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BACKGROUND: Sinonasal teratocarcinosarcoma (SNTCS) is a rare and highly invasive neoplasm originating from the nasal cavity and sinuses. Typically, it exhibits an invasive behavior towards adjacent structures; however, in exceptional instances, it may infiltrate the intracranial compartment. Due to the tumor's rarity and lack of distinctive features on computed tomography (CT) and magnetic resonance imaging (MRI) images, SNTCS is often misdiagnosed. CASE SUMMARY: In this study, we present a case of SNTCS in a 56-year-old patient who exhibited unexplained cognitive impairment before admission. CT and MRI scans revealed the presence of a mass in the right nasal cavity, with lesions extending to the right ethmoid sinus and right frontal region. Subsequently, the patient underwent pathological examination for confirmation and received surgical intervention to excise the tumor. The future advancement in our understanding of this disease will significantly contribute to the precise diagnosis and treatment of SNTCS. CONCLUSION: SNTCS is an exceptionally rare malignant tumor that originates from the nasal cavity and paranasal sinuses, presenting a diagnostic challenge due to its non-specific imaging findings. MRI accurately delineates the location, morphological characteristics, size, internal structure, extent of surrounding involvement, and metabolic information of the lesion. These aspects play a pivotal role in the precise localization and qualitative assessment of SNTCS. Nevertheless, a definitive diagnosis still requires a pathological biopsy.

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BACKGROUND: Over the past years, the introduction of direct-acting antivirals (DAAs) revolutionized chronic hepatitis C treatment. We aimed to characterize and assess treatment efficacy in three specific groups of patients treated with DAAs: those with active solid malignant tumors (SMTs), hematological diseases (HDs) and hepatocellular carcinomas (HCCs). METHODS: A total of 203 patients with active oncological disease (SMT n = 61, HD = 67, HCC n = 74) during DAA treatment in 2015-2020 selected from the EpiTer-2 database were analyzed retrospectively and compared to 12,983 patients without any active malignancy. RESULTS: Extrahepatic symptoms were more frequent in HD patients (17.2% vs. SMT = 10.3%, HCC = 8.2%, without = 7.8%, p = 0.004). HCC patients characterized with the highest ALT activity (81 IU/L vs. SMT = 59.5 IU/L, HD = 52 IU/L, without = 58 IU/L, p = 0.001) more often had F4 fibrosis as well (86.11% vs. SMT = 23.3%, HD = 28.8%, controls = 24.4%, p = 0.001). A significant majority of subjects in HCC, HD and SMT populations completed the full treatment plan (HCC = 91%; n = 67, HD = 97%; n = 65, SMT = 100%; n = 62). Concerning the treatment efficacy, the overall sustained virologic response, excluding non-virologic failures, was reported in 93.6% HD, 90.16% SMT and 80.6% in HCC patients. CONCLUSIONS: As presented in our study, DAA therapy has proven to be highly effective and safe in patients with active SMTs and HDs. However, therapy discontinuations resulting from liver disease progression remain to be the major concern in HCC patients.

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Marjolin's ulcer (MU) is a rare condition defined as a malignant skin tumor arising from chronic wounds and inflammation. The most common histological findings in MUs are squamous cell carcinomas (SCC) (or spinocellular carcinomas [SPC]), such as basal cell carcinomas (BCC) and malignant melanomas (MM). The aim of this study is to report the case of a patient with sequelae of leprosy who presented malignant transformation in a long-standing ulcer on the right leg, thereby contributing to understanding of the progression and significance of early diagnosis of MU. The MU was diagnosed by incisional biopsy of the lesion and upon obtaining a positive result the patient was referred to an oncology service. Treatment of MU is multidisciplinary and surgical excision is the first therapeutic option. Proper management and surveillance of chronic ulcers by the healthcare team are necessary for early recognition of MU.

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Appendicitis is predominantly observed in teens and young adults. While typical causes include fecalith-induced luminal obstructions, in older adults less common etiologies such as tumors should be considered. This report highlights a rare case of appendicitis secondary to cecal adenocarcinoma in a high-risk patient with a history of obesity and type 2 diabetes mellitus. This case underscores the necessity of considering malignancy as a differential diagnosis in older adults presenting with appendicitis-like symptoms.

