Gastric Cancer最新文献

{"title":"Reflux and stenosis after minimally invasive proximal gastrectomy with double-flap technique: risk factors and impact of robotic surgery.","authors":"Qingjiang Hu, Masaru Hayami, Noriyuki Ishida, Motonari Ri, Rie Makuuchi, Tomoyuki Irino, Takeshi Sano, Souya Nunobe","doi":"10.1007/s10120-026-01733-y","DOIUrl":"10.1007/s10120-026-01733-y","url":null,"abstract":"<p><p>BACKGROUND: Proximal gastrectomy (PG) with double-flap technique (DFT) is increasingly performed in East Asia as a function-preserving alternative to total gastrectomy. However, reflux esophagitis and anastomotic stenosis remain major concerns, and risk factors after minimally invasive approaches, including robotic surgery, have not been well defined. METHODS: We retrospectively analyzed 399 patients who underwent laparoscopic or robotic PG-DFT for esophagogastric junction (EGJ) or gastric cancers (GC) between 2009 and 2023. The primary endpoint was reflux esophagitis assessed by endoscopy at 1 year, and the secondary endpoint was anastomotic stenosis requiring balloon dilatation. Logistic regression analyses were performed to identify risk factors. RESULTS: Reflux occurred in 24 patients (6.0%) and stenosis in 51 patients (12.8%). Independent risk factors were EGJ cancer or GC with esophageal invasion for reflux (odds ratio [OR] 3.21, 1.31–8.00) and a narrow esophageal diameter (< 18 mm) for stenosis (OR 11.97, 5.93–24.66). Moreover, robotic surgery was associated with a lower incidence of reflux compared with laparoscopic surgery in patients with EGJ cancer or GC with esophageal invasion. In patients with a narrow esophagus, shorter operative time was associated with a lower risk of stenosis. CONCLUSIONS: Minimally invasive PG-DFT carries distinct risks of reflux and stenosis depending on tumor and anatomical factors. Robotic surgery was associated with a lower incidence of reflux in high-risk patients, whereas technical proficiency and shorter operative time may be critical for preventing stenosis in patients with a narrow esophagus. These findings may support individualized strategies and selective use of robotics to optimize outcomes after PG.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"658-668"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573683","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":"Early- versus late-onset gastroesophageal cancer: real-world outcomes from a 13-year central European cohort study.","authors":"Tomas Sokop, Iveta Selingerova, Vaclav Jedlicka, Lumir Kunovsky, Igor Kiss, Radka Lordick Obermannova","doi":"10.1007/s10120-026-01724-z","DOIUrl":"10.1007/s10120-026-01724-z","url":null,"abstract":"<p><p>BACKGROUND: Gastroesophageal cancer presents variably across different age groups, with early-onset (EO) cases showing distinct pathological and clinical characteristics compared to late-onset (LO) disease. This study aims to delineate these differences and assess treatment outcomes in a Central European population. METHODS: Data from patients diagnosed with gastroesophageal carcinoma and treated between 2010 and 2022, at a high-volume comprehensive cancer center representing approximately 5% of all national gastroesophageal cancer cases in the Czech Republic, were retrospectively analyzed. Patients were categorized into EO (< 50 years) and LO (≥ 50 years) groups. Clinicopathological characteristics were compared in the entire cohort, while treatment patterns and survival outcomes were evaluated in patients with adenocarcinoma. RESULTS: A total of 1,377 patients were included, with 161 (11.7%) classified as EO. EO patients are more frequently present with ECOG performance status 0 (42%), lower BMI, current smoking (44%), gastric cancer primaries (63%), and aggressive tumor characteristics such as poorly cohesive adenocarcinoma subtype (45%) and metastatic disease (55%). Hereditary cancer syndrome was confirmed in 4.3% of EO cases. Among adenocarcinoma patients, triplet chemotherapy was more frequently used in the EO group (29% vs. 11%, p < 0.001) in the first-line setting. However, no significant survival benefit was observed in inoperable or metastatic disease (median overall survival 9.1 vs. 9.6 months in EO and LO, respectively, p = 0.913). CONCLUSIONS: EO gastroesophageal cancer in the Central European population is associated with distinct clinicopathological characteristics, with no significant impact on survival. This study identifies distinct clinicopathological characteristics in early-onset gastroesophageal cancer in Central Europe, characterized by more aggressive attributes but without significant survival differences compared to late-onset cases.