Journal of gastrointestinal oncology最新文献

{"title":"Prognostic role of resting heart rate in patients with colorectal cancer.","authors":"Wonhee Cho, Dong Hoon Lee, Nam-Kyu Kim, Justin Y Jeon","doi":"10.21037/jgo-2026-0676","DOIUrl":"10.21037/jgo-2026-0676","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"272"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900253","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":"Endoscopic ultrasonography ablation for small pancreatic neuroendocrine tumors.","authors":"Tanmay Srinivasan, Tamas Gonda","doi":"10.21037/jgo-2026-0289","DOIUrl":"10.21037/jgo-2026-0289","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"279"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900522","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":"Application value of dual-phase cone-beam computed tomography during hepatic arteriography in the detection of ≤2 cm hypervascular hepatocellular carcinoma and its feeding arteries.","authors":"Ruihang Wang, Jingqi Qu, Wenyan Liu, Tao Wu, Wei Han, Shengjuan Yao","doi":"10.21037/jgo-2026-0511","DOIUrl":"10.21037/jgo-2026-0511","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide. Accurate detection of small hypervascular HCC (≤2 cm) and precise identification of tumor-feeding arteries are pivotal to optimizing transarterial chemoembolization (TACE) efficacy. Conventional imaging modalities have inherent limitations in identifying minute lesions and fine feeding vessels. This study aimed to investigate the diagnostic performance and vascular mapping capability of dual-phase cone-beam computed tomography during hepatic arteriography (CBCT-HA) for ≤2 cm hypervascular HCC and their feeding arteries, in comparison with conventional imaging modalities.</p><p><strong>Methods: </strong>This retrospective study enrolled 134 HCC patients with 222 target lesions (≤2 cm in diameter) who underwent TACE between February 2021 and April 2023. All patients received preoperative gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI), intraoperative dual-phase CBCT-HA and digital subtraction angiography (DSA), and immediate post-embolization lipiodol cone-beam computed tomography (L-CBCT); 99 patients also completed preoperative contrast-enhanced ultrasound (CEUS). Lesions were stratified into ≤1 cm (n=100) and 1-2 cm (n=122) subgroups. The chi-squared test was applied to compare lesion-level detection rates, patient-level diagnostic rates, and feeding artery identification rates across modalities.</p><p><strong>Results: </strong>At the lesion level, dual-phase CBCT-HA detected 217 lesions (overall sensitivity 97.7%), with significantly higher detection rates than DSA (78.4%) in both size subgroups (all P<0.001). For ≤1 cm lesions, its detection rate (97.0%) was significantly higher than EOB-MRI (86.0%, P<0.001); for 1-2 cm lesions, its performance was comparable to EOB-MRI (98.4% <i>vs.</i> 100.0%, P>0.05). In the CEUS subgroup, it outperformed CEUS in both groups (all P<0.001) and was equivalent to EOB-MRI. At the patient level, its positive diagnostic rate (98.5%) was significantly higher than DSA (87.3%, P<0.001) and comparable to EOB-MRI. For feeding artery detection, dual-phase CBCT-HA achieved an overall rate of 87.4%, markedly higher than DSA (45.0%, all P<0.001).</p><p><strong>Conclusions: </strong>Dual-phase CBCT-HA delivers significantly higher diagnostic sensitivity than CEUS and DSA for ≤2 cm hypervascular HCC, with superior performance to EOB-MRI for ≤1 cm micro-HCC and comparable efficacy for 1-2 cm lesions. It also greatly improves tumor-feeding artery detection, facilitating precise superselective TACE. EOB-MRI remains the superior non-invasive modality for hypovascular early-stage HCC and high-grade dysplastic nodules (HGDNs) via the hepatobiliary phase (HBP).</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"246"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900610","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":"Nodal status and advanced clinical stage as determinants of response and survival after induction chemoradiotherapy in esophageal and gastroesophageal junction cancer: a single-centre retrospective cohort study.","authors":"Sabrina Schaefer, Sindhu Kanjeekal, Tarek Elfiki, John Mathews, Akmal Ghafoor, Abdullah Nasser","doi":"10.21037/jgo-2026-0473","DOIUrl":"10.21037/jgo-2026-0473","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Induction (neoadjuvant) chemoradiotherapy based on the CROSS regimen (weekly carboplatin/paclitaxel with concurrent radiation) is a standard of care for resectable esophageal and gastroesophageal junction (GEJ) cancer. However, the pivotal trials enrolled predominantly cT2-3 tumors with limited nodal involvement, did not stratify by nodal status, and largely excluded cT4, cN2-3, and oligometastatic (cM1) disease. Because these higher-risk patients are common in routine practice yet under-represented in trials, real-world data are needed to clarify how baseline nodal and clinical-stage affect outcomes after CROSS-based treatment. We evaluated the association between baseline clinical-stage and outcomes following CROSS-based treatment in a real-world cohort.