Journal of gastrointestinal oncology最新文献

{"title":"Bevacizumab in biliary tract cancer: a clinical catalyst in the era of chemo-immunotherapy?","authors":"Umair Mahmood, Umer Khan, Khurum Khan","doi":"10.21037/jgo-2025-738","DOIUrl":"https://doi.org/10.21037/jgo-2025-738","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"42"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Partial splenic embolization plus antitumor therapy for treating patients with hepatocellular carcinoma and splenomegaly: a case series study.","authors":"Benke Li, Bozhao Jiang, Xiaolei Pang, Min Ji","doi":"10.21037/jgo-2025-1-1070","DOIUrl":"https://doi.org/10.21037/jgo-2025-1-1070","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a significant global health challenge and is frequently complicated by splenomegaly and consequent thrombocytopenia, which adversely impact survival outcomes. Although partial splenic embolization (PSE) combined with transarterial chemoembolization (TACE) has demonstrated clinical benefits, its integration with contemporary systemic therapies, including tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), remains largely unexplored. This case series aims to present the platelet elevation and survival outcomes in HCC patients with splenomegaly who underwent PSE while receiving various antitumor treatment regimens.</p><p><strong>Case description: </strong>This study included patients with clinically or pathologically diagnosed HCC and splenomegaly (spleen diameter ≥13 cm) who underwent PSE between January 2020 and February 2025. Participants received at least one antitumor intervention, such as with TACE, radiofrequency ablation (RFA), hepatic arterial infusion chemotherapy (HAIC), TKIs, or ICIs. Outcomes included platelet response rate (PRR) at ≥7 days and at 3-6 days post-PSE, duration of thrombocytopenia remission, and progression-free survival (PFS). A total of 50 patients were included in this study. The PRR at ≥7 days post-PSE varied between 33.33% and 100% among patients receiving different treatment strategies. The median duration of thrombocytopenia remission exceeded 10 months in all cases and ranged from 10.0 to 28.5 months. The median PFS varied from 4.5 to 21.0 months. The most frequent complication was splenic region pain, occurring from 25% to 100% of cases depending on the treatment, and no PSE-related mortality was observed.</p><p><strong>Conclusions: </strong>PSE combined with interventional and/or systemic therapy shows modest efficacy and a favorable safety profile in patients with HCC and splenomegaly. This approach may reduce the need for prolonged thrombopoietin agonist use and can be conveniently performed concurrently with TACE. Further validation through larger randomized controlled trials is recommended.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"32"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiangiogenic therapy for advanced biliary tract cancers: promising or illusory?","authors":"Raphael Colle, David Malka","doi":"10.21037/jgo-2025-aw-940","DOIUrl":"https://doi.org/10.21037/jgo-2025-aw-940","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"40"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regorafenib in refractory gastric cancer: modest median, meaningful milestone.","authors":"Yukiya Narita, Kei Muro","doi":"10.21037/jgo-2025-728","DOIUrl":"https://doi.org/10.21037/jgo-2025-728","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"39"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of systemic chemotherapy starting from comparison with best supportive care: commentary on the INTEGRATE IIa phase III study.","authors":"Narikazu Boku","doi":"10.21037/jgo-2025-aw-813","DOIUrl":"https://doi.org/10.21037/jgo-2025-aw-813","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"41"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between adherence to elective nodal volume guidelines and reduced distant metastasis in esophageal and gastroesophageal junction cancer: a retrospective analysis of elective nodal irradiation.","authors":"Jared Lyons, Garrett Harada, John Yeakel, Farshid Dayyani, Brian Smith, Shaun Daly, Ninh Nguyen, Harada Keshava, Suzanne Dufault, Caressa Hui, Alexandra Hotca, Steven Seyedin","doi":"10.21037/jgo-2025-609","DOIUrl":"https://doi.org/10.21037/jgo-2025-609","url":null,"abstract":"<p><strong>Background: </strong>In 2015, expert guidelines on esophageal/gastroesophageal junction (GEJ) cancer contouring for intensity-modulated radiation therapy (IMRT) were published in <i>International Journal of Radiation Oncology</i>, <i>Biology</i> <i>and Physics</i> (<i>IJROBP</i>) delineating recommended elective nodal basins (celiac, para-aortic, gastrohepatic ligament, supraclavicular) to be irradiated depending on the primary tumor location. The aim of this study seeks to determine if chemoradiotherapy (CRT) that is compliant with the recommendations from these guidelines affects disease free survival and distant failure rates. We hypothesize that incomplete coverage of these areas increases the risk of developing distant failures.</p><p><strong>Methods: </strong>Patients treated for non-metastatic esophageal or GEJ cancer with CRT pre-operatively or definitively from 2012 to 2021 were retrospectively identified from a single institution database. Radiation plans of eligible patients were then analyzed by tumor location. Plans were deemed guideline-compliant if radiation dose coverage, greater than 41.4 Gy, encompassed nodal basins recommended by the 2015 guidelines. The primary endpoint of this study was the overall rate of distant metastatic disease. Summary and descriptive statistics were used to characterize key cohort features.