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"494-505"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147528241","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":"Long-term survival outcomes from a phase II trial of perioperative capecitabine plus oxaliplatin for advanced gastric cancer with extensive lymph node metastases: OGSG 1701.","authors":"Shunji Endo, Yutaka Kimura, Naotoshi Sugimoto, Ryohei Kawabata, Atsushi Takeno, Shigeyuki Tamura, Jin Matsuyama, Masato Nakamura, Hiroki Takeshita, Motohiro Imano, Atsushi Yasuda, Hironaga Satake, Shogen Boku, Masahito Kotaka, Tomohira Takeoka, Yukinori Kurokawa, Toshimasa Tsujinaka, Toshio Shimokawa, Taroh Satoh","doi":"10.1007/s10120-026-01726-x","DOIUrl":"10.1007/s10120-026-01726-x","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced gastric cancer and para-aortic and/or bulky lymph node metastases have extremely poor prognosis after surgery alone. The OGSG1701 phase II trial evaluated the efficacy and safety of perioperative administration of capecitabine and oxaliplatin (CapeOx). Short-term results showed promising response and resection rates. Herein, we report the final survival outcomes.</p><p><strong>Methods: </strong>This multicenter, single-arm, phase II trial enrolled patients with histologically proven, HER2-negative or unknown gastric cancer with para-aortic (no.16a2/16b1) and/or bulky lymph node metastases. Patients received three cycles of preoperative CapeOx followed by gastrectomy with D2 ± para-aortic lymphadenectomy, and five cycles of postoperative CapeOx. The primary endpoint was response rate; the key secondary endpoints included overall survival (OS) and progression-free survival (PFS).</p><p><strong>Results: </strong>Thirty patients from 14 institutions were enrolled between 2018 and 2022. At a minimum follow-up of 36 months, the 3- and 5-years OS rates were 79.0% (95% confidence interval [CI], 59.0-90.0%) and 61.0% (95% CI 38.9-77.1%), respectively. Median OS was 64.9 months (95% CI 41.2-not estimable). The 3 years PFS rate was 46.7% (95% CI 28.4-63.0%), and the median PFS was 29.0 months (95% CI 9.4-not estimable). No additional treatment-related deaths occurred during the long-term follow-up.</p><p><strong>Conclusions: </strong>Perioperative CapeOx therapy resulted in encouraging long-term survival in patients with advanced gastric cancer and extensive nodal metastasis. These findings support its potential role as a perioperative strategy for biologically high-risk gastric cancer, with an acceptable safety profile.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"611-621"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456637","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":"The descriptive epidemiology of gastric cancer in Afghanistan: a population-based cancer registry, 2018-2020.","authors":"Maihan Abdullah, Fatemeh Ghasemi-Kebria, Goodarz Danai, Jesse B Bump, Timothy R Rebbeck, Chihaya Koriyama, Nisar Niazi, Ikram Hashimi, Mirwais Safi, Sayed Mohammad Milad Fekrat, Sabira Niyazi, Gholamreza Roshandel","doi":"10.1007/s10120-026-01734-x","DOIUrl":"10.1007/s10120-026-01734-x","url":null,"abstract":"<p><p>PURPOSE: Gastric cancer (GC) remains a global public health concern; however, studies on detailed epidemiological characteristics within Afghanistan are limited. This study was conducted to estimate the incidence of subtypes of GC in Afghanistan as well as in its eight regions by age and sex. METHODS: We used data from the Kabul Population-based Cancer Registry (KCR) to estimate age-standardized incidence rates (ASIRs) for cardia GC (CGC) and non-cardia GC (NCGC) in Afghanistan between 2018 and 2020. We also analyzed the ASIRs of GC in the eight regions of the country. RESULTS: The ASIRs of GC in males and females combined were 4.1 (95% CI 3.9–4.3) per 100,000 person-years in 2018–2020, with a male-to-female age-standardized incidence rate ratio (ASIRR) of 2.5. The ASIR of CGC was 2.4, and that of unspecified subsites was 1.6. The ASIR of GC adenocarcinoma was 2.8, whereas that of other types was 0.68. The incidence rate was highest (age-specific incidence rate: 30.2) in patients aged 70–74 years. Among the eight regions of Afghanistan, the GC incidence rate was highest in the Central region (ASIR: 3.8 per 100,000 person-years), followed by the Southeast region (ASIR: 3.5), whereas it was lowest in the Southwest region (ASIR: 0.38). CONCLUSION: This population-based cancer registry study reports the incidence rates of GC for the first time in Afghanistan. These findings demonstrate significant variation in GC epidemiology across Afghanistan’s demographic and geographic settings. The dominance of cardia tumors, male sex, and significant regional differences suggest the need for targeted screening and preventive strategies.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"550-560"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573675","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 phase II study of neoadjuvant chemotherapy with docetaxel, cisplatin, and S-1 followed by gastrectomy for type 4 or large type 3 gastric cancer (OGSG 1402).","authors":"Ryo Tanaka, Sang-Woong Lee, Kazumasa Fujitani, Shunji Endo, Junji Kawada, Toshifumi Yamaguchi, Yusuke Akamaru, Ko Takachi, Noriko Wada, Osamu Takayama, Haruna Furukawa, Masaaki Motoori, Keijiro Sugimura, Yoshio Oka, Izumi Komoto, Shugo Ueda, Tomono Kawase, Jin Matsuyama, Toru Masuzawa, Yukinori Kurokawa, Toshimasa Tsujinaka, Toshio Shimokawa, Taro Satoh","doi":"10.1007/s10120-026-01727-w","DOIUrl":"10.1007/s10120-026-01727-w","url":null,"abstract":"<p><strong>Background: </strong>A multi-institutional phase II study (OGSG 1402) evaluated the efficacy and safety of neoadjuvant docetaxel, cisplatin, and S-1 (DCS) therapy for type 4 or large type 3 gastric cancers.</p><p><strong>Methods: </strong>Patients with macroscopic type 4 or large type 3 gastric cancer received two or three cycles of neoadjuvant DCS therapy (docetaxel 40 mg/m² and cisplatin 60 mg/m² intravenously on day 1, and S-1 80-120 mg/body orally for 14 days, every 4 weeks), followed by gastrectomy with D2 lymphadenectomy. After R0 resection, adjuvant S-1 chemotherapy was administered for 1 year. The primary endpoint was the R0 resection rate.</p><p><strong>Results: </strong>Between March 2015 and June 2018, 48 patients were enrolled, 47 of whom were eligible. The R0 resection rate was 68.1% (32/47, 95% confidence interval [CI] 52.9-80.9). Forty-two patients (89.4%) completed neoadjuvant chemotherapy (NAC). The most common grade 3 or 4 adverse event during NAC was neutropenia (23/47, 48.9%). Surgical morbidity of Clavien-Dindo grade IIIa or higher occurred in 8.5% (4/47) of patients. The pathological response rate, defined as grades 1b to 3, was 42.6% (20/47, 95% CI 28.3-57.8). The 5-year overall survival rate was 38.3% (95% CI 24.6-51.8) and the 5-year progression-free survival rate was 29.8% (95% CI 17.6-43.0).</p><p><strong>Conclusions: </strong>In patients with type 4 or large type 3 gastric cancer, neoadjuvant DCS therapy did not meet the predefined threshold for the R0 resection rate. Despite its acceptable feasibility and manageable toxicity, the addition of docetaxel to the S-1 plus cisplatin regimen is unlikely to provide a survival benefit for this high-risk population.</p><p><strong>Trial registration: </strong>The study was registered with UMIN-CTR (number UMIN 000015631).