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Promoting student’s school engagement is a major goal in our society. The literature has shown that students’ proximal sources of social support can play a fundamental role in facilitating this engagement. The purpose of this study was (1) to compare perceived support from four sources (mother, father, teacher, and peers) as a function of two different middle-school student backgrounds, a priority education area and a privileged area; (2) and (3) to examine the contribution of these main sources of social support, either directly or indirectly (through sense of school belonging) to school engagement; and (4) to test whether perceived social support is more strongly related to school engagement, directly or indirectly, among students from priority education school compared to students from the advantaged area. In all, 623 middle-school students (aged 11–16) from either a privileged or priority education area participated in this study. The results showed that the mother was perceived as providing more support, followed by the father, the teachers, and the peers. Students from the priority education area perceived more support from their teachers than their counterparts from the more privileged area did. A path analysis showed that each source of social support, except for maternal support, contributed to school engagement. Peers and teachers emerged as the best source of support for school engagement, having significant direct effects among students from the priority education area and both direct and indirect (through the sense of school belonging) effects among students from the advantaged area. Peer support also appears to have a double-edged effect on school engagement among students in the priority education area. This study contributes to enlightening the phenomenon of school engagement in adolescence by clarifying the role of social support and the related mediating process. Being perceived as an important source of social support by students is not enough to contribute to their sense of school belonging and school engagement.

Objectives:To determine and evaluate the rate of diplopia after Ahmed glaucoma valve (AGV) implantation surgery.Materials and Methods:The records of patients who underwent AGV implantation in our hospital between the years of 2010 and 2017 were retrospectively reviewed. Patients who were referred to our strabismus department due to binocular diplopia after AGV implantation surgery were included. The details of postoperative day 1, day 7, day 15, and 1 month examinations were recorded. In the postoperative period, the onset time of diplopia complaints, diplopia type, and the presence of diplopia at distance and near fixation were noted. Ocular motility examination and deviation measurements were evaluated.Results:Ten (47%) of 211 patients who underwent AGV implantation in our hospital between 2010 and 2017 met the study inclusion criteria. Six of the 10 patients were men (60%) and 4 were women (40%). The mean age of the patients was 44.5 (34-63) years. Complaints of diplopia developed at a mean of 14.5±12.3 (1-30) days after AGV implantation. The prism measurements of the patients were found to be 8.4±1.4 prism diopters (PD) exotropia and 7.1±8.8 PD hypotropia. While 8 patients had diplopia only at near distance, 2 patients had diplopia at both distance and near. Three patients were treated with prismatic glasses, and their complaints of diplopia recovered spontaneously in 5.11±4.10 months. The other 7 patients were followed up without treatment, and their diplopia complaints resolved spontaneously in 6.11±4.40 months.Conclusion:Although most of the diplopia that develops after AGV implant surgery resolves without treatment, prismatic glasses might be considered as a treatment option in patients whose diplopia affects their daily lives.

INTRODUCTION[|]Duane retraction syndrome (DRS) is a congenital syndrome characterized by limitation in adduction and/or abduction eye movements and narrowing of the palpebral fissure in adduction, and may include globe retraction, upshoot or downshoot. Several systemic abnormalities, syndromes, and additional ocular findings can accompany DRS. This study is an evaluation of eye findings in patients with DRS.[¤]METHODS[|]The records of 632 patients with DRS who were followed up between 1995 and 2016 were reviewed retrospectively. Patients with a follow-up of less than 6 months and patients with a history of eye/cranial trauma or injury were not included in the study. Before the patients were examined, a detailed anamnesis was obtained. Details of the medical records, including additional systemic diseases, were recorded.[¤]RESULTS[|]The average of follow-up time was 45 months (min-max: 6-128 months). There were 255 male and 377 female patients. A total of 34 patients (5.4%) had additional ocular abnormalities. The most frequently observed ocular pathologies associated with DRS were congenital ptosis (n=6, 0.94%) and coloboma of the iris (n=4, 0.63%).[¤]DISCUSSION AND CONCLUSION[|]Most cases of DRS are observed as isolated. However, various ocular and systemic abnormalities and syndromes are associated with DRS. In particular, synkinetic syndromes may frequently be seen alongside DRS. Therefore, a complete ocular examination and anamnesis are crucial in cases with DRS.[¤]