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a single-centre retrospective cohort study of consecutive patients treated with CROSS-based induction chemoradiotherapy [weekly carboplatin area under the curve (AUC) =2 and paclitaxel 50 mg/m&lt;sup&gt;2&lt;/sup&gt; with concurrent 41.4 Gy] for esophageal/GEJ cancer between 2012 and 2022 at a Canadian regional cancer centre. Patients were identified from institutional pathology and systemic-therapy databases, cross-referenced with electronic records, and stratified a priori by initial clinical staging: group 1 (cT1-3N0M0), group 2 (cT1-3N1M0), and group 3 (cT4 and/or cN2-3 and/or oligometastatic cM1), the latter largely excluded from CROSS-based trials. Overall survival (OS) and progression-free survival (PFS), both measured from diagnosis, were primary outcomes; resection rate and pathologic complete response (pCR) were secondary. Survival was estimated using Kaplan-Meier methods and compared with log-rank testing; multivariable Cox models adjusted for age, sex, and Eastern Cooperative Oncology Group (ECOG) status, with two-sided statistical significance defined as P&lt;0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 138 patients (median age, 67 years; 81% male; 11% ECOG 2-3), 49% were group 1, 39% group 2, and 12% group 3, with no significant differences in age, sex, ECOG performance status, tumor location, histology, grade, or human epidermal growth factor receptor 2 (HER2) status. Overall, 86 deaths and 102 progression events occurred. Resection rates decreased with advancing clinical burden (70.6%, 57.4%, and 25.0%, respectively; P=0.004). Among resected patients, pCR occurred in 18.8%, 12.9%, and 0% (P=0.77). Median PFS was 34, 13, and 6 months, respectively (global log-rank P=0.001). Median OS was 46, 19, and 17 months (P=0.09). In adjusted models, PFS was significantly worse in group 2 [hazard ratio (HR) =1.86; 95% confidence interval (CI): 1.20-2.89] and group 3 (HR =2.84; 95% CI: 1.54-5.25), whereas the OS difference for group 3 was imprecise (HR =1.85; 95% CI: 0.91-3.78; P=0.09).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Greater baseline clinical disease burden was associated with progressively lower resection and pCR rates and sig","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"211"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900726","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":"Association of ctDNA <i>RAS</i> mutational status and clinical benefits in first-line metastatic colorectal cancer therapy with chemotherapy plus anti-EGFR (overall response rate and progression-free survival): a brief report of systematic review and meta-analysis.","authors":"Manuel Valladares-Ayerbes, Pilar García Alfonso, Volker Heinemann, Paolo Manca, Sebastian Stintzing, Filipo Pietrantonio, Clara Montagut, Maria José Safont Aguilera, Joan Maurel, Encarna González Flores, Joana Vidal, Vincenzo Formica, Montse Sabaté-Pina, Verónica Alfonso-González, Gerard Prat-Llorens","doi":"10.21037/jgo-2025-1-879","DOIUrl":"10.21037/jgo-2025-1-879","url":null,"abstract":"<p><p>Monitoring <i>RAS</i> mutations in circulating tumor DNA (ctDNA) is increasingly relevant in metastatic colorectal cancer (mCRC). In patients with tissue <i>RAS</i> wild-type (WT) tumors treated with first-line chemotherapy plus anti-epidermal growth factor receptor therapy (1LChT + anti-EGFR), some studies suggest that <i>RAS</i> WT ctDNA is associated with better outcomes, whereas others reported no differences according to ctDNA <i>RAS</i> mutational status. These inconsistencies may be related to small sample sizes, methodological heterogeneity, differences in assay sensitivity and tumor heterogeneity. We performed a systematic review in patients with tissue <i>RAS</i> WT treated with 1LChT + anti-EGFR. PubMed, Web of Science, and Scopus were searched up to April 2026. Risk of bias was assessed using the QUIPS tool, and random-effect models were applied. Fourteen studies met the inclusion criteria (ten