</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"622-634"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473385","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":"Clinicopathologic features and prognostic impact of late recurrence after gastrectomy for gastric cancer.","authors":"Kensuke Kudou, Tomoyuki Irino, Motonari Ri, Masaru Hayami, Souya Nunobe","doi":"10.1007/s10120-026-01725-y","DOIUrl":"10.1007/s10120-026-01725-y","url":null,"abstract":"<p><p>BACKGROUND: Most recurrences of gastric cancer (GC) occur within 2 years after curative gastrectomy, whereas late recurrence (≥ 3 years) has been less well studied. We aimed to clarify the clinicopathologic characteristics, recurrence patterns, and outcomes of late recurrence. METHODS: We retrospectively analyzed 8094 patients who underwent gastrectomy for GC at a single high-volume center between 2005 and 2024. Among 691 patients with recurrence, clinicopathologic features, recurrence patterns, and post-recurrence survival (PRS) were compared between early (< 3 years) and late (≥ 3 years) groups. RESULTS: Of 691 patients with recurrence, 104 (15.0%) developed late recurrence. Compared with early recurrence, the late recurrence group had a lower proportion of patients aged ≥ 75 years (9.6% vs. 18.6%). Late recurrence was more often observed in patients with carcinoembryonic antigen (CEA) ≤ 5 ng/mL (90.4% vs. 77.7%), carbohydrate antigen 19–9 (CA19-9) ≤ 37 U/mL (89.4% vs. 80.1%), pT1–2 stage (26.0% vs. 15.8%), and pN0 status (26.0% vs. 13.6%). Recurrence patterns differed by timing: 94.7% of hepatic recurrences developed within 3 years, while peritoneal, nodal, and bone recurrences remained relatively common beyond 3 years. Multivariate analysis of clinicopathologic factors associated with late recurrence identified CEA ≤ 5 ng/mL, pT1–2, pN0, and lymphatic invasion as significant characteristics. PRS did not differ significantly between the groups (5-year PRS: 10.4% vs. 9.4%, p = 0.096). CONCLUSIONS: Late recurrence accounted for 15% of all recurrences after curative gastrectomy. It was characterized by relatively early-stage disease features and distinct recurrence patterns, but survival after recurrence was comparable to that of early recurrence.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"650-657"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343422","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 two-sample Mendelian randomization study of the causal relationship between respiratory diseases, gastric cancer risk, and Helicobacter pylori infection.","authors":"Youjin Kim, Seunghyun Lee, Jongin Lee, Min Young Park, Jeehee Min, Xiaoxue Ma, Maiko Hajime Sumikawa, Jin-Ha Yoon, Wanhyung Lee","doi":"10.1007/s10120-026-01729-8","DOIUrl":"10.1007/s10120-026-01729-8","url":null,"abstract":"<p><p>BACKGROUND: Gastric cancer is a major global burden, yet evidence linking respiratory diseases to gastric cancer is limited. This study examined whether genetic susceptibility to respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and lung diseases due to external agents (LDEA) was associated with gastric cancer and Helicobacter pylori infection, given shared immune and inflammatory pathways. METHODS: We conducted a two-sample Mendelian randomization analysis using genetic variants as instrumental variables to assess causal associations between respiratory diseases and risk of gastric cancer and H. pylori infection. GWAS summary statistics for respiratory diseases were obtained from FinnGen, and for gastric cancer and H. pylori infection from the UK Biobank. Analyses were adjusted for confounders such as smoking and alcohol consumption. Sensitivity analyses evaluated robustness and assessed potential pleiotropy and heterogeneity among genetic variants. RESULTS: No significant direct causal associations were found between respiratory diseases and gastric cancer risk. However, asthma and LDEA were significantly associated with increased risk of H. pylori infection. No associations were observed for COPD or IPF with either outcome. Sensitivity analyses indicated minimal pleiotropic or heterogeneity effects. CONCLUSION: This study investigated genetic susceptibility to respiratory diseases and their potential links to gastric cancer and H. pylori infection. While direct genetic evidence linking respiratory disease susceptibility to gastric cancer was limited, significant associations with H. pylori infection suggest possible indirect pathways involving respiratory diseases.