</p><p><strong>Results: </strong>With a median follow-up of 22.3 months, 38 patients, with a median age at diagnosis of 66 years, were included in the study. Most patients were male (94.7%) with cT3 (52.6%), cN0 (44.7%), moderately differentiated (44.7%) and poorly differentiated (44.7%) adenocarcinoma (73.7%) located at the GEJ (57.9%). The median radiation dose used was 50.4 Gy, with most patients receiving concurrent carboplatin and paclitaxel (86.8%). Four patients received induction chemotherapy and 20 (52.6%) underwent esophagectomy. When examining guideline compliance, 17 (44.7%) radiation plans demonstrated adequate elective nodal irradiation (ENI). The most common improperly covered nodal basin was para-aortic (66.7%), followed by gastrohepatic (23.8%). One patient with sufficient ENI coverage (1/17) developed distant failure compared to 38.1% (8/21) with insufficient coverage (P=0.02). There were inappreciable differences in locoregional or local failure rates between those with and without complete ENI.</p><p><strong>Conclusions: </strong>These results suggest that proper coverage of nodal basins could improve distant metastasis. ENI analysis of previous prospective CRT studies for esophageal cancer could validate these findings.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"1"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overstaging of the mesorectal fascia following neoadjuvant therapy and its impact on therapeutic management: a single-center retrospective cohort study of 506 mesorectal fascia positive patients.","authors":"Xiao Huang, Tianan Guo, Huan Zhang, Yiwei Zeng, Dan Huang, Tong Tong, Ye Xu","doi":"10.21037/jgo-2025-792","DOIUrl":"https://doi.org/10.21037/jgo-2025-792","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of mesorectal fascia (MRF) involvement status after neoadjuvant therapy (NAT) is critical for guiding post-NAT treatment. However, the discordance between magnetic resonance imaging (MRI)-based evaluations and histopathological results may drive overtreatment and complicate organ-preservation strategies. This study aimed to evaluate the association between post-NAT MRF involvement and pathological circumferential resection margin (CRM) positivity.</p><p><strong>Methods: </strong>This retrospective cohort study included treatment-naïve rectal cancer patients with MRI-confirmed MRF involvement between January 2014 and January 2024. All patients underwent MRI restaging after the NAT. The diagnostic performance, including sensitivity and specificity, of MRI-assessed MRF status was assessed to determine its efficacy in predicting pathological CRM positivity. Logistic regression and mixed-effects models were used to quantify the association between MRF status and CRM positivity. Cox regression analysis was used to assess the effect of MRF positivity on survival outcomes.</p><p><strong>Results: </strong>Among 506 enrolled patients, restaging MRI showed persistent MRF involvement in 50.2% (254/506). The CRM-positive rate was 10.2% in the MRF-positive group, compared to 1.6% in the MRF-negative group. Concordance between MRI and pathological assessment was poor (sensitivity: 0.867, specificity: 0.521, Kappa: 0.086). Nevertheless, MRF positivity independently predicted CRM positivity [odds ratio (OR): 6.228, 95% confidence interval (CI): 2.349-21.507, P<0.001]. In non-metastatic (M0) patients, MRF positivity correlated with worse overall survival [hazard ratio (HR): 2.300, 95% CI: 1.067-4.957, P=0.03]. However, no significant association was observed in metastatic (M1) patients (HR: 1.614, 95% CI: 0.859-3.031, P=0.14). For patients with post-NAT MRF-positive, integrating RAS status improved postoperative survival prediction accuracy [area under the curve (AUC): 1-year: 0.74 <i>vs</i>. 0.59; 3-year: 0.66 <i>vs</i>. 0.58; 5-year: 0.75 <i>vs</i>. 0.63].</p><p><strong>Conclusions: </strong>MRI assessment of MRF involvement showed limited concordance with pathological CRM status after NAT. Integration of MRF status and RAS status refines prognostic stratification in non-metastatic MRF-positive rectal cancer, guiding subsequent treatment decisions.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"11"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cadonilimab plus chemotherapy <i>vs</i>. PD-1 inhibitor plus chemotherapy as first-line treatment for advanced gastric or gastroesophageal junction cancer with PD-L1 combined positive score <5: a propensity-matched, retrospective cohort study.","authors":"Duqin Zhao, Zhongyue Wu, Yihui Huang, Lei Zhang, Xing Yuan, Nannan Zhang, Qing Wei, Jingjing Li, Jieer Ying, Qi Xu","doi":"10.21037/jgo-2025-aw-866","DOIUrl":"https://doi.org/10.21037/jgo-2025-aw-866","url":null,"abstract":"<p><strong>Background: </strong>Cadonilimab (AK104) is a first-in-class bispecific antibody targeting programmed cell death-1 (PD-1) and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4). This study evaluated the effectiveness and safety of cadonilimab plus chemotherapy <i>vs.</i> PD-1 inhibitor plus chemotherapy as first-line treatment for advanced gastric/gastroesophageal junction (G/GEJ) cancer with programmed cell death-ligand 1 (PD-L1) combined positive score (CPS) <5.