Journal of gastrointestinal oncology最新文献

{"title":"Combined hepatocellular carcinoma-cholangiocarcinoma with sarcomatoid features: new insights into a rare and aggressive tumor.","authors":"Sumaya Abdul Ghaffar, Aline Hikari Ishida, Ana Luiza Gleisner","doi":"10.21037/jgo-24-752","DOIUrl":"https://doi.org/10.21037/jgo-24-752","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2748-2750"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006462","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":"Advanced approaches to loco-regional and surgical management for hepatocellular carcinoma.","authors":"Chase J Wehrle, William Archie, Dionisios Vrochides, Andrea Schlegel, David C H Kwon, Federico Aucejo","doi":"10.21037/jgo-2024-879","DOIUrl":"https://doi.org/10.21037/jgo-2024-879","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2739-2742"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006522","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 nomogram prediction of early postoperative recurrence in hepatocellular carcinoma based on preoperative CT imaging radiomic features and serum features related to microvascular infiltration.","authors":"Zhenzhou Xu, Weibiao Yuan, Yuan Zhou, Tianhua Yue","doi":"10.21037/jgo-2024-914","DOIUrl":"https://doi.org/10.21037/jgo-2024-914","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is characterized by high postoperative recurrence rates, and predicting early recurrence is crucial for improving clinical outcomes, yet remains challenging. Both preoperative computed tomography (CT) imaging radiomic features and serum biomarkers related to microvascular infiltration are important indicators of HCC prognosis. This study aimed to develop a nomogram model incorporating both preoperative CT radiomic features and serum biomarkers associated with microvascular infiltration to predict early postoperative recurrence in HCC patients.</p><p><strong>Methods: </strong>The study included 156 HCC patients who underwent radical surgery at the Tumor Hospital Affiliated to Nantong University between January 2021 and January 2022. Preoperative CT imaging data were obtained for each patient, and radiomic features were extracted using the 3D Slicer software. Preoperative serum biomarkers related to microvascular invasion were collected, including alpha-fetoprotein (AFP), vascular endothelial growth factor A (VEGF-A), Speckled Protein 100 (SP100), and the Fibrosis-4 (FIB-4) index levels. Postoperative follow-up was conducted for 2 years, during which recurrence data were collected. The radiomics score was generated through dimensionality reduction and least absolute shrinkage and selection operator (LASSO) regression analysis. Univariate and logistic regression analyses were used to identify independent risk factors for early postoperative recurrence of HCC. The nomogram model was constructed using R language, and its predictive performance was evaluated using receiver operating characteristic curves, calibration curves, and decision curve analysis curves.</p><p><strong>Results: </strong>Among the 156 patients, 60 experienced early recurrence, while 96 did not. Feature reduction through LASSO regression identified 10 optimal features from the venous phase and 4 optimal features from the arterial phase, leading to the development of a radiomics score formula. The early recurrence group had significantly higher radiomics scores than the non-early recurrence group [-1.35 (-2.29, 1.21) <i>vs.</i> 0.94 (-0.40, 1.87), P<0.001]. Logistic multivariate regression analysis identified lesion number, Edmondson grade, AFP and VEGF-A levels, and radiomics score as independent risk factors for early postoperative recurrence of HCC (P<0.05). The nomogram model demonstrated high predictive performance with area under the curve (AUC) values of 0.9265 and 0.9255 in the training and internal test sets, respectively. The model demonstrated good net benefit across a threshold range of 0.01-75%, effectively identifying high-risk patients for early postoperative recurrence.</p><p><strong>Conclusions: </strong>The nomogram model based on preoperative serum biomarkers related to microvascular infiltration and CT radiomic features demonstrated high predictive performance for early postoperative recurrence of HCC.","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2630-2641"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006533","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":"Erratum to Colon cancer-associated transcript-1 enhances glucose metabolism and colon cancer cell activity in a high-glucose environment <i>in vitro</i> and <i>in vivo</i>.","authors":"","doi":"10.21037/jgo-2024-03","DOIUrl":"https://doi.org/10.21037/jgo-2024-03","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/jgo-20-474.].