The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. Gates Foundation, Queensland Health, and University of Queensland.
Substantial variation in surgical care and outcomes has been identified by quality assurance initiatives. Quality improvement (QI) interventions have the potential to address these disparities. This paper aimed to assess the types of QI interventions that have been designed, implemented, and evaluated in surgical oncology. A systematic search of MEDLINE and EMBASE was conducted to identify studies on QI interventions published between January 2000 and September 2025. Studies reporting the impact of the QI intervention on predefined quality deficits in clinical outcomes or care and process measures were selected. Data on study design, QI methodology, quality deficits, intervention types, and outcomes were extracted. Results were summarized using narrative synthesis and appraised using the Cochrane Effective Practice and Organization of Care risk of bias tool. Of 11 373 studies, 109 were included. The majority were in the USA (48 (44.0%)), followed by Canada (20 (18.3%)), and the UK (11 (10.1%)). The commonest tumour types were gynaecological (22 (20.2%)) and colorectal (20 (18.3%)). The commonest quality deficits addressed were postoperative complications (22 (20.2%)) and prolonged length of stay (12 (11.0%)). One study was conducted globally, 6 nationally, 20 regionally, and 82 locally. Among randomized clinical trials, only 2 of 12 (16%) demonstrated a positive effect compared with 86 of 97 (89%) non-randomized studies. Only 28 (25.7%) studies referenced specific QI methodologies, most commonly the Plan-Do-Study-Act cycle (10 (9.2%)). QI interventions encompassed care pathway standardization, perioperative care bundles, audit, and feedback, combined with surgical skills workshops and digital tools, including checklists, and care coordination initiatives. Most studies were uncontrolled before-and-after studies (74 (67.9%)) and were classified as low quality. There are limited high-quality evaluations of QI interventions in the literature. Key gaps include interventions to improve equitable access to surgical care. Comprehensive QI studies leveraging large-scale, multidisciplinary collaborations and robust methodologies are needed to realize potential gains in surgical oncology care.
There is currently no comprehensive scale suitable for assessing the rehabilitation progress of Chinese tumor patients. This study aimed to evaluate the psychometric properties of the Rehabilitation Set of the International Classification of Functioning, Disability, and Health for that purpose. The Chinese version of the International Classification of Functioning, Disability, and Health's Rehabilitation Set (ICF-RS) was used by trained health professionals to assess 1055 Chinese tumor patients. The internal consistency of the responses was assessed in terms of Cronbach's alpha coefficient. Construct validity was explored through factor analysis. Test-retest reliability, inter-rater reliability, and criterion validity were evaluated using a subset of 121 patients. Criterion validity was quantified by correlating the scores with those generated using the Hospital Anxiety and Depression scale (HADS), the Eastern Cooperative Oncology Group (ECOG) performance status evaluation and the modified Barthel Index (MBI). The Cronbach's alpha for the rehabilitation set's scores was 0.87, indicating good internal consistency. The test-retest reliability analysis showed that most categories had an intraclass correlation coefficient in excess of 0.75, suggesting good reliability when the rehabilitation set is applied with tumor patients. Inter-rater reliability also demonstrated intraclass correlation greater than 0.75 for most categories. Construct validity was supported by the finding that 18 categories had factor loadings exceeding 0.40. After removing categories with lower factor loadings, the cumulative variance explained increased to 44.6% for the Activity and Participation component and 57.3% for the Body Functions component. Criterion validity was supported by significant associations with established instruments. Specifically, 66.7% (20/30) of the ICF-RS categories correlated significantly with the MBI, with effect sizes (r) ranging from 0.19 to 0.52 (p < 0.05). In contrast, only 10% (3/30) of categories demonstrated significant correlations with the ECOG ratings (ρ = 0.21-0.22, p < 0.05). Furthermore, categories related to emotional functions and psychological demands showed significant correlations with the HADS, with moderate effect sizes (ρ = 0.37-0.41, p < 0.001). The Chinese version of the ICF-RS exhibits promising psychometric properties in tumor patients, providing preliminary evidence for its clinical application. It demonstrates good internal consistency, high test-retest reliability and reliable inter-rater consistency. The moderate correlation with MBI ratings and HADS scale scores, along with the distinct factors identified through factor analysis, further supports the instrument's validity and utility when applied to this population. The data confirm that the ICF-RS is a reliable tool for assessing tumor patients' functioning and disability. However, the construct validity results recommend further work before the instrument is widely used with tumor patients.
