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Objectives The study describes functional outcomes and health‐related quality of life (HRQL) in patients with traumatic brain injury (TBI) 20 years postinjury. Materials and Methods Forty‐four survivors who acquired moderate and severe TBI during 1995–1996 were followed 10 and 20 years postinjury. Outcomes were Glasgow Outcome Scale Extended (GOSE), Community Integration Questionnaire (CIQ), and SF‐36 questionnaire (SF‐36). Multiple regressions were performed to examine the relationship between follow‐up measurements, controlling for baseline demographics and injury severity. Results There were no significant differences in baseline age and civil status between moderate and severe TBI, but patients with severe injury had significantly lower employment rates (p = 0.05). Mean age at 20‐years follow‐up was 50.8 (SD 11.4) years, and 73% were males. Most patients showed good recovery (52%) or moderate disability (43%). Disability levels remained stable between and within severity groups from 10 to 20 years. Community integration including social integration improved from 10 to 20 years (p = 0.01 and p = 0.005, respectively). HRQL remained stable, except for subscales Bodily Pain and Role Emotional (p = 0.02 and p = 0.06). Depression at 10 years and females were associated with poorer mental health, while productive activity at 10 years indicated better physical and mental health at 20 years postinjury, respectively. Conclusions Functional limitations persist even decades after moderate and severe TBI, with poorer prognosis for females and persons who were depressed at the 10‐year follow‐up. Development and evaluation of targeted long‐term follow‐up programs and access to rehabilitation services for these groups should be highlighted. Improved community integration despite stable functional limitations draws attention to long‐term adaptation to adversity and illness. The study describes long‐term disability and health‐related quality of life (HRQL) in 44 patients with moderate and severe traumatic brain injury (TBI) injured in 1995–1996. Functional limitations persist even 20 years postinjury, with poorer prognosis for females and persons who were emotionally distressed at the 10‐year follow‐up. Development and evaluation of targeted rehabilitation programs for these groups should be highlighted.

Introduction: Gastric adenomas are histologically defined as benign epithelial tumors. While some of them remain adenomas for a long time, others progress to carcinomas. However, long-term outcomes of such cases are not entirely clear. Here, we explored the risk factors and incidence of developing carcinoma from gastric adenoma as well as metachronous gastric cancer. Methods: This study was conducted at a facility that adopted a follow-up strategy for gastric adenoma. Lesions histologically diagnosed as gastric intestinal-type adenomas between January 2004 and December 2016 were analyzed. Clinicopathological data were collected from patients’ medical records, and histological changes from adenoma to carcinoma during endoscopic follow-up and risk factors of cancer development were evaluated. Results: This study involved 409 lesions from 376 patients. The analysis of the development of gastric cancer from adenoma and metachronous gastric cancer was ultimately performed for 282 lesions from 258 patients and 269 lesions from 246 patients, respectively, due to different follow-up periods. The 5-year rate of carcinoma development was 34.0%. Risk factors for carcinoma development upon multivariate analysis were lesion size ≥15 mm and morphological depression. All cases with both factors developed gastric carcinoma, and 50.5% of those with either factor developed carcinoma within 5 years. Gastric adenoma was accompanied by metachronous gastric cancer in 1.5% of the patients annually. The only risk factor for metachronous gastric carcinoma was primary adenoma progressing to carcinoma during the follow-up period. Discussion/Conclusion: Given the high rate of carcinoma development in patients with risk factors, resection of gastric adenoma should be considered during the initial examination. Careful observation and follow-up should also be conducted to detect not only changes in the primary adenoma but also the occurrence of metachronous carcinoma, especially in cases of adenoma progressing to carcinoma.

