Gastric Cancer最新文献

{"title":"Screening strategies for the early detection of non-cardia gastric cancer in low- to moderate-prevalence regions: Asia-Pacific gastroesophageal cancer congress consensus 2026.","authors":"Ayaka Takasu, Fumiaki Ishibashi, Rapat Pittayanon, Hon Chi Yip, James Weiquan Li, Munkhsaruul Bayaraa, Hyunsoo Chung, Do Hoon Kim, Kamin Harinwan, Quang Dinh Le, Adolfo Parra-Blanco, Paulo Kassab, Vincenzo Giorgio Mirante, José Murillo-Rodriguez, Regina Rie Imada, Renata Nobre Moura, Sabina Beg, Pedro Genaro Delgado-Guillena, Marta Rodriguez-Carrasco, Seung-Hun Chon, Chul S Hyun, Grigorios Christodoulidis, Vo Duy Long, Zili Xiao, Sergey Kashin, Roman Kuvaev, Ian Yu-Hong Wong, Robert Bechara, Mitsuru Esaki, Waku Hatta, Motohiko Kato, Seiichiro Abe, Sho Suzuki, Kohei Takizawa, Joo Ha Hwang, Wai Keung Leung, Duc Trong Quach, Matsuda Satoru, Han-Kwang Yang, Takuji Gotoda","doi":"10.1007/s10120-026-01800-4","DOIUrl":"https://doi.org/10.1007/s10120-026-01800-4","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) remains a major global health burden, and early detection is essential for improving patient outcomes. Although GC screening has been widely implemented in East Asian countries with a high disease burden, the optimal screening strategy for low- to moderate-prevalence regions remains unclear. To address this gap, the Asia Pacific Gastroesophageal Cancer Congress (APGCC) convened an international consensus meeting to develop evidence-based recommendations for improving the detection of non-cardia gastric cancer (NCGC).</p><p><strong>Methods: </strong>The APGCC working group developed 11 clinical questions (CQs) addressing GC screening, with a particular focus on NCGC. For each CQ, assigned authors conducted literature reviews using PubMed and prepared evidence summaries and draft recommendations. Consensus was achieved through a two-round modified Delphi process involving 37 international voting members.</p><p><strong>Results: </strong>The consensus recommendations addressed population-based screening, screening modalities, identification of high-risk individuals, quality indicators for esophagogastroduodenoscopy (EGD), image-enhanced endoscopy, and artificial intelligence-assisted endoscopy. Population-based endoscopic screening is not recommended in low- to moderate-prevalence regions because of insufficient evidence. However, if screening is performed, EGD is preferred over upper gastrointestinal series for the detection of early NCGC in asymptomatic individuals. The recommendations also emphasize the importance of high-quality endoscopic examinations, risk-stratified screening using serum biomarkers, and the appropriate integration of advanced endoscopic technologies.</p><p><strong>Conclusions: </strong>These APGCC consensus recommendations provide practical guidance for improving the early detection of NCGC in low- to moderate-prevalence regions. This consensus also highlights important evidence gaps and establishes a framework for future research and the development of region-specific GC screening strategies.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preoperative risk-scoring model for predicting intraoperative hemorrhage during endoscopic submucosal dissection for gastric neoplasms.","authors":"Yu-Ping Wang, Wen-Hua Wang, Jing Chen, Jian-Dong Luo, Jing Xuan, Xin He, Wen-Ming Liu, Xu-Jin Wei, Qian-Ye Wu, Yu-Xiang Zhang, Yi-Xuan Wang, Hong Xu","doi":"10.1007/s10120-026-01806-y","DOIUrl":"https://doi.org/10.1007/s10120-026-01806-y","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative hemorrhage is the most frequent complication of endoscopic submucosal dissection (ESD). We aim to develop and externally validate a preoperative risk-scoring model for predicting intraoperative hemorrhage during ESD for gastric neoplasms.</p><p><strong>Methods: </strong>Patients who underwent ESD for gastric neoplasms from four endoscopy centers were enrolled in this retrospective study, with 1123 patients in derivation cohort and 345 patients in validation cohort. In derivation cohort, univariable and multivariable logistic regression analysis were used to identify independent preoperative predictors of intraoperative hemorrhage. A risk-scoring model was created by assigning weighted points to selected predictors. External validation was conducted to analyse the discrimination and calibration of the prediction model.