Following the publication of the above article, a concerned reader drew to the Editor's attention that there were anomalies associated with the cellular images shown in Fig. 1A; essentially, groupings of cells/cellular features appeared to be strikingly similar in appearance, looking internally within four of the eight data panels in this figure. A similar phenomenon of strikingly similar features was observed in the majority of the panels showing spheroid formation assay data in Fig. 8A. Moreover, regarding the western blots shown in Fig. 2B for the D283 cell line, the protein bands shown for E‑cadherin for the normoxia and hypoxia cells [the (N) lanes] were strikingly similar, suggesting that the gels in this figure may have featured inappropriate editing. Finally, some of the western blot data featured in Fig. 5C were very similar to data that had appeared in a paper by the same authors published in the journal PLoS One. After having conducted an internal investigation of the data in this paper, the Editor of International Journal of Oncology has decided that this article should be retracted from the journal on the grounds of a lack of confidence in the data. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply.The Editor sincerely apologizes to the readership for any inconvenience caused, and we thank the reader for bringing this matter to our attention. [International Journal of Oncology 733‑744, 2011; DOI: 10.3892/ijo.2010.883].
The aim of this study was to achieve consensus on important topics related to tenosynovial giant cell tumour (TGCT) and giant cell tumour of bone (GCTB), and to identify areas for future research. In January 2026, a consensus meeting, The Birmingham Orthopaedic Oncology Meeting (BOOM), held in Cape Town, South Africa, gathered 314 delegates from 59 countries to debate 21 consensus statements on tenosynovial giant cell tumour (TGCT) and giant cell tumour of bone (GCTB) through a modified Delphi process. Of the 21 statements, two achieved unanimous consensus, 18 strong consensus, and one moderate consensus. Unanimous consensus was reached for prioritizing joint-preserving intralesional curettage in GCTB when feasible, and for supporting non-surgical approaches in anatomically challenging cases, particularly sacral lesions. The statement addressing the role of denosumab in GCTB achieved only moderate consensus. The use of adjuvants in GCTB, as well as the management of recurrent and systemic GCTB, including long-term use of denosumab, reached strong consensus. Strong consensus was achieved in the surgical and non-surgical management for both primary and recurrent TGCT. Surveillance strategies for both TGCT and GCTB generated substantial discussion despite strong consensus, reflecting ongoing uncertainty and lack in evidence. This international consensus provides practical guidance for the management of TGCT and GCTB while identifying important gaps in evidence. Joint-preserving surgery remains central to the treatment of GCTB, with selective integration of systemic therapies and individualized surveillance. The consensus framework highlights priorities for future collaborative research in orthopaedic oncology.
Cancer patients have a higher suicide risk than the general population. Oncology nurses play a critical role in assessing and managing this risk. However, they often lack the necessary awareness, knowledge, and skills. This study developed an Oncology-Specific Suicide Prevention Program (OSP) for oncology nurses. It aims to assess how the OSP affects nurses' suicide literacy, suicide stigma, and efficacy in suicide risk management. Researchers developed the OSP based on findings from cancer-related suicide studies. The intervention included three structured online sessions for the experimental group, each session addressing specific aspects of suicide prevention strategies in oncology care. Researchers conducted a randomized controlled trial with 86 nurses from two oncology hospitals in Ankara. Nurses were randomly assigned to an experimental group (n = 43) or a control group (n = 43) after stratifying by years of work experience. The control group received usual in-service training. Researchers collected data using the descriptive information form, the literacy of suicide scale, the stigma of suicide scale, and the efficacy perception scale for suicide risk management for oncology nurses. The experimental group showed a significant increase in suicide literacy (p < 0.001) and efficacy perception for suicide risk management (p < 0.001). They also showed a decrease in suicide stigma (p = 0.013) compared to the control group. These effects were measured at the end of the program and 3 months later. Integrating the OSP into in-service training for oncology units and national and international suicide prevention strategies is suggested.