</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2751-2752"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006570","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":"Colorectal metastasis from gastric cancer: insights from a 14-year case series at a tertiary hospital.","authors":"Ji You Jung, Jaram Lee, Hyeung-Min Park, Soo Young Lee, Mi Ran Jung, Chang Hyun Kim, Hyeong Rok Kim","doi":"10.21037/jgo-24-689","DOIUrl":"10.21037/jgo-24-689","url":null,"abstract":"<p><strong>Background: </strong>Colorectal metastasis from gastric cancer is very rare, with existing literature limited to only a few case reports. This study was designed to investigate the clinicopathological features and prognosis of colorectal metastasis arising from gastric cancer.</p><p><strong>Methods: </strong>Patients with colorectal metastasis from gastric cancer who underwent surgical intervention at a single tertiary hospital between January 2010 and June 2023 were included, and their clinicopathological characteristics and oncologic outcomes were analyzed.</p><p><strong>Results: </strong>A total of 13 patients were identified and analyzed. The majority (92.3%) experienced metachronous metastasis, with a median disease-free interval of 34.5 months (range, 16-92 months). Surgical resection was performed in 10 patients (76.9%), while the remaining 3 (23.1%) underwent diverting enterostomy. Histopathology revealed that the metastatic colorectal tumors were poorly differentiated adenocarcinoma (76.9%) or signet ring cell carcinoma (23.1%). Among the 10 patients undergoing surgical resection, 5 (50.0%) achieved R0 resection, while the others had R2 resection. After a median follow-up of 11 months (range, 0-158 months), the 2-year overall survival (OS) was 18.5%. Postoperative chemotherapy was significantly associated with improved 2-year OS (26.7% <i>vs.</i> 0.0%, P=0.008), and R0 resection trended toward improved 2-year OS (37.5% <i>vs.</i> 12.5%, P=0.17). Notably, one patient who received R0 resection and chemotherapy survived for 158 months.</p><p><strong>Conclusions: </strong>Colorectal metastasis from gastric cancer demonstrated unfavorable histological features and a poor OS. Nonetheless, the pursuit of R0 resection and postoperative chemotherapy appears to hold significance, suggesting a potential avenue for improved outcomes.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2437-2446"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006460","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":"Emerging role of spasmolytic polypeptide-expressing metaplasia in gastric cancer.","authors":"Qiange Ye, Yanmei Zhu, Yichun Ma, Zhangding Wang, Guifang Xu","doi":"10.21037/jgo-24-508","DOIUrl":"10.21037/jgo-24-508","url":null,"abstract":"<p><p>Gastric cancer (GC) ranks among the top five most diagnosed cancers globally, with particularly high incidence and mortality rates observed in Asian regions. Despite certain advancements achieved through early screening and treatment strategies in many countries, GC continues to pose a significant public health challenge. Approximately 20% of patients infected with <i>Helicobacter pylori</i> develop precancerous lesions, among which metaplasia is the most critical. Except for intestinal metaplasia (IM), which is characterized by goblet cells appearing in the stomach glands, one type of mucous cell metaplasia, spasmolytic polypeptide-expressing metaplasia (SPEM), has attracted much attention. SPEM represents a specific epithelial cell alteration within the gastric mucosa, characterized by the expressing trefoil factor 2 (TFF2) in basal glands, resembling the basal metaplasia of deep antral gland cells. It primarily arises from the transdifferentiation of mature chief cells, mucous neck cells (MNCs), or isthmus stem cells. SPEM is commonly regarded as a precursor lesion in the development of gastric inflammation and subsequent carcinogenesis. The formation of SPEM is intricately associated with chronic gastric inflammation, <i>Helicobacter pylori</i> infection, and various other environmental and genetic factors. Recently, with the profound exploration of the biological and molecular mechanisms underlying SPEM, a deeper understanding of its role in GC initiation and progression has emerged. This review summarizes the role, molecular mechanisms, and clinical significance of SPEM in the onset and progression of GC.