Journal of Gastrointestinal Cancer最新文献

{"title":"Prostate-Specific Membrane Antigen Expression in Colorectal Cancer and Its Potential Implication in Disease Monitoring in Rectal Cancer.","authors":"Eundong Park, Xin Wang, Michel Kmeid, Noureldien Darwish, Clifton G Fulmer, Nusret Bekir Subasi, Marcello P Toscano, Jing Zhou, Haiyan Qiu, Maciej Gracz, Xulang Zhang, Hwajeong Lee","doi":"10.1007/s12029-025-01277-x","DOIUrl":"https://doi.org/10.1007/s12029-025-01277-x","url":null,"abstract":"<p><strong>Purpose: </strong>Prostate-specific membrane antigen (PSMA) is expressed in tumor-associated vessels of diverse malignancies, such as colorectal cancer (CRC). PSMA-targeted approaches show promise for diagnosing, treating, and assessing therapy response in non-prostatic cancer. Disease monitoring following neoadjuvant chemoradiation (CRT) is especially important in rectal cancer.</p><p><strong>Methods: </strong>Firstly, clinical and histologic features of untreated CRC (n = 237; 54 from rectum) were examined for their association with PSMA expression. Secondly, rectal cancer cases following neoadjuvant CRT (n = 45) were retrieved to assess the relationship between PSMA expression, downstaging, and tumor volume reduction and were compared with untreated rectal cancers (n = 54).</p><p><strong>Results: </strong>In untreated CRC, PSMA expression was negatively associated with pTNM stage, pT stage, pN stage, tumor deposit presence and count, and post-op adjuvant therapy administration. Higher PSMA expression was correlated with shorter overall survival when pTNM stage was controlled. In the treated rectal cancer group, advanced pTNM stage was associated with a reduced PSMA expression. In addition, treated rectal cancers showed lower PSMA expression than untreated rectal cancers. While PSMA levels correlated with tumor volume reduction and downstaging following CRT, this association was lost in stage-matched analysis.</p><p><strong>Conclusion: </strong>PSMA expression was lower in more advanced CRCs, and the trend persisted in treated rectal cancer. After adjusting for pTNM stage, higher PSMA expression was predictive of reduced overall survival. Post-CRT PSMA level was associated with downstaging and pathologic tumor volume reduction in rectal cancer. Further studies are needed to assess the clinical value of PSMA-directed approaches in CRC management.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"159"},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statins and the Risk of Pancreatic Cancer.","authors":"Kuan-Fu Liao, Shih-Wei Lai","doi":"10.1007/s12029-025-01285-x","DOIUrl":"https://doi.org/10.1007/s12029-025-01285-x","url":null,"abstract":"","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"158"},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Analysis of Factors Associated with Treatment Delays in Asian, Native Hawaiian, and Other Pacific Islander Patients with Colorectal Cancer.","authors":"Manasawee Tanariyakul, Chalothorn Wannaphut, Toshiaki Takahashi, Edward Nguyen, Jared Acoba","doi":"10.1007/s12029-025-01279-9","DOIUrl":"10.1007/s12029-025-01279-9","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) is the second most common cause of cancer death in the USA. Many modifiable factors affect prognosis, including but not limited to diet, smoking, alcohol, and time of diagnosis to initial treatment (TTT). Studies have found that patients who had a delay in surgery of greater than one month during the COVID pandemic and a TTT of greater than 31 days were at increased risk of death. The purpose of this study is to uncover the factors associated with treatment delay (surgery, systemic therapy, or radiation therapy) in patients with CRC.</p><p><strong>Method: </strong>We analyzed data from patients diagnosed with CRC between 2000 and 2022 at Queen's Medical Center in Honolulu, Hawaii. Patients initiating treatment ≥ 31 days after diagnosis were categorized as having a delayed treatment. Binary logistic regressions were used to identify predictors, adjusting for clinical and pathological factors.</p><p><strong>Result: </strong>A total of 3192 patients were analyzed. 1128 (35.3%) patients experienced delayed treatment. On multivariable analysis, patients with older age demonstrated a progressively increased odds of delayed treatment, with odds ratio (OR) ranging from 1.35 (95% CI 1.02-1.79; p = 0.039) for patients aged 50-59 years to 1.81 (95% CI 1.32-2.47; p < 0.001) for those aged ≥ 80 years compared with patients under 50 years. Patients with Medicaid or being uninsured had significantly higher odds of delayed treatment compared with patients with private insurance (OR 1.54, 95% CI 1.25-1.89; p < 0.001). Stages 2 and 3 CRC were associated with lower odds of delay compared with stage 1. Tumor location was associated with delayed treatment. Compared with right-sided tumors, patients with rectal tumors (OR 3.16, 95% CI 2.56-3.90; p < 0.001) and left-sided colon cancer were significantly more likely to experience delayed treatment (OR 1.40, 95% CI 1.15-1.71; p < 0.001). Gender, race, and histopathology grading were not significantly associated with TTT ≥ 31 days.