Journal of gastrointestinal oncology最新文献

{"title":"Retraction: HMGB2 upregulation promotes the progression of hepatocellular carcinoma cells through the activation of ZEB1/vimentin axis.","authors":"","doi":"10.21037/jgo-20252-06","DOIUrl":"https://doi.org/10.21037/jgo-20252-06","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.21037/jgo-23-447.].</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"44"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432483","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":"Short- and long-term outcomes after laparoscopic and open liver resection for combined hepatocellular-cholangiocarcinoma patients: a propensity score-matched study.","authors":"Xin Deng, Fei Liang, Bo-Wen Wang, Shuai Xu, Wei Gong","doi":"10.21037/jgo-2025-716","DOIUrl":"https://doi.org/10.21037/jgo-2025-716","url":null,"abstract":"<p><strong>Background: </strong>The feasibility and safety of laparoscopic liver resection (LLR) and open liver resection (OLR) in combined hepatocellular-cholangiocarcinoma (cHCC-CCA) patients remain controversial. This study compared the clinical outcomes of LLR versus OLR for patients with cHCC-CCA.</p><p><strong>Methods: </strong>Clinicopathological features of cHCC-CCA patients who underwent liver resection (LR) between 2010 and 2022 were retrospectively analyzed. Propensity score matching (PSM) was employed to balance intergroup differences. Univariate and multivariate Cox analyses were employed to identify independent predictors of overall survival (OS).</p><p><strong>Results: </strong>Of the 141 cHCC-CCA patients, 78 underwent LLR and 63 underwent OLR. After PSM, the LLR group had lower estimated blood loss (EBL) (200 <i>vs</i>. 300 mL, P=0.004) and shorter postoperative length of stay (LOS) (10.0 <i>vs</i>. 15.0 days, P<0.001). Multifactor Cox regression analyses showed that hepatocellular carcinoma (HCC) as the tumor main ingredient [hazard ratio (HR) =0.323, 95% confidence interval (CI): 0.151-0.693, P=0.004] was an independent protective factor for OS. After PSM, no statistically significant difference in OS was observed between the two groups (60.0 <i>vs</i>. 69.0 months, P=0.54).</p><p><strong>Conclusions: </strong>cHCC-CCA patients undergoing LLR are safe and feasible with lower EBL, and shorter postoperative LOS. No statistically significant difference in long-term OS was observed between LLR and OLR.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"19"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432981","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 nine-gene nicotine-metabolism signature predicts prognosis and characterizes the immune landscape in colon adenocarcinoma.","authors":"Junliang Li, Junyi Zhang, Danning Wang, Jieyi Shen, Chong Shen, Weiqi Zeng, Jianwei Wang","doi":"10.21037/jgo-2025-aw-905","DOIUrl":"https://doi.org/10.21037/jgo-2025-aw-905","url":null,"abstract":"<p><strong>Background: </strong>Smoking is a preventable cause of colorectal cancer (CRC), and nicotine metabolism may promote tumorigenesis. We aimed to investigate the prognostic significance of nicotine metabolism‑related genes (NRGs) in colon adenocarcinoma (COAD) and to develop a gene signature for patient stratification.</p><p><strong>Methods: </strong>Using the Cancer Genome Atlas COAD cohort, we performed differential expression analysis and weighted gene co-expression network analysis to identify NRGs. Functional enrichment, Cox regression, and least absolute shrinkage and selection operator (LASSO) modelling were applied to build a multigene signature, which was validated in external cohorts. Single-cell transcriptomic data and immune infiltration analyses were used to evaluate gene expression patterns and tumor microenvironmental features.</p><p><strong>Results: </strong>We identified 767 differentially expressed NRGs enriched in extracellular matrix (ECM) organization and signaling pathways. A nine‑gene signature (<i>FOXC1, TRIP6, NRCAM, TIMP1, TSPAN11, STC2, CST2, SIX2, GPRASP1</i>) was derived; this risk model independently predicted overall survival and showed robust performance across multiple datasets. Single‑cell analyses confirmed cell‑type‑specific expression of these genes. High‑risk scores were associated with altered immune cell infiltration, distinct mutation profiles, and differential drug sensitivity patterns.</p><p><strong>Conclusions: </strong>We propose a novel NRG-based prognostic signature that accurately predicts outcomes in COAD. The model highlights the interplay between nicotine metabolism, ECM remodeling, and immune responses, highlighting genes and pathways that may inform future therapeutic stratification.