Restaging of mediastinal lymph nodes plays a crucial role in the multimodal treatment of stage IIIA Non-Small-Cell Lung Cancer (NSCLC). This study aimed to assess the impact of restaging using endobronchial ultrasound (EBUS), endoesophageal ultrasound (EUS), and transcervical extended mediastinal lymphadenectomy (TEMLA) after neoadjuvant chemotherapy (CHT) or chemoradiotherapy (CRT) on the 5-year overall survival (OS) of patients with NSCLC diagnosed with clinical stage IIIA-IIIB and metastatic ipsilateral mediastinal nodes (N2) who underwent radical pulmonary resections. Patients diagnosed with stage IIIA-IIIB NSCLC and N2 mediastinal nodes were included in this study. Restaging of mediastinal lymph nodes was performed using EBUS, EUS, and TEMLA. The patients were divided into two groups based on the restaging method: the TEMLA restaging group and the chest CT scan-only group. The primary outcome measure was the 5-year OS rate, and the secondary outcome measures included median OS and survival percentages. Statistical analysis, including the log-rank test, was conducted to assess the differences between the two groups. The TEMLA restaging group demonstrated significantly better overall survival compared to the chest CT scan-only group (log-rank test, p = 0.02). This was evident through a four-fold increase in median OS (59 vs. 14 months) and a higher 5-year OS rate of 55.9% (95% CI: 40.6–71.1) compared to 25.0% (95% CI: 13.7–36.3) in the chest CT scan-only group (p = 0.003). Invasive restaging of mediastinal lymph nodes improves the selection of patients with stage IIIA-IIIB (N2) NSCLC after neoadjuvant therapy. The use of EBUS, EUS, and TEMLA provides valuable information for identifying patients who may benefit from surgery by identifying N2 to N0-1 downstaging. These findings emphasize the importance of incorporating restaging procedures into the treatment decision-making process for NSCLC patients with mediastinal lymph node involvement.

Objectives: The aim of the study was to compare the diagnostic efficiency between combined endobronchial ultrasound (EBUS)/endoesophageal ultrasound (EUS) and transcervical extended mediastinal lymphadenectomy (TEMLA) for preoperative staging of mediastinal lymph nodes in non-small cell lung cancer (NSCLC). Material and Methods: Between June 2011 and December 2017, a single-institution prospective randomized trial was conducted, and 250 patients with cytologically confirmed NSCLC, clinical stages cI–IIIA, were included. Positron emission tomography/computed tomography (PET/CT) was performed in all patients. After exclusions, 204 patients were randomized into the EBUS/EUS or TEMLA arms. Patients without N2/N3 metastases after mediastinal staging underwent surgery. The diagnostic yield and complication rates of the EBUS/EUS and TEMLA groups were compared. Results: There were 103 patients in the EBUS/EUS group, and N2 metastases were found in nine cases (8.7%). Ninety-four patients underwent surgery; in six cases, previously unsuspected N2 metastases were revealed. One hundred and one patients were randomized to the TEMLA group, which detected N2/N3 metastases in 15 cases (15.1%). Three patients were not operated on due to postoperative complications following TEMLA. Eighty-three patients underwent surgery, and a single N2 metastatic nodule was detected in one case. The diagnostic sensitivity, specificity, accuracy, PPV, and NPV were 94%, 100%, 99%, 100%, and 99% for TEMLA, respectively, and 60%, 100%, 94%, 100%, and 94% for EBUS/EUS, respectively. There was a significant difference in sensitivity (60% vs. 94%) between the EBUS/EUS and TEMLA groups in favor of the TEMLA group. Postoperative complications occurred in 6/101 (6%) patients after TEMLA, while no complications were observed in the EBUS/EUS group. Conclusions: TEMLA demonstrated superior sensitivity for detecting N2/3 disease compared to EBUS/EUS in terms of diagnostic performance for mediastinal staging of cI–IIIA NSCLC. Due to its more invasive nature, TEMLA was associated with a higher number of complications compared with EBUS/EUS.

Introduction: Despite the use of highly specialized irradiation techniques in the treatment of head and neck tumors, it is still impossible to selectively destroy cancer cells without damaging normal structures, including connective tissue cells. Aim: The aim of the study was to analyze the concentration of degradation markers such as collagen type I (carboxyterminal telopeptide of type I collagen; ICTP) and elastin (elastin-derived peptides; EDPs) as well as selected metalloproteinases (MMP-1, MMP-2, MMP-9) in patients with head and neck malignancies undergoing radiotherapy. Material and methods: The test group consisted of 56 men, who underwent radical or palliative radiotherapy. The concentrations of ICTP, EDPs, MMP-1, MMP-2, MMP-9 were determined in three blood samples collected from patients prior to radiotherapy, immediately after its completion and 3 months after the therapy. Results: Both radical and palliative radiotherapy contribute to a significant increase in the concentration of EDPs. At the time of healing of post-irradiation lesions, the level of EDPs was reduced in both groups. The ICTP concentration was not affected by radiotherapy. No significant differences were observed in the concentration of MMP-1 and MMP-2 before and after radiotherapy. Radical radiotherapy caused a statistically significant late reduction in the concentration of MMP-9. The lowest concentrations of MMP-1, MMP-2, MMP-9 in the serum of patients qualified for palliative radiotherapy were recorded in a samples collected three months post-irradiation. Conclusions: The degradation markers of key extracellular matrix structural proteins may be helpful tools in the objective assessment of radiation-induced injuries to the connective tissue.