</p><p><strong>Conclusion: </strong>Older age, having Medicaid or being uninsured, and having a rectal or left-sided tumor location were associated with delayed initiation of treatment in patients with colorectal cancer. Further research is needed to explore the underlying reasons for treatment delays in patients with these specific characteristics. Specific interventions, such as improving insurance access or addressing logistical challenges, may reduce time to initial treatment.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"160"},"PeriodicalIF":1.6,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging Characteristics and Clinical Outcomes in Gastric Cancer with Brain Metastasis: A Propensity Score-Matched Study.","authors":"Weihao Yang, Mengting Lu, Wangjiao He, Wenjun He, Xin Tan, Hengyi Zhang, Fengping Li, Liying Zhao, Ye Dong, Hao Liu","doi":"10.1007/s12029-025-01284-y","DOIUrl":"https://doi.org/10.1007/s12029-025-01284-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impact of brain metastasis (BM) on the clinical outcomes of gastric cancer (GC) and explored related imaging characteristics.</p><p><strong>Methods: </strong>GC patients of tumor stage IV treated at Nanfang Hospital from October 2004 to September 2022 were included. The comparisons of non-BM and BM group were used by propensity score matching (PSM). The Kaplan-Meier method was used to compare the overall survival (OS) and cancer-specific survival (CSS). Cox regression was used for multivariate analyses.</p><p><strong>Results: </strong>A total of 1,051 patients were included. After PSM, non-BM group (n = 28) and BM group (n = 28) were more balanced in baseline variables. The OS (p < 0.05) and CSS (p < 0.05) of the BM group were inferior to those of the non-BM group. Multivariate Cox regression analysis suggests that brain metastasis is associated with poor OS (HR = 1.959, 95% CI: 1.031-3.721, p = 0.040) and CSS (HR = 1.988, 95% CI: 1.037-3.812, p = 0.038). Brain metastases predominantly occur in the frontal lobe (68.0%), followed by the parietal lobe (52.0%), and cerebellum (36.0%), these metastases frequently present with associated edema (65.1%) and necrosis (33.7%).</p><p><strong>Conclusion: </strong>The presence of brain metastasis is associated with poor OS and CSS. Brain metastases from GC commonly occur in the frontal lobe, parietal lobe, and cerebellum, with frequent imaging features of edema and necrosis.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"157"},"PeriodicalIF":1.6,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake of Colorectal Cancer Screening in Low- and Middle-Income Countries: a Systematic Review and Meta-analysis.","authors":"Fereshteh Moradoghli, Mir Hossein Aghaei, Mohammad Hossein Hakimi, Saeid Ghadimi, Reza Ebrahimoghli","doi":"10.1007/s12029-025-01274-0","DOIUrl":"10.1007/s12029-025-01274-0","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) remains a major global health burden with higher mortality rate in low- and middle-income countries (LMICs). It is well established that CRC screening reduces CRC incidence and mortality. However, data regarding uptake of CRC screening remains scarce in LMICs. Therefore, we aimed to quantify uptake of CRC screening in LMICs.</p><p><strong>Methods: </strong>We searched for scientific literature published in any language using four online databases (Scopus, Embase, PubMed, and Web of Knowledge) from their inception to 1 August 2024. We included observational studies reporting the prevalence of uptake of CRC screening modalities in LMICs. A random-effects model was used to estimate pooled prevalence with 95% confidence intervals (CIs). Subgroup analyses and meta-regression were used to investigate potential sources of heterogeneity.</p><p><strong>Results: </strong>Sixty-nine studies encompassing data from 19 LMICs were eligible for final inclusion in this systematic review. The pooled prevalence of self-reported uptake of screening colonoscopy was 5.2% (95% CI, 3.1-7.8). The pooled proportion of individuals who self-reported undertaking screening gFOBT was 11.5% (95% CI, 8.2-15.3). Pooled prevalence of self-reported uptake of any CRC screening modalities was 9.1% (95% CI, 6.2-12.5). Subgroup analyses showed that uptake of CRC screening did not vary significantly across available study-level variables.