{"title":"Diagnostic performance of staging laparoscopy after chemotherapy and the prognostic impact of peritoneal disease resolution in advanced gastric cancer.","authors":"Kensuke Kudou, Tomoyuki Irino, Motonari Ri, Masaru Hayami, Souya Nunobe","doi":"10.1007/s10120-026-01763-6","DOIUrl":"10.1007/s10120-026-01763-6","url":null,"abstract":"<p><strong>Background: </strong>The clinical utility of staging laparoscopy (SL) after chemotherapy for advanced gastric cancer remains unclear. This study evaluated the diagnostic performance of post-chemotherapy SL and the prognostic significance of peritoneal disease resolution.</p><p><strong>Methods: </strong>We retrospectively analyzed 128 patients who underwent SL after chemotherapy. Peritoneal disease was defined as macroscopic peritoneal dissemination and/or positive peritoneal lavage cytology. Diagnostic accuracy, sensitivity, and specificity of post-chemotherapy SL were evaluated. We examined the incidence of newly detected peritoneal disease among patients who were negative before chemotherapy and the rate of peritoneal/cytologic (P/CY) resolution among those who were positive before chemotherapy. Survival outcomes were compared according to post-chemotherapy P/CY status.</p><p><strong>Results: </strong>The overall positivity rate of post-chemotherapy SL was 38.3%. Newly detected peritoneal disease on post-chemotherapy SL was observed in 2.8% of initially negative patients; when false-negative cases were considered, the actual rate was 5.6%. Among 92 patients with peritoneal disease before chemotherapy, the true P/CY resolution rate after excluding false-negative cases was 37.0%. Patients who achieved P/CY resolution had significantly better survival than those with persistent peritoneal disease (median survival time, 53.7 vs. 21.5 months). Persistent P/CY positivity was an independent adverse prognostic factor.</p><p><strong>Conclusions: </strong>Post-chemotherapy SL appears to be most useful as a patient selection tool, particularly in patients with peritoneal disease at initial diagnosis, by identifying those who may benefit from subsequent treatment escalation. In contrast, newly detected peritoneal disease was uncommon in initially negative patients. Careful interpretation is required because of the risks of false-negative findings and early peritoneal recurrence.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"1065-1074"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148137808","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":"Modified transferrin saturation is associated with postoperative complications in patients undergoing curative gastrectomy for gastric cancer.","authors":"Chishou Mitsuura, Satoshi Ida, Hiroki Tsubakihara, Kohei Yamashita, Kojiro Eto, Chihiro Matsumoto, Keisuke Kosumi, Kazuto Harada, Yuji Miyamoto, Masaaki Iwatsuki","doi":"10.1007/s10120-026-01783-2","DOIUrl":"10.1007/s10120-026-01783-2","url":null,"abstract":"<p><strong>Background: </strong>Surgical complications after gastrectomy significantly impact recovery and long-term prognosis. While iron status influences outcomes, the conventional 20% transferrin saturation (TSAT) threshold ignores sex-specific physiological differences. We developed a modified TSAT (mTSAT) based on sex and anemia status and evaluated its value in predicting complications.</p><p><strong>Methods: </strong>We retrospectively analyzed 243 patients who underwent curative gastrectomy. Optimal TSAT cut-off values for predicting complications classified as Clavien-Dindo grade II or higher were determined using receiver operating characteristic curves stratified by sex and anemia status. Predictive performance was compared between mTSAT and the conventional 20% threshold using the corrected Akaike Information Criterion.</p><p><strong>Results: </strong>The optimal mTSAT cut-offs were 22.2% for men and 14.2% for women. The mTSAT model demonstrated an improved fit compared with the conventional threshold. The low mTSAT group (mTSAT below the sex-specific cut-off) comprised 78 patients and exhibited a significantly higher incidence of complications than the normal mTSAT group, particularly anastomotic leakage and delayed gastric emptying/ileus. Moreover, postoperative hospital stay was significantly longer in this group. In the primary multivariable analysis, low mTSAT was significantly associated with postoperative complications, whereas the conventional 20% threshold was not. After additional adjustment for clinical stage and surgical approach, the association was attenuated and no longer reached statistical significance.