Journal of gastrointestinal oncology最新文献

{"title":"Regorafenib monotherapy as the later-line treatment for elderly patients with metastatic colorectal cancer: a multicenter real-world study.","authors":"Jinglong Huang, Caifeng Gong, Zhichao Jiang, Wang Qu, Yongkun Sun, Nan Zun Teo, Wen Zhang, Lin Yang, Yunbo Zhao, Aiping Zhou","doi":"10.21037/jgo-24-464","DOIUrl":"10.21037/jgo-24-464","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is one of the tumors with the highest morbidity and mortality rates in China and the world. Regorafenib is a targeted drug for standard third-line treatment of metastatic colorectal cancer (mCRC). Regorafenib monotherapy has shown certain efficacy in the elderly population, but more robust evidence is needed. The aim of this study was to evaluate the dosing characteristics, prognosis, and safety of regorafenib monotherapy in elderly Chinese patients with mCRC.</p><p><strong>Methods: </strong>This retrospective study comprised elderly patients (aged ≥60 years) with mCRC who received regorafenib monotherapy as a third-line or above treatment in 10 hospitals from August 2017 to June 2020. We analyzed the association between different dosing regimens and prognosis. The primary endpoint was overall survival (OS), and other endpoints included progression-free survival (PFS) and adverse events (AEs).</p><p><strong>Results: </strong>In total, 203 patients were included in the analysis. The median PFS was 3.88 months [95% confidence interval (CI): 3.48-5.65], and the median OS was 10.1 months (95% CI: 8.94-12.1). There was no significant difference in the survival curves between the different dosage groups. The multivariate Cox analysis showed a significant benefit in OS in the high final daily dose group (120-160 mg/day) [hazard ratio (HR): 0.45, 95% CI: 0.25-0.84, P=0.01], which was further confirmed by the propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis. No significant association was found between the initial daily dose and prognosis. Nor was any significant association found between PFS and drug dosage. Subsequently, an age subgroup analysis was conducted using 70 years as the cut-off value. In those aged <70 years, the application of higher final doses (120-160 mg/day) was significantly associated with the prolongation of OS compared to a final dose of 80 mg/day [HR (95% CI): 0.38 (0.16-0.91), P=0.03], and the prolongation of OS was predominantly observed in the 120 mg/day dose group [HR (95% CI): 0.24 (0.09-0.67), P=0.006]. Besides, we observed a statistically insignificant increase in the incidence of AEs in the higher dose group compared to the lower dose group.</p><p><strong>Conclusions: </strong>Regorafenib monotherapy was shown to be efficacious in the elderly population, but further evidence is needed for guidance. Based on our multicenter real-world investigation, the final daily dose was significantly associated with OS. For those aged <70 years, maintaining the final dose at 120 mg/day may have prognostic advantages. The suggested medication protocol requires validation through comprehensive clinical trials.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 5","pages":"2166-2177"},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647807","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":"Identification of <i>DLAT</i> as a potential therapeutic target via a novel cuproptosis-related gene signature for the prediction of liver cancer prognosis.","authors":"Cunbing Xia, Yang Chen, Yongkang Zhu, Dexuan Chen, Haijian Sun, Tong Shen, Vishal G Shelat, Vasileios K Mavroeidis, Giovanni Battista Levi Sandri, Zhan Wang, Hong Zhu","doi":"10.21037/jgo-24-609","DOIUrl":"10.21037/jgo-24-609","url":null,"abstract":"<p><strong>Background: </strong>The prognosis for liver cancer (LC) is dismal. Researchers recently discovered cuproptosis, a novel form of controlled cell death whose expression in LC and prognosis are unclear. This study reveals a gene signature to predict LC prognosis.</p><p><strong>Methods: </strong>RNA and clinical data for 371 LC patients were obtained from The Cancer Genome Atlas (TCGA). Differentially expressed genes (DEGs) were identified by comparing cancerous and normal samples. Genes linked to overall survival (OS) were found using univariate Cox regression and least absolute shrinkage and selection operator (LASSO). The gene signature was validated across all patients. Gene expression and clinical traits were analyzed, and Kaplan-Meier (KM) curves were generated for high- and low-risk groups. DEGs were used for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), immune infiltration, and drug prediction analyses. <i>DLAT</i>'s functions were assessed using real-time polymerase chain reaction (RT-PCR), transwell invasion, Cell Counting Kit-8 (CCK-8), colony formation, and drug resistance assays.