Journal of Gastrointestinal Cancer最新文献

{"title":"The Landscape of Genomic Alterations in Receptor Tyrosine Kinase Pathways in Biliary Cancers: Implications for Targeted Therapies.","authors":"Ioannis A Voutsadakis","doi":"10.1007/s12029-025-01335-4","DOIUrl":"10.1007/s12029-025-01335-4","url":null,"abstract":"<p><strong>Background: </strong>Biliary carcinomas are aggressive cancers with a high mortality rate. When metastatic, biliary cancers are associated with a short survival and low response to treatments. The first line therapy of metastatic biliary carcinomas consists of a platinum doublet chemotherapy combination with an immune checkpoint inhibitor and results in a median overall survival in the range of approximately 12-13 months, with 20% to 25% of patients surviving at 2 years. Second line chemotherapy options based on fluoropyrimidines are associated with a median survival of less than 6 months. Genomic studies in recent years have clarified molecular aspects of biliary cancers and have confirmed the molecular heterogeneity between the intrahepatic, extrahepatic and gallbladder primary sites.</p><p><strong>Methods: </strong>Publicly available genomic cohorts of biliary cancer primary locations were interrogated for common mutations and copy number alterations with a focus on receptor tyrosine kinases and their signal transduction pathways.</p><p><strong>Results: </strong>Specific mutations and structural alterations have different prevalence depending on the primary location. Alterations in receptor tyrosine kinases and the transduction pathways originating from them show differential prevalence in the primary locations of the biliary cancers and create diverse treatment opportunities that can be harnessed for drug development. Approximately 49% of intrahepatic, 57.6% of gallbladder, and 66% of extrahepatic carcinomas harbor RTK pathway alterations.</p><p><strong>Conclusions: </strong>Targeted therapies for individual components of these kinase receptors and pathways, including FGFR2, HER2, BRAF and others, have already been introduced in clinical practice for the treatment of patients with biliary tumors bearing alterations in these genes. The findings underscore the need for primary site-driven genomic testing to guide therapy selection. The current analysis discusses strategies to create opportunities for clinically available targeted therapies.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"207"},"PeriodicalIF":1.6,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318327","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":"Does Malignant Ascites Define Prognosis in Gastric Cancer with Peritoneal Spread? A Systematic Review and Meta-analysis.","authors":"Francisco Cezar Aquino de Moraes, Luis Henrique Rios Moreira Rego, Gustavo Tadeu Freitas Uchôa Matheus, Clara Rocha Dantas, Ana Luiza Marçalo de Tolosa, Rommel Mario Rodríguez Burbano, Mario Hiroyuki Hirata","doi":"10.1007/s12029-025-01332-7","DOIUrl":"10.1007/s12029-025-01332-7","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is the fifth most common cancer and a leading cause of cancer-related death. Peritoneal metastases occur in up to 25% of patients, with nearly half developing malignant ascites (MA), which arises from lymphatic obstruction, vascular permeability, and immune dysregulation. Median overall survival (OS) in this setting is poor (2-8 months). This systematic review and meta-analysis evaluate the prognostic impact of ascites in metastatic GC.</p><p><strong>Materials and methods: </strong>PubMed, Embase, and Cochrane were searched for studies reporting OS in metastatic GC patients with and without ascites. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using fixed and random-effects models in RStudio 4.2.3.</p><p><strong>Results: </strong>Overall, 14 studies involving 2179 patients, with 1208 having ascites, were included in the analysis. Of these, 13 were retrospective studies and 1 was a prospective study. The presence of ascites was associated with a significantly worse prognosis compared to its absence (HR 1.8418; 95% CI 1.5657-2.1667; P < 0.001). Similarly, the comparison of massive type ascites with mild to moderate type shows a worse outcome for the higher grade of ascites (HR 1.8597; 95% CI 1.4633-2.3635; P < 0.001). Comparing no to moderate ascites vs massive ascites, the massive type also shows a significantly lower overall survival (HR 2.5114; 95% CI 1.5409-4.0931; P < 0.001).</p><p><strong>Conclusions: </strong>This meta-analysis suggests that the presence of ascites and its grades are essential prognostic factors for metastatic gastric cancer, significantly worsening overall survival.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"206"},"PeriodicalIF":1.6,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301377","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":"Comparative Outcomes of Spleen Preservation and Splenectomy in Total Gastrectomy for Proximal Gastric Cancer: A Systematic Review and Meta-Analysis.","authors":"Ana Luíza Rocha Soares Menegat, Brenda Luana Rocha Soares Menegat, Bárbara Corrêa Garcia Simões, Gustavo Tadeu Freitas Uchôa Matheus, Clara Rocha Dantas, Barbara Antonia Dups Talah, Francisco Cezar Aquino de Moraes","doi":"10.1007/s12029-025-01334-5","DOIUrl":"https://doi.org/10.1007/s12029-025-01334-5","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis evaluated whether spleen-preserving surgery with gastrectomy reduces the risk of intra-and postoperative complications compared with splenectomy in patients with proximal gastric cancer.</p><p><strong>Background: </strong>Total gastrectomy with splenic hilar lymph node dissection, often involving splenectomy, is the standard approach for proximal gastric cancer. However, the effect of splenectomy on patient outcomes remains unclear.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Cochrane, and Web of Science databases for studies comparing spleen preservation and splenectomy in total gastrectomy. Randomized clinical trials (RCTs) and observational studies were included in this study. Risk Ratios (RR) and Mean Differences (MD) with 95% confidence intervals (CI) were calculated. Heterogeneity was assessed using the I² test, and statistical significance was set at p < 0.05.