non-interventional studies and four clinical trials). Compared with ctDNA <i>RAS</i> mutated tumors, ctDNA <i>RAS</i> WT tumors showed significantly higher overall response rates [ORR: pooled odds ratio (OR) 2.1, 95% confidence interval (CI): 1.3-3.4; P=0.002] and longer progression-free survival [PFS: pooled hazard ratio (HR) 1.6, 95% CI: 1.3-1.9; P<0.001] [non-interventional studies (NIS) + clinical trials (CT) data]. The pooled prevalence of ctDNA <i>RAS</i> mutations was 10.5% (95% CI: 6.2-14.8%). These findings support ctDNA <i>RAS</i> status as a potential biomarker of benefit from anti-EGFR-based therapy in mCRC, although methodological standardization and prospective validation remain necessary.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"271"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900735","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":"A <i>CFH</i>- and <i>SPINT2</i>-based prognostic signature for cholangiocarcinoma.","authors":"Sen Chen, Weiyang Ma, Beiqi Li, Jie Zhang, Wenxi Xie","doi":"10.21037/jgo-2026-0798","DOIUrl":"10.21037/jgo-2026-0798","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cholangiocarcinoma (CCA) is a highly malignant tumor with a poor prognosis, and reliable biomarkers for postoperative risk stratification remain limited. This study aimed to develop and validate a &lt;i&gt;CFH&lt;/i&gt;- and &lt;i&gt;SPINT2&lt;/i&gt;-based prognostic signature to support postoperative risk stratification and inform adjuvant therapy selection in CCA through integrative machine learning and single-cell transcriptomics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Differentially expressed genes were screened from GSE26566. Integrative machine learning (least absolute shrinkage and selection operator-Cox, random forest, and univariate Cox regression) was performed in the training cohort (GSE89749; n=115) to construct a risk model, which was externally validated in two independent cohorts: cohort 1 (E-MTAB-6389; n=75) and cohort 2 [The Cancer Genome Atlas Cholangiocarcinoma (TCGA-CHOL) data set; n=36]. Systematic analysis was conducted and included examinations of immune infiltration [via single-sample gene set enrichment analysis (ssGSEA)], pathway enrichment (via hallmark GSEA), cellular localization (via single-cell RNA sequencing), and drug sensitivity (via the Genomics of Drug Sensitivity in Cancer 2 database).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Two genes, &lt;i&gt;CFH&lt;/i&gt; and &lt;i&gt;SPINT2&lt;/i&gt;, were identified and incorporated into a prognostic risk score. High-risk patients in the training cohort had a significantly worse overall survival (log-rank P=0.02). External validation was performed in two independent cohorts. In validation cohort 1, the risk group was an independent prognostic factor [hazard ratio =2.27, 95% confidence interval (CI): 1.18-4.37; P=0.01]. In validation cohort 2, the model demonstrated acceptable discriminative ability (concordance index =0.721; 3-year area under the curve =0.692). The high-risk group exhibited an immunosuppressive microenvironment characterized by increased infiltration of macrophages and myeloid-derived suppressor cells, along with the activation of epithelial-mesenchymal transition, inflammatory response, and NF-κB signaling pathways. Single-cell analysis revealed a cell-type-specific expression pattern: &lt;i&gt;CFH&lt;/i&gt; was predominantly expressed in fibroblasts, while &lt;i&gt;SPINT2&lt;/i&gt; was mainly expressed in malignant cells. Drug sensitivity analysis demonstrated that the high-risk group was more sensitive to gemcitabine, cisplatin, poly(ADP-ribose) polymerase (PARP) inhibitors, and mammalian target of rapamycin (mTOR) inhibitors, whereas the low-risk group was more sensitive to lapatinib.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The &lt;i&gt;CFH&lt;/i&gt;- and &lt;i&gt;SPINT2&lt;/i&gt;-based prognostic signature may serve as an independent biomarker for postoperative risk stratification in CCA. High-risk patients, characterized by fibroblast-derived &lt;i&gt;CFH&lt;/i&gt; enrichment and malignant-cell &lt;i&gt;SPINT2&lt;/i&gt; loss, exhibit an immunosuppressive microenvironment and may be more suitable for gemcitabine-based chemotherapy or PARP/mTOR inhibitors,","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"259"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900625","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":"Hepatic arterial infusion or intravenous infusion of adebrelimab, combined with bevacizumab and HAIC of the FOLFOX regimen for advanced