</p><p><strong>Conclusion: </strong>This meta-analysis revealed low colorectal cancer screening rates, impeding early detection at the population level. LMICs should prioritize context-specific strategies to improve screening uptake.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"154"},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Observational Study on Compliance with Enhanced Recovery Pathways and Their Impact on Postoperative Outcomes Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy.","authors":"Sohan Lal Solanki, Virinchi Sanapala, Reshma P Ambulkar, Vandana Agarwal, Avanish P Saklani, Amita Maheshwari","doi":"10.1007/s12029-025-01275-z","DOIUrl":"10.1007/s12029-025-01275-z","url":null,"abstract":"<p><strong>Background: </strong>Enhanced recovery pathways have been shown to improve postoperative morbidity and reduce hospital stay across various surgical settings. However, the implementation of Enhanced Recovery After Surgery (ERAS) pathways in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is often challenging and varies between institutions. We evaluated the impact of ERAS compliance on postoperative outcomes and return to intended oncological therapy (RIOT).</p><p><strong>Methods: </strong>All consecutive patients operated for CRS-HIPEC between May 2021 and August 2023 were included in the study. Compliance with 30 ERAS components was collected. Postoperative complications were categorized using the Clavien-Dindo (CD) classification. Patients were followed for 30 days post-surgery to assess readmissions and delays in RIOT. Pearson correlation analysis evaluated the relationship between ERAS compliance and CD grading, length of hospital stay, readmissions, and RIOT delays. Logistic regression analysis was done to evaluate the association between percentage compliance to ERAS components and postoperative morbidity and length of hospital stay.</p><p><strong>Results: </strong>Among 150 patients, the average compliance to ERAS components was 77.6%. There was a significant negative correlation between ERAS compliance and postoperative morbidity (r =  - 0.512, p < 0.001) and RIOT (r =  - 0.469, p < 0.001). Compliance with preoperative (r =  - 0.222, p = 0.006) and postoperative factors (r =  - 0.533, p < 0.001) significantly impacted postoperative morbidity and RIOT. Patients with less than 71.6% compliance had higher morbidity (χ² = 19.55; p < 0.001), longer hospital stays (χ² = 4.73; p = 0.03), and delayed RIOT (χ² = 12.70; p < 0.001). There is significant association between increase in percentage compliance to ERAS components and reduced major postoperative complications (OR 0.79; 95% CI 0.72-0.87; p = 0.001) and reduced length of hospital stay (OR 0.89; 95% CI 0.84-0.95; p = 0.001).</p><p><strong>Conclusion: </strong>Higher compliance is linked with reduction in postoperative morbidity, shorter hospital stays, and timely RIOT. These findings reinforce the safety profile of ERAS pathway in CRS-HIPEC. However, multicenter studies are needed to support these findings.</p><p><strong>Registry: </strong>Clinical Trial Registry of India (CTRI/2021/02/031151).</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"155"},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of Chronic Liver Disease Due to Chemotherapy-Associated Liver Injury in Patients with Gastrointestinal Cancers.","authors":"Fernanda Sales Melo Mendes, Gabriel Martins Nogueira, Beatriz de Almeida Cunha, Liana Codes, Vivianne Mello, Anelisa Coutinho, Paulo Lisboa Bittencourt","doi":"10.1007/s12029-025-01281-1","DOIUrl":"https://doi.org/10.1007/s12029-025-01281-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic liver disease (CLD) has been reported in long-term survivors of gastrointestinal (GI) cancers treated with irinotecan- and/or oxaliplatin-based chemotherapy. This study aims to investigate the frequency and clinical consequences of CLD in GI cancer patients treated with chemotherapy and its potential impact on survival.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with GI cancers treated at AMO Oncology Clinic from 2017 to 2022. CLD evaluation was performed in patients without prior liver disease who survived ≥ 12 months after chemotherapy. Diagnosis was based on imaging findings of cirrhosis or portal hypertension (PH), histologic evidence of advanced fibrosis, or esophagogastric varices on endoscopy.