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"519-526"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364986","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":"Clinical impact of intratumoral HER2 heterogeneity on trastuzumab deruxtecan efficacy in patients with HER2-positive gastric cancer.","authors":"Koichiro Yoshino, Manabu Takamatsu, Akira Ooki, Keisho Chin, Daisuke Takahari, Hiroki Osumi, Mariko Ogura, Mikako Tamba, Koshiro Fukuda, Keitaro Shimozaki, Shohei Udagawa, Shota Fukuoka, Eiji Shinozaki, Kensei Yamaguchi, Takeru Wakatsuki","doi":"10.1007/s10120-026-01736-9","DOIUrl":"10.1007/s10120-026-01736-9","url":null,"abstract":"<p><p>BACKGROUND: Intratumoral HER2 heterogeneity has been associated with poor response to trastuzumab-based chemotherapy in HER2-positive gastric cancer. However, its clinical significance in patients treated with trastuzumab deruxtecan (T-DXd) remains unclear. METHODS: Patients with advanced HER2-positive gastric cancer who received T-DXd as second-line or later therapy were enrolled. HER2-positive proportion was defined as the percentage of tumor cells with immunohistochemical score ≥ 2 + in diagnostic specimens obtained before first-line therapy. The cutoff value was determined using time-dependent receiver operating characteristic analysis. RESULTS: Forty-three patients were enrolled. Median progression-free survival (PFS) and overall survival (OS) were 4.7 and 8.1 months, respectively. With an optimal cutoff of 79%, 20 patients (47%) were in the HER2-homogeneity group and 23 (53%) in the HER2-heterogeneity group. The HER2-homogeneity group showed significantly longer PFS (6.3 vs. 3.1 months, p = 0.002) and OS (9.8 vs. 6.0 months, p = 0.006) with higher overall response rate (79% vs. 19%, p < 0.001). In Cox proportional hazards model, HER2-homogeneity was an independent prognostic factor for both PFS (hazard ratio (HR) 0.37, 95% confidence interval (CI) 0.18–0.76, p = 0.007) and OS (HR 0.41, 95% CI 0.21–0.82, p = 0.01). CONCLUSIONS: Intratumoral HER2 heterogeneity in pre-treatment diagnostic specimens was associated with T-DXd efficacy and may represent a potential prognostic factor.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"597-610"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591672","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":"Limited lymphadenectomy for elderly patient with gastric cancer: a systematic review and meta-analysis.","authors":"Yuichiro Miki, Tsubasa Bito, Rie Makuuchi, Kenichi Ishizu, Ayumi Shintani, Masanori Terashima","doi":"10.1007/s10120-026-01719-w","DOIUrl":"10.1007/s10120-026-01719-w","url":null,"abstract":"<p><strong>Background: </strong>With aging populations, elderly gastric cancer (GC) patients are increasing. D2 lymphadenectomy is widely accepted for advanced GC, but its efficacy and safety in elderly patients are still debated. To guide surgical decisions, we conducted a systematic review and meta-analysis evaluating optimal lymphadenectomy extent in elderly patients.</p><p><strong>Methods: </strong>A systematic review was performed in accordance with the preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension statement for reporting systematic reviews. Meta-analyses were performed regarding (i) total postoperative complications, (ii) pancreatic fistula, (iii) abdominal abscess, (iv) postoperative hospital stay, and (v) overall survival by using R software.</p><p><strong>Results: </strong>Seven retrospective studies met eligibility criteria, including three with propensity score matching. Meta-analysis showed that complication rates (any grade) were similar, while severe complications (grade ≥ 3) tended to be lower with limited lymphadenectomy. Pancreatic fistula rates showed no significant difference, but limited lymphadenectomy was significantly associated with reduced abdominal abscess incidence (RR: 0.15, p = 0.013). Postoperative hospital stay did not differ significantly between the groups. Furthermore, no significant difference in overall survival was observed between the groups (HR: 0.94, p = 0.834).