</p><p><strong>Conclusions: </strong>Preoperative low mTSAT was associated with an increased risk of postoperative complications. Rather than a standalone predictor, mTSAT functions as a valuable composite clinical indicator reflecting stage-related systemic vulnerability, surgical invasiveness, and underlying malnutrition or iron deficiency.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"1166-1174"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619533","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":"Loss of EMILIN-1/integrin axis drives microenvironmental reprogramming in gastric tumorigenesis.","authors":"Alessandra Capuano, Maddalena Vescovo, Samanta Muzzin, Enrica Timis, Laura Cesaratto, Eliana Pivetta, Roberto Doliana, Antonio Palumbo, Renato Cannizzaro, Vincenzo Canzonieri, Eugenio Scanziani, Simone Canesi, Gustavo Baldassarre, Maurizio Mongiat, Paola Spessotto","doi":"10.1007/s10120-026-01781-4","DOIUrl":"10.1007/s10120-026-01781-4","url":null,"abstract":"<p><strong>Background: </strong>EMILIN-1 is an extracellular matrix glycoprotein with tumor-suppressive functions. While its loss is implicated in cancer progression, its specific role in the gastric tumor microenvironment and its clinical relevance remain poorly defined.</p><p><strong>Methods: </strong>Using in vitro cellular systems and genetically modified mouse models we investigated the consequences of impaired EMILIN-1 function on gastric epithelial transformation, stromal remodeling, and fibroblast reprogramming. Histopathological analysis, gene expression profiling, and functional assays were employed to assess phenotypic changes in epithelial, fibroblastic, and endothelial compartments.</p><p><strong>Results: </strong>We found that gastric cancer (GC) cells downregulate EMILIN-1 in stromal fibroblasts and lymphatic endothelial cells via paracrine signaling, leading to reduced EMILIN-1 deposition and disrupted lymphatic organization. Mechanistically, the interaction between EMILIN-1 and α4β1 integrin, which is absent in GC cells, modulates tumor cell proliferation; loss of this axis allows tumor cells to escape ECM-mediated growth control. Furthermore, EMILIN-1 downregulation reprograms fibroblasts into a pro-tumorigenic phenotype, which enhances GC cell migration and clonogenic potential. EMILIN-1 loss-of-function (E955A) mice showed increased susceptibility to pre-neoplastic lesions, a finding mirrored in human dysplastic tissues where EMILIN-1 was markedly reduced.</p><p><strong>Conclusion: </strong>Our findings establish EMILIN-1 as a master regulator of gastric tissue integrity. Its loss creates a tumor-permissive microenvironment by disrupting epithelial homeostasis, impairing lymphatic structure, and promoting fibroblast activation. The consistent reduction of EMILIN-1 in early human dysplasia highlights its potential as a novel stromal biomarker for early GC risk stratification. Moreover, restoring the EMILIN-1/integrin axis represents a promising therapeutic strategy to re-establish growth control and suppress tumor progression.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"987-1000"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preoperative chemotherapy with docetaxel, oxaliplatin, and S-1 for gastric cancer with extensive lymph node metastasis: 3-year follow-up results from JCOG1704.","authors":"Yukinori Kurokawa, Yuichiro Doki, Junki Mizusawa, Kota Kawabata, Takashi Nomura, Kunihiro Tsuji, Sang-Woong Lee, Haruhiko Cho, Jun Hihara, Naoki Hiki, Souya Nunobe, Narikazu Boku, Masanori Terashima, Takaki Yoshikawa","doi":"10.1007/s10120-026-01766-3","DOIUrl":"10.1007/s10120-026-01766-3","url":null,"abstract":"<p><strong>Background: </strong>Prognosis of marginally resectable gastric cancer with extensive lymph node metastasis (ELM) remains poor, even after R0 resection. JCOG0405 established preoperative cisplatin plus S-1 as a provisional standard of care in Japanese guidelines, based on a favorable 3-year overall survival (OS) of 58.8%. We report the 3-year survival outcomes of JCOG1704, a phase II trial evaluating preoperative docetaxel, oxaliplatin, and S-1 (DOS) for marginally resectable gastric cancer with ELM, following promising short-term outcomes.