unresectable hepatocellular carcinoma (HAIBrave-001 trial): a study protocol of a prospective, double-arm, phase II trial.","authors":"Lujun Shen, Letao Lin, Yujie Zhang, Xiaoqiang Fang, Huijuan Lan, Weijun Fan","doi":"10.21037/jgo-2026-0607","DOIUrl":"10.21037/jgo-2026-0607","url":null,"abstract":"<p><strong>Background: </strong>Although atezolizumab plus bevacizumab is recommended as a first-line treatment for advanced unresectable hepatocellular carcinoma (HCC), its objective response rate (ORR) remains only about 30%. Hepatic arterial infusion chemotherapy (HAIC) using the FOLFOX regimen not only increases local drug concentration but may also enhance the efficacy of immune checkpoint inhibitors (ICIs) by inducing immunogenic cell death (ICD). Furthermore, delivering programmed cell death ligand 1 (PD-L1) inhibitors directly via hepatic arterial infusion (HAI) may maximize local antibody concentration in the tumor microenvironment and further potentiate regional immune responses. This study aims to explore the preliminary efficacy and safety of the PD-L1 inhibitor adebrelimab delivered via either HAI or the intravenous (IV) route, each combined with bevacizumab and HAIC-FOLFOX, for advanced HCC.</p><p><strong>Methods: </strong>This is a multicenter, randomized, non-comparative, open-label phase II trial. Seventy-six patients with previously untreated Barcelona Clinic Liver Cancer (BCLC) stage C HCC will be enrolled and randomly assigned (1:1) to either the HAI or IV cohort. To obtain independent efficacy estimates, Simon's two-stage design will be applied separately to each arm. Both groups will first receive HAIC-FOLFOX. The HAI group receives adebrelimab (1,200 mg) via HAI, followed by intravenous bevacizumab (15 mg/kg). The IV group receives both adebrelimab (1,200 mg) and bevacizumab (15 mg/kg) intravenously. Treatment continues for up to six cycles, after which HAIC-FOLFOX will be discontinued, and non-progressing patients will receive maintenance IV adebrelimab plus bevacizumab. The primary endpoint is investigator-assessed ORR per RECIST v1.1, evaluated independently for each arm. Secondary endpoints include progression-free survival, time to progression, overall survival and safety. Exploratory objectives include biomarker identification and evaluation of the regimen's effects on the tumor microenvironment and peripheral immune cells.</p><p><strong>Discussion: </strong>This is among the first studies to prospectively evaluate parallel cohorts receiving a PD-L1 inhibitor via hepatic arterial or intravenous delivery alongside HAIC-FOLFOX and bevacizumab. By utilizing a randomized non-comparative design, the trial will provide independent efficacy and safety profiles for each administration route. These findings will determine whether either regimen warrants further investigation, optimize immunotherapy delivery routes, and inform the design of future phase III comparative trials.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT06737913).</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"267"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900634","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":"A practical nomogram for predicting survival in patients with extrahepatic cholangiocarcinoma: a population-based cohort study.","authors":"Guanjun Zhang, Yaqi Zhai, Ke Meng, Yuting Han, Shengxin Chen, Mingyang Li","doi":"10.21037/jgo-2026-0258","DOIUrl":"10.21037/jgo-2026-0258","url":null,"abstract":"<p><strong>Background: </strong>Extrahepatic cholangiocarcinoma (ECC) is a highly aggressive malignancy. This study aimed to develop and validate a comprehensive prognostic nomogram incorporating treatment data to enable individualized risk stratification and refine patient selection for palliative interventions.</p><p><strong>Methods: </strong>Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) program (for the period from 2018 to 2022). There were 2,254 patients identified and randomly divided into model development (n=1,577) and validation (n=677) cohorts. Prognostic factors were selected through multivariate Cox regression using backward elimination based on the Akaike Information Criterion (AIC). A nomogram was developed to estimate 6-month, 1-year, and 3-year survival probabilities. Model performance was evaluated using the consistency index (C-index), calibration curves, and decision curve analysis (DCA). Finally, risk stratification cutoffs were determined to facilitate individualized prognostic assessment in palliative settings.