</p><p><strong>Results: </strong>A prediction model for intraoperative hemorrhage included 5 variables: upper-third location (5 points), large lesion size (≥ 25 mm) (4 points), current HP infection (3 points), junior endoscopist (3 points) and middle-third location (2 points). Patients were stratified into low- (0-2 points), intermediate- (3-4 points), high- (5-6 points), and very high-risk (≥ 7 points) groups, with corresponding bleeding rates of 4.8%, 35.9%, 80.2% and 98.5%, respectively. In external validation cohort, the model showed excellent discrimination, with a c-statistic of 0.96 (95% CI 0.95-0.98), and good calibration (calibration-in-the-large, - 0.04; calibration slope, 0.94).</p><p><strong>Conclusions: </strong>We developed a preoperative risk-scoring model to predict intraoperative hemorrhage of ESD for gastric neoplasms. For lesions of large size or located on the upper-third of the stomach, ESD should be performed by senior endoscopists after successful HP eradication to minimize the occurrence of bleeding.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From operating room to pathology report: Delphi consensus on pathological assessment of peritoneal cytology and biopsies in staging laparoscopy for gastric cancer.","authors":"Judith S E Quik, Micha J de Neijs, Heike I Grabsch, Niels A D Guchelaar, Jan Erik Freund, Lodewijk A A Brosens, Lindsey Oudijk, Marie-Louise F van Velthuysen, Michail Doukas, Petur Snaebjornsson, Astrid Klooster, Nienke Doddema, Kay van den Burg, Bas P L Wijnhoven, Johanna W van Sandick, Sybren L Meijer, Liudmila L Kodach","doi":"10.1007/s10120-026-01803-1","DOIUrl":"https://doi.org/10.1007/s10120-026-01803-1","url":null,"abstract":"<p><strong>Background: </strong>Staging laparoscopy with peritoneal cytology and biopsies is recommended in selected patients with gastric cancer (GC), but practical guidance for assessment of peritoneal lavage/ascites and peritoneal biopsies is lacking. We aimed to develop consensus-based recommendations for handling, assessing and reporting of these specimens.</p><p><strong>Methods: </strong>A modified Delphi study was conducted among Dutch experts in GC (cyto)pathology. In round 1, sixty-two statements on clinical information, specimen requirements, initial assessment, ancillary testing, biomarker testing and reporting were rated on a 3-point scale (agree/neutral/disagree); consensus was predefined as ≥ 80% agreement. Non-consensus statements were discussed in an online meeting, informed by comments and literature review, revised, and re-rated in Round 2 on a dichotomous agree/disagree scale, with consensus defined as ≥ 70% agreement.</p><p><strong>Results: </strong>Thirty-one experts from university, general, and independent pathology practices participated. Consensus was achieved for 39 of 62 statements (63%) in Round 1 and for 58 of 62 statements (94%) after Round 2. Consensus was achieved on required clinical information from surgeons, specimen submission and handling, cytological and histological assessment, use of ancillary immunocytochemistry/immunohistochemistry, structured reporting categories, and approaches to biomarker testing on peritoneal biopsies. The study also resulted in structured reporting templates for peritoneal cytology and biopsies.</p><p><strong>Conclusion: </strong>This Delphi study achieved broad expert consensus on pathological assessment of peritoneal fluid and biopsies obtained during staging laparoscopy in GC patients. The resulting recommendations and structured reporting templates provide a practical framework to harmonise specimen handling, evaluation and reporting, thereby promoting greater standardisation and consistency in GC staging.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal assessment of quality-of-life after gastrectomy for gastric cancer: a prospective study.","authors":"Shinji Kuroda, Yoshihiko Kakiuchi, Yudai Mimata, Hitoshi Minagi, Shunya Hanzawa, Hajime Kashima, Satoru Kikuchi, Toshiyoshi Fujiwara","doi":"10.1007/s10120-026-01805-z","DOIUrl":"https://doi.org/10.1007/s10120-026-01805-z","url":null,"abstract":"<p><strong>Background: </strong>The longitudinal recovery process for postoperative quality of life (QOL) after gastrectomy remains incompletely understood. We prospectively evaluated temporal changes in QOL using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45) and investigated predictors of poor postoperative QOL.