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"10"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433002","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":"Construction of taurine metabolism-related risk model and subtype identification in colorectal cancer to predict prognosis and immunological features.","authors":"Qinghua Wang, Xiaoxiao Chen, Hongjuan Zheng, Jianfei Fu, Ying Yuan","doi":"10.21037/jgo-2025-638","DOIUrl":"https://doi.org/10.21037/jgo-2025-638","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) represents a significant global health burden. Despite advances in treatment, survival rates remain low for patients diagnosed at advanced stages. Although taurine plays an indispensable role in cancer development and progression, its specific relationship with CRC prognosis has not been fully explored. Therefore, this study aims to construct a prognostic model based on taurine metabolism-related genes (TMRGs) to evaluate its potential value in CRC risk stratification, tumor microenvironment remodeling, and the development of personalized treatment strategies.</p><p><strong>Methods: </strong>This study integrated multi-omics data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases to systematically screen differentially expressed TMRGs (DETMRGs). Using least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox analysis, we constructed a prognostic model and established a risk stratification framework. Molecular subtyping was performed based on these signature genes, followed by a comprehensive evaluation of the immune microenvironment (CIBERSORT/ESTIMATE), tumor mutational burden, drug sensitivity (pRRophetic/CellMiner), and immunotherapy response [immunophenoscore (IPS)/IMvigor210 cohort] to thoroughly validate the clinical predictive utility of the model.</p><p><strong>Results: </strong>This study identified 175 DETMRGs and constructed a prognostic model comprising 9 key genes. The model demonstrated robust survival predictive capability in both training and independent validation cohorts [area under the receiver operating characteristic curve (AUC) >0.74], effectively stratifying patients into molecular subtypes with significant survival disparities. In-depth analyses revealed that the high-risk group was enriched in pro-oncogenic signaling pathways (e.g., WNT, RTK-Ras) and exhibited an immunosuppressive microenvironment (elevated Treg infiltration, reduced immune scores) with inferior response to programmed cell death ligand 1 (PD-L1) immunotherapy. Conversely, the low-risk group activated immune-related pathways (e.g., JAK-STAT) and showed heightened sensitivity to chemotherapy agents such as 5-fluorouracil (5-FU).</p><p><strong>Conclusions: </strong>The taurine metabolism-related risk model developed in this study reliably predicts the prognosis of CRC patients and their response to immunotherapy, thereby enabling personalized treatment strategies.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"7"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433259","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 APOBEC3 family: a narrative review of an alternative therapeutic agent for hepatitis B virus-induced hepatocellular carcinoma.","authors":"Jing Miao, Meng Zhang, En Ren, Lan-Tian Huang, Kai-Feng He, Zhi-Gang Gao","doi":"10.21037/jgo-2025-1-1073","DOIUrl":"https://doi.org/10.21037/jgo-2025-1-1073","url":null,"abstract":"<p><strong>Background and objective: </strong>Hepatocellular carcinoma (HCC) ranks among the most prevalent cancers globally, representing a significant challenge to healthcare systems around the globe. Hepatitis B virus (HBV) infection is the primary causal factor for HCC, alongside various other risk elements. Timely intervention for HBV holds the potential to effectively prevent the onset of HCC. However, standard first-line treatments, such as nucleos(t)ide analogues and interferon-α (IFN-α), seldom result in complete HBV eradication. Additionally, emerging approaches such as gene editing are still immature and entail certain risks. This review aimed to characterize the roles of the APOBEC3 (A3) family in HBV-associated disease, particularly HCC, with the goal of presenting a novel perspective for its management.</p><p><strong>Methods: </strong>A literature search of the relevant databases was conducted, with a focus on recent and key publications in the English language. The search strategy included terms related to APOBEC3, HBV, and HCC.</p><p><strong>Key content and findings: </strong>The APOBEC3 (A3) protein family, whose members function as DNA cytidine deaminases, exhibits the capacity to impede viruses and modulate a variety of tumor types. Members of the A3 family exert a dual effect in HBV-induced HCC (HBV-HCC), both demonstrating antiviral efficacy and potentially contributing to carcinogenic mutations that promote cancer initiation and advancement.</p><p><strong>Conclusions: </strong>The paradoxical nature of the A3 protein family-possessing both antiviral properties and carcinogenic potential-highlights its complex role in HBV-HCC. Understanding these regulatory mechanisms may provide novel insights into developing innovative management strategies for HBV-HCC.