjuvant chemotherapy in older patients undergoing curative resection for colorectal cancer.