</p><p><strong>Methods: </strong>Between August 2022 and August 2024, patients with PD-L1 CPS <5 G/GEJ cancer who received first-line cadonilimab plus chemotherapy (cadonilimab group) or PD-1 inhibitor plus chemotherapy (PD-1 inhibitor group) were included. After propensity score matching (PSM), the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety were analyzed.</p><p><strong>Results: </strong>Fifty-two patients were analyzed after PSM (26 per group). At data cutoff (February 28, 2025), median follow-up was 11.0 months [95% confidence interval (CI): 8.3-15.3]. Compared with the PD-1 inhibitor group, cadonilimab group exhibited a numerically higher ORR (73.3% <i>vs</i>. 57.1%, P=0.45). In addition, the median PFS [9.3 <i>vs</i>. 5.8 months; hazard ratio (HR) =0.43; 95% CI: 0.23-0.80; P=0.006] and OS (14.3 <i>vs</i>. 10.3 months; HR =0.49; 95% CI: 0.26-0.93; P=0.03) were significantly longer in the cadonilimab group than in the PD-1 inhibitor group. The incidence of treatment-related adverse events (AEs) was comparable between the two groups, occurring in 92.3% of patients receiving cadonilimab plus chemotherapy and 100.0% of those receiving PD-1 inhibitor plus chemotherapy. Immune-related AEs occurred in 8 patients (30.8%) in the cadonilimab group and 6 patients (23.1%) in the PD-1 inhibitor group.</p><p><strong>Conclusions: </strong>Compared to PD-1 inhibitor plus chemotherapy, cadonilimab plus chemotherapy significantly improved PFS and OS with a manageable safety profile in the first-line treatment of advanced G/GEJ cancer with PD-L1 CPS <5 in a real-world setting.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"5"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of chemoradiotherapy after induction in locally advanced pancreatic cancer: lessons learnt from CONKO-007.","authors":"Christos Athanasiou, Sanjay Pandanaboyana","doi":"10.21037/jgo-2025-aw-852","DOIUrl":"https://doi.org/10.21037/jgo-2025-aw-852","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"36"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ColoLDB: a machine learning-based predictive model for colorectal cancer using routine laboratory parameters.","authors":"Xing Zhang, Xuedong Tong, Jiangtao Mou, Jun Liu, Chenxi Zhang, Hongyan Han, Kun Deng","doi":"10.21037/jgo-2025-611","DOIUrl":"https://doi.org/10.21037/jgo-2025-611","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is one of the most common and highly prevalent cancers worldwide, posing a serious threat to public health. Current CRC screening and diagnosis primarily depend on colonoscopy, an invasive procedure that often misses early-stage tumors, contributing to delayed diagnoses. The aim of this study is to develop a simpler, more accessible screening method to assist clinicians in the early identification and diagnosis of CRC and its precancerous lesions.</p><p><strong>Methods: </strong>Using the patient's hospitalization number as the unique identifier, invalid age records were excluded, non-numerical laboratory test results were removed, and only the first diagnostic test result for each parameter per patient (i.e., the initial test value at first diagnosis) was retained. The study distinguished between the CRC experimental group and the control group. The study collected laboratory test data from each participant, including tumor markers, biochemical parameters, immunological indicators, complete blood count, coagulation tests, and routine urinalysis. We selected light gradient boosting machine (LightGBM), logistic regression (LR), random forest (RF), and extreme gradient boosting (XGBoost) to construct the models. Finally, the SHapley Additive explanations (SHAP) algorithm was employed to interpret the models.</p><p><strong>Results: </strong>After analyzing the four selected models, the intersection of the top-ranked features across all models was identified, ultimately screening eight laboratory parameters to construct the diagnostic colorectal laboratory digital biomarker (ColoLDB) model: specific gravity (SG), carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), age, albumin (ALB), cytokeratin 19 fragment (CYFRA21-1), high-density lipoprotein cholesterol (HDL-C) and carbohydrate antigen 72-4 (CA72-4). In the test set, the RF machine learning model demonstrated optimal performance in identifying CRC, achieving an area under the curve (AUC) of 0.863 (95% confidence interval: 0.792-0.922), an accuracy of 0.900, a sensitivity of 0.225, a specificity of 0.997, a positive predictive value (PPV) of 0.917, and a negative predictive value (NPV) of 0.900. When the specificity was set at 0.903, the ColoLDB model's sensitivity reached 0.694. In comparison, a diagnostic model combining CEA and CA19-9 yielded an AUC of 0.688, a sensitivity of 0.429 and a specificity of 0.947. The RF diagnostic ColoLDB model exhibited superior diagnostic efficacy compared to the combined CEA and CA19-9 diagnosis model.</p><p><strong>Conclusions: </strong>Our research findings indicate that eight laboratory test indicators may be related the risk of developing CRC. Our RF diagnostic ColoLDB model is an innovative and practical tool that effectively predicts the occurrence of CRC, enhancing the diagnostic efficiency for this disease. This method holds promise as a valuable tool for diagnosing CRC.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"12"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}