</p><p><strong>Conclusion: </strong>Limited lymphadenectomy may be a reasonable surgical option for elderly GC patients, as it reduces the risk of abdominal abscess without compromising long-term survival. These findings support a more tailored surgical approach based on patient age and risk profile.</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"485-493"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511540","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":"The whole-course of supervised home-based multi-modal prehabilitation to improve clinical outcome in patients undergoing neoadjuvant chemotherapy prior to gastrectomy: a single-center randomized controlled trial.","authors":"Qi Liu, Cheng Meng, Shougen Cao, Xiaodong Liu, Yulong Tian, Zequn Li, Lei Han, Qiang Wang, Zimin Liu, Jing Lv, Ning Liu, Qinglian Ji, Yanxia Jiang, Hongding Han, Lipeng Zhao, Zhaojian Niu, Haitao Jiang, Yuqi Sun, Gan Liu, Hao Zhong, Kun Wang, Yanbing Zhou","doi":"10.1007/s10120-026-01735-w","DOIUrl":"10.1007/s10120-026-01735-w","url":null,"abstract":"<p><p>BACKGROUND: Although neoadjuvant chemotherapy offers survival benefits to advanced gastric cancer patients, the severe chemotherapy-related toxic side effects and the decline in physical fitness that accompany it increase the difficulty of perioperative management and may result in adverse clinical outcomes for patients undergoing surgery. METHODS: An open-label, Phase II, single-center randomized clinical trial was conducted in the Affiliated Hospital of Qingdao University. Patients with advanced gastric cancer who were planned to undergo gastrectomy after neoadjuvant chemotherapy were randomly assigned (1:1) to the study group (multi-modal prehabilitation) or the control group. The multimodal prehabilitation program, comprising exercise, nutritional support, and psychological intervention, was implemented over a duration of 10–16 weeks. The primary endpoint was the functional fitness between neoadjuvant chemotherapy and preoperative time point. The secondary endpoints were nutritional status, inflammatory factor levels, anxiety and depression condition, quality of life, the adherence to neoadjuvant chemotherapy, postoperative recovery, and 30-day morbidity. RESULTS: Between July 2024 and January 2025, 85 participants were included in the intention-to-treat (ITT) population (43 in the study group and 42 in the control group). Compared with the control group, prehabilitation had alleviated the attenuation of cardiopulmonary fitness during neoadjuvant chemotherapy (17.3 ± 21.8 m vs. − 25.8 ± 34.9 m, P < 0.001) and improved the fitness prior to surgery (29.4 ± 26.0 m vs. − 17.9 ± 33.6 m, P < 0.001). Prehabilitation resulted in higher adherence to neoadjuvant chemotherapy, better nutritional status, and superior quality of life. Patients in the study group exhibited a significantly lower incidence of postoperative pneumonia (absolute risk difference [ARD] -12.0%, 95% CI − 23.5% to − 0.5%; number needed to treat [NNT] = 9), a reduced rate of Clavien-Dindo grade II complications (ARD − 16.8%, 95% CI − 31.8% to − 1.9%; NNT = 6), as well as faster postoperative functional recovery and a shorter length of hospital stay, all of which indicated the clinical value of prehabilitation intervention. CONCLUSIONS: The whole course of supervised, home-based multi-modal prehabilitation improves functional capacity prior to gastrectomy, which attenuates the adverse reaction of neoadjuvant chemotherapy. Improved physical, psychological, and nutritional status preoperatively may translate to better postoperative outcomes. TRIAL REGISTRATION: NCT06521541 ( http://www.clinicaltrials.gov ).</p>","PeriodicalId":12684,"journal":{"name":"Gastric Cancer","volume":" ","pages":"669-679"},"PeriodicalIF":6.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503494","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}