INTRODUCTION[|]Corneal biomechanical changes were also suspected and investigated after some scleral procedures but not after strabismus surgery. In this study we aimed to evaluate corneal biomechanical changes following strabismus procedures.with ocular responce analyser. [¤]METHODS[|]Methods: This study a retrospective case series. Corneal biomechanical properties were assessed using the Ocular Response Analyzer (ORA, Reichert Inc., Depew, New York, USA) before, and 6 months after the surgery in 67 eyes of 67 patients performing strabismus surgery. Preoperative and postoperative changes in corneal hysteresis (CH) and corneal resistance factor (CRF) outcomes were examined. [¤]RESULTS[|]Results: In the study group were divided Group1 and Group2 for the performed surgery. Preoperative and postoperative CRF were showed statistically significant differences in Group 1 and Group 2. In Group 1 at preoperative the mean CH was 11.7 +- 2.4 mmHg and 12.3 +- 2.5 mmHg at postoperative. The differences were not statistically significant in Group1. [¤]DISCUSSION AND CONCLUSION[|]This is the first study aimed at evaluating the corneal biomechanical changes after strabismus surgery. and CRF were found to statistically significance at 6 month after strabismus surgery. [¤]

Congenital scrotal sinuses are extremely rare midline raphe anomalies in children. Quite few cases are published in the literature up to date. Their etiology is unclear but similar to the perineal midline cystic defects it is believed that during the early phases of embryogenesis they could arise from trapped epithelial cells as a result of incomplate closure of epithelial folds. Diagnosis depends on the physical examination and some radiological investigations such as ultrasonography and contrast studies. The preferred treatment is total excision of the sinus structure both for cosmetic reasons and the prevention of probable future complications.

INTRODUCTION[|]The aim of this study was to evaluate the postoperative change in the angle of deviation in patients with partially accommodative esotropia or exotropia who underwent keratorefractive surgery.[¤]METHODS[|]The records of patients with partially accommodative esotropia or exotropia who underwent keratorefractive surgery (small incision lenticule extraction [SMILE], laser in situ keratomileusis [LASIK]) at Beyoglu Eye Training and Research Hospital between January 2017 and June 2017 were retrospectively reviewed. Preoperative and postoperative third month uncorrected and best corrected visual acuity, the angle of deviation in prism diopters, and titmus stereoacuity measurements were compared. Any preoperative strabismus surgery was also recorded.[¤]RESULTS[|]A total of 19 eyes of 11 patients with partially accommodative esodeviation or exodeviation who underwent keratorefractive surgery between January 2017 and June 2017 were included in the study. Eight patients had bilateral surgery and 3 patients had unilateral surgery. The mean age of the patients was 24.9+-5.78 years. Eight patients (72%) were men and 3 (28%) were women. Four patients had esotropia (36%), 5 had exotropia (45%) and 2 (18%) had exophoria. Five patients (45%) underwent a SMILE procedure and 6 patients underwent femtosecond LASIK surgery. No complications occurred preoperatively or postoperatively. One patient (0.9%) had a history of strabismus surgery before the keratorefractive procedure. No significant difference was detected in the ocular alignment and angle of deviation before and after keratorefractive surgery at postoperative third month.[¤]DISCUSSION AND CONCLUSION[|]Refractive surgery seems to be ineffective at providing orthophoria for patients with partially accommodative esodeviation or exodeviation.[¤]

INTRODUCTION[|]In this study we aimed to report our clinical observation and results of surgical treatment in the patients with Vertical retraction syndrome. [¤]METHODS[|]The medical records were analyzed retrospectively and five patients included in this study. Detailed ophthalmological examinations and orthoptic exam were performed patients. All patients were followed at least six months[¤]RESULTS[|]Mean age was 26.8 years. (min: 4 max: 65). In 10 patients, 3 females and 2 males. Family history was positive in 2 patients. All patients had orthophoria end of the surgical treatment.[¤]DISCUSSION AND CONCLUSION[|]Vertical retraction syndrome is a rare disease and a special form of retraction syndrome which eye movement is limited by fibrous band. Imaging was important and the surgical approach is featured in this group patients.[¤]

Objectives: This study aims to present a novel operation method of delivering both vascular protection and strengthening of the muscles, as well as the transposition of the muscles. Methods: The patients' files were scanned retrospectively. All patients underwent a complete eye examination in addition to motility examination, both preoperatively and postoperatively. Patients were followed up at least six months. Pre- and post-operative deviation measurement values were compared statistically. Operation technique: After being exposed and the rectus muscle was freed from the facial structure as far as planned resection amount. 6-0 coated vicryl sutures were then placed through the two sides of the muscle while protecting the blood vessels. Then, each suture was placed close to the muscle insertion and was aimed at transposition side. For example, if the target was to transpose the superior rectus at the temporal side, nasal side suture was placed at temporal edge of muscle insertion, and temporal side suture is placed approximately a tendon width laterally to the insertion. Results: In patients who were planned resection 7 mm and over, the procedure for complete muscle widening transposition was successful. Only 2/3 transpositions could be achieved in four patients who underwent less than 7 mm of strengthening. There was no anterior segment ischemia in three patients who underwent three rectus muscle surgery in the same eye. Conclusion: ‘Sliding shape' design extraocular muscle plication found a simple, safe and effective procedure for patients who needed resection and transposition operation. More patients and longer follow-up are needed to understand the real effectiveness.