Regarding: Hulscher et al., “Real-world Clinical Outcomes of Ivermectin and Mebendazole in Cancer Patients: Results from a Prospective Observational Cohort,” Anticancer Research Vol. 46, No. 6, pp. 3243-3255, 2026. The Editorial Board of Anticancer Research is issuing an official Expression of Concern regarding the article cited above. The study was published purely as “hypothesis-generating", opening the discussion for repurposing of these substances, establishing the ground for future approved, randomized clinical trials. Following publication, serious scientific concerns were raised by the international medical community regarding the verifiability and statistical reliability, and ethical oversight of the underlying dataset. In formal correspondence to the journal dated June 4, 2026, the authors clarified that the study cohort was not drawn from an unverified consumer survey, but instead comprised “provider-screened cancer patients enrolled in a structured prospective cohort” managed via an internal clinical workflow and licensed provider consultations. While the Editorial Board acknowledges the authors' transparency regarding the text-level limitations of selfreported data, a study published in a peer-reviewed oncology journal that reports a “Clinical Benefit Ratio of 84.4%” and specific percentages of “tumor regression” must rest on a verifiably real clinical foundation and adhere to established ethical frameworks for human subject research to maintain its validity in the permanent scholarly record. Anticancer Research does not endorse or condone the unvalidated off-label use of medications for unapproved oncological indications. Disclosing limitations does not exempt a clinical dataset from the foundational scientific requirements of empirical verifiability and independent ethical oversight. Accordingly, based on the authors' confirmation of an established clinical provider-patient workflow, the journal is initiating a formal Post-Publication Data Integrity and Ethical Oversight Audit. This investigation will evaluate the mandatory Institutional Review Board (IRB) approval or exemption documentation, the de-identified, source-verified clinical records confirming the baseline cancer diagnoses of the 197 initial participants and the objective medical documentation supporting the reported anatomical regressions. This Expression of Concern will remain prominently appended to the publication record online and in all indexing databases while this formal data and ethical verification audit is underway.
Management of cryptoglandular anal fistula is characterised by wide variation in diagnostic strategies, surgical techniques and outcome reporting, limiting comparison between studies and hindering evidence-based guideline development. This study aims to implement a standardised core outcome measurement set within a large international observational framework and to evaluate the feasibility of a scalable digitally supported model for global collaborative surgical research. Cryptoglandular anal fistula treatment is a prospective, international, multicentre observational study comprising two components: a short-term audit capturing clinician-reported outcomes at 3 months and a long-term cohort capturing clinician- and patient-reported outcomes over twelve months. Adults undergoing surgery for primary or recurrent cryptoglandular anal fistula are eligible, excluding non-cryptoglandular aetiologies. Data are collected using secure electronic case report forms and digitally administered patient-reported outcome measures, with paper alternatives available where required. Outcomes are defined according to the Anal Fistula Core Outcome Measurement Set and include clinical and radiological healing, recurrence, complications, reintervention, development of additional fistulas, symptoms, psychological impact of treatment, continence, quality of life and additionally work productivity. The study was designed around a predefined nine-step framework, including multidisciplinary coordination, central ethical approval to support local submissions, artificial intelligence-assisted translation of study materials with native review and implementation of secure digital data capture systems. Based on previous European Society of Coloproctology studies and expected centre volumes, the audit arm aims to include approximately 1000 patients and the cohort arm 500 to 750 patients. Central ethical approval has been obtained from the Medical Ethics Review Committee of the Maastricht University Medical Centre+ under METC 2024-0374 (audit arm) and METC 2024-0361 (cohort arm) with local approvals or waivers secured in participating countries according to national regulations. Written informed consent is obtained for cohort participation. Results will be disseminated through peer-reviewed publications and international conferences, with the aim of informing future guideline development and supporting patient-centred care in cryptoglandular anal fistula management.