</p><p><strong>Methods: </strong>This prospective observational study enrolled 433 patients who underwent gastrectomy for primary gastric cancer between 2015 and 2020. Patients completed the PGSAS-45 questionnaire preoperatively and at 1 month, 6 months, 1 year, and > 5 years after surgery. Longitudinal changes in QOL were analyzed, and multivariable logistic regression was performed to identify predictors of poor postoperative QOL at 1 year after surgery.</p><p><strong>Results: </strong>All PGSAS-45 domains except the mental component summary (MCS) were significantly deteriorated at 1 month after surgery. Most domains recovered substantially between 1 and 6 months and changed little thereafter. MCS was the only domain that improved beyond the preoperative level. Independent predictors of poor total symptom score were major postoperative complications (Clavien-Dindo grade ≥ III; odds ratio [OR] 4.78, p = 0.013) and preoperative MCS < 46 (OR 2.45, p = 0.001). Preoperative physical component summary (PCS) < 46 (OR 2.01, p = 0.028) independently predicted poor quality of ingestion, while preoperative MCS < 46 (OR 2.81, p < 0.001) independently predicted greater dissatisfaction with daily life.</p><p><strong>Conclusions: </strong>Postoperative QOL recovered predominantly within the first 6 months after gastrectomy and remained largely stable thereafter. Preoperative PCS and MCS, together with major postoperative complications, were important determinants of postoperative QOL.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of geriatric assessment with provider's clinical assessment among older adults with gastroesophageal cancer.","authors":"Namrata Vijayvergia, Caitlin R Meeker, Meghan Connors, Elizabeth A Handorf, Jinhong Cui, Lauren Laderman, Anush Sridharan, Mohamedtaki A Tejani, Grant R Williams, Arthur Winer, Sukeshi P Arora, Juhi Mittal, Melina Hillsberg, Kelly Filchner, Efrat Dotan","doi":"10.1007/s10120-026-01787-y","DOIUrl":"10.1007/s10120-026-01787-y","url":null,"abstract":"<p><strong>Background: </strong>Older adults with gastroesophageal cancer (GEC) frequently visit oncology practices, but provider assessments often overlook critical geriatric factors. This study compares the effectiveness of a geriatric assessment (GA) versus routine provider assessment (PA) in evaluating these patients.</p><p><strong>Methods: </strong>Patients (≥ 65 years) actively undergoing therapy for GEC completed a GA, while providers conducted a baseline PA. Both assessments identified abnormalities across multiple geriatric domains, including functional status, nutrition, comorbidities, psychological distress, cognition, social support, and chemotherapy toxicity risk. We compared abnormalities detected and their correlation with clinical outcomes (≥ grade 3 toxicity and hospitalization) at 3 months.</p><p><strong>Results: </strong>Among 82 patients, 89% had at least one severe abnormality. GA identified more severe abnormalities (53%) than PA (35%), particularly in nutrition, psychological status, social support, and cognition. PA was more effective in detecting patients with comorbidities impacting treatment (49 vs. 20 patients). Patients with high chemotherapy toxicity scores and psychosocial distress had greater toxicity risk, while severe abnormalities in function, nutrition, and psychological status were linked to increased risk of hospitalization.</p><p><strong>Conclusions: </strong>Geriatric assessment uncovers significant geriatric abnormalities that are often missed by PA in older adults with GEC. Findings support integrating GA into routine evaluations to improve patient care.