INTRODUCTION[|]The aim of this study was to describe the demographic details, features, and clinical management of pediatric patients with Duane retraction syndrome (DRS) type 2.[¤]METHODS[|]A total of 632 charts from patients who were diagnosed with DRS between January 1998 and January 2016 were retrospectively reviewed. DRS type 2 patients who were 1 year were collected. Orthotropia or +-10 prism diopters (PD) at near and distance fixation in primary position with available optical correction at the last visit was considered a satisfactory outcome. [¤]RESULTS[|]There were 5 girls (62.5%) and 3 boys (37.5%). The average age at the first visit was 8.87+-6.70 years (range: 2-18 years). The left eye was affected in 4 patients, the right eye in 3 patients, and 1 patient had bilateral involvement. Amblyopia was detected in 4 patients. Four patients had abnormal head posture (AHP). All of the patients had exotropia (XT). The near deviation angle was 24.75+-16.45 PD (range: 4-60 PD), and the distance deviation angle was 29+-23.12 PD (range: 10-80 PD). Orthotropia/

INTRODUCTION[|]This study is a comparison of the effectiveness of bimedial rectus recession surgery in patients with Down syndrome and those with normal neurological development.[¤]METHODS[|]Records of patients with Down syndrome (age range: 2-17 years) who underwent bimedial rectus recession surgery for esotropia (ET) between April 2005 and April 2016 were reviewed retrospectively. A control group was also selected from age-matched patients with normal neurological development who underwent the same surgical procedure during the period. Ocular alignment was measured with the Krimsky test. Surgical success was defined as within 10 prism diopters (PD) of orthotropia 1 year after surgery. The case and control groups were compared in terms of preoperative and postoperative esodeviation angle at 1-year follow-up, the size of the bimedial rectus recession, and postoperative surgical success.[¤]RESULTS[|]A total of 21 patients with Down syndrome and 42 control subjects were included. The groups did not differ in either preoperative (Down syndrome group: 39.73+-8.47 PD; control group: 37.91+-7.65 PD) or postoperative near deviation angle (Down syndrome group: 5.45+-11.45 PD; control group: 2.36+-7.13 PD) or size of bimedial rectus recession (Down syndrome group: 4.68+-0.40 mm; control group: 4.78+-0.38 mm). Surgical success had been achieved in 15 patients with Down syndrome (80.90%), and in 35 control patients (83.33%) at 1-year follow-up. There was a significant difference between the preoperative and postoperative deviation angles in both groups (p

This report is a description of a new surgical technique for palsy of the superior division of the oculomotor nerve. A 52-year-old female who had previously been operated on for an intracranial tumor described ocular motility restriction. A complete ophthalmological examination revealed elevation deficiency of -4 and accompanying ptosis in the left eye. Botulinum toxin injection was administered, and recession of the inferior rectus muscle, and tucking of the superior rectus following union of the medial and lateral rectus muscles were performed. In our technique, no scleral suture was used during the union of muscles procedure. Postoperatively, elevation improved significantly and hypotropia was fully corrected. In addition to being as effective as the previously described Knapp procedure, our technique is safer and easier.

A male patient was diagnosed with bilateral congenital third nerve palsy when he presented at the clinic for the first time in 2001 at the age of 22 with the complaints of decreased visual acuity in the right eye, exodeviation, and movement disability in the medial, upper, and inner gaze. The right eye was diagnosed with anterior segment ischemia and stem cell deficiency, which had developed after strabismus surgery. Lateral rectus (LR) augmented recession and conjunctival recession were performed in the left eye of the patient in 2001. The clinical follow-up was completed. The patient presented at the clinic again in 2014. In 2015, the left LR was transposed to the medial rectus region after being divided in 2 with a Y-split. The inferior part was passed under the inferior rectus and inferior oblique muscles, and the superior part was passed under the superior rectus and superior oblique muscles. When the patient described reduced vision on the postoperative first day, fundus examination was performed, followed by fundus fluorescein angiography. Optical coherence tomography findings were assessed and posterior scleritis was diagnosed. Medical treatment was planned and the case was closely monitored. Posterior scleritis had resolved at the fourth month after the operation. At the last visit, it was observed that preoperative visual acuity values and orthophoria in the primary position had been achieved.