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OBJECTIVE: To evaluate the impact of Internet-based multidisciplinary continuity care on the quality of life of home-based patients with PICC catheters for malignant tumors. METHOD: This study is a retrospective research analysis. A total of 131 patients with malignant tumors who received PICC catheterization at Xijing Hospital from Jan. 2023 to Dec. 2023 were enrolled in this study. Patients were divided into two groups: 61 in the control group who received conventional nursing care, and 70 in the observation group who received multidisciplinary continuous nursing care via an Internet platform in addition to conventional nursing. The Strategies Used by Patients to Promote Health (C-SUPPH), the Quality-of-Life Core Questionnaire (QLQ-C30), the Exercise of Self-care Agency Scale (ESCA), Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) were adopted for investigation and analysis. Six months after intervention, the two groups' ego-efficacy, living quality, self-care ability and psychological status, as well as treatment compliance and satisfaction with care were compared. RESULTS: Post-intervention, both groups showed significant improvements in ego-efficacy and self-care ability scores (all P<0.05). The observation group scored higher in all dimensions of ego-efficacy and self-care ability compared to the control group (all P<0.05). Furthermore, the observation group demonstrated significant improvements across all dimensions of quality of life (P<0.05), whereas the control group only showed improvement in social function (P<0.05). The observation group also exhibited lower scores for anxiety and depression post-intervention compared to the control group (all P<0.05). Additionally, the observation group had a significantly lower incidence of complications and higher post-intervention treatment compliance and satisfaction with nursing (P<0.05). CONCLUSION: Multidisciplinary continuing nursing care delivered via an Internet platform significantly enhances self-management efficiency, quality of life, and self-care ability of home-based patients with PICC catheters for malignant tumors. This care model also effectively improves patients' mental health and increases their compliance with treatment and satisfaction with nursing.

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BACKGROUND: Osteoporosis with pathological fractures is a significant public health issue, contributing to morbidity, disability, diminished quality of life, and increased mortality. Understanding mortality trends related to this condition is crucial for developing effective interventions to reduce mortality and improve healthcare outcomes. This study aimed to analyze trends and causes of death associated with osteoporosis and pathological fractures in the United States using a multi-cause approach. METHODS: Annual death and age-standardized mortality rate (ASMR) data from 1999 to 2020 were obtained from the Centers for Disease Control and Prevention (CDC) mortality database. Death certificates listing ICD-10 M82 (osteoporosis with pathological fracture) as an underlying or related cause of death were analyzed. Epidemiological data were analyzed, and the ASMR data were calculated for each year, and trends were assessed using the Cochran-Armitage trend test. RESULTS: From 1999 to 2020, there were 40,441 deaths related to osteoporosis with pathological fractures in the United States, with a female-to-male ratio of 5.6:1. Among these, 12,820 deaths (31.7%) listed osteoporosis with pathological fractures as the underlying cause of death (UCD), yielding a female-to-male ASMR ratio of approximately 5.0-7.7:1. When classified as a non-UCD, the ASMR ratio was approximately 4.8-6.2:1. At the same time, we found that the total number of deaths classified as UCD and multiple causes of death (MCD), but the trend ratio of the two groups in different years did not change statistically significant (P > 0.05), and the ASMR of both groups showed a downward trend. The UCD-to-MCD ratio increased between 1999 and 2007, then decreased from 2007 to 2020. As MCD, the number of female deaths was more than that of male, and both showed a decreasing trend, but there was no statistical significance in the change of trend ratio in different years (P > 0.05). Deaths were predominantly concentrated in individuals over 75 years of age, with those over 84 years being the most affected. The number of deaths in different age groups showed a decreasing trend, and the change of trend ratio in different years was statistically significant (P < 0.05). White individuals had the highest number of deaths. The leading causes of death were heart diseases, chronic lower respiratory diseases, and alzheimer's disease. In addition, the number of deaths of patients with prostate cancer and breast cancer showed a significant downward trend, and the change of trend ratio between the two groups in different years was statistically significant (P < 0.05). CONCLUSIONS: Although mortality from osteoporosis with pathological fractures is decreasing, anti-osteoporosis therapy remains essential for elderly patients. Healthcare providers should remain vigilant for potential complications, including malignant neoplasms, and ensure timely diagnosis and treatment to further reduce mortality in this population.