</p><p><strong>Implications for practice: </strong>Older adults with gastroesophageal cancers (GEC) represent a vulnerable and under-assessed population in oncology. This study demonstrates that geriatric assessment (GA) detects significantly more clinically relevant abnormalities-particularly in nutrition, psychosocial support, cognition, and chemotherapy toxicity risk-than routine provider assessments. These findings are particularly timely as gastroesophageal cancer therapy enters an era of increasingly complex and potentially toxic treatments, including antibody-drug conjugates and combination regimens. With nearly 90% of patients in our study presenting with at least one severe abnormality requiring intervention, GA offers a practical and evidence-based tool to improve treatment decision-making, minimize toxicities, and personalize care for older adults. Incorporating GA into routine oncology practice is essential to optimizing outcomes and ensuring equitable care delivery for this growing patient population.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IGF2-associated tumor cells and APOE-positive macrophages define an imatinib resistance-associated niche in gastrointestinal stromal tumors.","authors":"Mu Su, Chengqian Lv, Ruiyang Zhai, Yu Li, Chunyu Deng, Jie Xing, Peishen Yu, Ji Li, XinJing Gong, Yue Gu, Bo Qu, Yan Zhang","doi":"10.1007/s10120-026-01802-2","DOIUrl":"https://doi.org/10.1007/s10120-026-01802-2","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal stromal tumors (GISTs) are highly responsive to imatinib, but acquired resistance frequently develops. In particular, the roles of distinct tumor cells and their interactions with tumor-associated macrophages (TAMs) in shaping imatinib response remain poorly understood.</p><p><strong>Methods: </strong>We used integrative single-cell transcriptomic analysis to characterize tumor cells and tumor microenvironment heterogeneity in gastric GIST, with validation in independent imatinib-treated, metastatic, and spatial transcriptomic datasets. Cell-cell communication, metabolic pathway, in silico perturbation, and connectivity analyses were performed to identify resistance-associated microenvironmental programs.</p><p><strong>Results: </strong>We identified five transcriptionally distinct GIST tumor-cell states with distinct functional programs. Among them, the S100A6-associated and IGF2-associated states showed opposing associations with imatinib response and distinct relationships with TAM programs. A niche comprising S100A6-associated tumor cells and CCL4-positive TAMs was observed in imatinib-sensitive tumors and exhibited stress-response and immune-activation features. In contrast, the IGF2-associated state was enriched in imatinib-resistant and metastatic GIST samples and showed coordinated occurrence with APOE-positive TAMs in a resistance-associated niche characterized by metabolic remodeling and immunoregulatory features, with predicted IGF and KIT signaling and iron-related metabolic crosstalk. This tumor-cell state also showed predicted immunosuppressive interactions with regulatory T cells. Integrative perturbation analysis identified a 61-gene resistance-associated signature, with IFI6 emerging as top-ranked candidate marker.</p><p><strong>Conclusions: </strong>These findings reveal distinct tumor-cell-macrophage niches underlying imatinib sensitivity and resistance in GIST, and identify the IGF2-associated GIST tumor-cell state-APOE-positive TAM axis as a candidate resistance-associated tumor-immune state with potential biomarker and therapeutic implications.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter phase II trial of ramucirumab plus irinotecan for early recurrence of gastric cancer during or after adjuvant chemotherapy with docetaxel plus S-1 therapy: the RAMIEL trial (OGSG1901).","authors":"Toshifumi Yamaguchi, Ryohei Kawabata, Yusuke Akamaru, Hidekazu Hirano, Keijiro Sugimura, Yasuhiro Miyazaki, Yoshihiro Kakeji, Yosuke Kito, Takashi Nomura, Takeshi Kawakami, Masahiro Tanemura, Atsushi Takeno, Hiroyuki Okuda, Tomohiro Matsushima, Toshio Shimokawa, Yukinori Kurokawa, Shunji Endo, Narikazu Boku, Taroh Satoh","doi":"10.1007/s10120-026-01799-8","DOIUrl":"https://doi.org/10.1007/s10120-026-01799-8","url":null,"abstract":"<p><strong>Background: </strong>There is currently no established chemotherapy regimen for early recurrence of pathological stage III gastric cancer (GC) following adjuvant chemotherapy with docetaxel plus S-1 (DS) after D2 gastrectomy. We aimed to evaluate the efficacy and safety of ramucirumab plus irinotecan in patients with GC who experienced early recurrence during or within 6 months after DS adjuvant chemotherapy.