Objectives: To investigate the results of different surgical techniques for treating cases of dissociated vertical deviation (DVD). Materials and Methods: A retrospective review of medical records was performed, including 94 eyes of 47 patients who had undergone bilateral superior rectus (SR) recessions (Group 1), bilateral SR recession with posterior fixation sutures (Group 2), or bilateral inferior oblique (IO) anterior transposition surgery (Group 3) for treatment of DVD. Nineteen patients underwent secondary procedures (SR weakening or IO anterior transposition) because of unsatisfactory results. The amount of the DVD in primary position before and after surgery, postoperative success ratios, and probable complications were evaluated. The Wilcoxon signed ranks test and chi-squared test were used for statistical evaluations. Results: In 69% of the 32 eyes in group 1, 65% of the 20 eyes in group 2, and 79% of the 42 eyes in group 3, satisfactory control of the DVD in primary position was achieved. All eyes undergoing both SR weakening and IO anterior transposition had a residual DVD of less than 5 prism diopters (pd). Of the total of 94 eyes, in 26 (89.6%) of 29 eyes that had a preoperative DVD angle of more than 15 pd [ten eyes from group 1, seven eyes from group 2, and nine eyes from group 3], the residual DVD angle after surgery was more than 5 pd. However, in the 65 eyes with preoperative DVD of 15 pd or less (21from Group 1, 12 from Group 2, and 32 from Group 3), the residual DVD angle after the operation was less than 5 pd. Two eyes of 2 patients had -1 limitation to elevation after surgery. Conclusion: Only IO anterior transposition or SR weakening surgery appear to be a successful surgical approaches in the management of patients with mild- and moderate-angle (≤15 pd) DVD. Weakening both the SR and IO muscles yield a greater success in the management of patients with large-angle (>15 pd) DVD. (Turk J Ophthalmol 2014; 44: 132-7)

Objectives: To evaluate ocular biometric parameters including anterior chamber depth (ACD), corneal curvature (CC), central corneal thickness (CCT), horizontal corneal diameter, and corneal biomechanical properties using ocular response analyzer (ORA) in eyes with hypermetropic anisometropia and to compare the results with those obtained for the healthy eyes of the patients. Materials and Methods: Sixty-four eyes of 32 patients followed with the diagnosis of hypermetropic anisometropia-related ambliyopia were included in the study. Group 1 (n=32) consisted of eyes with hypermetropic anisometropia, and group 2 (n=32) consisted of healthy eyes of the same patients. Cycloplegic refraction, best-corrected visual acuity (BCVA), corneal topography, axial length (AL) measurement, biomicroscopy, and fundus examinations were performed. Corneal hysteresis (CH), corneal resistance factor (CRF), and Goldmann-correlated intraocular pressure (IOPg) measurements were recorded. Results: Mean age of the patients was 9.5±2.4; 13 were male and 19 were female. Mean spherical equivalent was +5.42±1.8 D and +1.9±1.28 D in group 1 and group 2, respectively (p

Purpose: The purpose of this study was to evaluate the near point of convergence break in Turkish population with normal binocular vision and to obtain the normative data for the near point of convergence break in different age groups. Such database has not been previously reported. Material and Method: In this prospective study, 329 subjects with normal binocular vision (age range, 3-72 years) were evaluated. The near point of convergence break was measured 4 times repeatedly with an accommodative target. Mean values of near point of convergence break were provided for these age groups (≤10, 11-20, 21-30, 31-40, 41-50, 51-60, and >60 years old). A statistical comparison (one-way ANOVA and post-hoc test) of these values between age groups was performed. A correlation between the near point of convergence break and age was evaluated by Pearson’s correlation test. Results: The mean value for near point of convergence break was 2.46±1.88 (0.5-14) cm. Specifically, 95% of measurements in all subjects were 60 year-old age groups in the near point of convergence break values (p=0.0001, p=0.0001, p=0.006, p=0.001, p= 0.004). A mild positive correlation was observed between the increase in near point of convergence break and increase of age (r=0.355) (p

No-reflow is an undesirable result of percutaneous coronary interventions. Vasoactive drug administration at the distal part of the coronary artery is suggested as a therapeutic option for no-reflow treatment. Here, we represent two cases of successful no-reflow management with previously used monorail balloon at the same procedure as a hand-made distal infusion catheter.

Pur po se: To evaluate the efficacy and safety of unilateral anterior transposition of the inferior oblique (ATIO) muscle in patients with unilateral superior oblique palsy (SOP). Ma te ri al and Met hod: In this study, the medical records of 52 patients with SOP were retrospectively reviewed. The study comprised patients with a preoperative vertical squint of less than 25 prism diopters (PD) and a (+3) - (+4) inferior oblique hyperfunction (IOHF); all cases were Knapp’s class 1 or class 3. The angle shift in the primary gaze position, the presence of abnormal head posture, and IOHF were evaluated before and after surgery. Re sults: The mean postoperative follow-up time was 10 months. The mean preoperative angle of hypertropia at the primary gaze position was 15.3±7.89 PD, and the mean postoperative angle was 0.84±1.49 PD (0-4). Of the 32 patients with head tilt before surgery, 29 (91%) patients recovered fully after surgery. Improvement was noted in 88% of patients with preoperative IOHF. At the postoperative follow-up, none of the patients showed hypotropia in the primary gaze position, limitation of the superior gaze, elevation of lower lid in the superior gaze, or diplopia in the superior gaze position, but in other eyes of three cases, secondary IOHF occurred. Dis cus si on: AIn unilateral SOP accompanied by secondary IOHF that has more than 15 PD squint, ATIO surgery is an effective and safe method for reduction of hypertropia as well as for elimination of IOHF in primary position and abnormal head posture. The short-term complication rate was very low, but a longer follow-up period is required. (Turk J Ophthalmol 2011; 41: 392-5)