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PURPOSE: This study aimed to investigate the impact of nephrostomies on the outcome of total renal function (TRF) and split renal function (SRF) in patients with malignant pelvic tumors associated with upper urinary tract obstruction (UUTO). METHODS: Patients with pelvic tumors suffering severe unilateral hydronephrosis treated at our hospital from 2000 to 2022 were included. Data for nephrostomy placement, short- and long-term renal function, and radiological and nuclear imaging studies were collected. The TRF and SRF of patients who underwent nephrostomy were compared to those who did not. RESULTS: Seven patients were included (rhabdomyosarcoma: 5, ovarian germ cell tumor: 1, malignant rhabdoid tumor: 1). Nephrostomies were placed in four, which were successfully managed without severe infections. Estimated glomerular filtration rate (eGFR) was significantly improved at the end of treatment in patients with nephrostomy. In contrast, eGFR in patients who did not undergo nephrostomy was not improved. Nuclear imaging studies (renograms or renal scintigrams) revealed impaired SRF of the affected kidney compared to the contralateral kidney, even in patients whose eGFR was within normal levels. Notably, SRF showed a trend to improve over time in one patient treated with nephrostomy. CONCLUSION: Nephrostomy for UUTO caused by pelvic tumors may improve renal outcome.

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BACKGROUND: Angelica sinensis (Oliv.) Diels, a renowned traditional Chinese medicine, has gained widespread recognition for its antitumor properties. Further investigation is warranted to determine whether ligustilide (LIG), which is extracted from this plant, can effectively inhibit tumors. OBJECTIVE: We delved into the impact of LIG on cholangiocarcinoma cells, aiming to unravel the mechanisms underlying its effects. MATERIALS AND METHODS: Cholangiocarcinoma cells (HuccT1 and RBE) were exposed to varying concentrations of LIG (2, 5, 10, 15, 20 µg/mL) for 24, 48, and 72 h. After identifying differentially expressed genes, stable transcription strains were utilized to explore LIG's antitumor mechanism. The inhibitory effects of LIG (5 µg/mL, 48 h) were assessed by CCK-8, colony formation, wound healing, transwell migration, western blotting, and immunofluorescence. In vivo, experiments in NOG mice (Ac, Ac+LIG; five per group) evaluated LIG's antiproliferative efficacy (5 mg/kg, intraperitoneal injection, 18-day period). RESULTS: LIG significantly inhibited cell proliferation and migration with IC50 5.08 and 5.77 µg/mL in HuccT1 and RBE cell lines at 48h, increased the expression of E-cadherin while decreased N-cadherin and the protein of PI3K/AKT pathway. Silenced NDRG1 (N-Myc downstream- regulated gene 1) attenuated these effects. In vivo, the AC+LIG group (LIG, 5 mg/kg, qd, 18 d) exhibited smaller tumor volumes compared to the Ac group. The expression of Ki-67 was significantly downregulated in the AC+LIG group. CONCLUSION: For the first time, our study has revealed that LIG holds therapeutic potential for treating cholangiocarcinoma. These findings hold promise for advancing innovative therapeutic approaches in the treatment of cholangiocarcinoma. LIG may serve as a useful patent for treating CCA.

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Objective:To investigate the therapeutic effect of free forearm flaps in repairing the postoperative defect of external nasal malignant tumor. Methods:Six patients with nasal malignant tumor were treated with radical operation of external nasal malignant tumor and simultaneous reconstruction of external nasal defects with free forearm flap. Preoperative Allen experiment, ultrasonic Doppler blood flow meter or CT angiography confirmed that the forearm blood vessels were in good condition. Results:The free forearm flaps were obtained from six patients, and completely survived. During the follow-up period of 6-12months, all patients had good external nasal morphology, good nasal function, no nasal obstruction and anterior nostril stenosis, no obvious complications in donor hand and no local cancer recurrence. Conclusion:The free forearm flap is a reliable method to reconstruction the postoperative defect of external nasal malignant tumor, with a high success rate and good recovery of morphology and function recovery.

