Journal of Gastrointestinal Cancer最新文献

{"title":"Correction to: Survival Outcomes Between Minimally Invasive and Open Gastrectomy in Early and Locally Advanced Gastric Adenocarcinoma in a Western Center.","authors":"Sandhya Kalavacherla, Nicholas Neel, Vasan Jagadeesh, Michael Bouvet, Andrew Lowy, Santiago Horgan, Winta T Mehtsun, Kaitlyn J Kelly","doi":"10.1007/s12029-025-01208-w","DOIUrl":"https://doi.org/10.1007/s12029-025-01208-w","url":null,"abstract":"","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"91"},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772100","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":"Combined Chemotherapy-Immunotherapy for Advanced Biliary Tract Cancer (BTC): A Clinical, Genomic, and Biomarker Analysis.","authors":"Yong Zhang, Miaomiao Gou","doi":"10.1007/s12029-025-01215-x","DOIUrl":"https://doi.org/10.1007/s12029-025-01215-x","url":null,"abstract":"<p><strong>Background: </strong>Biliary tract cancer (BTC) represents a heterogeneous disease spectrum associated with an unfavorable prognosis. A combination of immunotherapy and chemotherapy has become a new standard strategy for advanced BTC. However, understanding the association between genomic alterations and outcomes of immunotherapy in BTC is crucial for further improving clinical benefits.</p><p><strong>Method: </strong>Patients with metastatic BTC were included in this study retrospectively, who received PD-1/PD-L1 (ICI) antibodies combined with chemotherapy. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included overall response rate (ORR) and disease control rate (DCR). Additionally, we conducted exploratory analysis of genomic alterations and biomarkers.</p><p><strong>Results: </strong>Ninety-one patients were enrolled in this study. The patients were divided into two groups: albumin paclitaxel + S1 (AS) + PD-1 (n = 56) group and GC + ICI (n = 35) group. There were no significant differences in terms of PFS, ORR, and DCR between the two groups. Regarding biomarker analysis, 44 patients had positive PD-L1 expression, with a mPFS of 4.8 months and an ORR of 15.9%. Surprisingly, 29 patients had negative PD-L1 expression, with a mPFS of 9.9 months and an ORR of 27.6%. The average tumor mutational burden (TMB) was 4.5 mutations per megabase (mut/MB) for patients with microsatellite-stable (MSS) tumors. There was no significant difference in PFS between patients with TMB high and low (cutoff = 4.5 mut/MB). Genomic analysis revealed TP53 (n = 13, 43.3%), KRAS (n = 8, 26.7%), NTRK1/2/3 (n = 8, 26.7%), isocitrate dehydrogenase (IDH) 1/2 (n = 6, 20.0%), PIK3CA (n = 6, 20.0%), BRCA2 (n = 5, 16.7%), MDM2/4 (n = 5, 16.7%), and BRAF (n = 4, 13.3%) as the most common gene alterations. MDM2/4 mutations were associated with shorter survival (p < 0.05).</p><p><strong>Conclusion: </strong>GC plus immunotherapy is still the standard of care for late stage BTC. PD-L1 expression and TMB were not good predictors for selecting patients who would benefit more from immunotherapy plus chemotherapy.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"90"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752806","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 Novel Diagnostic Model of Biomarkers in the Washing Fluid Obtained by EUS-FNA in Pancreatic Cancer.","authors":"Chen-Fan Li, Lan-Xiang Hao, Yi-Jia Chen, En-De Lin, Chun-Ping Zhang, Li-Hua Wu, Xu-Ying Liao, Jia-Li Zhou, Jian-Hui Zhu, Ling-Hui Zhan, Xian-Ming Liang, Yi-Qun Hu","doi":"10.1007/s12029-025-01209-9","DOIUrl":"10.1007/s12029-025-01209-9","url":null,"abstract":"<p><strong>Background and aims: </strong>Currently, there are no biomarkers with high accuracy in the detection of pancreatic cancer. This article aims to evaluate the performance of a novel diagnostic model based on a combination of biomarkers in the washing fluid obtained by EUS-FNA with imaging examination in pancreatic cancer.</p><p><strong>Methods: </strong>This study included 59 patients with pancreatic lesions who underwent EUS-FNA and were categorized into malignant and benign groups on the basis of pathology diagnosis. The levels of CEA, CA19-9, CA125, CA724, CYFRA 21-1, IMP3, SMAD4, and S100P in EUS-FNA washing fluid were detected by ELISA. We attempted to construct a new diagnostic method by combining the above biomarkers with EUS, CT, MRI, and PET-CT.</p><p><strong>Results: </strong>CEA, CA19-9, CA724, CA125, and CYFRA 21-1 showed statistical significance in the diagnosis of pancreatic cancer (AUC > 0.7, p < 0.05). CA724 had a specificity of up to 100% in the group with positive EUS diagnosis. If at least two positive imaging results (EUS/CT/MRI/PET-CT) combined with at least one tumor marker (CEA/CA199/CA724) in series, the sensitivity was 88.57% and the specificity was 91.67%.