Introduction Fertility‐sparing treatments using oral progestins have demonstrated promising oncologic outcomes for endometrial intraepithelial neoplasia and early‐stage endometrial cancer. However, the high recurrence rate remains a major concern, and the literature on long‐term follow‐up outcomes is limited. This study aimed to identify recurrence risk factors by analyzing clinicopathological and molecular profiles in a cohort with a median follow‐up of 9 years. Material and Methods This retrospective study included patients under 45 years of age who were diagnosed with endometrial intraepithelial neoplasia or endometrial cancer and received fertility‐sparing treatments at our center between 2010 and 2021. Patients who achieved complete responses were categorized according to recurrence status. Demographic, clinical, and molecular data were compared between groups. The primary endpoint was to identify risk factors for recurrence; secondary endpoints assessed obstetric and oncologic outcomes in patients with relapse. Results Out of 40 patients, 8 underwent hysterectomy within 1.5 years, while 32 responded to treatment and continued follow‐up. The recurrence and non‐recurrence groups contained 20 and 12 patients, respectively, with a median follow‐up of 107.5 months (range, 35–175 months). Multivariate analysis showed that a family history of cancer (HR = 2.597, p = 0.039) and treatment with megestrol acetate as the initial therapy (HR = 3.130, p = 0.021) were independent risk factors for shorter time to recurrence. Although mismatch repair deficiency was positively correlated with recurrence, the association did not reach statistical significance (p = 0.057). Four out of 24 patients were upstaged after hysterectomy, and all were in the recurrence group. Nine patients (22.5%) achieved pregnancy, with three successfully conceiving after achieving complete response following retreatment. Conclusions In patients with long‐term follow‐up after fertility‐sparing treatment, a family history of cancer and initial treatment with megestrol acetate were significantly associated with recurrence. Fertility‐sparing treatment demonstrated a 62.5% recurrence rate at 10 years. Recurrence was more likely in patients initially treated with megestrol acetate or those with a family history of cancer. As most patients lacked high‐risk molecular features, conservative treatment may remain a safe option for selected individuals under close long‐term surveillance.

Zusammenfassung Hintergrund Überlebende von Krebs im Kindes- oder Jugendalter haben dank besserer Therapien hohe Langzeitüberlebensraten, leiden aber oft unter komplexen Spät- und Langzeitfolgen, die frühzeitig erkannt und behandelt werden sollten. Fragestellung Im vorliegenden Beitrag werden die in Deutschland bestehenden Modelle der Transition und Langzeitnachsorge von erwachsenen Überlebenden einer Krebserkrankung im Kindes- bzw. Jugendalter dargestellt und Perspektiven für die Versorgung und Forschung in diesem Bereich skizziert. Ergebnisse Es besteht Verbesserungspotenzial im Bereich der Vernetzung der beteiligten Fachdisziplinen sowie in der Einbindung und Aufklärung der Patient:innen. Schlussfolgerung Das Bestreben zur bundesweiten Harmonisierung und Standardisierung der Nachsorge- und Transitionseinrichtungen ist wichtig, um sicherzustellen, dass alle Krebsüberlebenden in Deutschland Zugang zu einer leitliniengerechten Versorgung erhalten.

Purpose The critical shoulder angle (CSA) and the acromion index (AI) are measurements of acromial shape reported as predictors of degenerative rotator cuff tears (RCT) and glenohumeral osteoarthritis (GH OA). Whether they are the cause or effect of shoulder pathologies is uncertain since pre-morbid radiographs most often are lacking. The main aim of this study was to investigate if CSA or AI were related to the development of RCT or GH OA after 20 years. A secondary aim was to investigate if the CSA and AI had changed over time. Methods In the hospital archive, 273 preoperative plain shoulder radiographs were found of patients scheduled for elective surgery other than cuff repair and arthroplasty. Forty-five images fulfilled the strict criteria published by Suter and Henninger (2015) and were used to measure CSA and AI with two independent assessors. No patient had any sign of OA in the index radiographs or any information in the medical records indicating RCT. After a median of 20 (16–22) years, 30 of these patients were radiologically re-examined with bilateral true frontal views and ultrasound of the rotator cuff. There were 19 men (20 study shoulders) and 11 females (12 study shoulders). Results Mean age at follow-up was 56 (32–78) years. There was no correlation between CSA ( r  = 0.02) (n.s) or AI ( r  = − 0.13) (n.s) in the primary radiographs and OA at follow-up. Nor was any correlation found between index CSA ( r  = 0.12) (n.s) or AI ( r  = − 0.13) (n.s) and RCT at follow-up. Mean difference in CSA was − 1.7 (− 10–3) degrees and mean AI difference was − 0.04 (− 0.13–0.09) between the first and the second radiographs, 20 years later. Bilaterally, mean CSA was 32 and AI 0.61 at follow-up. Conclusion In this study, no correlation between the CSA, AI and development of OA or RCT could be found. The mean CSA and AI decreased over a 20-year period but the difference was very small. No difference was found between the study shoulders and the contralaterals. These findings question previously reported etiological associations between scapular anatomy and the development of OA or RCT and thereby the use of these calculations as the basis of treatment. Level of evidence III.