</p><p><strong>Results: </strong>The final nomogram incorporated age, N stage, M stage, surgery, and chemotherapy status. The model demonstrated good discrimination, with C-indices of 0.770 [95% confidence interval (CI): 0.750-0.790] in the training cohort and 0.789 (95% CI: 0.768-0.802) in the validation cohort. Calibration curves indicated good agreement between predicted and observed probabilities. DCA revealed good net benefit across clinically relevant threshold probabilities. Risk stratification identified high-risk (<3 months, score ≥70), intermediate-risk (3-12 months, score 59-69), and low-risk (>1 year, score ≤58) groups, potentially guiding the selection between plastic and metal stents in palliative settings.</p><p><strong>Conclusions: </strong>This prognostic model provides accurate individualized survival prediction for ECC and facilitates objective risk stratification.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"256"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900679","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 and validation of a nomogram based on three-dimensional quantitative parameters from dual-layer detector spectral computed tomography for predicting treatment response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma.","authors":"Ya Zou, Xinwei Wang, Zuhua Song, Dan Zhang, Zhuoyue Tang","doi":"10.21037/jgo-2026-1-0194","DOIUrl":"10.21037/jgo-2026-1-0194","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemotherapy (NAC) can improve margin-negative resection rates and control occult systemic disease in pancreatic ductal adenocarcinoma (PDAC). However, not all patients benefit from NAC, and reliable pretreatment response predictors are lacking. This study aimed to develop and validate a nomogram combining three-dimensional (3D) quantitative parameters from dual-layer detector spectral computed tomography (DLCT) and clinical features for predicting treatment response to NAC in PDAC.</p><p><strong>Methods: </strong>This retrospective study enrolled 184 patients with pathologically confirmed PDAC who received 2-3 cycles of NAC (including FOLFIRINOX, gemcitabine-based, or other platinum-containing regimens) between December 2019 and July 2025. After excluding 34 patients due to absence of baseline DLCT, concurrent second primary malignancies, lack of 8-12-week follow-up imaging, or poor image quality, 150 patients were ultimately included. The patients were randomly divided (7:3) into training and validation cohorts. The pretreatment DLCT-based 3D quantitative parameters and clinical features were reviewed. Univariable and multivariable logistic regressions identified independent predictors of NAC response in the training cohort. The predictive performance of a nomogram integrating key predictors was assessed using the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).</p><p><strong>Results: </strong>The normalized effective atomic number in the portal venous phase (nZeffPVP) [odds ratio (OR), 1.497; 95% confidence interval (CI): 1.173-1.910; P=0.001], Carbohydrate antigen 19-9 (CA19-9) (OR, 0.999; 0.006; 95% CI: 0.998-1.000; P=0.006), and extracellular volume (ECV) (OR, 0.896; 95% CI: 0.837-0.959; P=0.002) of tumors were identified as independent predictors of NAC response. Incorporating all three independent predictors, the nomogram outperformed both the DLCT model and the clinical model, yielding the highest AUC of 0.839 (95% CI: 0.755-0.904) for the training set and 0.849 (95% CI: 0.711-0.938) for the validation set, respectively. When using the optimal cut-off value of the nomogram, sensitivity, specificity, PPV, and NPV for predicting the response group were 69.4%, 87.0%, 73.5%, and 84.5% in the training set, and 93.8%, 69.0%, 62.5%, and 95.2% in the validation set, respectively.</p><p><strong>Conclusions: </strong>The nomogram that integrates nZeffPVP, CA19-9, and ECV offers a promising approach for predicting treatment response to NAC in patients with PDAC. Following large‑scale, multicenter external validation, the nomogram may serve as an adjunctive tool to inform clinical decision-making and risk stratification.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"262"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900296","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":"Ferroptosis in gastrointestinal stromal tumors.","authors":"Robert Jenke, Achim Aigner","doi":"10.21037/jgo-2026-1-0171","DOIUrl":"10.21037/jgo-2026-1-0171","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"282"},"PeriodicalIF":2.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900520","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}