</p><p><strong>Methods: </strong>Patients with histologically confirmed HER2-negative gastric adenocarcinoma and bulky nodal (BN) involvement and/or para-aortic node (PAN) metastasis were eligible. Patients received three cycles of DOS (docetaxel 40 mg/m<sup>2</sup>, day 1; oxaliplatin 100 mg/m<sup>2</sup>, day 1; S-1 80-120 mg/m<sup>2</sup>, days 1-14) every 3 weeks, followed by gastrectomy with D2 plus PAN dissection and postoperative S-1 for 1 year.</p><p><strong>Results: </strong>Between December 2018 and March 2022, 47 patients (BN only, 20; PAN only, 17; both, 10) were enrolled. At the data cutoff date (May 2025), the 3-year OS and progression-free survival (PFS) were 86.7% (95% CI 72.7-93.8%) and 75.6% (95% CI 60.2-85.6%), respectively, among 46 eligible patients. Among 42 patients who underwent R0 resection, the 3-year relapse-free survival (RFS) was 78.6% (95% CI 62.9-88.2%). In subgroup analyses, the 3-year OS/PFS/RFS were 85.0%/75.0%/77.8% in BN only, 93.8%/81.3%/86.7% in PAN only, and 77.8%/66.7%/66.7% in both.</p><p><strong>Conclusions: </strong>Preoperative DOS for gastric cancer with ELM yielded unprecedentedly favorable 3-year survival outcomes and was considered a provisional standard of care without a phase III trial within our JCOG community.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"1075-1082"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastric CancerPub Date : 2026-09-01Epub Date: 2026-06-13DOI: 10.1007/s10120-026-01745-8
Patryk Rogaczewski, Michał Janiak, Justyna Durślewicz, Krzysztof Koper, Jędrzej Borowczak
{"title":"Oral vitamin B₁₂ after total gastrectomy for gastric cancer: mapping the evidence.","authors":"Patryk Rogaczewski, Michał Janiak, Justyna Durślewicz, Krzysztof Koper, Jędrzej Borowczak","doi":"10.1007/s10120-026-01745-8","DOIUrl":"10.1007/s10120-026-01745-8","url":null,"abstract":"<p><strong>Background: </strong>Patients who undergo total gastrectomy lose the ability to produce intrinsic factor and require lifelong supplementation to prevent vitamin B<sub>12</sub> deficiency. While oral B<sub>12</sub> has emerged as a potential alternative to parenteral therapy, data remain limited, and most clinicians still favor intramuscular injections. This scoping review aimed to map the current evidence on the efficacy, safety, and implementation of oral vitamin B<sub>12</sub> supplementation in patients after total gastrectomy for gastric cancer.</p><p><strong>Methods: </strong>We included peer-reviewed studies reporting outcomes of oral vitamin B<sub>12</sub> supplementation after total gastrectomy. A systematic literature search was conducted in scientific databases, including articles published up to November 2025. The reference lists of included articles were screened manually. Extracted data were synthesized narratively. The review was conducted in accordance with the PRISMA-ScR guidelines.</p><p><strong>Results: </strong>Seven studies (n = 449, including 310 patients receiving oral B₁₂) were included. Most used mecobalamin at daily doses of 500-1500 µg. Oral B<sub>12</sub> consistently normalized serum levels and alleviated symptoms in the majority of patients. Comparative studies showed that, in terms of biochemical response, oral supplementation was not inferior to parenteral therapy. However, symptom monitoring was inconsistent, follow-up durations were generally short (< 6 months), and only one study was randomized. Standardized clinical outcome measures were rarely used, and data from Western populations were limited. Heterogeneity in dosing regimens and B<sub>12</sub> formulations further limited comparability across studies.</p><p><strong>Conclusions: </strong>Oral B<sub>12</sub> appears to be a feasible route of supplementation after total gastrectomy, but current evidence is limited by heterogeneity, underreporting of clinical outcomes, and lack of long-term follow-up. High-quality trials with standardized outcome measures are warranted.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"920-929"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13524985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gastric CancerPub Date : 2026-09-01Epub Date: 2026-06-14DOI: 10.1007/s10120-026-01770-7
Xuezhe Yuan, Kaibo Guo, Song Zheng
