Journal of gastrointestinal oncology最新文献

{"title":"Identifying a CD8T cell signature in the tumor microenvironment to forecast gastric cancer outcomes from sequencing data.","authors":"Xiangyue Zeng, Tiannake Shapaer, Jianguo Tian, Abulajiang Abudoukelimu, Zeliang Zhao, Paerhati Shayimu, Binlin Ma","doi":"10.21037/jgo-24-603","DOIUrl":"10.21037/jgo-24-603","url":null,"abstract":"<p><strong>Background: </strong>The tumor microenvironment (TME) could be critical in carcinogenesis, immune evasion, and treatment response. TME-related genes are limited in their ability to predict gastric cancer (GC) outcomes. We utilized data from The Cancer Genome Atlas (TCGA) to investigate the functional roles of TME-related genes in GC.</p><p><strong>Methods: </strong>We acquired single-cell data, bulk sequencing data, and clinical characteristics of GC patients from the TCGA database. The CD8T cell genes associated with the TME were selected for bioinformatic analysis in GC. Tumor classification of GC was established through consistent cluster analysis. We then evaluated the prognosis and immune cell infiltration in connection with a CD8T cell-related model for GC.</p><p><strong>Results: </strong>The single-cell messenger RNA (mRNA) sequencing (scRNA-Seq) dataset of GSE134520 was utilized to investigate the pathogenesis and disease-specific cell types in GC. Interestingly, compared to healthy tissue, the proportions of CD8Tex cells, malignant cells, and gland mucous increased in GC, whereas the proportion of pit mucous decreased in GC. Since CD8Tex cells may play a vital role in pancreatic adenocarcinoma (PAAD), based on the 612 differentially expressed genes (DEGs) involved in CD8Tex cells, TCGA-GC patients were stratified into low- and high-risk groups. The downregulated DEGs in the low-risk G1 group were associated with proteoglycans in cancer, the cGMP-PKG signaling pathway, focal adhesion, and cell adhesion molecules (CAMs), whereas the upregulated DEGs were associated with viral protein interaction with cytokine and cytokine receptors, the tumor necrosis factor (TNF) signaling pathway, the interleukin (IL)-17 signaling pathway, and the chemokine signaling pathway. Combined with univariate Cox analysis, we ultimately identified 23 CD8T cell-related prognostic genes: <i>TCIM</i>, <i>AADAC</i>, <i>SLC2A3</i>, <i>ZNF331</i>, <i>TSC22D3</i>, <i>CMTM3</i>, <i>ZFP36</i>, <i>VIM</i>, <i>CLDND1</i>, <i>GABARAPL1</i>, <i>SOCS3</i>, <i>RGS1</i>, <i>TCEAL9</i>, <i>RGS2</i>, <i>CD59</i>, <i>SPRY1</i>, <i>EMP3</i>, <i>ZEB2</i>, <i>PDE4B</i>, <i>GLIPR1</i>, <i>ERRFI1</i>, and <i>LBH</i>. Using the Cox regression model to prioritize the 23 CD8T cell-related genes, we finally selected 7 genes: <i>CXCR4</i>, <i>AADAC</i>, <i>SLC2A3</i>, <i>CMTM3</i>, <i>RGS2</i>, <i>CD59</i>, and <i>ZEB2</i>.</p><p><strong>Conclusions: </strong>CD8T cell-related genes have a strong association with tumor classification and immune response in GC patients. A CD8T cell-related signature demonstrated robust prognostic predictive performance for GC. Our findings may reveal novel insights into the diagnosis and treatment of GC.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647364","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":"Liposomal eribulin (E7389-LF) plus nivolumab: a potential treatment option for patients with advanced gastric cancer?","authors":"Ali Raza Shaikh, Daniel Lin","doi":"10.21037/jgo-24-415","DOIUrl":"10.21037/jgo-24-415","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647386","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":"Nomogram-based prognostic stratification for patients with large hepatocellular carcinoma: a population study of SEER database and a Chinese cohort.","authors":"Kun Ji, Hanlong Zhu, Cong Zhang, Jing Ai, Li Jing, Tiejian Zhao, Hui Tao, Feng Chen, Wei Wu","doi":"10.21037/jgo-24-288","DOIUrl":"10.21037/jgo-24-288","url":null,"abstract":"<p><strong>Background: </strong>Large hepatocellular carcinoma (HCC) with a diameter ≥5 cm remains a significant challenge of poor survival and raises the need for prognosis evaluation. This study aimed to develop and validate a nomogram-based prognostic stratification to assess overall survival (OS) of patients with large HCC.</p><p><strong>Methods: </strong>Data of patients with large HCC were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database and our hospital, and were divided into the training cohort, internal validation cohort and external validation cohort. Cox analysis was performed to identify independent prognostic factors for the construction of nomogram in training cohort. The predictive ability of the nomogram was validated compared with the tumor node metastasis (TNM) classification staging system. Furthermore, prognostic stratification system based on nomogram was developed.</p><p><strong>Results: </strong>Independent prognostic factors including histological grade, T stage, M stage, alpha fetoprotein (AFP), fibrosis score and surgery, were incorporated to construct nomogram. C-indexes of nomogram were 0.730, 0.726 and 0.724 in the training, internal and external validation cohorts, respectively. Importantly, nomogram harbored a superior discrimination and clinical benefit than the TNM staging system. Nomogram-based prognostic stratification divided patients into three groups: 345-414 (low-risk group), 415-460 (medium-risk group) and 461-513 (high-risk group). As shown in Kaplan-Meier curves, there were significant differences in OS among low-, medium- and high-risk groups (P<0.01).</p><p><strong>Conclusions: </strong>Nomogram showed a superior prognostic predictive ability compared with the TNM staging system. The prognostic stratification serves as a valuable tool to assist clinicians on the selection of optimal treatment method and follow-up plan, particularly for the high-risk population.