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At least 19 recordsLinked to original sources
PubMed2026

Clinical Validation of a Multiplex Urine Biomarker Assay for Surveillance of Recurrent Bladder Cancer.

PURPOSE: More than 50% of patients with non-muscle-invasive bladder cancer experience recurrence, requiring lifelong surveillance with repeated cystoscopy. Given the invasive nature and cost of cystoscopy, accurate noninvasive tools are needed to support risk-adapted monitoring. We evaluated the ability of Oncuria-Monitor, a multiplex urine biomarker assay, to detect recurrent bladder cancer during surveillance. PATIENTS AND METHODS: Between February 2017 and August 2020, six medical centers in the United States and Japan prospectively enrolled 300 patients with a history of bladder cancer, generating 1,248 serial urine samples. Participants were divided into training and validation cohorts. At each surveillance visit over 2 years, urine samples were analyzed in a blinded manner using Oncuria-Monitor and BladderChek, alongside urine cytology. Test performance was compared with cystoscopy and histopathology-confirmed recurrence. RESULTS: Recurrent bladder cancer was identified in 31% (93/300) of participants, with 143 total recurrences during follow-up, including 90 tumors in the validation cohort. In the validation cohort, Oncuria-Monitor achieved a sensitivity of 85.6% [95% confidence interval (CI), 78.1%-92.2%] and a negative predictive value (NPV) of 93% (95% CI, 89.2%-96.4%). In comparison, BladderChek demonstrated a sensitivity of 20.0% and an NPV of 88%, whereas urine cytology showed a sensitivity of 36.9% and an NPV of 91.6%. The number needed to evaluate to detect one recurrence was 3 for both cystoscopy and Oncuria-Monitor, compared with 15 for BladderChek and 8 for cytology. CONCLUSIONS: In this large prospective longitudinal study, Oncuria-Monitor demonstrated clinically actionable performance, enabling a rule-out strategy that could safely reduce cystoscopy in approximately 25% of surveillance visits. These findings support a paradigm shift toward biomarker-guided, risk-adapted surveillance in bladder cancer that reduces unnecessary invasive procedures while maintaining oncologic safety.

Humans↗
PubMed2026

Nonmuscle-Invasive Recurrence and Management During Surveillance in Patients with Muscle-Invasive Bladder Cancer Who Achieve Clinical Complete Response to Neoadjuvant Chemotherapy.

PURPOSE: Many patients are medically unfit for or refuse radical cystectomy. Few postchemotherapy bladder-sparing active surveillance programs have reported on nonmuscle-invasive recurrences and treatment outcomes. In this study, we present data on nonmuscle-invasive recurrences and their management in this population. MATERIALS AND METHODS: This is a retrospective review of a prospectively maintained database. All patients received cisplatin-based neoadjuvant chemotherapy and were determined to have a clinical complete response (cCR) based on negative endoscopic resection, urine cytology, and cross-sectional imaging. Patient data were entered into a strict active surveillance protocol. Primary outcomes of interest were number of nonmuscle-invasive recurrences, grade and stage, and treatment. Secondary outcomes of interest were nonmuscle-invasive treatment response rate and muscle-invasive and metastatic recurrence rate. RESULTS: A total of 61 cCR patients were identified. In total, 28 patients experienced a median of 1 nonmuscle-invasive recurrence over a median follow-up of 28.3 months. There were a total of 46 nonmuscle-invasive recurrences, including 9 (20%) low-grade recurrences and 37 (80%) high-grade recurrences. Of the 37 high-grade recurrences, the majority (60%) were treated with Bacillus Calmette-Guérin induction. Nonmuscle-invasive recurrence was not associated with later muscle-invasive recurrence or metastasis. Genomic analysis of paired tumor samples demonstrated clonal relatedness in one patient sample while another sample demonstrated a likely precancerous urothelial field effect. CONCLUSIONS: There is a high rate of nonmuscle-invasive recurrences in patients who achieve cCR to neoadjuvant chemotherapy. However, most of these patients may be safely managed with bladder-preserving treatments. These findings emphasize the importance of vigilant surveillance protocols and appropriate patient selection.

bladder cancer↗
PubMed2026

Long-Term Survey to Assess Recurrence and Complications of Surgically Treated Pleomorphic Adenoma.