</p><p><strong>Results: </strong>A total of 328 patients (165 males; mean age 64 ± 13 years) were included. Most had colorectal cancer (58%) and TNM stage III or IV disease (69.6%). They received a median of 15.5 (8-28) chemotherapy cycles, mainly with oxaliplatin (86%), 5-fluorouracil (76%), irinotecan (49%), and capecitabine (43%). After a mean follow-up of 30.5 (21-49) months, CLD was identified in 47 patients (14.3%). Overall survival did not differ significantly between those with and without CLD (77.0 [51-102] vs. 85.7 [69-102] months, p = 0.385). CLD was associated with a greater number of chemotherapy agents (4 vs. 3, p = 0.002), cycles (21 vs. 13, p = 0.005), and exposure to 5-FU (89% vs. 73%, p = 0.02) and irinotecan (66% vs. 46%, p = 0.01).</p><p><strong>Conclusions: </strong>Among patients with GI cancer receiving chemotherapy, CLD was relatively frequent but no difference in survival was observed. As PH complications may occur, screening for CLD should be recommended for long-term survivors.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"156"},"PeriodicalIF":1.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anal Verrucous Carcinoma: A Case Report and a Systematic Review of the Literature.","authors":"Ioannis D Gkegkes, Nikolaos Katsoulas, Dimitrios Vlachodimitropoulos, Apostolos P Stamatiadis","doi":"10.1007/s12029-025-01272-2","DOIUrl":"https://doi.org/10.1007/s12029-025-01272-2","url":null,"abstract":"<p><strong>Background: </strong>Αn uncommon variant of squamous cell carcinoma is represented by verrucous carcinoma. Regarding the anal and perianal area, verrucous carcinoma is rarely described in the literature.</p><p><strong>Methods: </strong>A systematic PubMed and Scopus search was performed, a propos of a case report.</p><p><strong>Results: </strong>A 39-year-old man presented to our proctology practice, complaining of a palpable, perianal lump. A small size of the lesion was decided to be excised, under local anaesthesia. Pathology revealed the presence of verrucous carcinoma. Thirty patients from 17 studies were included. The mean age of the patients was 47.4 years (range: 33-77). The majority of them were males (24 out of 30, 80%). Considering the comorbidities of the included patients, only in 4 patients were mentioned to have a history of multiple perianal fistulas due to Crohn's disease, colorectal cancer, heart-lung transplantation and hidradenitis suppurativa, respectively. The most frequent symptoms at the time of presentation were painless perianal mass (7 out of 30, 23.3%), perianal pain (5 out of 30, 16.7%), ulcerated / exophytic mass (4 out of 30, 13.3%), pruritus ani (2 out of 30, 6.7%), perianal sepsis (1 out of 30, 10%) and bleeding (1 out of 30, 10%). The duration of the symptoms ranged between 2 months and 14 years. Regarding the surgical treatment of the included patients, local excision was the most common surgical option (76.7%). Combined chemoradiotherapy was administered in 5 out of 30 patients (16.7%). Recurrence of the disease was reported in 5 out of 30 patients (16.7%). Death was reported in 3 out of 30 cases (10%).</p><p><strong>Conclusion: </strong>Αnal verrucous carcinoma (VC) is an extremely rare neoplasm of the perianal area. In most of the cases, early diagnosis of VC is difficult due to the fact that its appearance and its symptoms commonly mimic benign conditions. Histopathological confirmation is the principal requisite in any further therapeutic treatment. In general, the prognosis is relatively good, especially when an early and radical excision is performed.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"152"},"PeriodicalIF":1.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic Versus Laparoscopic Lateral Lymph Node Dissection for Advanced Pelvic Cancers: a Systematic Review and Meta-analysis.","authors":"Mohamed Ali Chaouch, Paul Leblanc-Even, Ahmed Loghmari, Adriano Carneiro da Costa, Alessandro Mazzotta, Salah Khayat, Bassem Krimi, Amine Gouader, Jim Khan, Christoph Reissfelder, Wahid Fattal, Hani Oweira","doi":"10.1007/s12029-025-01251-7","DOIUrl":"https://doi.org/10.1007/s12029-025-01251-7","url":null,"abstract":"<p><strong>Background: </strong>Lateral pelvic lymph node dissection (LPND) is a key component in the surgical treatment of advanced pelvic malignancies. Minimally invasive techniques have evolved over the past decade, with laparoscopic surgery as the traditional standard and robotic-assisted surgery emerging as a promising alternative. This study aimed to systematically compare robotic (R-LPND) and laparoscopic (L-LPND) approaches in terms of perioperative outcomes in patients undergoing LPND for advanced pelvic cancers.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. The search was performed until April 1, 2024. The primary outcome was postoperative morbidity. Secondary outcomes included operative time, LPND-specific operative time, hospital stay duration, number of lymph nodes harvested, and rate of major complications.