Min Zhang

Frailty and the Survival of Patients With Endometrial Cancer: A Meta‐Analysis

ABSTRACTThe aim of this study is to investigate the association between frailty and overall survival (OS) and progression‐free survival (PFS) in women with endometrial cancer (EC). Frailty is increasingly recognized as a significant predictor of outcomes in cancer patients, yet its impact on survival among EC patients remains unclear. This study is a systematic review and meta‐analysis. PubMed, Embase, and Web of Science from database inception to September 28, 2024 were searched for cohort studies evaluating frailty in relation to survival in EC patients. Inclusion criteria focused on studies reporting hazard ratios (HRs) for OS or PFS, comparing frail versus nonfrail patients. A random‐effects model was applied. Eight cohort studies involving 486,138 women reported the outcome of OS, and 4 of them involving 378 women also reported the outcome of PFS. Frailty was associated with poor OS (HR: 1.78, 95% confidence interval [CI]: 1.56–2.03, p < 0.001) without significant heterogeneity (I2 = 0%). Sensitivity analyses confirmed the stability of this association. Subgroup analyses according to the mean age of the patients, tools for evaluating frailty, follow‐up duration, and study quality score showed consistent results (p for subgroup difference: 0.35–0.98). Four studies indicated a significant association between frailty and worse PFS (HR: 1.91, 95% CI: 1.24–2.95, p = 0.003), also with no heterogeneity (I2 = 0%). The results of the study conclude that frailty is associated with poor survival in EC. Although these findings should be validated in large prospective cohort studies, this meta‐analysis highlights the possible role of frailty assessment in risk stratification and prognostic prediction of patients with EC. No patient or public contribution.

Imaging appearance of ovarian mature teratoma with gliomatosis peritonei

AbstractGliomatosis peritonei (GP), almost exclusively linked to mature or immature ovarian teratoma, is a very rare disease. To the best of our knowledge, reports on the complete clinical course and imaging features of ovarian mature teratoma with GP are extremely rare. We present a case of ovarian mature teratoma with GP in a 9‐year‐old girl admitted to the emergency department for a 2‐month history of a large abdominal mass found accidentally. Carcinoembryonic antigen and cancer antigen 125 levels were elevated. CT scans suggested a large mass with mild enhancement, and an immature teratoma derived from the left ovary with ascites was diagnosed by ultrasound. Subsequently, left ovarian tumor resection and omentectomy were performed, and a solid cystic mass accompanied by massive ascites and numerous white to grayish nodules was identified on the left ovary. The pathology results revealed a mature teratoma with GP. The patient had good postoperative recovery, and her serum tumor marker levels decreased to normal at the 3‐month follow‐up.

Health-related hardiness and influencing factors among cervical cancer radiotherapy patients: A cross-sectional study

Health-Related Hardiness (HRH) is a key psychological resource for adaptive recovery in cancer patients, but evidence remains limited among cervical cancer (CC) patients undergoing radiotherapy. Based on the hardiness model, this study assesses HRH levels in this population and examines its associations with coping styles, perceived social support, and health literacy, aiming to identify key influencing factors and inform targeted psychological support. This cross-sectional study enrolled 230 eligible CC patients via convenience sampling from the radiotherapy department of a tertiary hospital in Northeast China between December 2024 and August 2025. Research instruments included the General Demographic Information questionnaire, Health-Related Hardiness Scale, Medical Coping Modes Questionnaire, Perceived Social Support Scale, and Health Literacy Management Scale. The total HRH score for CC radiotherapy patients was (128 ± 20.04), indicating a moderately low level. Among the HRH dimensions, control had the lowest mean score (3.44 ± 0.77), followed by commitment (3.88 ± 0.79) and challenge (4.05 ± 0.72). Confronting coping styles, perceived social support, and health literacy were positively correlated with HRH, while avoiding and yielding coping styles were negatively correlated. Multiple linear regression analysis identified education level (β = 0.157, p = 0.004), number of children (β =  - 0.134, p = 0.013), number of radiotherapy sessions (β =  - 0.171, p = 0.002), and coping dimensions of confrontation, avoidance, and submission (β = 0.351, p < 0.01; β =  - 0.235, p < 0.01; β =  - 0.145, p = 0.015), perceived social support (β = 0.136, p = 0.021), and health literacy (β = 0.125, p = 0.045) as significant factors influencing HRH, jointly accounting for 41.3% of the total variance. The overall HRH among CC radiotherapy patients remains suboptimal. Healthcare institutions should prioritize fostering patients' positive psychological states and guiding them toward adaptive coping strategies. By improving health literacy and strengthening social support, healthcare providers can enhance patients' HRH, thereby promoting treatment adherence and health outcomes.