</p><p><strong>Methods: </strong>This prospective, open-label, multicenter phase II trial enrolled eligible patients treated at 25 centers of the Osaka Gastrointestinal Cancer Chemotherapy Study Group in Japan. Patients received ramucirumab (8 mg/kg) and irinotecan (150 mg/m²) every 2 weeks. The primary endpoint was overall survival (OS), and secondary endpoints included progression-free survival (PFS), objective response rate (ORR), and safety. The sample size was set at 40 based on a threshold median OS of 7 months and an expected median OS of 11 months, with a one-sided alpha error of 0.05 and a power of 0.80.</p><p><strong>Results: </strong>Between November 2019 and July 2023, 43 patients were enrolled, and 39 were included in the analysis after excluding three ineligible patients and one who did not initiate protocol treatment. The median OS was 15.9 months (95% CI: 8.8-42.0; p = 0.003). The median PFS was 5.5 months (95% CI: 3.9-8.1), and the ORR was 38.5%. Grade  ≥ 3 adverse events, including neutropenia (25.6%) and hypertension (25.6%), were observed in more than 20% of patients.</p><p><strong>Conclusion: </strong>Ramucirumab plus irinotecan demonstrated promising efficacy and manageable toxicity in patients with early recurrence of GC following adjuvant DS therapy.</p><p><strong>Trial registration: </strong>This study was prospectively registered in the Japan Registry of Clinical Trials (jRCTs05119071, October 6, 2019, https://jrct.niph.go.jp/latest-detail/jRCTs051190071 ).</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological characterization of extremely low-grade fundic gland tumors: a study of 11 of a variant of oxyntic gland adenomas.","authors":"Sunao Akiyama, Takashi Yao, Tetsuya Tanihira, Tatsushi Suwa","doi":"10.1007/s10120-026-01801-3","DOIUrl":"https://doi.org/10.1007/s10120-026-01801-3","url":null,"abstract":"<p><strong>Background: </strong>Gastric adenocarcinoma of the fundic gland type (GA-FG) is a well-characterized entity showing differentiation toward oxyntic gland cells. However, extremely low-grade lesions that do not meet the established diagnostic criteria for GA-FG are increasingly encountered in clinical practice. We aimed to characterize these lesions, which we termed a variant of oxyntic gland adenomas (OGAs).</p><p><strong>Methods: </strong>We retrospectively reviewed 11 lesions in 10 patients with OGAs identified between 2018 and 2025. All lesions were managed via endoscopic surveillance. We evaluated the clinicopathological and endoscopic features of these lesions and performed immunohistochemical staining for MUC6, pepsinogen I, H⁺/K⁺-ATPase (proton pump), and cyclin D1.</p><p><strong>Results: </strong>All lesions were flat, whitish, and located in the upper stomach, notably lacking subepithelial tumor-like elevations. Magnifying endoscopy with narrow-band imaging revealed minimal structural changes on the surface. Histologically, the tumors showed well-circumscribed proliferation in the deep fundic mucosa, consisting of chief cell-like cells with minimal architectural atypia and an extremely low nuclear-to-cytoplasmic ratio. Although all lesions showed diffuse positivity for MUC6 and pepsinogen I, cyclin D1 expression was absent. No lesions showed progression or structural transformation during the follow-up period (range, 6-84 months).</p><p><strong>Conclusions: </strong>These lesions represent a distinct clinicopathological entity characterized by minimal cytological atypia and lack of surface mucosal changes and cyclin D1 expression. Our findings suggest that these lesions are a variant of OGAs and behave as benign mimics of GA-FG. Recognizing this extremely low-grade variant is crucial to avoid overdiagnosis and unnecessary aggressive interventions.