Cancer最新文献

{"title":"Disparities in the cancer continuum experienced by transgender and gender-diverse patients: A rapid review","authors":"Laura E. Stamm PhD,&nbsp;Kristefer Stojanovski PhD, MPH,&nbsp;Milena E. Insalaco BA,&nbsp;Laura Wright MIS,&nbsp;Charles Kamen PhD, MPH,&nbsp;Chunkit Fung MD","doi":"10.1002/cncr.35788","DOIUrl":"https://doi.org/10.1002/cncr.35788","url":null,"abstract":"<p>Transgender and gender-diverse (TGD) populations experience health disparities across all areas of health care due to issues of bias, discrimination, and structural barriers to care. Existing literature on cancer screening in TGD populations demonstrates significant gaps in care; for example, transgender men receive Pap smears at lower rates than cisgender women. Because of known disparities in cancer screening, and gaps in our understanding in terms of diagnosis, treatment, and survivorship, the authors conducted a rapid review of the literature to examine cancer care continuum (screening, treatment, and survivorship) disparities among TGD persons. The results reported disparities across the cancer care continuum. Although there is currently limited research on cancer diagnosis, treatment, and survivorship, the available evidence indicates TGD patients are diagnosed with cancer at later stages than cisgender patients. TGD patients were also less likely than cisgender patients to receive treatment for some types of cancer. The results of this rapid review demonstrate the need for more research across the cancer care continuum for TGD patients with significant gaps in knowledge for cancer treatment and survivorship.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of physical activity with survival in colon cancer versus a matched general population: Data from Cancer and Leukemia Group B 89803 and 80702 (Alliance)","authors":"Justin C. Brown PhD,&nbsp;Chao Ma MS,&nbsp;Qian Shi PhD,&nbsp;Leonard B. Saltz MD,&nbsp;Anthony F. Shields MD,&nbsp;Jeffrey A. Meyerhardt MD, MPH","doi":"10.1002/cncr.35727","DOIUrl":"https://doi.org/10.1002/cncr.35727","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colon cancer patients have inferior overall survival than a matched general population (MGP). It is unknown if physical activity is associated with a reduction in this survival disparity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were analyzed from two National Cancer Institute–sponsored postoperative treatment trials in stage III colon cancer, Cancer and Leukemia Group B (CALGB) 89803 and 80702, with 2876 patients who self-reported physical activity. Physical activity was converted to metabolic equivalents (MET-hours/week). The MGP was derived from the National Center for Health Statistics and matched on age, sex, and year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In CALGB 89803, among patients who were alive at 3 years, those with &lt;3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −17.1% (95% confidence interval [CI], −22.4 to −11.8) and −3.5% (95% CI, −7.7 to 0.3) lower than MGP, respectively. In CALGB 80702, among patients who were alive at 3 years, those with &lt;3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −10.8% (95% CI, −15.4 to −6.9) and −4.4% (95% CI, −7.6 to −1.6) lower than MGP, respectively. In pooled analyses, among patients who were alive and did not have tumor recurrence by year 3 (<i>n</i> = 1908), those with &lt;3.0 and ≥18.0 MET-hours/week had subsequent 3-year overall survival rates that were −3.1% (95% CI, −6.2 to −0.3) lower and 2.9% (95% CI, 1.5–4.2) higher than MGP, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Physical activity is associated with an attenuation of the survival disparity between patients with stage III colon cancer participating in clinical trials and MGP. Colon cancer survivors who are physically active may achieve survival that approximates the MGP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment-free remission in nontransplanted patients with Philadelphia chromosome-positive acute lymphoblastic leukemia","authors":"Eitan Kugler MD, PhD,&nbsp;Hagop Kantarjian MD,&nbsp;Elias Jabbour MD,&nbsp;Niranjan Khaire MBBS, MD,&nbsp;Nicholas J. Short MD,&nbsp;Tapan M. Kadia MD,&nbsp;Fadi G. Haddad MD,&nbsp;Koji Sasaki MD, PhD,&nbsp;Rashmi Kanagal Shamanna MD,&nbsp;Rebecca Garris MS,&nbsp;Farhad Ravandi MD,&nbsp;Nitin Jain MD","doi":"10.1002/cncr.35773","DOIUrl":"https://doi.org/10.1002/cncr.35773","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The BCR::ABL1 tyrosine kinase inhibitors (TKIs) have significantly improved the outcomes of patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL). However, the optimal duration of TKI therapy in patients who achieve a complete molecular response (CMR; undetectable <i>BCR::ABL1</i> transcripts) and who do not undergo allogeneic stem cell transplantation (allo-SCT) remains undefined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The authors conducted a retrospective analysis of patients with Ph-positive ALL in first complete remission who achieved a CMR and discontinued TKI therapy, most commonly due to treatment-related side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 14 patients were identified. The regimen of hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with high-dose methotrexate and cytarabine was the primary backbone chemotherapy and was received by 12 patients (86%) combined with either imatinib (14%), dasatinib (43%), or ponatinib (29%) during induction. Two patients received blinatumomab and ponatinib. The median duration of TKI therapy was 60 months. The median CMR duration before TKI discontinuation was 46.1 months (range, 2.7–121.3 months). After a median follow-up of 42.5 months from TKI discontinuation, three patients (21%) experienced relapse (two molecular, one morphologic), whereas 11 patients (79%) maintained treatment-free remission. The median time to relapse was 6.4 months (range, 4–16 months), and two of three relapsed patients regained CMR after resuming TKI therapy. Importantly, none of the six patients with a CMR duration &gt;48 months before TKI discontinuation relapsed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The current findings suggest that TKI discontinuation may be safe for highly selected patients with Ph-positive ALL in first complete remission who maintain CMR for at least 48 months. Larger studies are needed to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician's primer for soft tissue sarcomas: Nuances of histologic subtypes","authors":"Amy J. Wisdom MD, PhD,&nbsp;Chandrajit P. Raut MD, MS,&nbsp;Candace L. Haddox MD,&nbsp;Jason L. Hornick MD, PhD,&nbsp;Jyothi P. Jagannathan MD,&nbsp;Corrie A. Painter PhD,&nbsp;Elizabeth H. Baldini MD, MPH","doi":"10.1002/cncr.35772","DOIUrl":"https://doi.org/10.1002/cncr.35772","url":null,"abstract":"<p>Soft tissue sarcomas are a rare group of mesenchymal malignancies, with greater than 100 histologic subtypes. Advancements in understanding these subtypes has enabled histology-tailored management. This primer describes the workup and management of generalized soft tissue sarcomas of the extremity, trunk, and retroperitoneum while also highlighting the unique attributes of many subtypes. The subtypes chosen for review include those that are most common as well as those demonstrating unique behaviors or targets for management. The focus is on initial management of localized disease; however, for situations in which novel systemic agents have been discovered, the treatment of metastatic disease is discussed. This report is a reference to be used in addition to other comprehensive reviews, such as guidelines from the National Comprehensive Cancer Network, the European Society for Medical Oncology, and the American Society for Radiation Oncology. It is not a substitute for referral to an expert sarcoma center for critical pathology review and management by an experienced team. Importantly, patients who are treated at expert sarcoma centers have better outcomes than those who are not.</p>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous opioids and the risk of addiction in individuals with cancer","authors":"Kendall Downer MD,&nbsp;Julie Childers MD, MS","doi":"10.1002/cncr.35765","DOIUrl":"https://doi.org/10.1002/cncr.35765","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Müllerian hormone for assessing ovarian toxicity of cancer treatment in young women: It’s complicated","authors":"Kimia Sorouri MD, MPH,&nbsp;Karen Glass MD,&nbsp;Kathryn J. Ruddy MD, MPH,&nbsp;Ellen Warner MD, MSc,&nbsp;Ann H. Partridge MD, MPH","doi":"10.1002/cncr.35774","DOIUrl":"https://doi.org/10.1002/cncr.35774","url":null,"abstract":"","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 5","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143455950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthy diet may reduce the risk of low-grade prostate cancer progressing to a higher grade","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35740","DOIUrl":"https://doi.org/10.1002/cncr.35740","url":null,"abstract":"&lt;p&gt;Higher adherence to a healthy diet significantly reduced the risk of prostate cancer progression in men with low-risk prostate cancer on active surveillance, according to a study published in &lt;i&gt;JAMA Oncology&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The study is the first to show a significant association between a healthy diet and a significantly decreased risk of grade reclassification in this setting, according to the senior author of the study, Bruce J. Trock, PhD, Frank Hinman Jr. Endowed Professor of Urology and professor of oncology and epidemiology at the Johns Hopkins School of Medicine.&lt;/p&gt;&lt;p&gt;Using the Healthy Eating Index (HEI), a validated measure of overall diet quality that adheres to the Dietary Guidelines for Americans developed by the US Department of Agriculture, the study found that the likelihood of disease progression from Grade Group 1 to Grade Group 2 or higher decreased by 30% for every 25-point increase in the HEI. (The HEI provides a score of 0–100 for each category of healthful and unhealthful foods eaten by a person, with higher scores indicating a healthier diet.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;)&lt;/p&gt;&lt;p&gt;Even more important, according to Dr Trock, was the finding that a 25-point increase in the HEI significantly decreased (by nearly 50%) the risk of progressing to Grade Group 3 or higher. “This is important because men with Grade 2 can sometimes continue on active surveillance, but the Grade Group 3 nearly always mandates definitive treatment with surgery and/or radiation,” he says.