</p><p><strong>Results: </strong>A total of 12 cuproptosis regulators were discovered in LC and normal liver tissues. A 3-gene signature based on LASSO Cox regression was utilized to categorize TCGA LC patients into low- and high-risk categories. Low-risk patients exhibited better survival than high-risk patients (P<0.05). Tumor grade, stage, and T stage differed between high- and low-risk groups. Long-term prognosis was well predicted by male subgroup survival studies. We predicted LC patient survival using sex, tumor grade, tumor stage, and risk score. Functional enrichment showed that extracellular matrix (ECM) architecture, channel function, and tumor-associated pathways were enriched in LC, suggesting that cancer related functions were collected. Immune microenvironment inhibition was found in the high-risk group suggesting that immunosuppression was closely related. We also discovered five small molecules that could be potentially useful for LC treatment. <i>DLAT</i> was discovered to promote the migration and proliferation of LC cells and is connected to drug resistance as a prognostic marker.</p><p><strong>Conclusions: </strong>Cuproptosis-related genes contribute to tumor development and can aid the prediction of LC patient prognosis. <i>DLAT</i> is a potential LC prognostic and therapeutic target.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 5","pages":"2230-2251"},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647360","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 predictive model based on radiomics, clinical features, and pathologic indicators for disease-free survival after liver transplantation for hepatocellular carcinoma: a 7-year retrospective study.","authors":"Hao Xie, Bin Shi, Junzhen Fan, Shui Liu, Qiaozhi Ma, Junnan Dai, Siqing Dong, Ying Liu, Han Meng, Hui Liu, Ya Yang, Xuetao Mu","doi":"10.21037/jgo-24-347","DOIUrl":"10.21037/jgo-24-347","url":null,"abstract":"<p><strong>Background: </strong>Disease-free survival (DFS) is an essential indicator for evaluating the prognosis of liver transplantation (LT) in hepatocellular carcinoma (HCC) patients. Despite progress in the prediction of DFS by radiomics, only preoperative clinical features have been combined in most studies. The aim of this study was to construct a nomogram model (NM) using preoperative clinical features, radiomics, and postoperative pathological indicators for more effective prediction of DFS.</p><p><strong>Methods: </strong>This was a retrospective study of a single-center cohort comprising 139 HCC patients. Using the whole cohort, we constructed and assessed a clinical model (CM) based on alpha-fetoprotein (AFP) and alkaline phosphatase (ALP), a pathological model (PM) based on Ki-67 and tumor number, a radiomics model (RM) based on the radiomics score (Rad-score), and an NM based on the above five independent predictors.</p><p><strong>Results: </strong>Significant correlations between the NM and DFS were observed in the training and validation cohorts. Among the four prediction models, the C-index of the NM was the highest [(training/validation cohort) CM: 0.664/0.676, PM: 0.737/0.691, RM: 0.706/0.697, NM: 0.817/0.760], and the areas under the receiver operating characteristic curves (AUCs) of the NM prediction of 1-year, 2-year, and 3-year DFS were also the highest [(training/validation cohort) 1-year, 2-year, and 3-year CM: 0.726/0.726, 0.685/0.744, 0.645/0.686, PM: 0.789/0.780, 0.801/0.748, 0.841/0.735, RM: 0.769/0.752, 0.717/0.805, 0.748/0.765, NM: 0.882/0.854, 0.867/0.849, 0.882/0.801]. The NM also exhibited the highest net clinical benefit.</p><p><strong>Conclusions: </strong>Based on radiomics, clinical features, and pathological indicators, the NM could be used to effectively predict DFS after LT in HCC patients, guiding the follow-up and complementary treatment.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 5","pages":"2187-2200"},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648318","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":"Metastasis patterns and prognosis in patients with gastric cancer: a Surveillance, Epidemiology, and End Results-based analysis.","authors":"Qiumei Dong, Minqing Huang, Xiaorong Lai","doi":"10.21037/jgo-24-738","DOIUrl":"10.21037/jgo-24-738","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is one of the most commonly diagnosed malignancies, and a majority of patients with gastric cancer are diagnosed at an advanced stage. However, the association between metastatic patterns and survival outcomes in patients with advanced gastric cancer has not been fully explored. In the present study, we aimed to investigate the metastatic patterns and their association with prognosis in patients with gastric cancer.</p><p><strong>Methods: </strong>We collected and reviewed data of patients with metastatic gastric cancer from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The Kaplan-Meier method was used to create survival curves, and the Cox proportional regression model was applied to analyze the association between metastatic pattern and prognosis.