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity and specificity of endoscopic and radiographic screening for localized gastric cancer in a real-world, population-based setting.","authors":"Choy-Lye Chei, Sho Nakamura, Kaname Watanabe, Hiroaki Saito, Soichiro Isshiki, Satoshi Tamura, Hiroto Narimatsu","doi":"10.1007/s10120-026-01797-w","DOIUrl":"https://doi.org/10.1007/s10120-026-01797-w","url":null,"abstract":"<p><strong>Background: </strong>In Japan, radiography with barium meal and endoscopy are recommended methods for population-based gastric cancer screening for individuals aged ≥ 50 years. However, no recent real-world evidence is available on the performance of endoscopic and radiographic screening in detecting localized gastric cancer. Therefore, we estimated the sensitivity and specificity of endoscopy and radiography in detecting gastric cancer and its clinical stages in a real-world, population-based screening setting.</p><p><strong>Methods: </strong>We cross-referenced data from a population-based gastric cancer screening database with a regional cancer registry database. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value of endoscopy (n = 61,658) and radiography (n = 73,653) for gastric cancer and its clinical stages. Age- and sex-standardized sensitivity values were estimated using regression standardization.</p><p><strong>Results: </strong>For localized gastric cancer, endoscopy showed higher sensitivity (83.4% vs. 65.3%), specificity (99.0% vs. 88.7%), and PPV (27.4% vs. 2.2%) than radiography. The corresponding estimates for men were 83.3% vs. 65.6%, 98.7% vs. 87.3%, and 31.1% vs. 3.1%; for women, they were 83.6% vs. 64.5%, 99.3% vs. 89.9%, and 20.5% vs. 1.2%. The age- and sex-standardized sensitivity of endoscopy was also higher than that of radiography (83.6% vs. 65.3%, p < 0.001).</p><p><strong>Conclusions: </strong>In this descriptive study, endoscopy showed higher sensitivity, specificity, and PPV than radiography for gastric cancer overall and across its clinical stages (localized, regional, distant). Our findings provide updated evidence to inform population-based screening efforts in countries with high gastric cancer incidence.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation and comparison of five prediction models for lymph node metastasis after noncurative endoscopic submucosal dissection for early gastric cancer.","authors":"Ayaka Takasu, Waku Hatta, Takuji Gotoda, Yohei Ogata, Yuichiro Kemmoto, Hiroto Noda, Souya Nunobe, João Santos-Antunes, Hiroshi Kawachi","doi":"10.1007/s10120-026-01798-9","DOIUrl":"10.1007/s10120-026-01798-9","url":null,"abstract":"<p><strong>Background: </strong>Additional gastrectomy is recommended after noncurative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) despite the low incidence of lymph node metastasis (LNM). The eCura system, W-eCura score, and 11-point score reportedly predict LNM risk; however, their comparative performance remains unclear. We aimed to externally validate and directly compare five risk stratification approaches in patients with noncurative ESD.</p><p><strong>Methods: </strong>We retrospectively evaluated 634 consecutive patients with EGC who underwent noncurative ESD at a single high-volume center. Five prediction models were evaluated: the eCura system (7-point score and three-risk classification), W-eCura score (7-point score and three-risk classification), and 11-point score. All pathological findings were re-evaluated by an outcome-blinded expert pathologist. Model performance was assessed by discrimination, calibration, and decision-curve analysis (DCA).</p><p><strong>Results: </strong>LNM was identified in 26 (4.9%) patients. All models showed comparable discrimination (c-statistics, 0.71 to 0.72). However, calibration-in-the-large and calibration slope were poorer in the W-eCura score and 11-point score (- 1.43 to - 0.96 and 0.26 to 0.64) than in the eCura system (- 0.43 to - 0.40 and 0.83 to 0.84). Using DCA, the eCura system and W-eCura score consistently showed higher net benefits than did the 11-point score across clinically relevant threshold probabilities. Recalibration improved both calibration and net benefits across all models.</p><p><strong>Conclusions: </strong>Despite similar discriminative performance, the eCura system demonstrated relatively favorable calibration and potential clinical utility in this Japanese cohort. Given their simplicity and structural similarity, three-risk classifications of the eCura system and W-eCura score, when appropriately calibrated, may support decision-making regarding additional gastrectomy.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}