Journal of gastrointestinal oncology最新文献

{"title":"Cancer metastasis to the upper gastrointestinal tract-a case series.","authors":"Mohamed Bakry, Hasib Ahmadzai, Mitali Fadia, Geoffrey Peters, Yada Kanjanapan, Shivakumar Chitturi, Ganesalingam Pranavan","doi":"10.21037/jgo-24-532","DOIUrl":"https://doi.org/10.21037/jgo-24-532","url":null,"abstract":"<p><strong>Background: </strong>Metastasis of non-gastrointestinal (non-GI) cancers to the upper GI tract is a rare occurrence, with limited cases reported in the literature. Recognising this type of metastasis is crucial, as it presents unique diagnostic and therapeutic challenges. This case series adds to the literature by discussing seven rare cases of non-GI cancer metastasising to the upper GI tract, emphasising the complications and clinical manifestations. These cases highlight the importance of early recognition and interdisciplinary management to optimise patient outcomes.</p><p><strong>Case description: </strong>This retrospective series spans from 2016 to 2024 and includes seven consecutive patients from a tertiary hospital. The primary cancers include renal clear cell carcinoma, non-small cell lung cancer, prostate cancer, and melanoma. Each patient presented with unique patterns of metastasis to the GI tract, manifesting as complications such as upper GI bleeding, melaena, bowel perforation, abdominal pain and weight loss. Interventions ranged from gastroscopy and biopsy to surgical resection, and outcomes varied from disease control to progression with palliative interventions and fatality in some cases, despite targeted treatments. Follow-up of some of the cases highlights the difficulties in managing recurrent bleeding and perforation in these patients.</p><p><strong>Conclusions: </strong>Metastasis of non-GI primary tumours to the upper GI tract-although rare, requires clinicians to maintain a high index of suspicion when encountering unexplained GI symptoms in patients with a history of malignancy. This case series highlights the diverse presentations and complications of upper GI metastasis from non-GI cancers and underscores the need for personalised management strategies. Early recognition and tailored interventions can improve patient outcomes and reduce morbidity.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2728-2734"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006541","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 potential role of tumor deposits in the prognosis and TNM staging for colorectal cancer.","authors":"Xinhong Shi, Lin Lu, Zihan Wang, Yingying Dai, Shuyi Hu, Zipeng Wu, Ruofan Yu, Tianyi Liu, Yingying Jiang, Yuxin Ma, Bo Shen, Guoren Zhou, Emerson Y Chen, Cheng Chen, Lili Zhao, Yue Shi, Xiaohua Wang","doi":"10.21037/jgo-24-786","DOIUrl":"10.21037/jgo-24-786","url":null,"abstract":"<p><strong>Background: </strong>Tumor deposits (TDs) can impact proper staging of cancer, which is crucial for discussing prognosis and determining the appropriate treatment plan. Our study aimed to correlate how TDs influence prognosis of resected colorectal cancer (CRC) and how to optimize tumor-node-metastasis (TNM) staging with respect to TDs for clinical decision-making.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 611 patients with CRC treated in Jiangsu Cancer Hospital from January 1, 2010 to December 31, 2020 among whom 197 had TDs. The influence and distribution characteristics of TDs on the median overall survival (mOS) of patients with CRC were quantitatively and qualitatively analyzed, and the differences in mOS between different subgroups were also analyzed.</p><p><strong>Results: </strong>Patients with TDs had a shorter mOS (only 60.3±3.9 months) than did patients without TDs. TDs had a more significant association with the survival of M0 patients, and there were significant differences in the prognosis of M0 patients with stage pN0 and pN1c or stage pN0, pN1, and pN2. The combination of lymph node metastases (LNMs) and TDs was associated with mOS. The proportion of rectal cancer, papillary tissue type, and nerve invasion was higher in the TD-positive group, and proportion of metastasis to the brain, spleen, lung, and bone in this groups was also higher. Subgroup analysis showed that the degree of tumor differentiation, the depth of tumor invasion, vascular invasion, nerve invasion, liver metastasis, lung metastasis, bone metastasis, peritoneal metastasis, ovarian metastasis, pelvic and abdominal metastasis, and the number of distant metastases were associated with the prognosis of patients with CRC.</p><p><strong>Conclusions: </strong>TDs were closely correlated with the poor prognosis of patients with CRC. Greater attention should be paid to improving the quality of pathological reports in clinical decision-making and the comprehensive assessment of patients' baseline characteristics so that accurate prognosis and corresponding treatment plan can be properly communicated with patients.</p>","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2473-2495"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006249","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":"Pancreatic cancer: a haystack of needles.","authors":"Nicholas L Michael, Robert W Krell","doi":"10.21037/jgo-24-697","DOIUrl":"https://doi.org/10.21037/jgo-24-697","url":null,"abstract":"","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2743-2744"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006562","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 cancer: local results and significance in Hungary.","authors":"Stefan Longobardi","doi":"10.21037/jgo-24-318","DOIUrl":"https://doi.org/10.21037/jgo-24-318","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Colorectal cancer (CRC) causes substantial morbidity and mortality internationally. In Hungary, the incidence and mortality of CRC are among the world's highest. Fortunately, CRC is a highly preventable disease, since there is a long asymptomatic phase before neoplastic transformation. Numerous countries have instituted programs for CRC screening. However, Hungary did not implement population-based screening programs until December 2018, consisting of a voluntary 2-step screening program based on the fecal immunochemical test (FIT) and if positive, referral to colonoscopy. Asymptomatic individuals aged over 50 years were invited to participate in the 2-step program. This study aims to analyze the results of these colonoscopies and raise public awareness of the CRC disease process and prevention, especially in Hungary.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Various literature sources were reviewed, and external information was gathered and consolidated based on CRC etiopathogenesis, management options, screening options, cost, benefits, modalities, and quality control. Semmelweis University Department of Internal Medicine and Hematology's database was accessed for the cross-sectional study results of 168 screening colonoscopies within the 2-step program from 2019 to 2020. I quantified and compared the results obtained during the colonoscopies with that of said literature within Hungary and worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Colonoscopy was performed in 168 patients of average age 63.4 years. The incidence of CRCs in the population was 4.76%. Among the CRC cases, 75% were in the rectosigmoid area and 25% were in the remaining colon. The total adenoma detection rate (ADR) in the study was 57.1%, higher than the recommended 25% for adequate screening colonoscopy. The total number of resected polyps was 270; 8.1% were adenomas with high-grade dysplasia and 0.76% contained CRC. Out of the 185 resected adenomas, 141 were tubular, 34 were tubulovillous, and 10 were villous. Adenoma localizations included 14.6% rectum, 38.4% sigmoid, 11.9% descending colon, 8.6% transverse colon, 17.8% ascending colon, and 8.6% cecum. The average age of CRC patients was 63.9 years (range, 56-68 years) with a slight female predominance (5 females, 3 males). The ADR of the different endoscopists did not seem to correlate with experience. Optimal participation rate of the screening program would be &gt;60%. Population outreach through mailed FIT is evidence-based and shown to increase CRC screening rates in underserved populations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Hungary would benefit immensely in most aspects from mandatory, population-based CRC screening with this 2-step program. This alternative is proposed in lieu of 1-step screening, because of the limited capacity for colonoscopy in the country and the limited participation rates in the screened population. To reach maximum cost-benefit, the participation rate of the screened populatio","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"15 6","pages":"2552-2577"},"PeriodicalIF":2.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006457","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":"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":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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) &lt;i&gt;vs.&lt;/i&gt; 0.94 (-0.40, 1.87), P&lt;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&lt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;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}