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In complex anal fistula, the patient's anus has multiple internal or external openings. The closure of the external opening can be broken again in other trips and another external opening. It is one of the refractory diseases in the field of anorectal surgery. In the treatment of a high recurrence rate, poor functional protection and other problems, surgical treatment such as incision and retention of sphincter hanging line, incision and suture internal opening drainage, fistula removal, and suture were used for different situations. After the failure of surgical treatment, it becomes chronic anal fistula or become cancerous tumor. In this case, the patient had a long time of illness, the mass was huge, the color was black, and it was suspected to be a secondary malignant tumor. This situation is extremely rare in clinical treatment. In our hospital, a case of complex anal fistula secondary to perianal huge tumor was found, and good therapeutic effect was achieved after complex anal fistula resection and tumor resection. In this case, the patient had complex anal fistula for about 5 years without timely treatment, and the perianal mass was rare and huge. It is shown by ultrasonography the secondary malignant tumor, which was extremely rare in clinical treatment. During the operation, it was found that three fistulas at the root of the tumor were connected with one of the anal fistulas. From the appearance, the tumor seems to have a malignant tendency. After surgical resection, the pathology was suppurative inflammation and granulation tissue hyperplasia. The patients recovered well after follow-up and did not relapse. This case report provides case reference and reference for clinical treatment of anorectal diseases.

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OBJECTIVES: On 18F-Fludeoxyglucose (FDG) PET/CT, active sarcoid lesions are often difficult to differentiate from malignant lesions. We investigated the potential of the glucose metabolic rate (MRglc, mg/min/100 mL), a new quantification of glucose metabolic kinetics derived from direct reconstruction based on linear Patlak analysis, to distinguish between sarcoidosis and malignant lesions. MATERIALS AND METHODS: A total of 100 patients with cardiac sarcoidosis (CS) and 67 patients with cancer who underwent four-dimensional FDG PET/CT were enrolled. The lesions with a standardized uptake value (SUV) ≥ 2.7 on the standard scan were included as active lesions in the analysis. SUV and MRglc were derived using data acquired between 30 min and 50 min on four-dimensional FDG PET/CT. The mean value in the volume of interest (size 1.5 cm3) was measured. The diagnostic performance of sarcoidosis using MRglc and SUV was evaluated using receiver-operating-characteristic (ROC) analysis. RESULTS: A total of 90 sarcoidosis lesions from 44 CS patients (18 males, 63.4 ± 12.2 years) and 87 malignant lesions from 57 cancer-bearing patients (32 males, 65 ± 14 years) were analyzed. SUV and MRglc for sarcoid lesions were significantly lower than those for malignant lesions (SUV, 4.98 ± 2.00 vs 6.21 ± 2.14; MRglc, 2.52 ± 1.39 vs 3.68 ± 1.61; p < 0.01). ROC analysis indicated that the ability to discriminate sarcoid patients from those with malignancy yielded areas under the curves of 0.703 and 0.754, with sensitivities of 64% and 77% and specificities of 75% and 72% for SUV 5.025 and MRglc 2.855, respectively. CONCLUSION: MRglc was significantly lower in sarcoid lesions than malignant lesions, and improved sarcoid lesions identification over SUV alone. CLINICAL RELEVANCE STATEMENT: MRglc improves sarcoid lymph node identification over SUV alone and is expected to shorten the examination time by eliminating delayed scans. KEY POINTS: Active sarcoid lesions are sometimes associated with FDG accumulation and should be differentiated from malignant lesions. SUV and metabolic rate of glucose (MRglc) strongly positively correlated, and MRglc could differentiate sarcoid and malignant lesions. MRglc allows for accurate evaluation and staging of malignant lesions.

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An uncommon entity in the class of malignant neuroectodermal nasal tumors is the olfactory neuroblastoma, which originates in the roof of the nasal cavity from the olfactory epithelium. It is often mistaken by clinicians for a nasal polyp because it presents with indistinct features such as nasal obstruction and secondary sinus disease. Olfactory neuroblastoma has been observed to cause morbidity by distant metastasis, invasion through the cribriform plate, and secondary meningitis in most instances. It exhibits a range of biologic activities, from slow growth accompanied by long-term patient survival to a very aggressive malignancy with extensive metastases. We report the incidence of a rare case in which a patient, previously operated on and irradiated for squamous cell carcinoma of the maxilla, developed an olfactory neuroblastoma with orbital protrusion.