Purpose: To assess the results of surgery techniques used in Duane’s retraction syndrome (DRS) type 1. Material and Method: 194 DRS cases followed in the department of strabismus were retrospectively investigated. We assessed 58 cases operated for esotropic DRS type 1 in terms of pre- and post-operative deviations in primary position, abnormal head posture (AHP), abduction deficiency, globe retraction, and up-down shoot. The cases were divided into 3 groups according to the surgical technique applied. The mean follow-up period was 22.4±4.6 (1-13 years) months. Results: The cases in group 1 had undergone uni- or bilateral medial rectus (MR) recession, and the postoperative 1stmonth improvement rates for distance deviation, near deviation and AHP were 68.6%, 73.9% and 50%, respectively. These rates were 69.3%, 64.7% and 57.1%, respectively in group 2 which consisted of eyes that had undergone vertical rectus muscle transposition (VRT) surgery. In group 3, in which we had performed Y-split (with or without LR/MR recession) surgery, the improvement rates for distance and near deviation were 63.6% and 63.9%, and 50% was determined for AHP. The improvement in globe retraction was 60% in group 1 and 66.6% in group 3. Discussion: Medial rectus muscle recession was more effective for correction of deviation and AHP in cases of DRS type 1. VRT was found to be more effective surgical option in abduction deficiency. Y-split surgery has an important place in eliminating globe retraction and up/down shoot. (Turk J Ophthalmol 2011; 41: 156-63)

Spasm of the near reflex is a rare disorder that involves intermittent and variable episodes of esotropia, pseudomyopia, and pupillary myosis. It is usually functional in origin and is seen mainly in young patients. Treatment options for spasm of the near reflex have had variable success. In instances where the etiology of spasm of the near reflex was suspected to be hysteria, psychotherapy has proven beneficial. We report the case of an 11-year-old girl who had functional spasm of the near reflex. The symptoms persisted for two years. Symptomatic relief was achieved by cycloplegia and spectacle correction (added plus lenses at near). The patient also underwent psychological counseling. In our case, the functional spasm of the near reflex spontaneously resolved after 2 years. (Turk J Ophthalmol 2014; 44: 161-3

Cyclic esotropia is a rare form of strabismus characterized by alternating periods of esotropia and orthophoric (or almost orthophoric) eye position. Herein, we discuss two children with cyclic esotropia and their surgical treatment results. A six-year-old boy was brought to our clinic with the typical complaint of a convergent squint which had been appearing and disappearing in a regular 24-hour cycle over a period of four years. He had a large deviation angle with associated suppression and no binocular function for a 24-hour cyclic pattern, but he had a small angle of esotropia with fusion and stereopsis for another 24 hours. He had undergone strabismus surgery on the left eye at another clinic 3 years ago. The other patient was a ten-year-old girl who was brought to our clinic with the reoccurring complaint of esotropia on alternating days over a period of four years. We determined that a large deviation angle with near-distance disparity and a 24-hour cyclic pattern were present. For both cases, we planned strabismus surgery according to the amount of deviation on the esotropic day. Following the surgery, the eyes have continued to remain permanently straight during the follow-up period. (Turk J Ophthalmol 2014; 44: 164-6)