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"30"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433291","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":"DAWN trial: a prospective, multicenter, single-arm phase II study of neoadjuvant disitamab vedotin (RC48) in combination with adebrelimab, apatinib, and S-1 for locally advanced HER2-positive gastric cancer.","authors":"Yuting Ding, Hao Qian, Hongda Liu, Jiaguang Zhang, Xinyi Zhang, Jia Wei, Xiaofeng Chen, Hao Xu","doi":"10.21037/jgo-2025-aw-959","DOIUrl":"https://doi.org/10.21037/jgo-2025-aw-959","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer is the fifth most common malignancy worldwide and a major cause of cancer-related mortality, with over 750,000 deaths annually. Neoadjuvant chemotherapy remains the standard treatment for human epidermal growth factor receptor 2 (HER2)-positive gastric cancer, but recent evidence suggests that incorporating immunotherapy could offer synergistic effects. However, clinical benefits are limited in patients with low HER2 expression or programmed death-ligand 1 (PD-L1) levels due to primary or acquired resistance. To address this, we are conducting a prospective study to evaluate the efficacy and safety of a four-drug neoadjuvant regimen combining RC48 [a HER2-targeted antibody-drug conjugate (ADC)], adebrelimab (a PD-L1 inhibitor), apatinib (a VEGFR2 inhibitor), and S-1 (an oral fluoropyrimidine) in patients with locally advanced HER2-positive gastric cancer.</p><p><strong>Methods: </strong>The DAWN trial is a prospective, open-label, phase II clinical trial designed to enroll 32 treatment-naïve patients with resectable, locally advanced HER2-positive gastric adenocarcinoma. Eligible patients will receive 3-4 cycles of neoadjuvant therapy, with each cycle lasting 21 days. The treatment regimen includes: RC48: 2.5 mg/kg, intravenous (iv), day 1, every 3 weeks (q3w). Adebrelimab: 1,200 mg, iv, day 1, q3w. S-1: For patients with a body surface area (BSA) ≤1.5 m², 50 mg orally, twice daily (bid), days 1-14, q3w; for BSA >1.5 m², 60 mg orally, bid, days 1-14, q3w. Apatinib: 250 mg orally, once daily (qd), q3w. The primary endpoint is the pathological complete response (pCR) rate. Secondary endpoints include major pathological response (MPR) rate, R0 resection rate, disease-free survival (DFS), overall survival (OS), and safety. All patients must provide written informed consent before enrollment. The study protocol was approved by the independent ethics committee at each participating institution.</p><p><strong>Discussion: </strong>Previous preclinical and clinical studies have demonstrated the synergistic effects among chemotherapy, immunotherapy, anti-angiogenic therapy, and anti-HER2 antibody-drug conjugates (ADCs). We hypothesize that the combination of these four therapeutic strategies could significantly enhance treatment efficacy in HER2-positive gastric cancer, particularly in combined positive score (CPS) PD-L1-negative patients.</p><p><strong>Trial registration: </strong>This study was registered at ClinicalTrials.gov (Identifier: NCT06385873).</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"31"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433323","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":"Risk factors and prognostic implications of upper or middle mediastinal lymph nodes metastasis and recurrence in esophagogastric junction carcinoma.","authors":"Shintaro Nozu, Takashi Fukuda, Shinichiro Shiomi, Daiji Oka","doi":"10.21037/jgo-2025-1-980","DOIUrl":"https://doi.org/10.21037/jgo-2025-1-980","url":null,"abstract":"<p><strong>Background: </strong>The risk factors for upper and middle mediastinal lymph node (UMMLN) metastasis and the prognostic value of mediastinal lymphadenectomy (MLA) in patients with esophagogastric junction cancer (EGJC) remain unclear. This study aims to identify predictors for UMMLN metastasis or recurrence in EGJC with an esophageal invasion length (EIL) of >2 cm to ≤4 cm, and to clarify the histology specific prognostic impact of mediastinal dissection.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent radical resection for stage II-IV EGJC with an EIL of >2 cm to ≤4 cm between 2000 and 2022. Risk factors for UMMLN involvement, defined as pathological metastasis or locoregional recurrence within 3 years, were evaluated. Postoperative outcomes were compared according to UMMLN involvement and histological subtype.</p><p><strong>Results: </strong>Among 43 patients with adenocarcinoma (AC) and 45 with squamous cell carcinoma (SCC), the proportion undergoing UMMLN dissection was similar. UMMLN involvement was identified in 20 patients (17 pathological metastases and 3 locoregional recurrences). Esophagus-predominant tumors [odds ratio (OR) 9.24, 95% confidence interval (CI): 1.11-77.2; P=0.04] and clinical N2 or higher (OR 3.7, 95% CI: 1.07-12.8; P=0.04) were independently associated with UMMLN involvement. However, the wide CI reflects a high degree of uncertainty, likely due to the limited number of events. Among patients with SCC, total MLA resulted in comparable survival rates between those with and without pathological UMMLN metastases, while patients with AC and UMMLN metastases had poor long-term outcomes.