Uterine fibroids remain one of the most common benign tumors of the female reproductive system and a significant cause of menorrhagia, pain, symptoms of pelvic organ compression, and a reduced quality of life. Due to the limitations of surgical methods, organ-preserving and minimally invasive technologies are attracting increasing interest, including MRI-guided focused ultrasound ablation (FUS-MRI). To evaluate the immediate imaging efficacy, early morphological response, and safety of FUS-MRI in the treatment of uterine fibroids based on the non-perfused volume ratio (NPVR) and 3-month changes in fibroid volume. A prospective, single-center study was conducted involving 120 female patients with symptomatic uterine fibroids who underwent FUS-MRI ablation between December 20, 2019, and October 7, 2024. We analyzed clinical characteristics, morphological and MRI parameters of the target lesion, technical characteristics of the procedure, immediate post-procedural effects, and safety indicators. Efficacy was assessed based on contrast-enhanced MRI data immediately after the procedure, with determination of NPVR (%), as well as by changes in the volume of the target lesion at 3 months. Safety was assessed based on data from the registry and medical records. The mean age of the patients was 47.3±6.1 years. The most common complaints were bladder pressure (49.2%), dysmenorrhea (24.2%), and menorrhagia (20.8%). The median NPVR was 80% (IQR 48-90), and the mean was 68.2±29.2%. An NPVR threshold of ≥60% was reached in 71.7% of patients, ≥70% in 61.7%, ≥80% in 54.2%, ≥90% in 38.3%. Median NPVR values were numerically higher in hypointense and isointense nodules than in hyperintense nodules; however, the overall between-group comparison did not reach statistical significance (Kruskal-Wallis test, p=0.532). After 3 months, the median reduction in the volume of the index nodule was 2.32% (IQR 1.29-3.69), with a mean of 2.96±2.80%. No serious complications requiring invasive intervention, emergency hospitalization, or referral for surgical treatment were reported. In a single-center setting, FUS-MRI demonstrated high immediate post-procedural imaging efficacy and a favorable safety profile. T2-weighted MRI characteristics of the lesion showed a numerical association with NPVR in the present cohort, although the between-group differences were not statistically significant and should be interpreted cautiously.
Cancer care in Palestine operates within a health system constrained by occupation, movement restrictions, resource scarcity, and chronic instability. These conditions fragment service delivery and create major inequities. This study foregrounds the roles, challenges, and ethical responsibilities of oncology and palliative care nurses across the cancer care continuum, and examines how political instability, blockade, and health system fragmentation shape access to care and nurses' capacity to sustain services under profound constraint. A hybrid methodology combined a comprehensive review of peer-reviewed and grey literature with situational and experiential insights from Palestinian and international nurses working across oncology and palliative care. This triangulated approach enabled an in-depth understanding of systemic barriers and facilitators across the continuum of care. Substantial inequities were identified at every stage of the cancer pathway. Prevention and early detection are constrained by stigma, limited health promotion, and minimal screening. Fragmented referral systems disrupt continuity of care. Diagnostic and treatment capacity is undermined by shortages of medicines, equipment, and specialized staff. Urban-centered services with movement restrictions, especially for patients in Gaza, make care extremely challenging. Nurses emerged as pivotal in sustaining patient education, psychosocial support, and care coordination despite resource scarcity and significant moral distress. Cancer care in Palestine is severely limited by structural, political, and resource-related factors. Nevertheless, nurses' adaptability and commitment remain central to sustaining oncology services. Strengthening cancer care requires embedding nursing leadership within national cancer strategies, expanding training, and integrating supportive care into routine pathways.
Following the publication of the above paper, it was drawn to the Editor's attention by a concerned reader that, regarding the western blot analyses shown in Fig. 2A and B on p. 179, the control β‑actin blots in Fig. 2A were very similar to a section of the control blots in Fig. 2B, albeit with some horizontal and vertical resizing of the bands in question, even though the affected lanes of the gel highlighted different experimental treatments. The authors were contacted by the Editorial Office to offer an explanation for this apparent anomaly in the presentation of the data in this paper, and we are awaiting their response. Owing to the fact that the Editorial Office has been made aware of potential issues surrounding the scientific integrity of this paper, we are issuing an Expression of Concern to notify readers of this potential problem while the Editorial Office continues to investigate this matter further. [International Journal of Oncology 32: 177‑184, 2008; DOI: 10.3892/ijo.32.1.177].