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2673-2683"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006568","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":"Multimodal transesophageal echocardiography in the surgical resection of patients with hepatocellular carcinoma and inferior vena cava tumor thrombus.","authors":"Baochun Lai, Yonghuo Ye, Dimitrios Moris, Matteo Donadon, Zhensheng Ye, Jie Lin, Sanrong Lan","doi":"10.21037/jgo-24-731","DOIUrl":"https://doi.org/10.21037/jgo-24-731","url":null,"abstract":"<p><strong>Background: </strong>The incidence and mortality rate of hepatocellular carcinoma (HCC) are increasing globally. HCC with inferior vena cava tumor thrombus (HCCIVCTT) represents an advanced stage of the disease. Research suggests that for patients with advanced HCCIVCTT, liver resection combined with thrombectomy is a safe and feasible option that can provide moderate survival benefit. The aim of this study was to evaluate the application value of multimodal transesophageal echocardiography (TEE) in the perioperative period for patients with HCCIVCTT.</p><p><strong>Methods: </strong>TEE was used for routine intraoperative examination in 17 patients to determine the location and classification of tumor thrombi, guide the proper placement of the inferior vena cava occlusion band during surgery, and evaluate whether the tumor thrombus was completely removed postoperatively.</p><p><strong>Results: </strong>Among the 17 patients with HCCIVCTT, tumor thrombi invaded the hepatic veins and extended into the inferior vena cava, with 3 cases of extension into the right atrium. The tumor thrombi varied in shape, size, and echogenicity, with high-velocity turbulent flow signals observed within the occluded vessels. There were 10 cases of type I, 4 cases of type II, and 3 cases of type III. Under the guidance of intraoperative TEE, preocclusion bands were successfully placed above the tumor thrombi in type I and II patients, with real-time dynamic monitoring showing no rupture or dislodgement of the thrombi, and postoperatively, the thrombi appeared to be completely removed.</p><p><strong>Conclusions: </strong>TEE plays an important role in the perioperative management of HCCIVCTT. It can aid in deterring the type of tumor thrombus, selecting the suitable surgical method, and postoperatively assessing the completeness of tumor thrombus removal.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2588-2598"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006553","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":"Genomic profiles and their associations with microsatellite instability status, tumor mutational burden, and programmed death ligand 1 expression in Chinese patients with colorectal cancer.","authors":"Bo Luo, Min Liao, Bin Nie, Yunbao Yu, Qipeng Yao","doi":"10.21037/jgo-24-748","DOIUrl":"https://doi.org/10.21037/jgo-24-748","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is among the most prevalent malignancies globally, with a rising incidence observed in younger demographics. Despite surgical resection remaining the cornerstone of treatment, metastatic CRC poses significant therapeutic challenges. Immunotherapy, a mode of treatment that leverages the patient's immune system, presents a promising frontier in CRC management, particularly for late-stage cases with limited treatment options. The study was aimed to elucidate the relationships between genetic profiles and predictive biomarkers in CRC patients to inform immunotherapy decisions and improve outcomes.</p><p><strong>Methods: </strong>We conducted a large-scale study involving 660 patients with CRC, analyzing genetic profiles and predictive biomarkers for immune checkpoint inhibitors (ICIs) using next-generation sequencing (NGS) and immunohistochemistry (IHC). The study focused on assessing the association between gene mutations and markers such as microsatellite instability (MSI) status, tumor mutational burden (TMB), and programmed death ligand 1 (PD-L1) expression.</p><p><strong>Results: </strong>Analysis revealed a diverse mutational landscape in CRC, with <i>TP53</i> (73.64%), <i>APC</i> (67.58%), and <i>KRAS</i> (46.82%) being the most frequently mutated genes. We observed significant associations between <i>KRAS</i> mutations and co-occurrences with <i>FBXW7</i>, <i>PIK3CA</i>, and <i>SMAD4</i> mutations, while <i>KRAS</i> mutations were mutually exclusive with <i>TP53</i> mutations. <i>KRAS</i> mutations were enriched in the PD-L1 tumor proportion score (TPS) ≥1% population (P=0.03), whereas <i>APC</i> mutations were enriched in the PD-L1 TPS <1% population (P=0.10) as compared to their wild types. Additionally, specific mutations such as <i>KRAS</i> p.A146T, <i>PIK3CA</i> p.H1047R, and <i>BRAF</i> p.V600E were significantly associated with higher TMB and MSI-high status, indicating potential benefits from ICI therapy.