Objective: Recent evidence suggests that elevated levels of PD-L1 expression may be linked to early resistance to TKI and reduced survival in NSCLC with EGFR mutations. This study aimed to characterize the clinical and molecular features of EGFR-mutated lung adenocarcinomas and determine the prognostic significance associated with high PD-L1 expression., Materials and Methods: We conducted a retrospective chart review of 103 consecutive patients with advanced EGFR-mutated NSCLC, who received treatment between 01/01/2016 and 30/12/2020, at our institution., Results: Among the tumors, 17% (n = 18) exhibited high PD-L1 expression (≥50% tumor proportion score), which was associated with a lower prevalence of common EGFR mutations (56% vs. 82%, p = 0.03) and a higher frequency of complex EGFR mutations (28% vs. 7%, p = 0.02). Univariate analysis did not reveal any significant differences in first-line response, progression-free survival, or overall survival between the PD-L1 ≥50% and <50% groups. However, multivariate analysis demonstrated that PD-L1 ≥50% was independently associated with shorter survival (HR = 2.57; 95%CI[1.20-5.55]; p = 0.02), along with male gender (HR = 2.77; 95%CI[1.54-4.19]; p<0.005), presence of liver metastases (HR = 5.80; 95%CI[2.86-11.75]; p<0.005) or brain metastases (HR = 1.99; 95%CI[1.13-3.52]; p = 0.02), and poor general condition at diagnosis (ECOG 3 and 4) (HR = 10.69; 95% CI[4.42-25.85]; p<0.005). Additionally, a trend towards a higher frequency of de novo resistance was observed in the PD-L1 >50% group (7% vs. 17%, p = 0.19)., Conclusion: High PD-L1 expression was more commonly found in lung adenocarcinomas with uncommon and complex EGFR mutations. Furthermore, high PD-L1 expression independently predicted poor survival. These findings warrant validation through prospective studies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Slomka et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Small-cell lung carcinoma (SCLC) is a high-grade neuroendocrine carcinoma of poor prognosis. Although immune checkpoint blockers have shown promising results in advanced SCLC, the tumor immune microenvironment (TME) remains poorly understood, with no validated prognostic or predictive biomarkers of efficacy., Methods: This retrospective study included surgically samples from 48 SCLC patients between 2009 and 2018. We assessed the TME using two quantitative 7-plex immunofluorescence panels focusing on T and B cells, and compared it to NSCLC (N = 10). Molecular subtypes were determined by assessing the expression of ASCL1, NEUROD1 and YAP1 using immunohistochemistry., Results: Immune-hot SCLC were defined as those exhibiting the highest immune cell and immune-related marker densities. They were associated with longer overall survival, significantly more frequently detected at early stages, and exhibited high PD-L1 expression in immune cells, but were not associated with molecular subtypes. Compared to NSCLC, SCLC had significantly lower densities of CD20 + cells and higher density of PD1 + cells, with no significant differences in CD4 + , CD8 + and plasma cell densities. In univariate analysis, the highest OS was significantly associated with early stage (p < 0.001), low expression of NEUROD1 (p = 0.047), high PD1 + cell density (p < 0.001) and high PD-L1 immune cell expression (p = 0.04). Only stage and PD1 + cell density emerged as independent prognostic markers., Conclusion: SCLC TME is highly heterogeneous. Immune-hot tumors were associated with OS but not with molecular classification. PD1 expression and PD-L1 expression by immune cells may thus serve as a prognostic marker., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Pregnancy-associated haematological malignancy is a rare event; therefore, data available to guide the treatment are scarce. We aimed to evaluate the incidence, overall survival, and maternal morbidity and mortality of women with pregnancy-associated haematological malignancies., Methods: We conducted a nationwide observational cohort study using the French National Healthcare Data System (SNDS), a health-care administrative database covering up to 99% of the French population. We included all pregnancies in France ending between Jan 1, 2012, and Dec 31, 2022. Pregnancies with terminations or miscarriages managed on an outpatient basis, and women with a history of haematological malignancies before pregnancy were excluded. A Cox proportional hazards model was used to assess overall survival, defined as the date of haematological malignancy diagnosis to either death or the end of the study follow-up, in the haematological malignancy during pregnancy group (pregnancies with a diagnosis of haematological malignancy during pregnancy) compared with the haematological malignancy post-pregnancy group (pregnancies with a diagnosis of haematological malignancy in the year following pregnancy). Severe maternal morbidity was compared in the haematological malignancy during pregnancy group versus the reference group (pregnancies without a history of haematological malignancy or a diagnosis of pregnancy-associated haematological malignancy). Births were classified as very preterm (<32 weeks of pregnancy), preterm (32-36 weeks), and term (≥37 weeks) and compared in the haematological malignancy during pregnancy group versus the reference group. Inverse probability weighting (IPW) was used for confounder adjustment, using maternal age (categorised), comorbidities, socioeconomic status, and year of delivery (as a category)., Findings: Of 9 996 523 pregnancies in 5 995 235 women, 1366 pregnancy-associated haematological malignancies were identified: 413 during pregnancy (4·13 per 100 000 pregnancies) and 953 (9·53 per 100 000 pregnancies) within 12 months of the end of pregnancy (post-pregnancy). No significant differences in overall survival were observed between the haematological malignancy during and post-pregnancy groups across all types of haematological malignancy (IPW-adjusted hazard ratio 0·91 [95% CI 0·62-1·34], p=0·63), specifically for Hodgkin lymphoma (0·56 [0·07-4·53], p=0·59), aggressive B-cell non-Hodgkin lymphoma (0·52 [0·12-2·38], p=0·40), and acute leukaemia alone (0·84 [0·50-1·41], p=0·51). Severe maternal morbidity was more frequent in the haematological malignancy during pregnancy group than in the reference group (86 [26·2%] of 328 completed pregnancies vs 120 335 [1·5%] of 7 945 909 completed pregnancies; IPW-adjusted odds ratio 22·71 [95% CI 17·72-29·10], p<0·0001). We observed an increase in very preterm birth (32 [9·8%] vs 92 712 [1·2%]; IPW-adjusted odds ratio 11·90 [95% CI 7·91-17·91], p<0·0001) and preterm birth (116 [35·4%] vs 430 472 [5·4%]; 11·76 [9·34-14·81], p<0·0001) in the haematological malignancy during pregnancy group compared with the reference group., Interpretation: This nationwide observational study examines pregnancy-associated haematological malignancies in France, revealing no significant difference in overall survival between women diagnosed during pregnancy and post-pregnancy. Our data highlight an increased frequency of severe maternal morbidity and obstetric complications among women diagnosed during pregnancy. Notably, the study underscores the necessity for specialised care to manage these complex cases effectively., Funding: None., Translation: For the French translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests CC declares consulting fees from Pfizer. LH declares support for attending meeting from Servier. NB is an unpaid member of the French Birth Defects Scientific Expert Committee (Santé Publique France). RB declares consulting fees from Bristol Myers Squibb, honoraria for presentations form Jazz Pharma, and support for attending meetings from Sandoz. All other authors declare no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.)