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Laryngeal squamous cell carcinoma (LSCC) is one of the most aggressive cancers that affect the head and neck region. Recent researches have confirmed that long non-coding RNAs (lncRNAs) present an emerging role in diversiform diseases including cancers. Prostate cancer-associated ncRNA transcript 6 (PCAT6) is an oncogene in lung cancer, cervical cancer, colon cancer and gastric cancer, but its role in LSCC is still unknown. In the current study, we attempted to figure out the role of PCAT6 in LSCC. RT-qPCR was to analyze PCAT6 expression in LSCC cells. Functional assays were to uncover the role of PCAT6 in LSCC. Mechanism assays were to explore the regulatory mechanism behind PCAT6 in LSCC. PCAT6 exhibited higher expression in LSCC cells and PCAT6 strengthened cell proliferation and inhibited cell apoptosis. Furthermore, lncRNA PCAT6 modulated notch receptor 3 expression and activated NOTCH signaling pathway via serving as a sponge for miR-4731-5p. Taken together, lncRNA PCAT6 was identified as an oncogene in LSCC, which revealed that PCAT6 might be used as potential therapeutic target for LSCC.

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Chimeric antigen receptor-T cell therapy, a groundbreaking cancer treatment, has achieved remarkable success against hematologic malignancies. However, CAR-T monotherapy faces challenges in certain cases, including treatment tolerance and relapse rates. To overcome these challenges, researchers are investigating combining CAR-T cells with other treatments to enhance therapeutic efficacy. Therefore, this review aims to investigate the progress of research in combining CAR-T cells for hematologic malignancies. It covers the basic principles and clinical applications of CAR-T cell therapy, detailing combinations with chemotherapy, immune checkpoint inhibitors, targeted drugs, radiotherapy, hematopoietic stem cell transplantation, and other treatments. These combinations synergistically enhance the antitumor effects of CAR-T cells and comprehensively target tumors through different mechanisms, improving patient response and survival rates.

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Introduction: Osteosarcoma is a malignant mesenchymal neoplasm in which the tumor cells produce defective and immature bone (osteoid). The risk factors for developing the disease include: Patients with hereditary retinoblastoma and germline mutations of the p53 tumor suppressor gene. Case Report: A 32-year old male presented with pain and swelling of the left thigh of 9 months duration. The pain was progressive, excruciating, worse at night, and unresponsive to paracetamol with moderate weight loss. He had sought treatment from a traditional bonesetter 6 months before presentation and had no improvement of the symptoms. Conclusion: In medullary osteosarcoma of the femur, where there is extracomparmental disease with no distant metastasis, clinically and radiologically, radical tumor resection with a free oncological margin increases survival of the patient up to 7 years.

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OBJECTIVES: To observe the efficacy and safety of ginger-partitioned moxibustion combined with ringheaded thumb-tack needle stimulation in the prevention and treatment of chemotherapy-induced nausea and vomiting (CINV) in patients with malignant tumors. METHODS: Patients with malignant tumors and suffering from chemotherapy were randomly divided into control group (35 cases, 4 cases dropped off) and observation group (35 cases, 2 cases dropped off). The patients of the control group were treated by orally taking ondansetron hydrochloride tablets 8 mg/time, 3 times a day for 3 d, and those of the observation group treated by ginger-partitioned moxibustion combined with ringheaded thumb-tack needle stimulation of Zusanli(ST36), Neiguan(PC6), Tianshu(ST25), Zhongwan(CV12) and Guanyuan(CV4) once a day for a total of 3 d, based on the treatment of the control group. The patients' gastrointestinal reaction degree after the 1st , 2nd and the 3rd day of treatment were recorded. The Karnofsky performance status (KPS) score (0-100 points) was used for assessing the patients' quality of life. The TCM syndrome score (4 grades：no, mild, medium and severe, i.e. 0, 2, 4 and 6 points) was given according to the patients' severity of symptoms of spleen (stomach) qi deficiency (nausea and vomiting, abdominal distension after eating, belching, loss of appetite, weakness and laziness to speak, fatigue, and loose stool). The safety of the treatment was assessed by examining the patients' blood routine, liver function and kidney function, and the adverse reactions including blisters, allergies, burns and fainting during acupuncture treatment. RESULTS: After the 2nd and 3rd day of treatment, the patients conditions of vomiting and nausea in the observation group were significantly better than those of the control group (P<0.05). The TCM syndrome score and KPS score were significantly decreased in comparison with those of pre-treatment in both groups (P<0.05), and the TCM syndrome score was obviously lower in the observation group than in the control group (P<0.05). No significant differences were found between the two groups in the KPS score after the treatment , and in the levels of white blood cells (WBC), hemoglobin (HGB), platelets (PLT), absolute neutrophil count (ANC), alanine transaminase (ALT), aspartate aminotransferase (AST), creatinine(Cr), and blood urea nitrogen (BUN). CONCLUSIONS: The use of ginger-partitioned moxibustion combined with ringheaded thumb-tack needle stimulation is safe for CINV patients, and can effectively relieve nausea and vomiting and alleviate digestive symptoms.