OBJECTIVE(S): To (1) report on the long-term recurrence rate of surgically managed pleomorphic adenoma (PA) and (2) assess long-term surgical outcomes after parotidectomyMethods:Cross-sectional survey of all patients with a pathologic diagnosis of PA who underwent surgical management in a tertiary care center from 01/1997 to 12/2023 and had access to an electronic patient portal. Surveys were delivered via electronic patient portal or phone call with 6 questions to assess recurrence and long-term surgical outcomes. Time to first recurrence and recurrence free survival were analyzed using a Kaplan-Meier curve. RESULTS: Seven hundred-forty-five patients met inclusion criteria and received the survey, with a 56% response rate (n&#x2009;=&#x2009;420). The clinical median follow-up length was 51&#x2009;days, which extended to a median length of 6.2&#x2009;years following the survey. The median change in follow-up length was 5.37&#x2009;years (P&#x2009;<&#x2009;.001). The recurrence rate was 1% at 5&#x2009;years, with a median time to first recurrence of 7.54&#x2009;years. 13% and 9% of responders reported facial asymmetry and incisional cosmetic concerns, respectively. 33% of patients reported experiencing Frey syndrome, which increased from 5.2% of survey responders with documented Frey syndrome at their original post-operative assessment. CONCLUSION: Long-term assessment of PA outcomes confirms low recurrence rates, suggesting regular surveillance of recurrence is likely unnecessary. Complaints of Frey syndrome increased in frequency with longer term follow-up, which should be considered during patient counseling. LEVEL OF EVIDENCE: 3.

Humans↗
PubMed1977

[Therapy of recurrent herpes simplex and its surveillance by MIF determination: with levamisole, BCG, urushiol and herpes antigen vaccine (author's transl)].

Thirty patients with recurrent herpes simplex and 6 controls were included in our study. Before initiation of treatment, during therapy with Levamisole, BCG, poison ivy and herpes antigen vaccine and, thereafter, MIF-determinations were performed. The latter test proved to be a useful parameter in evaluating the sensitivity against herpes infection, (and subsequent recurrent manifestations), and effect of therapy. Treatment with Levamisole, BCG and herpes antigen vaccine was successful. MIF-inhibition values paralleled the therapeutic effect in the Levamisole- and herpes antigen vaccine treated group, not however, in the BCG-treated patients

Antigens, Viral↗
PubMed2026

A stratified urine-based molecular diagnostic and prognostic model for non-muscle-invasive bladder cancer management.

BACKGROUND: Non-muscle-invasive bladder cancer (NMIBC) is characterized by a high recurrence rate requiring lifelong cystoscopic surveillance. Existing urine-based molecular assays mainly rely on mutations or methylation, which fail to capture large-scale genomic instability. Copy number variation (CNV) profiling offers complementary information on tumor evolution and aggressiveness, but its application in urinary diagnosis remains limited. We aimed to integrate CNV and DNA methylation signals from urinary DNA to establish a noninvasive and biologically informed stratified diagnostic model for NMIBC recurrence surveillance and risk stratification. METHODS: Urine samples were prospectively collected from 91 patients (75 evaluable) between June 2021 and August 2023. Shallow whole-genome sequencing (sWGS) was used to detect CNVs at chromosomal arm and focal gene levels, while ONECUT2 promoter methylation was quantified by qPCR. Diagnostic and prognostic performance was evaluated by ROC analysis, Kaplan-Meier survival, and stratified recurrence assessment. RESULTS: We evaluated a stratified diagnostic model combining CNV and ONECUT2 methylation testing in a cohort of 79 patients. CNV analysis alone showed high specificity (0.923) for NMIBC diagnosis. A combined model, using CNV as an initial screen followed by ONECUT2 methylation testing in CNV-positive cases, achieved a sensitivity of 0.783, specificity of 0.981, and a negative predictive value (NPV) of 0.911. This approach reduced the number of required ONECUT2 tests by 35% and identified a high proportion of true-negative patients (98.1%), which may help reduce unnecessary cystoscopy procedures. The model also demonstrated significant prognostic value, with the molecularly defined high-risk group showing significantly shorter recurrence-free survival (RFS) than the low-risk group (median RFS: 4.33 months vs. not reached; p&#x2009;<&#x2009;0.001). Additional, in patients with initially negative cystoscopy after urine sample collection, the model demonstrated a predictive accuracy of 0.922 for recurrence, with molecular positivity observed a median of 9.6 months prior to clinical diagnosis. CONCLUSIONS: Integrating CNV and DNA methylation profiling from urinary DNA provides a powerful and noninvasive molecular framework for NMIBC surveillance. By combining early epigenetic changes with genomic instability signals, this approach enhances recurrence risk assessment and enables earlier detection compared with conventional cystoscopy. It offers a practical route toward personalized and adaptive post-treatment monitoring of NMIBC. TRIAL REGISTRATION: NCT04994197.