</p><p><strong>Results: </strong>A total of 10,262 patients were enrolled in the present study. Among them, 4,699 (45.79%) had single-site metastasis, including 3,358 (32.72%) with liver-only metastasis, 699 (6.81%) with bone-only metastasis, 560 (5.46%) with lung-only metastasis, and 82 (0.80%) with brain-only metastasis. Moreover, 1,308 (12.75%) patients had multisite metastases, and 4,255 (41.46%) patients had distant metastases but no other detailed information. The median overall survival for patients with single-site and multisite metastases was 4 and 3 months, respectively. The multivariate Cox regression analysis showed that compared with bone-only metastasis, liver-only metastasis (P<0.001) and lung-only metastasis (P=0.001) were associated with better prognosis.</p><p><strong>Conclusions: </strong>The liver is the most common metastatic site in patients with gastric cancer. N stage, chemotherapy, surgery, and metastatic pattern are independent risk factors associated with prognosis.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 5","pages":"2079-2087"},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647701","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":"Changing of gamma-H2AX in peripheral blood mononuclear cells during concurrent chemoradiation in locally advanced rectal cancer patients: a potential response predictor.","authors":"Piyapasara Toapichattrakul, Narongchai Autsavapromporn, Aphidet Duangya, Suwalee Pojchamarnwiputh, Wittanee Nachiangmai, Kittikun Kittidachanan, Somvilai Chakrabandhu","doi":"10.21037/jgo-24-488","DOIUrl":"10.21037/jgo-24-488","url":null,"abstract":"<p><strong>Background: </strong>The most detrimental effect of DNA damage from radiation is DNA double-strand breaks, making it critical to identify reliable biomarkers for treatment response in cancer therapy. Gamma-H2AX (γ-H2AX), a marker of DNA double-strand breaks, was evaluated in this study as a potential biomarker for treatment response in locally advanced rectal cancer patients undergoing preoperative concurrent chemoradiation (CCRT).</p><p><strong>Methods: </strong>Thirty patients with locally advanced rectal cancer received preoperative CCRT. Peripheral blood mononuclear cells (PBMCs) were collected at five time points: baseline, 24 hours after the first radiation fraction, mid-treatment, end of treatment, and six weeks post-CCRT. γ-H2AX levels were measured in these samples. MRI was used to assess treatment response based on magnetic resonance tumor regression grade (mrTRG). Patients were classified as responders or non-responders based on mrTRG. <i>T</i>-test and repeated measures analysis of variance (ANOVA) evaluated dynamic changes in γ-H2AX levels, and a multilevel linear regression model analyzed the relationship between γ-H2AX levels and treatment response.</p><p><strong>Results: </strong>Nineteen out of thirty patients (63.33%) were classified as responders. Significant dynamic changes in γ-H2AX levels were observed between non-responders and responders (P=0.01). The multilevel linear regression model showed a trend towards increased γ-H2AX levels in responders [1.17, 95% confidence interval (CI): -0.02 to 2.34, P=0.053]. Significant differences in γ-H2AX levels were observed from baseline to mid-treatment, end of treatment, and six weeks post-CCRT. Pathologic complete response (pCR) after CCRT was associated with significantly higher γ-H2AX ratios compared to those without pCR (P=0.04). However, no significant difference was identified in the multilevel linear regression model.</p><p><strong>Conclusions: </strong>γ-H2AX may have potential as a biomarker for treatment response in locally advanced rectal cancer patients undergoing preoperative CCRT, although further validation is required.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 5","pages":"2117-2128"},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646626","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":"Patient-controlled analgesia with hydromorphone treatment for advanced colon cancer with severe pain in an older adult patient: a case report and literature review.","authors":"Mao-Dong Zheng, Yan-Xia Li, Ze-Yu Wang, Huan Ma, Yu Wang, Ting-Ting Qiao, Michael S Krasovitsky, Cihad Tatar, Mohana Karlekar, Juan Yan","doi":"10.21037/jgo-24-713","DOIUrl":"10.21037/jgo-24-713","url":null,"abstract":"<p><strong>Background: </strong>Unrelieved cancer pain can seriously reduce patients' quality of life. Hydromorphone based patient-controlled analgesia (PCA) is widely used in surgery. In recent years, it has also gained attention in the field of cancer pain. We report the case of an older patient with refractory pain secondary to colorectal cancer for whom PCA therapy led to improved symptomatic outcomes.