</p><p><strong>Conclusions: </strong>Combining the tumor markers CEA, CA19-9, CA724, CA125, and CYFRA 21-1 in the washing fluid of EUS-FNA with commonly used imaging methods can help distinguish benign and malignant pancreatic lesions.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"89"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719818","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":"Neoadjuvant Imatinib in Recurrent/Metastatic Gastrointestinal Stromal Tumors: A Systematic Review and Meta-analysis of Proportions.","authors":"Niki Stavrou, Nikolaos Memos, Charalampos Filippatos, Theodoros N Sergentanis, Flora Zagouri, Maria Gavriatopoulou, Ioannis Ntanasis-Stathopoulos","doi":"10.1007/s12029-025-01210-2","DOIUrl":"10.1007/s12029-025-01210-2","url":null,"abstract":"<p><strong>Introduction: </strong>Metastatic and recurrent gastrointestinal stromal tumors (GISTs) present challenging clinical management. Imatinib is the standard first-line therapy, improving survival and reducing tumor burden in the neoadjuvant use, facilitating surgical intervention. This systematic review and meta-analysis assessed the efficacy of neoadjuvant imatinib in metastatic/recurrent GISTs, highlighting its potential to enhance surgical outcomes and overall patient management.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase and Scopus (end-of-search: February 13, 2025) for records on neoadjuvant imatinib therapy in recurrent/metastatic GISTs. Pooled proportions and 95% confidence intervals were calculated with common-effect and random-effects models. Subgroup and meta-regression analysis were performed, addressing heterogeneity and examining any potential association between the factors that varied and the outcomes reported. The present meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.</p><p><strong>Results: </strong>The search identified 957 articles, and 14 were analyzed. The meta-analysis of proportions indicated that 2-year and 5-year PFS were 76% (95% CI 58-88%) and 43% (95% CI 17-74%), respectively, while 2-year and 5-year OS were 84% (95% CI 78-89%) and 60% (95% CI 51-68%), respectively. The pooled R0 resection rate was 82% (95% CI 64-92%), associated positively with that of radiological partial response (PR) (β = 3.92, p < 0.001). Further meta-regression analysis yielded no significant association with preoperative imatinib duration.</p><p><strong>Conclusion: </strong>The present meta-analysis of trials and studies on metastatic or recurrent GISTs highlights key insights into post-surgery patient outcomes following neoadjuvant treatment with imatinib. Pooled effect estimates revealed promising 2-year and 5-year PFS rates of 76% and 43%, respectively, and 2-year and 5-year OS rates of 84% and 60%, respectively. Furthermore, the high pooled R0 resection rate of 82% emphasizes a substantial surgical efficacy in this population, while it was significantly correlated with successful R0 resections in patients with favorable outcomes.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"88"},"PeriodicalIF":1.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719820","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":"The Dynamic Changes of Circulating Myeloid-Derived Suppressor Cells (MDSCs) Subsets in Colorectal Cancer Patients Undergoing Oxaliplatin-Based Chemotherapy.","authors":"Ralph Girson Gunarsa, Aru Wisaksono Sudoyo, Ricci Steven, Dilafitria Fauza, Fajar Lamhot Gultom, Ibrahim Basir, Dicky Kurniawan, Akterono Dwi Budiyati","doi":"10.1007/s12029-025-01207-x","DOIUrl":"10.1007/s12029-025-01207-x","url":null,"abstract":"<p><strong>Purpose: </strong>Increased level of circulating myeloid -derived suppressor cells (MDSCs) in colorectal cancer (CRC) patients has been associated with higher tumor stage and poorer survival due to poorer response to therapeutic agents. However, studies reported inconsistent results on how chemotherapeutic agents affecting the depletion of two major types of MDSCs, polymophonuclear MDSC (PMN-MDSC) and monocytic MDSC (M-MDSC). The present study aims to learn deeper on the dynamic changes of circulating MDSCs, especially in response to oxaliplatin-based treatment in CRC patients.</p><p><strong>Methods: </strong>This was a prospective study that recruited 30 treatment-naive patients with varying stages of CRC who were scheduled to receive oxaliplatin-based chemotherapy. Blood sampling was conducted prior to and at several time points during and after chemotherapy. Multicolor flow cytometry assay was used to analyse the proportion of HLA-DR^- and CD33⁺ with CD15⁺ (PMN-MDSCs) or CD14⁺ (M-MDSCs) cells within peripheral blood mononuclear cells (PBMCs). Other essential tumor biomarkers such as carcinoembryonic antigen (CEA) and tumor-infiltrating lymphocytes (TILs) were also assessed. As a control, 14 healthy subjects were recruited in this study.