{"title":"Comment on 'Clinical impact of intratumoral HER2 heterogeneity on trastuzumab deruxtecan efficacy in patients with HER2-positive gastric cancer'.","authors":"Xuezhe Yuan, Kaibo Guo, Song Zheng","doi":"10.1007/s10120-026-01770-7","DOIUrl":"10.1007/s10120-026-01770-7","url":null,"abstract":"","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"1175-1176"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251257","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":"Clinical advantages of robotic gastrectomy for gastric cancer over conventional laparoscopic approach: a retrospective cohort study using a nationwide registry database in Japan.","authors":"Susumu Shibasaki, Hideki Endo, Hiroyuki Yamamoto, Masaya Nakauchi, Tsuyoshi Tanaka, Shigeo Hisamori, Kazutaka Obama, Hirokazu Noshiro, Koshi Kumagai, Hideki Ueno, Ken Shirabe, Ichiro Uyama, Koichi Suda","doi":"10.1007/s10120-026-01764-5","DOIUrl":"10.1007/s10120-026-01764-5","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate contemporary short-term outcomes of robotic gastrectomy (RG) approximately 5 years after its widespread implementation, compared with laparoscopic gastrectomy (LG) using a nationwide Japanese database.</p><p><strong>Background: </strong>RG has been introduced to overcome the technical limitations of LG; however, its real-world clinical advantages remain to be fully defined.</p><p><strong>Methods: </strong>This retrospective study used the Japanese National Clinical Database to identify patients with gastric cancer who underwent minimally invasive distal gastrectomy (DG) or total gastrectomy (TG) between January 2023 and December 2024. Patients were classified as undergoing robotic (RDG or RTG) or laparoscopic (LDG or LTG) procedures. Propensity score matching was performed separately for the DG and TG cohorts to adjust for patient-, tumor-, and hospital-related confounders. The primary outcome was postoperative morbidity within 30 days (Clavien-Dindo grade ≥ IIIa).</p><p><strong>Results: </strong>After propensity score matching, 9743 RDG-LDG pairs and 1617 RTG-LTG pairs were analyzed. RDG was associated with a significantly lower morbidity rate than LDG (4.3 vs. 4.9%, P = 0.049). Despite longer operative time, RDG was associated with lower blood loss, lower conversion rates, fewer intra-abdominal infectious complications, and shorter postoperative hospital stay than LDG. Overall morbidity did not differ significantly between RTG and LTG (8.7 vs. 8.3%, P = 0.66); however, RTG was associated with lower blood loss, lower conversion rates, and shorter hospital stay.</p><p><strong>Conclusions: </strong>RDG was associated with improvements in multiple short-term outcomes, whereas RTG still did not improve the primary outcome measure.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"1115-1126"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029275","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":"Identification of patients at risk for poor survival among those with normal skeletal muscle mass: a multicenter retrospective validation study in gastric cancer.","authors":"Ryota Matsui, Kazuyoshi Yamamoto, Yoshiro Yukawa, Masayoshi Terayama, Yukinori Kurokawa, Daisuke Ichikawa, Yoshitomo Yanagimoto, Takashi Oshima, Souya Nunobe, Takashi Kamei, Hiroya Takeuchi, Yoshihiro Nabeya, Masaki Kaibori, Naoki Hiki, Hidetoshi Eguchi, Yuichiro Doki","doi":"10.1007/s10120-026-01778-z","DOIUrl":"10.1007/s10120-026-01778-z","url":null,"abstract":"<p><strong>Background: </strong>Although a low skeletal muscle mass index (SMI) leads to poor overall survival (OS) after gastrectomy in patients with gastric cancer, the cutoff value that predicts long-term survival in patients with normal SMI remains unclear. This study aimed to determine the cutoff SMI value for predicting OS in patients with normal SMI.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study included patients with normal SMI who underwent radical gastrectomy for pStage I-III primary gastric cancer between January 2011 and December 2016. The patients were randomly divided at a 6:4 ratio into a training set, which examined the cutoff values for SMI, and a validation set, which validated the cutoff values. Patients were classified into high and low SMI groups according to the cutoff values. We compared OS between the high- and low-SMI groups using log-rank test and identified prognostic factors using Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>Of the 2516 patients, 1389 (55.2%) and 1127 (44.8%) were classified into the training and validation sets. We examined the cutoff values of SMI, which were 44.3 cm<sup>2</sup>/m<sup>2</sup> for men and 37.6 cm<sup>2</sup>/m<sup>2</sup> for women. Both men and women in the low-SMI group had poorer OS than those in the high-SMI group. Multivariate analysis revealed that a low SMI was an independent adverse prognostic factor for OS (hazard ratio: 1.314, 95% confidence interval: 1.044-1.654, P = 0.020). These cutoff values were associated with lower cancer-specific survival.