</p><p><strong>Conclusions: </strong>Our findings underscore the importance of genetic profiling in guiding treatment decisions for patients with CRC, particularly in the era of immunotherapy. Understanding the complex interplay between genetic alterations and immune markers is critical for optimizing therapeutic strategies and improving clinical outcomes. Further research is warranted to validate these findings and explore personalized treatment approaches in CRC.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2460-2472"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006583","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":"Pathological complete response following neoadjuvant chemotherapy with PD-1 inhibitor for locally advanced pancreatic cancer: case report.","authors":"Junsheng Chen, Da Wang, Fei Xiong, Guanhua Wu, Wenzheng Liu, Qi Wang, Yiyang Kuai, Feng Peng, Yongjun Chen","doi":"10.21037/jgo-24-549","DOIUrl":"https://doi.org/10.21037/jgo-24-549","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the incidence of pancreatic cancer has shown an obvious increasing trend worldwide and even causes a greater disease burden to the mankind. Due to the lack of effective early surveillance methods, patients are often in the middle to advanced stages of their disease at the time of detection, thus losing the opportunity for surgery. The currently available chemotherapy regimens are yet to be further improved to prolong patient survival. The use of immune monotherapy in pancreatic cancer is even more frustrating, with poor therapeutic results.</p><p><strong>Case description: </strong>Here, we present two cases of locally advanced pancreatic cancer in which neoadjuvant chemotherapy (gemcitabine with albumin-bound paclitaxel) was administered in combination with a programmed cell death protein 1 (PD-1) inhibitor (tislelizumab), resulting in the opportunity for surgical intervention. Notably, one patient exhibited a pathological complete response, characterized by minimal residual highly intraepithelial neoplasia accompanied by extensive fibrosis and transparency. Genetic testing found that the patient had a KRAS mutation (c.35G>T, p.G12V).</p><p><strong>Conclusions: </strong>The efficacy of this combination therapy has renewed our interest in the mechanism of action or drug resistance of tumor cells in chemotherapy and immunotherapy. An in-depth study of the possible synergistic mechanisms of action of these drugs will provide new research directions for the treatment of pancreatic cancer.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2692-2705"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006633","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 case of pancreatic acinar cell carcinoma implantation in multiple branches of the pancreatic duct without main tumor continuity: a rare case report.","authors":"Atsushi Yamaguchi, Hiroki Kamada, Shigeaki Semba, Naohiro Kato, Yuji Teraoka, Takeshi Mizumoto, Yuzuru Tamaru, Tsuyoshi Hatakeyama, Hirotaka Kouno, Takeshi Sudo, Rie Yamamoto, Kazuya Kuraoka, Shigeto Yoshida","doi":"10.21037/jgo-24-511","DOIUrl":"https://doi.org/10.21037/jgo-24-511","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic acinar cell carcinoma (PACC) is a rare subtype of pancreatic cancer and the clinicopathological behavior of PACC is not yet fully understood. PACC rarely invades the main pancreatic duct (MPD), which causes intraductal growth. Thus, herein, we have reported a rare case of PACC that invaded the MPD and disseminated to the branches of the pancreatic duct (BDs) without exhibiting any continuity with the main tumor.</p><p><strong>Case description: </strong>A 60-year-old man was found to have a hypo echoic pancreatic head mass on abdominal ultrasonography during a routine medical checkup. In computed tomography, a 30-mm hypo-dense mass was found in the pancreas head. An endoscopic retrograde pancreatography was performed to collect pancreatic juice for cytological examination. MPD was narrowing in pancreatic head and caudal MPD was slightly dilated. Although no malignant cells were detected, a pancreaticoduodenectomy was performed. Histological examination of the excised specimen confirmed the diagnosis of PACC with MPD invasion. Furthermore, tumor implantation was detected in multiple BDs that were downstream of the main tumor, without any continuity with the main tumor.</p><p><strong>Conclusions: </strong>PACC can metastasize and get implanted in multiple BDs. Thus, post-surgical relapse can occur due to metastatic lesions implanted in the remnant pancreas.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2721-2727"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006443","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}