Osteoarthritis year in review 2024: Epidemiology and therapy.

This "Year in Review" presents a curated selection of research themes and individual studies within the clinical osteoarthritis (OA) field, focusing on epidemiology and therapy. The search was conducted in electronic database MEDLINE from March 4, 2023, to March 31, 2024, specifically targeting English-language articles involving human participants. Inclusions were based on perceived importance and relevance to identifying risk factors or advancing OA treatments. A total of 6539 studies were screened by the 5 authors, resulting in 157 studies considered for potential inclusion. Ultimately, 44 studies were selected, uncovering six key OA-related themes: i) the burden of OA (mostly from Global Burden of Disease studies), ii) pain drivers and trajectories, iii) impacts of sex/gender, iv) OA risk factors, and treatments for v) hand and vi) knee OA. The prevalence of OA continues to rise, particularly affecting women, with unclear distinctions in risk factors and treatment responses between sexes. Associations with atopy were demonstrated in two significant databases. Notably, the authors were particularly interested in recent high-quality methodology randomized controlled trials focusing on hand (methotrexate, denosumab, colchicine, topical betamethasone) and knee OA with conflicting results about stem cell injection. These findings collectively contribute to show the growing burden of OA, but also to help the understanding of OA pathophysiology and inform ongoing efforts to enhance management for people with OA.

Molecular profiling in the management of hepatocellular carcinoma.

PURPOSE OF REVIEW: The purpose of this review is to both summarize the current knowledge of hepatocellular carcinoma molecular biology and to suggest a framework in which to prospectively translate this knowledge into patient care. This is timely as recent guidelines recommend increased use of these technologies to advance personalized liver cancer care. RECENT FINDINGS: The main themes covered here address germline and somatic genetic alterations recently discovered in hepatocellular carcinoma, largely owing to next generation sequencing technologies, and nascent efforts to translate these into contemporary practice. SUMMARY: Early efforts of translating molecular profiling to hepatocellular carcinoma care demonstrate a growing number of potentially actionable alterations. Still lacking are a consensus on what biomarkers and technologies to adopt, at what scale and cost, and how to integrate them most effectively into care.

Impact of skip mediastinal lymph node metastasis on outcomes after resection for primary lung cancer.

OBJECTIVES: Patients with non-small cell lung cancer and nodal disease are a heterogeneous group with varied patterns of disease. The aim of this study was to assess long-term outcomes of patients with skip N2 disease in comparison to those with N1 or non-skip N2 disease. MATERIALS AND METHODS: A retrospective review of 445 patients undergoing anatomical lung resection for primary lung cancer between 2012 and 2019 with post-operative histological confirmation of nodal disease was undertaken. Log rank analysis was used to assess differences in estimated median overall survival according to nodal status. Multivariable Cox regression analysis was performed to determine whether skip N2 disease was independently associated with overall survival. RESULTS: Mean patient age was 67.0 years (standard deviation ± 9.2 years) and 48.1% (n = 214) were male. In total, 20.7% (n = 92) of patients had N1 disease, 32.1% (n = 143) had skip N2 disease and 47.2% (n = 210) had non-skip N2 disease. Post-operative upstaging took place in 33.0% (n = 147) of patients. Median follow-up time was 35 months (interquartile range 14-68 months). Skip N2 patients had significantly longer estimated median overall survival in comparison to their non-skip N2 counterparts (47 months vs 28 months, log rank analysis p = 0.029) and non-skip N2 disease remained independently associated with reduced overall survival after multivariable analysis (hazard ratio 1.421, 95% confidence interval 1.060-1.907, p = 0.019). CONCLUSION: Skip N2 disease is a positive prognostic factor for patients with N2 lung cancer, suggesting that lung cancer staging guidelines should consider separating N2 disease into additional subgroups in order to improve prognostic accuracy.