Radiation oncology has long paired precision with compassion, technical excellence with daily human connection. Integrative oncology extends that legacy, advancing a shift from reactive symptom management to proactive, coordinated care; from fragmented referrals to integrated pathways; and from isolated pilot efforts to implementation-ready science. In this volume of Seminars in Radiation Oncology international experts reflect on the collective toolbelt of integrative oncology, the maturation of the science, and the exciting opportunity before us in radiation oncology. By integrating complementary approaches alongside conventional treatment, integrative oncology seeks to improve symptom control, functional outcomes, treatment adherence, and quality of life, with emerging evidence supporting benefits in disease-free and overall survival in select settings. Integrative approaches include nutrition and the microbiome, physical activity, mind-body and nature-based interventions, acupuncture and East Asian medicine, Ayurveda, massage and manual therapy, yoga, tai chi, qi gong, music therapy, stress management, sleep medicine, herbs and supplements, psycho-oncology, and supportive care. Across this collection, three central themes emerge: (a) patient-centered care targeting symptoms that matter most to patients and caregivers; (b) data-driven practice grounded in clinical trials, guidelines, and mechanistic science; and (c) operational compatibility with radiation oncology workflows. We hope readers leave with two clear outcomes: practical integrative strategies applicable to patients beginning radiation therapy tomorrow, and a sharper understanding of the research and systems infrastructure required to make integrative oncology a standard and equitable component of care. The work presented here signals a structural evolution -aligning tumor control and survival with symptom science, biologic insight, and whole-person care. In doing so, radiation oncology is uniquely positioned not merely to participate in, but to lead the redefinition of integrative cancer care for the decades ahead.
Following the publication of the above paper, it was drawn to the Editor's attention by a concerned reader that, for the immunocytochemical and immunohistochemical experiments shown in Fig. 5A‑C on p. 815, several of the data panels exhibited overlapping sections, such that the data shown in the affected panels had all apparently been derived from the same original sources. Owing to the large number of duplications of data that were identified in this paper, the Editor of International Journal of Oncology has decided that it should be retracted from the Journal on account of a lack of confidence in the presented data. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [International Journal of Oncology 36: 809‑816, 2010; DOI: 10.3892/ijo_00000557].
Following the publication of the above paper, it was drawn to the Editor's attention by a concerned reader that Fig. 1, showing that the downregulation of SEMA5A in lung adenocarcinoma tissues is associated with poor overall survival, was strikingly similar to a figure that had previously appeared in an article by Dan Wang and colleagues in American Journal of BioMedicine in 2014 (doi: 10.18081/2333‑5106/014‑03/292‑305). Upon receiving notification of this issue, the authors identified that Fig. 1, as shown, had been included in this paper erroneously, and requested that a corrigendum be published, featuring the correct data for Fig. 1. However, after carefully considering the matter, the Editor of International Journal of Oncology has decided that this paper should instead be retracted from the Journal on account of a lack of confidence in the presented data. The Editor apologizes to the readership for any inconvenience caused. [International Journal of Oncology 56: 165‑177, 2020; DOI: 10.3892/ijo.2019.4932].
Cancer patients are at increased risk for suicidal crises, making suicide prevention a pertinent issue for clinical practice. However, international research suggests that healthcare providers are anxious and, for example, do not actively inquire about suicidality. Such avoidance does not follow expert recommendations and puts patients at risk. First international investigations have reported diverse barriers standing in the way of the recommended clinical care. The present study aimed to expand this investigation to the German context. A preregistered qualitative study following a semi-structured interview guide was conducted with healthcare professionals (HCPs) (N = 20) working in the oncological setting. The interviews were transcribed and analyzed using qualitative content analysis, following an explorative theory-generating approach. The main result was a category system giving insight into both barriers and resources HCPs experienced concerning suicide prevention in their practice. Barriers comprised structural (e.g., scarcity of resources) and personal ones (e.g., lack of knowledge, difficult feelings). Resources were distinguished into work-related support, self-efficacy and skills, and private life/after work as an important equalizer. Along with the mentioned personal and structural dimensions, HCPs also highlighted possibilities for improvement. The results provide an important basis for the development of needs-based solutions to strengthen suicide prevention in oncology. The study highlights that this can be achieved by both individual-level interventions (e.g., specific training) as well as organization-level changes (e.g., better implementation of standard operating procedures and shared responsibility). Addressing the reported shortcomings will support practitioners and improve clinical practice for patients. In-depth qualitative interviews with oncology practitioners on suicide preventionBarriers to suicide prevention/exploration pertain on a structural/personal levelPossibilities for improvement concern practical changes and strengthening resources.