&lt;/p&gt;&lt;p&gt;The prospective cohort study included 886 men diagnosed with Grade Group 1 prostate cancer between January 2005 and February 2017 who were undergoing active surveillance. All the men completed a validated food frequency questionnaire on their usual dietary patterns. Researchers also looked at a measure of how much diet likely contributes to inflammation (i.e., the Dietary Inflammatory Index), but they found no association between this measure and grade reclassification.&lt;/p&gt;&lt;p&gt;Dr Trock says that the findings offer urologists evidence to share with their patients on active surveillance that a healthy diet may improve their prognosis, and they also provide concrete steps that patients can take to play an active role in the management of their disease, something that men on active surveillance often ask about.&lt;/p&gt;&lt;p&gt;“But this isn’t a magic cure-all, and men should continue with their active surveillance regimen,” says Dr Trock, who emphasizes that he would like to see the results of the study replicated in other studies. “But there is no downside to improving your diet quality, and it has other health benefits for cardiovascular disease, diabetes, and weight control,” he adds.&lt;/p&gt;&lt;p&gt;Commenting on the study, Walter M. Stadler, MD, Fred C. Buffett Professor of Medicine and senior advisor to the Comprehensive Cancer Center director at UChicago Medicine, calls the study interesting and agrees that a healthy diet accompanied by regular exercise is always","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First person profile: Ronald P. DeMatteo, MD","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35736","DOIUrl":"https://doi.org/10.1002/cncr.35736","url":null,"abstract":"&lt;p&gt;During his fellowship in surgical oncology at the Memorial Sloan Kettering Cancer Center, Ronald P. DeMatteo, MD, stumbled onto a cancer that was new to him. His imagination was piqued, and this led to his study of the relatively uncommon and little investigated gastrointestinal stromal tumor (GIST). His investigation into the biology of the tumor paved the way to leading the first national trial, funded by the National Cancer Institute (NCI), to examine the benefit of a relatively new drug on the market as adjuvant therapy after surgical resection of the tumor.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The drug was imatinib, and the results of the trial (ACOSOG-Z9001), which showed significantly improved outcomes, led to the 2008 accelerated approval of the treatment regimen and changed the standard of care for patients with resectable GISTs.&lt;/p&gt;&lt;p&gt;He also led two additional national trials testing the benefit of imatinib as adjuvant therapy for patients with resectable GISTs. The US Food and Drug Administration granted full approval in 2012.&lt;/p&gt;&lt;p&gt;Fast-forward to today, and Dr DeMatteo is continuing his research into the biology of abdominal tumors while also serving as an academic surgical oncologist. He is currently chair of the Department of Surgery at the Perelman School of Medicine at the University of Pennsylvania, a position he has held since 2017. He maintains an active clinical practice, runs a research training program for young surgeons (funded by two NCI grants), and is in his final months as president of the Society of Surgical Oncology. In all these capacities, he cites the high reward in helping to shape the field of surgical oncology—from guiding the faculty and direction of a specific department to educating new surgical oncologists on how to perform research and ultimately to bringing all the training and expertise to bear on improving the lives of patients.&lt;/p&gt;&lt;p&gt;“Academic medicine allows you to do any or all of these jobs, and that is its big appeal,” Dr DeMatteo says. “That is what I find the most enjoyable, that you can eventually tailor the job to you and to what you like to do.”&lt;/p&gt;&lt;p&gt;From Dr DeMatteo’s accounting, the wish to tailor his career to suit his drive and purpose started at a very early age. In first grade, he decided that he wanted to be a surgeon. He did not know of any, but he liked to work with his hands—taking the lawn mower apart, building model airplanes—and somehow, he made the leap to the desire to take apart and put together the human body.&lt;/p&gt;&lt;p&gt;After a failed attempt at gaining access to an operating room as a seventh grader (he was allowed only outside the door to count sponges to ensure that the 10-packs used in surgery were accurate), he succeeded in getting into an emergency room at a local hospital, where he was given menial tasks to perform. His big break came while he was a premed undergraduate at the Johns Hopkins University, where he finally was allowed into the operating room at the Johns Hopkins","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35736","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New standard of care for patients with locally advanced cervical cancer","authors":"Mary Beth Nierengarten","doi":"10.1002/cncr.35739","DOIUrl":"https://doi.org/10.1002/cncr.35739","url":null,"abstract":"&lt;p&gt;A short course of induction chemotherapy delivered immediately before chemoradiotherapy significantly improved progression-free survival and overall survival for patients with locally advanced cervical cancer in comparison with the current standard of care with chemoradiotherapy alone, according to the results of the INTERLACE trial published in &lt;i&gt;The Lancet&lt;/i&gt;.