</p><p><strong>Conclusions: </strong>Nodal status and histological type, together with tumor epicenter, may help guide the indications for, and prognostic benefit from, UMMLN dissection in EGJC with an EIL of >2 cm to ≤4 cm. Nonetheless, the risk factors for UMMLN involvement remain to be completely elucidated, and further investigation is needed.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"2"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432533","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 hybrid molecular-imaging model for high-accuracy early colorectal cancer diagnosis.","authors":"Yong Zhao, Weirong Zeng","doi":"10.21037/jgo-2025-687","DOIUrl":"https://doi.org/10.21037/jgo-2025-687","url":null,"abstract":"<p><strong>Background: </strong>Early and accurate detection of colorectal cancer (CRC) is crucial for improving patient survival; however, current screening methods often suffer from high false-negative rates, hindering timely diagnosis and treatment. This study aims to develop an innovative dual-path strategy that integrates molecular biomarkers with artificial intelligence (AI)-driven imaging techniques to enhance CRC detection accuracy and overcome limitations in existing screening methods.</p><p><strong>Methods: </strong>We utilized transcriptomic data from the Gene Expression Omnibus (GEO) database to identify nine key molecular biomarkers associated with CRC, including CDC25B and TEAD4, through differential expression analysis. Machine learning algorithms were employed to assess the diagnostic performance of these biomarkers. In parallel, an edge-aware Mamba-enhanced transformer network (EMT-Net) was developed for imaging segmentation, tested on the Computer Vision Center-Clinic Database (CVC-ClinicDB).</p><p><strong>Results: </strong>The molecular biomarkers showed significant diagnostic potential, achieving an area under the receiver operating characteristic curve (AUROC) of 0.987 in independent validation. The EMT-Net model demonstrated superior segmentation performance compared to current state-of-the-art methods on the CVC-ClinicDB, showing improved accuracy and precision in CRC detection.</p><p><strong>Conclusions: </strong>By combining molecular biomarker analysis with advanced imaging segmentation, our dual-path strategy offers complementary advantages: biological insights from molecular data and clinical precision from imaging techniques. This integrated approach shows exceptional cross-dataset robustness, with significant potential to enhance early CRC detection in clinical practice.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"9"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432960","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":"Separation of liver focal nodular hyperplasia (FNH) and liver malignant tumors by a combination of T2-weighted imaging signal and three diffusion magnetic resonance metrics of diffusion-derived vessel density, slow diffusion coefficient, and apparent diffusion coefficient.","authors":"Cai-Ying Li, Cun-Jing Zheng, Xiao-Hui Duan, Jun Shen, Yì Xiáng J Wáng","doi":"10.21037/jgo-2025-aw-860","DOIUrl":"https://doi.org/10.21037/jgo-2025-aw-860","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the differentiation of liver focal nodular hyperplasia (FNH) from liver malignant tumor (MT) by a combination of T2-weighted imaging (T2WI), diffusion-derived vessel density (DDVD), slow diffusion coefficient (SDC), and apparent diffusion coefficient (ADC). Based on the odds ratio (OR) for a sign to suggest the possibility of a lesion being FNH, we propose a liver mass sum score (LiverMss-FNH) scheme to facilitate the diagnosis.</p><p><strong>Methods: </strong>Liver diffusion-weighted magnetic resonance imaging included 13 cases of FNH and 82 cases of MT. DDVD was calculated from <i>b</i>=0 and <i>b</i>=10 s/mm² images, SDC was calculated from <i>b</i>=500 and <i>b</i>=800 s/mm² images, and ADC was calculated from <i>b</i>=0 and <i>b</i>=800 s/mm² images. For liver semi-quantitative analysis, relative to the adjacent liver signal, a liver lesion's signal was assigned to five categories: low signal, iso-signal, slightly high signal, high signal, and markedly high signal. The lesion on T2WI being not high signal was assigned a sub-score \"1\" (otherwise scored 0); the lesion being iso-signal on DDVD was assigned a sub-score \"1.5\" (otherwise scored 0); the lesion on SDC being not high signal was assigned a sub-score \"1\" (otherwise scored 0); the lesion on ADC being not low signal was assigned a sub-score \"0.5\" (otherwise scored 0); the existence of stellate scar was assigned a sub-score \"0.5\" (otherwise scored 0). The sum of these five sub-scores was termed LiverMss-FNH.