Humans↗
PubMed1977

Short-term versus continuous antimicrobial therapy for asymptomatic bacteriuria in pregnancy.

Asymptomatic bacteriuria was identified in 300 pregnant women prior to the 28th week of gestation. In one group of 200 women short-term treatment with either nitrofurantoin or sulfamethizole was given for 14 days, and in another group of 100 women continuous therapy with one of these drugs was given for the remainder of gestation. Weekly urine cultures were obtained from all the women. Of the women treated with short-term therapy, 65% were abacteriuric for the remainder of pregnancy following one course of therapy, 24% became abacteriuric but subsequently relapsed, 2% had reinfection after becoming abacteriuric, and 9% demonstrated no response. Following treatment with a second course of short-term therapy, another 19% of these women were cured for the remainder of their pregnancy, and 3.5% responded to a third course. In the continuous therapy group, 88% of the women became abacteriuric for the remainder of the gestation, 3% demonstrated relapse, 2% developed reinfection, and 7% had no response to the first drug given. These data demonstrate that short-term administration of antimicrobials, when combined with surveillance for recurrent bacteriuria, is effective for the management of the pregnant woman with asymptomatic bacteriuria.

Bacteriuria↗
PubMed1978

Carcinoembryonic antigen follow-up and selection of patients for second-look operation in management of gastrointestinal carcinoma.

A long-term postoperative carcinoembryonic antigen (CEA) follow-up study is carried out with patients having undergone primary resection of histologically proved adenocarcinomas of the gastrointestinal tract. Up to now, 122 patients who underwent curative resections, as judged from the situs and the results of histologic examinations, were followed up for tumor recurrence by computerized CEA surveillance diagrams and clinical diagnostic methods. In the cases of tumor recurrence the rise of the CEA level preceded a positive clinical diagnosis by a mean of 4 months. On the basis of the CEA time course, we selected 28 patients for second-look surgery. In all cases proof of recurrence of the disease was obtained. A local recurrence correlating with a slow CEA rise was generally resectable, metastases correlating with a rapid CEA rise were only in some cases resectable, provided that second-look surgery was carried out without delay.

Adenocarcinoma↗
PubMed1975

Patterns of Plasmodium vivax recurrence in a high-incidence coastal area of El Salvador, C. A.

During field studies carried out in 1971, 1972 and 1973 in a highly malarious coastal area of El Salvador, it was possible to collect information on the patterns of Plasmodium vivax parasite occurrence in a large number of infected individuals. In most of the persons who had experienced a malaria attack during the high transmission period in June, July, August and September, renewed activity occurred 5 to 8 months later, during the low transmission season the next year. Subsequent activity in these same cases occurred after intervals of about 4 to 9 weeks in duration. On epidemiologic grounds, and on the basis of the life patterns of the El Salvador P. vivax strains demonstrated in previous studies in volunteers, this renewal of activity probably represents the occurrence of relapses rather than new infections. This pattern is similar to the "temperature zone" strains of P. vivax, where initial relapses occur after prolonged periods, followed by subsequent relapses after much shorter intervals of inactivity. This type of relapse pattern in a tropical area may enhance the survival of the parasite through a prolonged period of vector inactivity, such as the long dry season experienced in El Salvador.

Blood↗
PubMed2026

From detection to action: ctDNA-MRD surveillance and translational strategies in early breast cancer.

Recurrence remains a major cause of mortality in early breast cancer (EBC), and conventional follow-up often identifies relapse only after clinically detectable disease has emerged. Circulating tumor DNA-based minimal residual disease (ctDNA-MRD) testing offers the possibility of detecting molecular relapse earlier and refining recurrence-risk assessment during follow-up. This narrative review examines the evolving role of ctDNA-MRD in EBC, focusing on assay interpretation, longitudinal surveillance, MRD-guided trial design, and clinical implementation. Prospective studies consistently show that postoperative or surveillance ctDNA positivity is associated with an increased risk of recurrence. However, test performance and interpretation vary with assay characteristics and sampling strategies, and whether treatment initiated solely on the basis of MRD positivity can improve patient outcomes remains unresolved. The central challenge is no longer simply to detect residual disease earlier, but to determine when and how that information should influence care. Further prospective validation, assay standardization, clear pathways for uncertain findings, and patient-centered implementation will be needed before ctDNA-MRD can be integrated into routine management of EBC.

circulating tumor DNA↗
PubMed2026

Recent Advances in Surveillance Strategies for Nasopharyngeal Carcinoma.