Pelvic exenteration (PE) has evolved from a palliative "procedure of desperation" into a potentially curative operation for selected patients with locally advanced or recurrent pelvic malignancy. Christchurch Hospital has delivered PE for more than three decades and has been an active contributor to the international development of these procedures. Retrospective description of the Christchurch PE programme and its evolution since the mid‑1990s, contextualised against contemporary multicentre evidence, is provided. Service components evaluated include multidisciplinary governance, patient selection, operative strategies for posterior and lateral compartment disease (including sacrectomy), peri‑operative optimisation and survivorship pathways. Since 1995, Christchurch has undertaken over 520 multivisceral pelvic resections. Centralisation of complex patient care supports operative volume, consistency of team performance and benchmarking against international standards. Prospective audits with collaborative international research have strengthened the understanding of what drives good oncological outcomes (particularly the impact of R0 resection), as well as morbidity patterns in high‑risk sub-groups, feasibility of repeat PE and patient‑reported outcomes including quality of life. A centralised multidisciplinary programme can safely deliver ultra‑complex pelvic oncology surgery. Continued international collaboration and systematic capture of patient‑reported outcomes will define the next phase of PE service development.
Childhood cancer survival and stage at diagnosis vary internationally. Here, we explore differences in child health surveillance and healthcare practices across countries participating in the International Benchmarking of Childhood Cancer Survival by Stage (BENCHISTA) collaboration-with a focus on timely cancer diagnosis. We conducted a scoping review of five databases (MEDLINE, Embase, SCOPUS, Web of Science, and ProQuest Central) for articles published in English or Spanish between 1 Jan 2012 and 15 Oct 2025, describing child health surveillance and acute care pathways, limited to the 29 countries involved in the BENCHISTA collaboration. Two reviewers independently screened abstracts; a third resolved conflicts. In parallel, a semi-structured questionnaire was distributed (to one general practitioner, one paediatrician) in 27 countries who contributed to the BENCHISTA database. We collected standardised information on national child health practices and validated against published national guidance. Of 2,963 articles screened, 33 were included. Three key themes emerged: (1) healthcare-seeking behaviour of families and their interaction with frontline professionals, (2) awareness of alarm symptoms by caregivers and clinicians, and (3) system-level and training-related factors affecting timely diagnosis. Studies highlighted challenges such as low symptom recognition, variation in paediatric training, and limited referral guidance. Questionnaire responses showed variation in the number of routine child health checks with physical examination for children < 5 years (median 10; range 2-21), paediatric training, and access to diagnostic tools.  There is substantial international variation in routine child health surveillance and acute illness assessment. These findings will inform interpretation of BENCHISTA data and may guide future strategies to support early cancer diagnosis. • Childhood cancer survival and stage at diagnosis vary internationally. • Early recognition of alarm symptoms is critical but often delayed due to system-level gaps. • This study combines a scoping literature review and clinician survey across 27 countries, identifying shared barriers to timely diagnosis. • It reveals variation in paediatric training of front-line healthcare practitioners, referral pathways, and child health surveillance practices, even among high-income countries.
Hand-foot syndrome (HFS) is a common side effect of chemotherapy drugs such as 5-fluorouracil and capecitabine, impairing daily function and quality of life. This study aimed to compare international clinical guidelines regarding assessment and management of HFS to identify areas of consensus and divergence and evidence gaps. Guidelines were identified through PubMed (from inception to February 2025), with a supplementary search on Google. Only the most recent versions of English guidelines were included. Data extraction focused on the guideline methodology and recommendations on the prevention, assessment, and management of HFS. Each guideline was critically appraised using the AGREE II checklist. Six guidelines were identified authored by the following cancer agencies: British Columbia Cancer (BCC), European Society of Medical Oncology (ESMO), Cancer Institute NSW (eviQ), Oncology Nursing Society (ONS), United Kingdom Oncology Nursing Society and Acute Oncology (UKONS AO), and United Kingdom North Cancer Alliance (UKNCA). Regarding prevention, five of six guidelines (83%) advised avoiding chemical and physical stressors to the hands and feet and using alcohol-free moisturizer. Only ESMO, BCC, and eviQ recommended oral celecoxib to prevent capecitabine-induced HFS. ESMO and ONS recommended cooling procedures to prevent taxane-induced HFS. Likewise, BCC and eviQ recommend cooling procedures for all agents. All guidelines except ONS recommended dose suspension with grade 2 or 3 HFS and continuation when resolved or improved. ESMO and BCC recommended topical corticosteroids for grade 1 HFS, ESMO for grade 2 or 3, and eviQ for prophylactic use. Finally, BCC and ESMO suggested to consider oral dexamethasone for PEGylated doxorubicin-induced HFS. While general skin care and dose modification guideline recommendations were consistent, pharmacological recommendations varied. Guidelines are key for healthcare professionals in supporting patients with HFS. Therefore, regular updates with emerging evidence for interventions such as topical diclofenac are needed to ensure the quality of care.