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;At a median follow-up of 67 months, the 5-year overall survival rates were 80% for patients treated with induction chemotherapy followed by chemoradiotherapy and 72% for patients treated with chemoradiotherapy alone, whereas the 5-year progression-free survival rates were 72% and 64%, respectively. Overall, patients who received induction therapy had a 38% lower risk of disease progression and a 40% lower risk of death than those treated with chemoradiotherapy alone.&lt;/p&gt;&lt;p&gt;The findings indicate a new standard of care for these patients according to the study authors, who were led by Mary McCormack, MD, a consultant clinical oncologist at the University College Hospitals NHS Trust in London.&lt;/p&gt;&lt;p&gt;Of critical importance is the timing of chemoradiotherapy after induction therapy to avoid any gaps in treatment. Up to 93% of patients in the study who received induction chemotherapy received it 14 days or less before chemoradiotherapy. Dr McCormack underscores the importance of ensuring that patients proceed to chemoradiotherapy immediately after induction chemotherapy (i.e., induction chemotherapy is delivered in Weeks 1–6 and is followed by radiotherapy plus cisplatin, including brachytherapy, in Weeks 7–13).&lt;/p&gt;&lt;p&gt;Dr McCormack stresses that induction chemotherapy did not compromise the delivery of definitive radiation, with 96% of the patients who were treated with induction chemotherapy completing the course of definitive radiation within 56 days. Prior evidence shows a higher tumor control probability when the overall radiation treatment time is less than 56 days.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;She says that radiotherapy, particularly in under-resourced settings, should be scheduled before induction chemotherapy is initiated, and she emphasizes that “the induction chemotherapy approach is not designed to manage radiotherapy wait times.”&lt;/p&gt;&lt;p&gt;INTERLACE is a multinational, phase 3 trial of 500 patients with locally advanced cervical cancer randomized to standard cisplatin-based chemoradiotherapy alone (&lt;i&gt;n&lt;/i&gt; = 250) or induction chemotherapy (carboplatin and paclitaxel) followed by chemoradiotherapy (&lt;i&gt;n&lt;/i&gt; = 250).&lt;/p&gt;&lt;p&gt;Commenting on the study, Elise Kohn, MD, head of Gynecologic Cancer Therapeutics in the Cancer Therapy Evaluation Program at the National Cancer Institute, agrees that the results of the study could translate into a change in practice for treating patients with early-stage cervical cancer. As with all treatments, she emphasizes that practitioners should assess patients for signs, symptoms, and risks of this approach and engage in sha","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cncr.35739","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of artificial intelligence in the detection of Borrmann type 4 advanced gastric cancer in upper endoscopy (with video)","authors":"Mi Jin Oh MD,&nbsp;Jinbae Park MS,&nbsp;Jiwoon Jeon BS,&nbsp;Mina Park MS,&nbsp;Seungkyung Kang MD,&nbsp;Su Hyun Kim MD, PhD,&nbsp;Su Hee Park MD,&nbsp;Young Hoon Chang MD,&nbsp;Cheol Min Shin MD, PhD,&nbsp;Seung Joo Kang MD, PhD,&nbsp;Seunghan Lee MD,&nbsp;Sang Gyun Kim MD, PhD,&nbsp;Soo-Jeong Cho MD, PhD","doi":"10.1002/cncr.35768","DOIUrl":"https://doi.org/10.1002/cncr.35768","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Borrmann type-4 (B-4) advanced gastric cancer is challenging to diagnose through routine endoscopy, leading to a poor prognosis. The objective of this study was to develop an artificial intelligence (AI)-based system capable of detecting B-4 gastric cancers using upper endoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Endoscopic images from 259 patients who were diagnosed with B-4 gastric cancer and 595 controls who had benign conditions were retrospectively collected from Seoul National University Hospital for training and testing. Internal validation involved prospectively collected endoscopic videos from eight patients with B-4 gastric cancer and 148 controls. For external validation, endoscopic images and videos from patients with B-4 gastric cancer and controls at the Seoul National University Bundang Hospital were used. To calculate patient-based accuracy, sensitivity, and specificity, a diagnosis of B-4 was made for patients in whom greater than 50% of the images were identified as B-4 gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The accuracy of the patient-based diagnosis was highest in the internal image test set, with accuracy, sensitivity, and specificity of 93.22%, 92.86%, and 93.39%, respectively. The accuracy of the model in the internal validation videos, the external validation images, and the external validation videos was 91.03%, 91.86%, and 86.71%, respectively. Notably, in both the internal and external video sets, the AI model demonstrated 100% sensitivity for diagnosing patients who had B-4 gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An innovative AI-based model was developed to identify B-4 gastric cancer using endoscopic images. This AI model is specialized for the highly sensitive detection of rare B-4 gastric cancer and is expected to assist clinicians in real-time endoscopy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":138,"journal":{"name":"Cancer","volume":"131 4","pages":""},"PeriodicalIF":6.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}