</p><p><strong>Conclusions: </strong>Among patients with normal SMI, those with a lower SMI had poorer long-term survival after radical gastrectomy.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"1140-1149"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A proof-of-concept study of surgical-VLM for surgical support in robotic surgery: contextual benchmarking against ChatGPT-5.","authors":"Jumpei Ikeda, Hirofumi Kawakubo, Masashi Takeuchi, Yosuke Morimoto, Kazuaki Matsui, Satoru Matsuda, Yuko Kitagawa","doi":"10.1007/s10120-026-01760-9","DOIUrl":"10.1007/s10120-026-01760-9","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has rapidly advanced in surgical applications. However, existing single-modality AI models relying solely on image input lack the ability to integrate anatomical understanding with clinical reasoning, which is essential for safe and actual surgical decision-making. We constructed an AI model with multimodal training combining visual and linguistic data and named Surgical Vision-Language Model (Surgical-VLM) for real-time surgical support.</p><p><strong>Methods: </strong>We analyzed surgical videos from 50 cases of robotic distal gastrectomy and extracted 50 still images per case, generating 10,000 vision-question-answer (VQA) pairs. The model was fine-tuned using the Large Language and Vision Assistant (LLaVA) framework. Model performance was assessed using the newly developed Surgical-VLM Bench, which evaluates appropriateness of expression, anatomical accuracy, and clinical usefulness on a 5-point scale, and the Bidirectional Encoder Representations from Transformers (BERT) score. The results were compared with those of ChatGPT-5.</p><p><strong>Results: </strong>Surgical-VLM achieved a mean total benchmark score of 11.33 ± 0.697 versus 10.72 ± 0.536 for ChatGPT-5. Surgical-VLM showed numerically higher mean scores in anatomical accuracy and clinical usefulness. The BERTScore was 0.768 ± 0.008 for Surgical-VLM and 0.804 ± 0.013 for ChatGPT-5.</p><p><strong>Conclusions: </strong>This proof-of-concept study demonstrates the feasibility of domain adaptation for a Surgical-VLM and proposes a clinically grounded benchmark for structured evaluation. In this pilot setting, the prototype generated context-aware responses and showed domain-dependent differences compared with a general-purpose multimodal model. Further validation with larger independent test sets, expanded VQA items, and external evaluators is required before any clinical use.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"1092-1100"},"PeriodicalIF":6.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194601","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}
Gastric CancerPub Date : 2026-08-31DOI: 10.1007/s10120-026-01789-w
Oscar Hou In Chou, Vinod Kumar Chauhan, Cheuk To Skylar Chung, Lei Lu, Teddy Tai Loy Lee, Zita Man Wai Ng, Karin Kai Wing Wang, Sharen Lee, Haipeng Liu, Ronald Ting Kai Pang, Apichat Kaewdech, Bernard Man Yung Cheung, Gary Tse, Jiandong Zhou
{"title":"Correction: Comparative effectiveness of sodium-glucose cotransporter-2 inhibitors for new-onset gastric cancer and gastric diseases in patients with type 2 diabetes mellitus: a population-based cohort study.","authors":"Oscar Hou In Chou, Vinod Kumar Chauhan, Cheuk To Skylar Chung, Lei Lu, Teddy Tai Loy Lee, Zita Man Wai Ng, Karin Kai Wing Wang, Sharen Lee, Haipeng Liu, Ronald Ting Kai Pang, Apichat Kaewdech, Bernard Man Yung Cheung, Gary Tse, Jiandong Zhou","doi":"10.1007/s10120-026-01789-w","DOIUrl":"https://doi.org/10.1007/s10120-026-01789-w","url":null,"abstract":"","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":""},"PeriodicalIF":6.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864649","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}