Background/Objectives: Prostate cancer is one of the most prevalent cancers among men, with a significant proportion progressing to metastatic disease. Traditional treatments for metastatic prostate cancer have primarily been palliative, focusing on symptom relief. However, recent advances in radiotherapy have shown promise in improving outcomes for these patients. Methods: This study presents a modern treatment plan for extensive metastatic prostate cancer. Pre-treatment imaging revealed extensive lymph node metastases and high metabolic activity in the prostate. The treatment regimen included bicalutamide, androgen deprivation therapy with leuprorelin, and six cycles of docetaxel chemotherapy, followed by a targeted radiotherapy regimen aimed at both the primary tumor and metastatic lymph nodes. Results: Following the comprehensive radiotherapy regimen, the patient’s PSA level dropped below the edge of detection, indicating complete biochemical remission. Follow-up imaging and clinical assessments confirmed the absence of active metastatic sites. Conclusions: The findings support the integration of radiotherapy into comprehensive treatment plans for metastatic prostate cancer, demonstrating that radiotherapy can achieve complete remission even in patients with extensive metastatic disease. This suggests a need for re-evaluating traditional approaches and exploring more personalized, multimodal treatment strategies. Enhanced imaging techniques, such as PET/PSMA scans, play a crucial role in accurately targeting metastatic sites, enabling more effective and individualized treatment.

Background: Early cancer detection remains a critical challenge in clinical oncology, requiring further development of innovative diagnostic methods with improved sensitivity and specificity. This study addresses the issue by investigating the potential of exhaled air metabolome analysis, using highly porous carbon material for sample collection, as a promising approach for the early diagnosis of laryngeal cancer. Volatile organic compounds (VOCs) present in exhaled breath are known to reflect underlying metabolic changes. This research explores the feasibility of using VOC-derived metabolomic signatures as non-invasive biomarkers for cancer detection. Methods: The primary objective was to evaluate exhaled air metabolome analysis as a diagnostic tool for individuals at risk of respiratory tract malignancies. The study involved 36 participants, including 13 patients diagnosed with laryngeal cancer and 23 healthy individuals serving as a control group. Breath samples were collected using a highly porous carbon material, selected for its superior sorption properties, enabling efficient capture and stabilization of VOCs. These samples were subsequently analyzed using gas chromatography-mass spectrometry (GC-MS) to identify and compare VOC patterns between the two groups. Results: Preliminary analysis revealed apparent differences in VOC profiles between cancer patients and healthy individuals, with cancer patients exhibiting elevated peak intensities for specific metabolites such as diethyl phthalate, nonadecane, and trimethyl-dodecane. Multivariate analysis using principal component analysis (PCA) demonstrated separation between the two groups, reflecting systematic differences in exhaled VOC signatures. Conclusions: This initial study supports the potential of breath VOC profiling for laryngeal cancer detection, laying the groundwork for further validation and refinement of this diagnostic approach. The use of porous carbon material facilitated efficient VOC capture, supporting its role in non-invasive breath analysis.

Background and Clinical Significance: Femoral neck fracture frequently occurs in the elderly population but may also present in patients diagnosed with primary cancer or bone metastases. A pathological, oligosymptomatic fracture associated with epithelioid haemangioendothelioma (EHE), a rare endothelial cell-derived sarcoma, is uncommon. Case Presentation: A 44-year-old patient underwent biopsy procedures three times (2010, 2012, 2013) for a focal lesion of the left ischium, none confirming its malignant nature. The last biopsy revealed a neoplastic tissue with features of discrete dysplasia. The lesion did not undergo medical follow-up for seven consecutive years. In August 2020, the patient presented with right lower limb pain. A CT scan, PET/CT scan, and biopsy confirmed EHE with spindle/sarcomatous features. In November 2020, chemotherapy (5xADIC) started (PET/CT confirmed a partial response). After its completion in July 2021, bone progression occurred and sirolimus-based therapy was started. After 3 months, a small liver metastasis was visualized on PET/CT, which did not result in the termination of treatment. In December 2021, pamidronate-based antiresorptive therapy was started. Liver metastasis remained stable in follow-up CT scans. Due to pelvic and spinal lesions, the patient was assisted by elbow crutches and underwent radiotherapy, remaining professionally active. The patient did not report any trauma, but in August 2023, a subsequent CT scan revealed a subcapital fracture of the left femoral neck in the fusion phase. Due to pelvic changes and the stable nature of the fracture, surgical treatment was abandoned. Conclusions: An oligosymptomatic femoral neck fracture, not requiring medical intervention is considered a rare complication of bone cancer.