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647710","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":"Hepatoid adenocarcinoma of the stomach: discrimination from conventional gastric adenocarcinoma with a computed tomography-based radiomics nomogram.","authors":"Xiaoyu Gu, Jian Rong, Li Zhu, Zhaoyan Dai, Shuai Ren, Jianxin Chen, Bo Yin, Zhongqiu Wang","doi":"10.21037/jgo-24-210","DOIUrl":"10.21037/jgo-24-210","url":null,"abstract":"<p><strong>Background: </strong>Previous studies found it difficult to differentiate hepatoid adenocarcinoma of the stomach (HAS) from conventional gastric adenocarcinoma (CGA). We aimed to assess the efficacy of a computed tomography (CT)-based radiomics nomogram in identifying HAS.</p><p><strong>Methods: </strong>Portal phase CT images were collected from 59 patients with HAS and 122 patients with CGA. HAS and CGA were differentiated through univariate analysis of clinical characteristics, serum biochemical biomarkers, and CT features. The construction of the radiomics signature involved the application of the least absolute shrinkage and selection operator (LASSO) regression model. Multivariable logistic regression analysis was employed to establish the CT-based radiomics nomogram.</p><p><strong>Results: </strong>The separation of HAS patients from CGA patients relied on the serum alpha-fetoprotein (AFP) level and radiomics signature. The area under the curve (AUC) of AFP was 0.726 [95% confidence interval (CI): 0.639-0.801] in the training cohort and 0.681 (95% CI: 0.541-0.800) in the test cohort, whereas the radiomic signature demonstrated a significantly higher AUC of 0.949 (95% CI: 0.895-0.980) in the training cohort and 0.868 (95% CI: 0.749-0.944) in the test cohort. The nomogram model yielded excellent accuracy for identifying HAS, achieving an AUC of 0.970 (95% CI: 0.923-0.992) in the training cohort and 0.905 (95% CI: 0.796-0.968) in the test cohort.</p><p><strong>Conclusions: </strong>Radiomics analysis offers promise for differentiating HAS from CGA, and the CT-based radiomics nomogram is likely to have significant clinical implications on HAS distinction.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647356","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":"Poor prognosis of hepatocellular carcinoma patients-how, why, and what?","authors":"Vishal G Shelat","doi":"10.21037/jgo-24-595","DOIUrl":"10.21037/jgo-24-595","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647784","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":"Real-world experience of lenvatinib-based therapy in patients with advanced hepatocellular carcinoma.","authors":"Hung-Wei Wang, Hsueh-Chou Lai, Wen-Pang Su, Jung-Ta Kao, Wei-Fan Hsu, Hung-Yao Chen, Che-Wei Chang, Guan-Tarn Huang, Cheng-Yuan Peng","doi":"10.21037/jgo-24-351","DOIUrl":"10.21037/jgo-24-351","url":null,"abstract":"<p><strong>Background: </strong>Given the significant advancements in the management of hepatocellular carcinoma (HCC) and the emergence of novel treatment approaches, establishing reliable predictors has become crucial for optimizing patient selection and therapeutic sequencing in HCC. In this study, we aimed to investigate the prognostic factors and treatment efficacy associated with lenvatinib-based therapy.</p><p><strong>Methods: </strong>We retrospectively enrolled 53 patients receiving lenvatinib monotherapy, and 19 patients receiving lenvatinib plus immune checkpoint inhibitor combination therapy as their first-line systemic treatment for unresectable HCC at a single medical center. We employed univariate and multivariate Cox regression analyses to ascertain the factors influencing survival in these cohorts.</p><p><strong>Results: </strong>For lenvatinib monotherapy and the combination therapy, the objective response rates were 30.2% and 63.2%, respectively (P=0.03); the median progression-free survival (PFS) durations were 7 months [95% confidence interval (CI): 4.5-9.5] and 12 months (95% CI: 6.4-17.6), respectively (P=0.74); and the median overall survival (OS) was not reached in either group (P=0.93). Although patients receiving the combination therapy had a greater treatment response, no significant survival differences were observed between the lenvatinib monotherapy and combination therapy subgroups, even after inverse probability of treatment weighting (IPTW). Patients who received lenvatinib monotherapy could be stratified based on a combination of albumin-bilirubin (ALBI) grade (either grade 1 or 2a) and a neutrophil-lymphocyte ratio (NLR) of ≤5.8. Compared to the other subgroups combined, those who met both of these criteria exhibited PFS with a hazard ratio (HR) of 0.382 (95% CI: 0.168-0.871; P=0.02), corresponding to 11 and 5 months, respectively; and an OS (HR: 0.198, 95% CI: 0.043-0.920; P=0.04) of not reached versus 12 months, respectively, according to multivariate Cox regression analysis.</p><p><strong>Conclusions: </strong>In our study cohort, there were no statistically significant differences observed in the survival rates between patients treated with lenvatinib monotherapy and those treated with a combination of lenvatinib and immunotherapy. The incorporation of ALBI grade and NLR facilitates the stratification of survival outcomes in patients with unresectable HCC undergoing lenvatinib monotherapy.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11565097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regorafenib 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":null,"pages":null},"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":null,"pages":null},"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":"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":null,"pages":null},"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":"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":null,"pages":null},"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}