Background: Pulmonary sarcomatoid carcinomas (PSC) are notorious for their poor prognosis and resistance to chemotherapy. The literature suggests that immunotherapy might be effective against this aggressive tumor. This study aims to evaluate the efficacy of immunotherapy, either alone or combined with chemotherapy, as first-line treatment for PSC patients., Methods: In a retrospective, multicentric, real-world study conducted between July 2017 and April 2021, patients with stage III (ineligible for surgery or radio-chemotherapy) or stage IV PSC were enrolled. These patients received their first-line treatment with immunotherapy and were categorized into two groups based on their treatment modality: the immuno-chemotherapy (IO CT) group or the immunotherapy-alone (IO) group., Results: This study analyzed a population of 34 patients from eight different hospital centers. In this cohort, the objective response rate (ORR) was 56%, median duration of response was 20.5 months, median progression-free survival (PFS) was 5.11 months, and median overall survival (OS) 13.9 months. Demographic characteristics remained consistent among the treatment groups except for the age (54.0- and 71.0-year-old in the IO CT and IO group, respectively, P=0.02). The IO CT group demonstrated an ORR of 64.0%, a median PFS at 8.72 months, and a median OS of 16.08 months, while the IO group displayed respective values of 52.0%, 3.45 months, and 13.11 months., Conclusions: This study showed the potential efficacy of immunotherapy as a first-line treatment for PSC. While acknowledging the retrospective nature of the study, our findings suggest a trend favoring the combination of IO CT over IO alone in these patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-24-263/coif). N.G. received research grants/support from Abbvie, Amgen, AstraZeneca, Beigene, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi-Sankyo, Gilead, Hoffmann-La Roche, Janssen, LeoPharma, Lilly, Merck Serono, Merck Sharp & Dohme, Novartis, Sanofi, Sivan; provided consultative services for Abbvie, Amgen, AstraZeneca, Beigene, Bristol Myers Squibb, Daiichi-Sankyo, Gilead, Ipsen, Hoffmann-La Roche, Janssen, LeoPharma, Lilly, Merck Sharp & Dohme, Mirati, Novartis, Pfizer, Pierre Fabre, Sanofi, Takeda; participated on a data safety monitoring board for Hoffmann-La Roche; employment of a family member with AstraZeneca. Jacques Cadranel received consulting fees for participation to boards of experts from AMGEN, AZ, Daiichi (and travelling, BMS, MSD, Roche, Sanofi, Janssen (and travelling), Takeda, Pfizer (and travelling). I.M. received honoraria from Regeneron and support from Takeda, MSD, Pfizer, Oxyvie. E.G.L. received honoraria from AMGEN, AstraZeneca, Ipsen, Janssen, Lilly, MSD, Novartis, Pfizer, Sanofi, Takeda and support for attending meetings and/or travel from Takeda, MSD, AstraZeneca. K.L. received honoraria from AstraZeneca, MSD, Janssen, GSK, Lilly, AMGEN, Roche for lectures, presentations or educational events and support for attending meetings and/or travel from AMGEN. Jeanne Chapron received honoraria from BMS, AstraZeneca, Pfizer, Sanofi, MSD and support for attending meetings and/or travel from Sanofi and Regeneron. M.W. received payment or honoraria for lectures and presentations from AMGEN, AstraZeneca, Bristol Myers Squibb, F. Hoffmann-La Roche, Janssen, MSD Oncology, Lilly, Merck KGaA; grants from AstraZeneca; support for attending meetings and/or travel from Janssen, Amgen, MSD and F. Hoffmann-La Roche; participated on a data safety monitoring board or advisory board for AMGEN, AstraZeneca, Bristol Myers Squibb, F. Hoffmann-La Roche, Janssen, MSD Oncology, Lilly and Merck KGaA. The other authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Background: STK11/LKB1 mutations have been associated with primary resistance to PD-1 axis inhibitors and poor prognosis in advanced KRAS-mutant lung adenocarcinoma. This study aimed to assess the prognostic significance of STK11/LKB1 alterations in localized non-squamous non-small cell lung carcinoma (non-sq NSCLC)., Patients and Methods: Surgical samples from patients undergoing complete resection for stage IIa, IIb, or IIIa (N2 excluded) non-sq NSCLC in the randomized adjuvant phase II trial (NCT00775385 IFCT-1801 TASTE trial) were examined. Patients received either standard chemotherapy (Pemetrexed Cisplatin) or personalized treatment based on EGFR mutation (Erlotinib) and ERCC1 expression. Tumor molecular profiles were analyzed using targeted NGS and correlated with overall