</p><p><strong>Results: </strong>Indonesian treatment-naive CRC patients exhibited significantly higher circulating PMN-MDSCs compared to healthy subjects (p = 0.003), while M-MDSCs levels showed no significant difference between the groups (p = 0.890). Following chemotherapy, the MDSCs level demonstrated dynamic changes. Interestingly, a subgroup of CRC patients with decreased in both PMN- and M-MDSCs levels on D-14 of chemotherapy consistently showed a significant reduction in MDSCs levels during and after therapy completion compared to baseline (p = 0.0078).</p><p><strong>Conclusions: </strong>Circulating MDSCs level, particularly PMN-MDSCs, in CRC patients, was significantly higher compared to healthy subjects. Changes in both circulating PMN- and M-MDSCs levels at D-14 chemotherapy might have prognostic value in oxaliplatin-based chemotherapy.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"87"},"PeriodicalIF":1.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719821","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":"Economic Evaluation of Gastric Cancer Screening Strategies: A Systematic Review.","authors":"Aziz Rezapour, Kamran Irandoust, Maryam Eri, Faeze Foruzanfar, Aghdas Souresrafil, Somayeh Afshari, Seidamir Pasha Tabaeian","doi":"10.1007/s12029-025-01202-2","DOIUrl":"https://doi.org/10.1007/s12029-025-01202-2","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is one of the most prevalent cancers worldwide, with high mortality and economic burden. Early detection through cost-effective screening strategies can improve patient outcomes and optimize healthcare resource allocation. This systematic review evaluates the cost-effectiveness of various GC screening approaches.</p><p><strong>Methods: </strong>A comprehensive search was conducted in Web of Science, Scopus, PubMed, Embase, the NHS Economic Evaluation Database, and Google Scholar for studies published between 1990 and 2023. Relevant studies were selected based on predefined inclusion and exclusion criteria. The CHEERS 2022 checklist was used to assess study quality.</p><p><strong>Results: </strong>A total of 6027 studies were retrieved, and after a two-phase screening and quality assessment, 47 studies were included. Most studies originated from China, Japan, the USA, Singapore, and South Korea. Findings indicate that screening is generally more cost-effective than no screening. Endoscopy was more cost-effective than upper gastrointestinal (UGI) X-ray but not superior to Helicobacter pylori (H. pylori) screening, serum pepsinogen (PG) testing, or novel risk scoring methods. H. pylori screening was more cost-effective than endoscopy and symptomatic treatment but not superior to serum PG testing and risk scoring methods. Urea breath test (UBT)-based H. pylori screening was less cost-effective than most alternatives.</p><p><strong>Conclusions: </strong>Selecting cost-effective GC screening strategies can improve early detection rates and reduce healthcare costs. Policymakers should consider population-specific factors when implementing screening programs to maximize health benefits and economic efficiency.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"85"},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710179","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":"Microsatellite Stable Colorectal Tumours in Patients with Lynch Syndrome: A Case Report and Systematic Review Analysing Clinical Features and Implications for Immunotherapy.","authors":"Fani Kapoulitsa, Davide Mauri, Konstantinos K Tsilidis, Konstantinos Katsanos, Eleni Timotheadou, Maria Smaragdi Vlachou, Konstantinos Kamposioras","doi":"10.1007/s12029-025-01203-1","DOIUrl":"10.1007/s12029-025-01203-1","url":null,"abstract":"<p><strong>Purpose: </strong>Lynch syndrome is an autosomal dominant genetic disorder associated with early-onset colorectal cancer (CRC), endometrial cancer and other malignancies. This condition is defined by deficient DNA mismatch repair and high microsatellite instability (dMMR/MSI-high), exhibiting a substantial response to immunotherapy. However, microsatellite-stable (MSS) tumours may infrequently occur in individuals with Lynch syndrome. Our aim was to evaluate the efficacy of immunotherapy in patients with Lynch Syndrome and dMMR/MSS colorectal cancer.