PURPOSE OF REVIEW: Nasopharyngeal carcinoma (NPC) is a malignant tumor characterized by a distinct geographical distribution. Effective surveillance is crucial for the early detection of recurrence or metastasis and for improving patient prognosis.This review systematically examines current NPC follow-up protocols and recent developments to inform individualized precision surveillance. RECENT FINDINGS: This review focuses on two main aspects. 1) We compare and analyze current major NPC follow-up guidelines, with key discussions covering follow-up frequency, imaging modalities (including magnetic resonance imaging [MRI] and positron emission tomography [PET]), plasma Epstein-Barr virus DNA (EBV-DNA) monitoring, and functional assessments. 2)We elaborate on the application prospects and research progress of genomics, radiomics, and artificial intelligence in NPC surveillance. Studies suggest that risk-stratified, individualized follow-up strategies, such as those based on conditional survival models, can enhance the cost-effectiveness of surveillance. Additionally, emerging technologies, including radiomics and artificial intelligence, show promise for improving recurrence risk assessment, prognostic stratification, and individualized surveillance in NPC. Concurrently, advances in genomics and radiomics offer new opportunities for predicting complications and guiding treatment adjustments. Future efforts should focus on integrating multidisciplinary expertise to develop dynamic monitoring systems that enable precise follow-up and ultimately improve patient survival outcomes.

Humans↗
PubMed2026

Genomic Landscape of 6597 Hong Kong HBOC Patients: Implications for Beyond-BRCA Multi-Gene Panel Testing and Cancer Surveillance.

Breast cancer remains highly prevalent, where the lifetime risk before age 75 is one in 13. However, known genetic factors were only identified in 14.7% of cases in our Hong Kong Hereditary Breast Cancer Family Registry. Our current local policy for genetic testing does not cover the detection of beyond BRCA1/2. Here we highlight the clinical value of extending testing to beyond BRCA susceptibility genes for improved prevention, diagnosis, and management. We recruited 6597 hereditary breast and ovarian cancer (HBOC) patients from our registry based on family history and clinical criteria. Germline mutations were identified by multi-gene sequencing analysis using next-generation sequencing (NGS). Clinical-pathological characteristics of BRCA and beyond BRCA carriers were compared and the real-world management and surveillance services adopted in Hong Kong were highlighted. In this multi-gene hereditary cancer cohort, germline mutations were identified in 10.9% of cases for BRCA1/2 and 3.5% for beyond BRCA susceptibility genes. These beyond BRCA mutations constitute a considerable proportion of actionable hereditary risk. Notably, PALB2 emerged as the most prevalent non-BRCA gene, followed by TP53, ATM, and BARD1. New cancers or recurrences were detected during their surveillance; the overall pick up rates were 8.3% (PALB2), 29.4% (TP53), 33.3% (PTEN) and 5.6% (BARD1). This study provides the first comprehensive characterization of the beyond BRCA germline landscape in a Hong Kong hereditary cancer cohort and highlights the current need for implementing multi-gene sequencing analysis and surveillance services for HBOC patients, establishing the predominant non-BRCA drivers and providing a robust empirical basis for expanding public genetic screening frameworks.

Humans↗
PubMed2024

Extracellular Vesicle- MDM2 -DNA as a Potential Liquid Biopsy Biomarker for Disease Identification in Retroperitoneal Liposarcoma.

OBJECTIVE: We aimed to assess the levels of MDM2 -DNA within extracellular vesicles (EVs) isolated from the serum of retroperitoneal liposarcoma (RLS) patients versus healthy donors, as well as within the same patients at the time of surgery versus postoperative surveillance visits. To determine whether EV- MDM2 may serve as a possible first-ever biomarker of liposarcoma recurrence. BACKGROUND: A hallmark of well-differentiated and dedifferentiated (WD/DD) retroperitoneal liposarcoma is elevated MDM2 due to genome amplification, with recurrence rates of >50% even after complete resection. Imaging technologies frequently cannot resolve recurrent WD/DD-RLS versus postoperative scarring. Early detection of recurrent lesions, for which biomarkers are lacking, would guide surveillance and treatment decisions. METHODS: WD/DD-RLS serum samples were collected both at the time of surgery and during follow-up visits from 42 patients, along with sera from healthy donors (n=14). EVs were isolated, DNA purified, and MDM2 -DNA levels determined through q-PCR analysis. Nonparametric tests were employed to compare EV- MDM2 DNA levels from patients versus the control group, as well as the time of surgery versus postsurgery conditions. RESULTS: EV -MDM2 levels were significantly higher in WD/DD-RLS than controls ( P =0.00085). Moreover, EV- MDM2 levels were remarkably decreased in WD/DD-RLS patients after resection ( P =0.00036), reaching values comparable to control group ( P =0.124). During postoperative surveillance, significant increases of EV- MDM2 were observed in some patients, correlating with computed tomography scan evidence of recurrent or persistent postresection disease. CONCLUSIONS: Serum EV- MDM2 may serve as a potential biomarker of early recurrent or postoperatively persistent WD/DD-RLS, a disease currently lacking such determinants.