Dans le cadre du dispositif de suivi médical destiné aux adultes guéris d'un cancer pédiatrique à l'Institut Gustave-Roussy (Villejuif, France), un entretien psychologique est proposé. Cet article s'appuie sur 198 entretiens auprès de patients ayant entre 18 et 67 ans, diagnostiqués entre 0 et 24 ans. Ces rencontres donnent à entendre la subjectivité du vécu du cancer et de la guérison, révélant les traces de cette expérience dans l'après-coup. Les enjeux de l'activité narrative amorcée dans le cadre de cette consultation, et pouvant se poursuivre au-delà, sont abordés dans une perspective métapsychologique. As part of the medical follow-up program for adult survivors of childhood cancer at the Institut Gustave Roussy (Villejuif, France), a psychological consultation is offered. This article is based on 198 interviews with patients between the ages of 18 and 67 who were diagnosed between the ages of 0 and 24. These meetings give voice to the subjectivity of cancer and recovery, revealing the traces of this experience aprèscoup . The issues at stake in the narrative activity initiated in the context of this consultation, and which may continue beyond, are approached from a metapsychological perspective.

Zusammenfassung Hintergrund Überlebende von Krebs im Kindes- oder Jugendalter haben dank besserer Therapien hohe Langzeitüberlebensraten, leiden aber oft unter komplexen Spät- und Langzeitfolgen, die frühzeitig erkannt und behandelt werden sollten. Fragestellung Im vorliegenden Beitrag werden die in Deutschland bestehenden Modelle der Transition und Langzeitnachsorge von erwachsenen Überlebenden einer Krebserkrankung im Kindes- bzw. Jugendalter dargestellt und Perspektiven für die Versorgung und Forschung in diesem Bereich skizziert. Ergebnisse Es besteht Verbesserungspotenzial im Bereich der Vernetzung der beteiligten Fachdisziplinen sowie in der Einbindung und Aufklärung der Patient:innen. Schlussfolgerung Das Bestreben zur bundesweiten Harmonisierung und Standardisierung der Nachsorge- und Transitionseinrichtungen ist wichtig, um sicherzustellen, dass alle Krebsüberlebenden in Deutschland Zugang zu einer leitliniengerechten Versorgung erhalten.

Objective Metacognitive therapy (MCT) and cognitive–behavior therapy (CBT) are effective treatments for generalized anxiety disorder. In this study, we followed‐up patients who had previously participated in a randomized controlled trial of MCT compared against CBT. Method We collected 9‐year follow‐up data on 39 out of 60 original patients (i.e., 65% response rate). Results At 9 years, the recovery rates were 57% for MCT and 38% for CBT (completer analysis). Following MCT, 43% maintained their recovery status and a further 14% achieved recovery. Following CBT, the sustained recovery rate was 13%, while a further 25% achieved recovery. Patients in the MCT condition showed significantly more improvement with respect to symptoms of worry and anxiety. In the CBT group, 23.1% were re‐diagnosed with generalized anxiety disorder (GAD) compared with 9.5% in the MCT group. Conclusions This follow‐up study showed a continuation of gains in both treatments at long‐term follow‐up, but with outcomes continuing to favor MCT and strengthening its comparative superiority. We collected 9‐year follow‐up data on patients treated with cognitive–behavioral therapy (CBT) or metacognitive therapy (MCT). At 9 years, the recovery rates were 57% for MCT and 38% for CBT. In conclusion, this follow‐up study showed a continuation of gains in both treatments at long‐term follow‐up, but with MCT strengthening its comparative outcome superiority.