</p><p><strong>Results: </strong>Eleven studies with 667 robotic and 568 laparoscopic cases were included. Robotic LPND was associated with significantly lower postoperative morbidity (OR 0.52; p = 0.02) and shorter hospital stays (MD - 2.30 days; p = 0.0003). However, robotic procedures had significantly longer operative times (MD 40.58 min; p = 0.003). No significant differences were observed in the number of lymph nodes harvested, LPND time, or rates of major complications. Heterogeneity was moderate to high for most outcomes, and the overall certainty of evidence ranged from low to moderate.</p><p><strong>Conclusion: </strong>Robotic LPND may offer clinical benefits in terms of reduced morbidity and shorter hospitalization compared to laparoscopic surgery, although it is associated with longer operative time. These findings are based on evidence of low to moderate certainty and should be interpreted with caution due to the predominance of retrospective studies and notable inter-study heterogeneity.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"151"},"PeriodicalIF":1.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Significance of Circulating Tumor DNA Mutations in Gastrointestinal Stromal Tumors: A Systematic Review and Meta-analysis Based on Time-To-Event Data.","authors":"Gustavo Tadeu Freitas Uchôa Matheus, Danilo Monteiro Ribeiro, Ana Luiza Rocha Soares Menegat, Brenda Luana Rocha Soares Menegat, Isabela Junger Meirelles Aguiar, Pedro Henrique de Souza Wagner, Rommel Mario Rodríguez Burbano, Francisco Cezar Aquino de Moraes","doi":"10.1007/s12029-025-01271-3","DOIUrl":"10.1007/s12029-025-01271-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the digestive tract, most commonly originating in the stomach or small intestine, and driven by activating mutations in the KIT or PDGFRA genes. Liquid biopsy has emerged as a promising, minimally invasive technique to detect and monitor circulating tumor DNA (ctDNA), offering real-time insights into tumor dynamics and treatment response. Specifically, detecting KIT/PDGFRA mutations in ctDNA may aid in assessing prognosis, therapeutic response, and resistance. However, the clinical utility of this approach remains unclear. To address this, we conducted a systematic review and meta-analysis to evaluate the prognostic relevance of ctDNA mutations in GIST patients by comparing survival outcomes between those with KIT/PDGFRA mutations and those with wild-type profiles or no detectable ctDNA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive systematic search was performed in the PubMed, Scopus, and Web of Science databases to identify studies evaluating overall survival (OS) at different time points in patients with GIST, stratified by ctDNA status (ctDNA-negative vs. ctDNA-positive). Hazard ratios (HRs) were extracted or calculated, and Kaplan-Meier curves were reconstructed using an adjusted Cox proportional hazards model, with 95% confidence intervals (CIs). A p-value &lt; 0.05 was considered statistically significant. All statistical analyses were performed using RStudio software, version 4.2.3.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This study included seven eligible studies comprising a total of 2024 histologically confirmed GIST patients, of whom 1610 were classified as ctDNA-positive and 414 had no detectable ctDNA mutations. OS at different time points was consistently more favorable in the ctDNA-negative group compared to the ctDNA-positive group (reference). The pooled hazard ratios (HR) were as follows: at 1year, HR 0.91 (95% CI: 0.89-0.93; p &lt; 0.01; I&lt;sup&gt;2&lt;/sup&gt; = 0%); at 2years, HR 0.85 (95% CI: 0.83-0.88; p &lt; 0.01; I&lt;sup&gt;2&lt;/sup&gt; = 20%); at 3years, HR 0.77 (95% CI: 0.74-0.81; p &lt; 0.01; I&lt;sup&gt;2&lt;/sup&gt; = 28.2%); and at 5years, HR 0.63 (95% CI: 0.54-0.73; p &lt; 0.01; I&lt;sup&gt;2&lt;/sup&gt; = 70.8%). At maximum follow-up (mean follow-up of 7.5months), OS showed a 49% reduction in survival in the ctDNA-positive group (HR 0.51; 95% CI: 0.40-0.64; p &lt; 0.01; I&lt;sup&gt;2&lt;/sup&gt; = 79.9%). Additionally, in a pooled analysis of Kaplan-Meier data from patients with the KIT exon 11 (KIT11) mutation, the adjusted Cox proportional hazards model estimated an HR of 0.66 (95% CI: 0.49-0.89; p = 0.007), favoring the ctDNA-positive group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This meta-analysis highlights the potential of ctDNA as a prognostic biomarker in GIST, showing that its presence is consistently associated with poorer survival outcomes across mutational subtypes. These findings support the integration of ctDNA analysis into clinical practice as a minimally invasive tool for d","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"153"},"PeriodicalIF":1.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}