Humans↗
PubMed2026

Hepatocellular Carcinoma With JAK1 Mutations Harbors Distinct Histologic Features and Specific Mutational Hotspots in an Asian Cohort.

The pathogenesis and clinicopathological features of hepatocellular carcinoma (HCC) harboring JAK1 mutation have not been reported. Sixty inflammatory hepatocellular adenoma-like HCCs (IHA-like HCCs) and 16 IHAs were analyzed using targeted next-generation sequencing. Nearly all IHA-like HCCs (n=59, 98%) showed positive SAA/CRP expression. Genetic alterations of the JAK/STAT pathway were detected in 35 (58%) IHA-like HCCs, encompassing mutations in JAK1 (n=22), STAT3 (n=8), and IL6ST (n=5). Nine (56%) IHAs harbored mutations in STAT3 (n=3), IL6ST (n=4), GNAS (n=1), and FRK (n=1). All the mutations occurred in a mutually exclusive manner. JAK1 mutations were frequent (22/60, 37%) in IHA-like HCCs. JAK1-mutated IHA-like HCCs displayed distinctive cytologic characteristics, including abundant eosinophilic cytoplasm, vesicular chromatin, and prominent central nucleoli. Recurrent hotspot JAK1 mutations were identified at S703, S729, and L910. Surveillance for JAK1 mutations in the HCC genomics of other cohorts also revealed recurrent mutations at S703, S729, and L910. In particular, the S703 and S729 mutations were strongly associated with the features of Asian ethnicity, presence of chronic viral hepatitis, and hepatic fibrosis/cirrhosis. In conclusion, JAK1 mutations were frequent in HCC with IHA-like morphology in an Asian cohort. JAK1 mutation exhibited recurrent and specific hotspot mutations at S703, S729, and L910 in HCC. Patients diagnosed with JAK1-mutated HCC may be eligible for JAK-targeted molecular therapy.

JAK therapeutics↗
PubMed1978

[Comparison of the variations in the levels of beta2-microglobulin and carcino-embryonic antigen in the breast cancer and malignant melanoma (author's transl)].

A variety of markers have been used in the surveillance of carcinoma of the breast and malignant melanoma, including carcino-embryonic antigen (CEA) beta2-microglobulin (beta2m) and prolactin. The dual purpose of the surveillance was the detection of early recurrence or metastasis and the monitoring of the treatment. In cancer of the breast 92% of patients having bone metastases have elevated levels of CEA or beta2m. In malignant melanoma 2/3 of the patients in relapse have elevated beta2m levels.

Beta-Globulins↗
PubMed2026

Nucleic acid amplification testing and genome sequencing for WHO priority viruses in Africa: a scoping review.

Emerging viruses continue to pose serious public health threats across Africa, with recurrent outbreaks exposing gaps in diagnostics and surveillance systems. Nucleic acid amplification tests (NAATs) and genome sequencing are increasingly important for diagnostics and outbreak responses; however, their routine implementation is fragmented. This scoping review examines NAATs and genome sequencing technologies for viral detection and surveillance in Africa from 2019 to 2024, mapped to the 2024 updated WHO R&D Blueprint for Epidemics pathogen priority list. We identified 117 studies from 34 African countries reporting applications across 20 virus families, including ten designated as priorities by WHO. PCR-based assays were the most frequently reported NAATs. Illumina platforms predominated sequencing, and Oxford Nanopore Technologies were commonly used in outbreak investigations. Genome sequencing applied to priority viruses was largely reactive. NAAT-capable mobile laboratories were reported in 13 countries. Our findings underscore the need for proactive integration of NAATs into diagnostic and surveillance systems to strengthen decentralised testing, sustain genomic surveillance beyond outbreak periods, and improve early detection and preparedness for viral threats.

Journal Article↗
PubMed1975

[Early recognition of relapse hazards following thyroidectomy using TSH serum level].

The determination of the serum level of TSH, the essential factor in goitrogenesis, was the best indicator in order to recognize imminent recurrence of goitre in strumectomized patients. The functional reserve of the hypothalamic-pituitary system proved to be important: Elevation of basic TSH level and increase of TSH after stimulation with TRH was significantly higher in patients with recurrent goitre. We, therefore, recommend this test for the postoperative surveillance of patients after strumectomy.

Female↗