Bilateral elective nodal irradiation (ENI) remains standard for treating most head and neck squamous cell carcinomas (HNSCC) but is associated with significant toxicity. Advances in lymphatic mapping, particularly with SPECT/CT-guided sentinel lymph node (SLN) identification, have enabled more personalized radiotherapy strategies. This systematic review evaluates the efficacy and quality-of-life impact of ENI strategies using SPECT/CT-guided SLN mapping. This systematic review, conducted according to PRISMA guidelines, included ten studies published between January 2014 and March 2024, including prospective, retrospective studies, randomized trials, and systematic reviews, examining oncologic outcomes and toxicity in patients undergoing SPECT/CT-guided SLN mapping or individualized ENI. Findings show that in well-lateralized, early stage carcinomas, SPECT/CT-guided ENI safely allows for unilateral treatment in up to 82% of patients, with a low contralateral regional failure rate. This approach significantly reduces radiation exposure to organs at risk and rates of xerostomia, dysphagia, and hypothyroidism, leading to improved quality of life. However, its applicability to advanced or midline tumors remains limited. SPECT/CT-guided SLN mapping and individualized ENI offer a promising, less toxic alternative for selected patients. Further prospective, multicenter, and randomized studies are needed to confirm these benefits and support broader clinical adoption.

Background and objective Recent studies have demonstrated that minimally invasive techniques are a viable alternative to open surgery for the treatment of gastric cancer (GC), providing both intraoperative and postoperative benefits for patients. In addition, preliminary data suggest that laparoscopic gastrectomy (LG) may have morbidity, mortality, and oncologic outcomes comparable to those of the traditional open approach for treating GC. This study aimed to review our institution's experience with totally laparoscopic gastrectomy for the treatment of early- and advanced-stage GC. Methods A retrospective study was conducted to examine the short-term outcomes of LG performed at Attikon University Hospital in Athens between June 2022 and November 2024. We reviewed postoperative complications, surgical margins, the number of resected lymph nodes, estimated blood loss, length of hospital stay, and recurrence rates. Results Fourteen patients with gastric adenocarcinoma were included in the study. The mean operative time was four hours, and blood loss was minimal. The median length of hospital stay was six days. The mean number of harvested lymph nodes was 16. Early postoperative complications occurred in two patients and included delayed gastric emptying and pulmonary infection. There were no postoperative deaths. Conclusions Totally laparoscopic gastrectomy represents a feasible treatment option for gastric malignancy. Our early institutional experience demonstrates the technical feasibility of this approach, with favorable perioperative outcomes and encouraging short-term survival. While the benefits of the laparoscopic approach are well recognized, larger prospective studies with long-term follow-up are required to confirm its oncologic equivalence or superiority over open gastrectomy (OG) in patients with advanced disease.

Background/Objectives: Breast metastases originating from extramammary malignant tumors represent an exceptionally rare clinical entity, particularly in the male population. This study aims to review relevant literature on secondary breast involvement in male patients, focusing on clinical presentation, imaging features, histological and immunohistochemical characteristics and management strategies. To date, no published systematic review focusing on this topic exists in the international literature. Methods: A systematic review of the available literature was conducted through a comprehensive search of the PubMed/MEDLINE database up to December 2025. A total of 376 records were identified, of which 98 articles met the inclusion criteria and were included in the analysis. Results: A total of 192 cases were identified, mainly from case reports and small case series. The mean age was 58 years, with similar distribution between breasts and occasional bilateral involvement. Breast metastases often occurred months to years after the primary tumor (mean 32 months) and typically indicated advanced disease with additional metastases. The most common primary tumors were prostate, lung, and melanoma. Diagnosis relied on biopsy with histological and immunohistochemical evaluation. Management was primarily directed at the underlying systemic disease, while surgery, although frequently performed, contributed mainly to diagnostic confirmation and local disease control. Conclusions: Histological identification and immunohistochemical characterization are crucial in the differential diagnosis between primary breast carcinoma and metastatic disease to the breast. The diagnosis of a metastatic lesion, rather than a primary breast malignancy, alters the therapeutic approach.