</p><p><strong>Case description: </strong>We present the case of a 79-year-old male with severe pain from advanced colon cancer. After receiving anti-cancer therapy for 7 years, the patient developed pain in the right groin with a pain score of 7/10. The results of whole-body bone imaging suggested the underlying cause to be a pelvic osseous metastasis. Contemporaneous computed tomography (CT) scanning confirmed disease progression in previously noted non-osseous sites of disease. Systemic therapy with bevacizumab, oxaliplatin, and raltitrexed was commenced. For pain palliation, the patient was treated with morphine hydrochloride tablets, morphine hydrochloride injections, compound codeine phosphate and ibuprofen sustained release tablets, incadronate disodium for injection, and oxycodone hydrochloride sustained-release tablets; despite this, his pain remained poorly controlled. The patient was admitted to hospital with a pain score of 8/10. Other symptoms at presentation included fatigue, anorexia, distress and insomnia. A hydromorphone PCA was initiated, which led to a rapid improvement in the patient's pain. The patient died peacefully 17 days later; his family was highly satisfied.</p><p><strong>Conclusions: </strong>Older patients with cancer experience pain in myriad ways. Patients with advanced cancer pain should receive safe, rapid, and effective pain relief. Hydromorphone-based PCA therapies may provide a valuable therapeutic option for individuals with malignant pain.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 5","pages":"2330-2337"},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647722","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":"Peroxisome proliferator-activated receptor gamma (PPAR-γ) activation through gut microbiota modulation as a novel therapeutic approach against anastomotic leak after colorectal cancer surgery.","authors":"María Ángeles Núñez-Sánchez, María Antonia Martínez-Sánchez, Bruno Ramos-Molina","doi":"10.21037/jgo-24-314","DOIUrl":"10.21037/jgo-24-314","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 5","pages":"2338-2342"},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647723","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":"Concomitant or antecedent intraductal papillary mucinous neoplasm is not a prognostic factor in resected pancreatic cancer.","authors":"Pedro Luiz Serrano Uson Junior, Ana Luiza Spina Nagy, Igor Wanderley Reis Dias, Marcelo Bruno de Rezende, Roberto Pestana, Diogo Bugano, Francisco Tustumi, Guilherme Naccache Namur, Jaime Arthur Pirola Kruger, Alberto Goldenberg, Sergio Eduardo Alonso Araujo, Nam Jin Kim, Sidney Klajner, Mitesh Borad, Fernando Moura","doi":"10.21037/jgo-24-157","DOIUrl":"https://doi.org/10.21037/jgo-24-157","url":null,"abstract":"<p><strong>Background: </strong>Intraductal papillary mucinous neoplasm (IPMN)-associated pancreatic cancer is becoming a common subtype of pancreatic cancer found in resected specimens. The prognostic of this subtype is still under evaluation. The study aims to evaluate the prognosis of IPMN-associated pancreatic adenocarcinoma compared to the conventional pancreatic adenocarcinoma.</p><p><strong>Methods: </strong>In this study, patients with resected pancreatic neoplasms and IPMN treated at Hospital Israelita Albert Einstein, from January 2016 to December 2020, were analyzed. Overall survival (OS) was estimated using the Kaplan-Meier method, and correlations between the variables of interest and the disease specific OS was assessed by multivariate analysis.</p><p><strong>Results: </strong>Of 187 patients undergoing resection for pancreatic adenocarcinoma or IPMN, 125 (67%) had pancreatic adenocarcinoma, 33 (18%) had IPMN-associated pancreatic adenocarcinoma, and 29 (16%) had IPMN. Resected IPMN was associated with long-term OS for most of the patients. Similar OS was identified in this study in upfront resected pancreatic cancer associated or not with IPMN. No statistical differences in median OS were identified between resected pancreatic adenocarcinoma and IPMN-associated pancreatic adenocarcinoma (48 <i>vs.</i> 44 months, P=0.44). Size of the tumor [hazard ratio (HR), 1.33], resected stage III (HR, 1.31), perineural invasion (HR, 1.58), lymphovascular invasion (HR, 1.44), positive lymph nodes (HR, 1.34), and neoadjuvant treatment (HR, 1.70) were associated with worse outcomes.</p><p><strong>Conclusions: </strong>Our findings confirm that resected pancreatic cancer has a poor prognosis and IPMN-associated pancreatic adenocarcinoma has the same prognosis as a conventional pancreatic adenocarcinoma. More than half of the cases of IPMN-associated adenocarcinoma already had positive lymph nodes. The impact of neoadjuvant treatment in this group of patients should be investigated in larger cohorts.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 4","pages":"1820-1826"},"PeriodicalIF":2.