</p><p><strong>Results: </strong>A total of 26 MT cases had large (median 8.1 cm, standard deviation: 4.2 cm) and very heterogeneous masses which were very unlikely to be FNH. The remaining 13 FNH cases (median 3.8 cm, standard deviation: 1.7 cm) and 56 MT cases (median 4.9 cm, standard deviation: 4.3 cm; hepatocellular carcinoma, n=40; metastasis, n=12; intrahepatic cholangiocarcinoma, n=4) were evaluated with LiverMss. Liver lass lesion being not high signal on T2WI, being iso-signal on DDVD, being not high signal on SDC, being not low signal on ADC, and the existence of stellate scar had ORs of 49.1, 45.8, 30, 8.5, and 13.3, respectively, favoring the diagnosis of FNH. A total of 69.2% (9/13) of the FNH had LiverMss-FNH ≥4.0, while the remaining 4 cases (30.8%) all had a LiverMss-FNH of 3.0. A total of 89.3% (50/56) of the MT had LiverMss-FNH ≤1.5.</p><p><strong>Conclusions: </strong>Liver FNH tend to have lower DDVD signal and lower SDC signal than liver MT. A LiverMss ≥4 can strongly suggest the diagnosis for a liver mass being FNH, and while a LiverMss-FNH ≤1.5 can strongly suggest the diagnosis for a liver mass being MT.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"20"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433035","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":"Non-surgical management of malignant bowel obstruction: strategies and outcomes in inoperable patients.","authors":"Tomas Escobar Gil, Pooja Viswanath, Stephanie Rosenberg, Mohammed A Quazi, Valeria Hanson, Alan Ortega Macias, Amy Tarnower","doi":"10.21037/jgo-2025-708","DOIUrl":"https://doi.org/10.21037/jgo-2025-708","url":null,"abstract":"<p><strong>Background: </strong>Malignant bowel obstruction (MBO) is a complication of advanced abdominal cancer. Management should be individualized, ranging from surgical or endoscopic interventions to symptom control and comfort measures in inoperable cases. This study examines predictors of survival and disparities in treatment among patients with inoperable MBO.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 63 patients with MBO treated non-operatively between July 2019 and June 2023 at the University of New Mexico in the Southwestern United States. Of 421 patients screened, exclusions were based on incomplete records or failure to meet clinical and radiological criteria for MBO. Data included demographics, tumor types, treatments, inflammatory markers, and outcomes. Statistical analyses included <i>t</i>-tests, logistic regression, and adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Length of stay (LOS) and survival duration were analyzed using mean differences. Subgroup comparisons identified disparities across gender, ethnicity, and language preferences.</p><p><strong>Results: </strong>The cohort included 39 females (61.9%) and 24 males (38.1%) with a mean age of 63.2 years [standard deviation (SD) =13.8]. The most common causes of MBO were gastrointestinal (GI) tumors (46%) and gynecologic cancers (34%). The median survival was 25 days, with significant disparities observed. Non-English speakers had higher odds of survival [odds ratio (OR) =5.56, P=0.04], while sepsis at admission was associated with 100% mortality. Elevated C-reactive protein (CRP) (15.85 <i>vs</i>. 8.78 days, P=0.06), steroid use (11.36 <i>vs</i>. 9.92 days, P=0.15), nasogastric (NG) tube placement (10.95 <i>vs</i>. 9 days, P=0.11), and parenteral hydration (12.55 <i>vs</i>. 9.16 days, P=0.37) were associated with longer LOS, though these differences did not reach statistical significance. Higher body mass index (BMI) correlated positively with survival [25.57 (24.0) <i>vs.</i> 24.17 (24.72) kg/m², P=0.03]. Female patients were more likely to receive NG tubes (OR =3.05, P=0.050) and achieve nonsurgical resolution (OR =3.45, P=0.041) but were less likely to enroll in hospice (OR =0.17, P=0.003). Steroids (22.2%) and octreotide (11.1%) were underutilized despite their role in symptom management.</p><p><strong>Conclusions: </strong>Disparities in MBO management highlight gaps in equitable care, particularly gender and language preference. Non-English-speaking patients had a survival advantage, underscoring the importance of culturally tailored care. The underutilization of palliative treatments, such as steroids and octreotide, reveals inconsistencies in guideline adherence. The association of sepsis with 100% mortality reinforces the need for early infection management. Standardized, evidence-based protocols and culturally appropriate care could improve outcomes for this high-risk population.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 1","pages":"8"},"PeriodicalIF":2.0,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433255","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}