survival (OS) and disease-free survival (DFS), adjusting for relevant clinical variables. Additionally, interactions between treatment groups and molecular alterations on OS, PD-L1 expression, and tumor-circulating DNA in post-operative plasma samples were evaluated., Results: Among 134 patients (predominantly male smokers with adenocarcinoma), KRAS mutations were associated with shorter DFS (HR: 1.95, 95 % CI: 1.1-3.4, p = 0.02) and OS (HR: 2.32, 95 % CI: 1.2-4.6, p = 0.014). Isolated STK11/LKB1 mutations (n = 18) did not significantly impact DFS or OS. However, within KRAS-mutated samples (n = 53), patients with concurrent STK11/LKB1 mutations (n = 10) exhibited significantly shorter DFS (HR: 3.85, CI: 1.5-10.2, p = 0.006) and a trend towards shorter OS (HR: 1.80, CI: 0.6-5.3, p = 0.28). No associations were found between PD-L1 expression, other gene mutations, progression-free survival (PFS), or OS., Conclusion: This analysis reinforces KRAS mutations as predictive factors for relapse and poor survival in localized non-sq NSCLC. Furthermore, the presence of concomitant STK11/LKB1 mutations exacerbated the prognosis within the KRAS-mutated subset. These findings emphasize the clinical relevance of these molecular markers and their potential impact on treatment strategies in non-sq NSCLC., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Oudart has received consulting fees from Astra Zeneca and Novartis; has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astra Zeneca; has received support for attending meetings and/or travel from Astra Zeneca. Dr. Barlesi has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astra-Zeneca, Bayer, Bristol-Myers Squibb, Boehringer–Ingelheim, Eli Lilly Oncology, F. Hoffmann–La Roche Ltd, Novartis, Merck, MSD, Pierre Fabre, Pfizer and Takeda. Dr. Mazière has received grants from Roche, Astra Zeneca, Pierre Fabre, BMS and Illumina; has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Roche, Astra Zeneca, Pierre Fabre, Pfizer, Jiangsu Hengruii, Blueprint, Takeda, BMS, MSD, Daiichi, Novartis and Amgen. Dr. Audigier-Valette has received consulting fees from Roche and Abbvie; has received support for attending meetings and/or travel from Pfizer and MSD; has received participation on a Data Safety Monitoring Board or Advisory Board from Roche, Sanofi, MSD, BMS, Lilly, Pfizer, Astra Zeneca, Janssen and Abbvie. Dr. Moro-Sibilot has received consulting fees and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astra Zeneca, Roche, Pfizer, Amgen, BMS, MSD, Lilly and Takeda; has received support for attending meetings and/or travel from Roche, Takeda and BMS. Dr. Blons has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astra Zeneca, BMS and MSD. Dr. Wislez has received grants from Astra Zeneca; and has received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from MSD, Astra Zeneca, Amgen, BMS, Roche, Janssen and Sanofi; and has received support for attending meetings and/or travel from Roche and Janssen; and has received Participation on a Data Safety Monitoring Board or Advisory Board from MSD, Astra Zeneca, Amgen, BMS, Roche, Janssen and Sanofi. The remaining authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The ability of CD8 + T cells to infiltrate solid tumors and reach cancer cells is associated with improved patient survival and responses to immunotherapy. Thus, identifying the factors controlling T cell migration in tumors is critical, so that strategies to intervene on these targets can be developed. Although interstitial motility is a highly energy-demanding process, the metabolic requirements of CD8 + T cells migrating in a 3D environment remain unclear. Here, we demonstrate that the tricarboxylic acid (TCA) cycle is the main metabolic pathway sustaining human CD8 + T cell motility in 3D collagen gels and tumor slices while glycolysis plays a more minor role. Using pharmacological and genetic approaches, we report that CD8 + T cell migration depends on the mitochondrial oxidation of glucose and glutamine, but not fatty acids, and both ATP and ROS produced by mitochondria are required for T cells to migrate. Pharmacological interventions to increase mitochondrial activity improve CD8 + T cell intratumoral migration and CAR T cell recruitment into tumor islets leading to better control of tumor growth in human xenograft models. Our study highlights the rationale of targeting mitochondrial metabolism to enhance the migration and antitumor efficacy of CAR T cells in treating solid tumors., (© 2024. The Author(s).)