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289044","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":"Cultural and social barriers to hope in gastrointestinal cancer patients.","authors":"Vera Qu, Caressa Hui, Zhihui Fang, Scott Jackson, Lucas Vitzthum, Elham Rahimy, Jennifer Hall, Erqi L Pollom","doi":"10.21037/jgo-23-938","DOIUrl":"https://doi.org/10.21037/jgo-23-938","url":null,"abstract":"<p><strong>Background: </strong>Hope is correlated with quality of life and overall survivorship among patients with cancer. We aimed to identify sociodemographic and clinical determinants of hope among patients with gastrointestinal (GI) cancer.</p><p><strong>Methods: </strong>Patients with GI cancer seen in radiation oncology between 10/2022 and 6/2023 were surveyed with the Adult Hope Scale (AHS) questionnaire, which assesses hope based on goal-setting and goal-striving beliefs. Linear regression and Pearson's/Spearman's correlation coefficients were used to evaluate associations between AHS scores and demographic or disease variables.</p><p><strong>Results: </strong>One-hundred and forty-five (71.1% response rate) patients were included in the analysis. Most (75%) patients were symptomatic from disease, and Asian American and Pacific Islander (AAPI) patients accounted for 30.3% of our cohort. Identifying as AAPI or needing an interpreter for clinic visits was significantly associated with lower AHS scores, and more AAPI patients required interpreter assistance compared to non-AAPI patients (P=0.04). Being divorced, unemployed, or female was also linked to less hope. No other differences in hope were found.</p><p><strong>Conclusions: </strong>Sociodemographic rather than prognostic clinical factors were predictive of hope among patients with GI cancer. Interventions to contextualize psychosocial risk factors have the potential to improve quality of life and oncologic outcomes.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 4","pages":"1487-1496"},"PeriodicalIF":2.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289046","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":"Developing a prognostic signature: identifying differentially expressed genes in cardia and non-cardia gastric cancer for immunity and therapeutic sensitivity analysis.","authors":"Xianmin Li, Chong Zhou, Yindi Zhu, Wenjie Wang, Shuguang Han, Yicen Zou, Lian Lian, Kai Chen","doi":"10.21037/jgo-24-541","DOIUrl":"https://doi.org/10.21037/jgo-24-541","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) can be anatomically categorized into two subtypes; that is, cardia gastric cancer (CGC) and non-cardia gastric cancer (NCGC), which have distinct molecular mechanisms and prognoses. At present, the majority of pharmacological interventions for GC adhere to non-specific treatment regimens. The stratification of GC based on molecular disparities between CGC and NCGC has important clinical guidance value and could help in the development of precision therapies tailored to individual patient needs. Nevertheless, research in this specialized field remains notably limited. This study aims to investigate the molecular differences between CGC and NCGC and to leverage these differences to develop a prognostic risk scoring model (PRSM).</p><p><strong>Methods: </strong>We used patient data from The Cancer Genome Atlas (TCGA) and performed a differentially expressed gene (DEG) analysis between CGC and NCGC. A PRSM was developed from the prognosis-associated DEGs identified through Cox regression analyses and was well validated using Gene Expression Omnibus (GEO) data.</p><p><strong>Results: </strong>A total of 339 DEGs were identified between CGC and NCGC, and four prognosis-associated genes were used to construct the PRSM. Using the risk coefficients and expression levels of signature genes, a median risk score (RS) was calculated to classify patients into high- and low-risk groups. The high-risk group had a significantly worse prognosis than the low-risk group. An in-depth analysis revealed that <i>TP53</i> mutations were more prevalent in the high-risk group, and <i>MUC16</i> mutations were more prevalent in the low-risk group. A gene set enrichment analysis (GSEA) and the CIBERSORT algorithm were used to assess the differences in the significantly enriched pathways and immune microenvironment in the high- and low-risk groups, respectively. The inhibitory concentration (IC₅₀) values of the chemotherapy drugs for GC also varied between the two groups.</p><p><strong>Conclusions: </strong>This study elucidated the unique molecular characteristics of GC subtypes based on the anatomical site and provided a preliminary contribution for the development of precision medicine for GC.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 4","pages":"1446-1463"},"PeriodicalIF":2.0,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289047","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}