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Objectives: The Patient-Generated Subjective Global Assessment (PG-SGA) serves as a specialized nutritional assessment instrument designed for cancer patients. Despite its specificity, the complexity and time requirements of this tool, along with the necessity for administration by trained professionals, limit its practicality in clinical settings. Our objective is to identify a straightforward, efficient, and dependable nutritional assessment tool to promote broader adoption in clinical practice. Methods: This study encompassed a total of 450 patients diagnosed with cancer. Of these, 315 individuals constituted the training set, and the remaining 135 were allocated to the external validation set. The model variables were identified through the Least Absolute Shrinkage and Selection Operator (LASSO) regression method. Binary logistic regression outcomes facilitated the development of a nomogram, offering a visual depiction of the predicted probabilities. The predictive accuracy of the nomogram model was evaluated by calculating the area under the Receiver Operating Characteristic (ROC) curve. Results: The LASSO method detected four variables that were included in the final prediction model: age, serum albumin levels (ALB), body mass index (BMI), and activities of daily living (ADL). The area under the curve (AUC) for this prediction model was 0.905. Both the internal and external calibration curves for malnutrition showed that the predictive nomogram model was highly accurate. Conclusion: The study has developed a prediction model that demonstrates remarkable accuracy in forecasting malnutrition. Furthermore, it presents a streamlined nutritional assessment tool aimed at swiftly identifying cancer patients at nutritional risk, thereby facilitating oncologists in delivering targeted nutritional support to these individuals.

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BACKGROUND AND OBJECTIVE: Immune checkpoint inhibitors (ICIs) have shown remarkable efficacy against various cancers in clinical practice. However, ICIs can cause immune checkpoint inhibitor-associated pancreatic injury, often leading to drug withdrawal, and then patients must go to specialized treatment. The patients, their primary tumors are sensitive to ICIs therapy, may experience treatment delays due to such adverse reactions. Therefore, there is a need for systematic clinical researches on immune-related pancreatic toxicity to provide a clinical basis for its prevention and treatment. METHODS: This study involved the collection of data from patients treated with ICIs and addressed pancreatic injury with preemptive treatment before continuing ICIs therapy. Then, we also statistically analyzed the incidence of pancreatic injury in patients with different courses and combined treatment, and the success rate of rechallenge treatment. RESULTS: The study included 62 patients, with 33.9% (21/62) experiencing varying degrees of pancreatic injury. Patients with pancreatic injury, 10 cases evolved into pancreatitis, representing 47.6% (10/21) in the pancreatic injury subgroup and 16.1% (10/62) of the total patient cohort. Preemptive treatment was administered to 47.6% (10/21) of patients with pancreatitis, the effective rate was 100%. Among these patients, 70% (7/10) underwent successful rechallenge with ICIs. The occurrence of pancreatic injury was positively correlated with the treatment duration (P < 0.05) but showed no significant correlation with combination therapies (P > 0.05). CONCLUSION: The likelihood of pancreatic injury increased with longer treatment durations with ICIs; no significant association was found between the incidence of ICIs-related pancreatic damage and combination therapies. Preemptive treatment for immune-related pancreatitis is feasible, allowing some patients to successfully undergo rechallenge with ICIs therapy.