Cervical cancer is still a significant issue, especially in low- and middle-income countries. Adding HPV self-sampling to cervical cancer screening programs could make the process simpler for people to receive essential health care and support universal health coverage. Therefore, this study is aimed at mapping research output, global trends, and collaboration networks related to the implementation of HPV self-sampling in cervical cancer screening programs. A bibliometric, descriptive, and retrospective study was performed, covering the period from 2006 to October 2025. A search was conducted in Scopus, confined to the TITLE-ABS-KEY fields, without language limitations, and restricted to documents in their final publication stage and original research articles. The search syntax used Boolean operators (AND, OR) to combine four thematic blocks: self-sampling/self-collection, etiological agent, cervical screening, and implementation and programmatic delivery. The study examined a number of indicators, such as the volume of research output, the amount of authorship credit per article, the number of normalized citations, the number of citations, the h-index, the g-index, and the m-index. R (RStudio) Version 4.3.1 was used to analyze the data. There were 824 articles published in 268 journals. The number of research papers published each year went up by 14.90%, and each paper received an average of 21.16 citations per year. Each paper had 8.38 coauthors, and 39.56% of the time, the coauthors were from other countries. The United States and Australia became major contributors, working together in dense networks that crossed continents. Editorial dissemination was primarily found in oncology and public health journals, with cocitation patterns connecting clinical and public health areas. The authorship distribution mirrored Lotka's pattern, with 71.90% of authors contributing a single article and 4.10% producing five or more. The focus shifted from cytology and acceptability to molecular testing and self-sampling from 2006 to 2011. From 2012 to 2016, the focus was more on equity and digital support tools along the screening pathway. The focus on sociocultural issues got stronger between 2017 and 2019. From 2020 to 2025, the literature began to emphasize clinical outcomes, HPV-16, populations living with HIV, and programmatic implementation, including the collection of urine samples. Research on HPV self-sampling is expanding, although it remains geographically concentrated. International collaboration is substantial, and the thematic focus has shifted toward programmatic implementation in higher-risk populations, with increasing emphasis on equity and digital support. These patterns underscore the need for stronger translational partnerships led by stakeholders in high-burden settings and supported by open science practices to reduce geographic disparities and inform context-sensitive public policies.
Anthropometry regarding muscle and fat is related to the mortality and quality of life in patients with cancer. We evaluated the role of muscle (hand grip strength, HGS) and fat (triceps skinfold thickness, TSF) in survival and quality of life among patients with cancer. The study included 15,788 (53.9% men) patients with cancer from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers Project of China. Outcomes included survival and health-related quality of life (QoL). Statistical analysis was performed using a maximally selected rank statistical method for sex-specific cutoff values. Cox analysis and Kaplan-Meier curves were used for survival analysis, and one-way ANOVA trend testing was used for quality of life. The patients' mean age was 57.25 ± 11.66 years. High TSF (adjusted HR = 0.77, 95% CI = 0.72-0.81, P < 0.001) and high HGS (adjusted HR = 0.72, 95% CI = 0.68-0.76, P < 0.001) were positively associated with survival. Patients with high TSF and low HGS (adjusted HR = 0.61, 95% CI = 0.54-0.68, P < 0.001) had better survival than patients with low TSF and high HGS (adjusted HR = 0.73, 95% CI = 0.67-0.78, P < 0.001). The quality of life of patients with high TSF and low HGS was also better than that of patients with low TSF and high HGS. The results were consistent in subgroup analyses of men and women and in sensitivity analyses that excluded patients who died within 6 months. TSF and HGS are positively associated with survival and quality of life. Considering the differences in TSF and HGS between men and women, fat mass is a better indicator of patients' survival and quality of life than muscle function.