</p><p><strong>Methods: </strong>A systematic review of the literature in medical databases, major related conferences and relevant oncology journals was conducted to identify the available evidence. Medical records from the Medical and Clinical Oncology Department of the University Hospital of Ioannina were also reviewed.</p><p><strong>Results: </strong>Four cases of MSS colorectal cancer associated with Lynch syndrome and MSH6 germline mutation were identified. Three of these four patients were treated with immune checkpoint inhibitors. Two patients with metastatic disease experienced disease progression, but one patient who received neoadjuvant immunotherapy achieved a partial response. All four patients were diagnosed with colorectal cancer in ages younger than 52 (16-51 years old).</p><p><strong>Conclusion: </strong>MSS CRC tumours in patients with Lynch syndrome is an infrequent phenomenon and under-represented in the literature. The limited efficacy of immune checkpoint inhibitors is highlighted in this rare subset of patients.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"86"},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710185","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":"Preoperative Radiotherapy in Patients with Gastric and Gastro-Oesophageal Cancer: A Systematic Review and Meta-analysis.","authors":"Gustavo Tadeu Freitas Uchôa Matheus, Pedro Henrique de Souza Wagner, João Arthur Cerqueira Taumaturgo, Shi Juin Lam, Francisco Cezar Aquino de Moraes","doi":"10.1007/s12029-025-01204-0","DOIUrl":"https://doi.org/10.1007/s12029-025-01204-0","url":null,"abstract":"<p><strong>Background: </strong>Gastric (GC) and gastroesophageal junction (GEJ) cancers are among the most prevalent digestive cancers, characterized by a poor prognosis, particularly in advanced stages, where the 5-year survival rate remains below 20%. While surgery is still the standard treatment, its limited ability to lower recurrence rates highlights the necessity for effective perioperative therapies. In this context, Radiotherapy (RT) and chemoradiotherapy (CRT) have been investigated for their potential to improve tumor control, pathologic complete response (pCR), and overall survival (OS) in advanced GC. This systematic review and meta-analysis aimed to assess the efficacy and safety of preoperative RT/CRT on key clinical outcomes in patients with GC, focusing on pathologic complete response (pCR), overall survival (OS), and postoperative complications, such as anastomotic leaks and postoperative mortality.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Web of Science databases was conducted for randomized controlled trials and single-arm studies comparing preoperative RT/CRT with chemotherapy or surgery alone. Outcomes were pooled using risk ratios (RRs) or hazard ratios (HRs) with 95% confidence intervals (CIs), and heterogeneity was assessed using I² statistics. Furthermore, quality assessment was performed using RoB 2 and ROBINS-I tools. We also utilized tools to enhance the interpretation and understanding of the meta-analysis results, including GRADE, the leave-one-out method, Baujat and Doi plots.</p><p><strong>Results: </strong>Ten studies including 6 RCTs and 4 single-arm studies, comprising 2,138 patients were included. CRT significantly improved pCR rates compared to control groups (RR 2.72; 95% CI 1.89-3.92; p < 0.000001; I² = 0%), with a pCR rate of 21% in single-arm analysis. No statistical significance was observed in the hazard ratio analysis for OS (HR 0.84; 95% CI 0.65-1.10; p = 0.209; I² = 67%), including the subgroup analyses at three (RR 1.15; 95% CI 0.93-1.43; p = 0.183; I² = 70%) and five years (RR 1.23; 95% CI 1.00-1.51; p = 0.051; I² = 58%). Moreover, the rates for anastomotic leaks (RR 0.86; 95% CI 0.66-1.14; p = 0.294; I² = 0%) and postoperative mortality (RR 0.88; 95% CI 0.46-1.70; p = 0.71; I² = 25%) showed no significant differences between groups, with low event rates in single-arm studies, 7% and 3%, respectively.</p><p><strong>Conclusion: </strong>Preoperative CRT significantly improves pCR rates, highlighting its potential as a valuable strategy in tumor downstaging. However, it does not enhance survival outcomes, while notably, it does not increase surgical complications. Future studies incorporating biomarkers and standardized protocols are essential to refine patient selection, ensuring optimized treatment strategies and maximizing clinical benefits.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"84"},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692354","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":"Current Status of Gastrectomy for Gastric Cancer in Oldest-old Patients Aged 85 Years or Older.","authors":"Kazuaki Matsui, Yoshiki Kawaguchi, Takahiro Iwai, Yukiko Torizaki, Yoko Adachi, Hirofumi Shimoda, Takehiro Shimada, Yasuhito Sekimoto, Hidejiro Urakami, Shiko Seki","doi":"10.1007/s12029-025-01205-z","DOIUrl":"https://doi.org/10.1007/s12029-025-01205-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the safety of gastrectomy for gastric cancer in oldest-old patients aged ≥ 85 years.</p><p><strong>Methods: </strong>This study retrospectively analyzed the patients aged ≥ 85 years who diagnosed with gastric cancer between 2008 and 2022. The study patients were divided into three groups: a surgery group, an endoscopic submucosal dissection (ESD) group, and a non-surgery and non-ESD group (n = 64, 57, and 152). Surgical outcomes and 3-year overall and recurrence-free survival (OS and RFS) were investigated.</p><p><strong>Results: </strong>In the surgery group, the study cohort comprised 30 males and 34 females with a median age of 87 years. Distal, proximal, and total gastrectomy (DG, PG, and TG) were performed in 54, 1, and 9 patients, respectively. There were 27, 16, 17, and 4 patients with pStage I, II, III, and IV, respectively. Thirty-day morbidity with Clavien-Dindo grade ≥ 3 and 30-day mortality were 12.5% and 3.1%, respectively. Kaplan-Meier curves for the 3-year OS and RFS demonstrated that survival curves worsened with increasing pStage (p = 0.005 and p < 0.001, respectively). In multivariate analyses for the 3-year OS and RFS, TG and pStage ≥ III were independent risk factors (p = 0.028 and 0.011 in OS, p = 0.021 and 0.001 in RFS). In comparisons of 3-year OSs among the three groups in each cStage, survivals in the surgery group were consistently better than those in the non-surgery and non-ESD group in cStages I to III (p < 0.001, 0.001, and < 0.001 in cStage I, II, and III, respectively).</p><p><strong>Conclusion: </strong>Our findings suggest that the radical gastrectomy for gastric cancer can be performed safely and has a chance to improve survival even in the oldest-old patients aged ≥ 85 years.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"83"},"PeriodicalIF":1.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692283","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":"Preoperative Prediction of Sarcopenia in Patients Scheduled for Gastric and Colorectal Cancer Surgery.","authors":"Beijia Zhou, Yanjun Song, Chen Chen, Xiaotian Chen, Tingting Tao","doi":"10.1007/s12029-025-01206-y","DOIUrl":"https://doi.org/10.1007/s12029-025-01206-y","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia negatively impacts surgical outcomes in gastrointestinal cancer patients, yet practical preoperative screening tools are lacking. The CRP/ALB ratio, a novel biomarker of systemic inflammation and nutritional status, may enhance sarcopenia prediction but remains underexplored in surgical oncology. This study aims to identify the predictors for preoperative sarcopenia prediction in gastric and colorectal cancer patients.</p><p><strong>Methods: </strong>This retrospective study analyzed 145 patients undergoing curative surgery (2019-2021). Sarcopenia was defined by sex-specific CT-measured L3 skeletal muscle index (cutoffs, male ≤ 40.8 cm²/m²; female ≤ 34.9 cm²/m²). Multivariable logistic regression identified predictors, with model performance assessed via ROC analysis and Cohen's Kappa.</p><p><strong>Results: </strong>The cohort (median age 64 years; 73.8% male) comprised 66 gastric (45.5%) and 79 colorectal (54.5%) cancer patients, with 29 (20%) diagnosed with sarcopenia. Sarcopenic patients exhibited a higher NRS 2002 score (P < 0.001), lower PNI score (P < 0.05), and higher CRP/ALB ratio (P < 0.05). Multivariate logistic regression analysis results showed that CRP/ALB ratio (OR = 3.084, 95% CI 1.071-8.882, P = 0.037), age (OR = 1.074, 95% CI 1.021-1.130, P = 0.006), and BMI (OR = 0.667, 95% CI 0.542-0.820, P = 0.000) were associated with the increased risk of sarcopenia. The combined model achieved superior discrimination (AUC = 0.854, 95% CI 0.770-0.937), yielding 75.86% sensitivity and 84.82% specificity at optimal cutoff value - 1.0340, and a Cohen's Kappa coefficient of 0.542 when compared to CT results.</p><p><strong>Conclusion: </strong>The CRP/ALB ratio combined with BMI and age is utilized as a convenient and effective tool for preoperative sarcopenia screening. This model-driven approach provides robust strategies to facilitate preoperative interventions, optimize perioperative care, and enhance long-term oncological outcomes for patients undergoing gastric and colorectal cancer surgery.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"82"},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673976","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}