</p><p><strong>Results: </strong>Ten studies with 2 221 patients were included, 1 RCT and 9 retrospective cohort studies. Of these, 1 173 (52.81%) underwent spleen-preserving surgery, and 1 048 (47.19%) underwent splenectomy. Spleen-preserving surgery was associated with reduced pancreatic fistula (RR 0.30; p < 0.000001), blood loss (MD -172.47; p = 0.012396), anastomotic leak (RR 0.51; p = 0.006769), intra-abdominal abscess (RR 0.40; p = 0.000160), and complications according to the Clavien-Dindo classification (RR 0.50; p = 0.010315). Other outcomes, such as the length of hospital stay, operative time, pulmonary complications, and wound infection showed no significant differences.</p><p><strong>Conclusion: </strong>Spleen-preserving gastrectomy reduces postoperative complications compared with splenectomy, supporting its use as the safer approach in proximal gastric cancer whenever oncologic safety is ensured.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"204"},"PeriodicalIF":1.6,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292550","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":"Overcoming the Challenge: A Comprehensive Review of Neoadjuvant Treatment Resistance in Rectal Cancer.","authors":"Alexandru Micu, Andrei Diaconescu, Corina-Elena Minciuna, Teodora Manuc, Simona Olimpia Dima, Gabriela Droc, Vlad Herlea, Gabriel Becheanu, Adina Emilia Croitoru, Catalin Vasilescu","doi":"10.1007/s12029-025-01324-7","DOIUrl":"10.1007/s12029-025-01324-7","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is the third most commonly diagnosed cancer and remains a leading cause of cancer-related mortality, particularly among younger men. Approximately one-third of colorectal cancers occur in the rectum. For patients with locally advanced rectal cancer, neoadjuvant therapy is considered the standard treatment approach. Despite advances in therapeutic approaches, improvements in the 5-year survival rate have been modest. Accurate assessment of tumor response to neoadjuvant therapy (NAT) is critical for guiding subsequent treatment strategies, especially when considering eligibility for non-operative management (NOM). Common evaluation methods include digital rectal examination (DRE), magnetic resonance imaging (MRI), and high-definition flexible endoscopy (HDFE). Tumor regression grading (TRG) systems-both histopathological (pTRG) and MRI-based (mrTRG)-are valuable tools for quantifying treatment response and predicting long-term outcomes. However, resistance to NAT remains a significant clinical challenge and is driven by a complex interplay of molecular mechanisms. Genetic factors, such as RAS mutations, have been linked to resistance to chemoradiotherapy (CRT), while tumors exhibiting microsatellite instability (MSI-high) tend to respond poorly to CRT but may show favorable outcomes with immune checkpoint inhibitors. Epigenetic pathways, including dysregulation of Wnt/β-catenin and PI3K/AKT signaling, along with alterations in DNA damage repair mechanisms, further influence CRT sensitivity. The tumor microenvironment also plays a pivotal role in modulating therapy response. Elements such as immune cell infiltration, hypoxia, angiogenesis, and the presence of cancer-associated fibroblasts (CAFs) contribute to a pro-resistance landscape. Moreover, emerging evidence suggests that gut microbiota composition-particularly an enrichment of Bacteroides species-is associated with diminished response to NAT. Understanding these multifaceted biological interactions is essential for developing personalized and more effective therapeutic strategies, with the goal of enhancing response to NAT and ultimately improving clinical outcomes in patients with rectal cancer.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"205"},"PeriodicalIF":1.6,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301455","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":"Area Deprivation Index as a Predictor of Hepatocellular Carcinoma Prognosis: Limited Predictive Utility in an Integrated Care Model.","authors":"Avi Toiv, Hope B O'Brien, Anqi Wang, Laila Poisson, Reena J Salgia","doi":"10.1007/s12029-025-01326-5","DOIUrl":"https://doi.org/10.1007/s12029-025-01326-5","url":null,"abstract":"<p><strong>Purpose: </strong>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide, yet mortality outcomes in patients with HCC can vary widely. Socioeconomic disparities are known to influence health outcomes in patients with various cancers. We aim to investigate the relationship between socioeconomic status as measured by the Area Deprivation Index (ADI) and risk of mortality and Barcelona Clinic Liver Cancer (BCLC) stage at the time of diagnosis in patients with HCC.</p><p><strong>Methods: </strong>A retrospective cross-sectional study of patients treated for HCC at an academic liver center between January 1, 2016, and December 31, 2020. The primary outcome was time to cause-specific death. The secondary outcome was BCLC stage at the time of HCC diagnosis.</p><p><strong>Results: </strong>A total of 980 patients (median age 66 years; interquartile range 61-72) were included. ADI was not a significant predictor of mortality across all ADI quintiles. Severity of HCC at diagnosis was associated with increasing deprivation at the state level ADI (P < 0.5 at all quintiles) but not the national ADI level. Advanced BCLC stage (C and D) was significantly associated with cause-specific death in patients with HCC in both models (hazard ratio, 1.94, 95% CI, 1.44-2.62; P < 0.001; hazard ratio, 1.94; 95% CI, 1.44-2.61; P < 0.001).</p><p><strong>Conclusion: </strong>In patients with HCC treated at an academic liver center, ADI was associated with the severity of cancer at HCC diagnosis; however, mortality risk remained consistent across all ADI quintiles. Access to centers that provide coordinated, multidisciplinary HCC care may help mitigate the impact of socioeconomic disparities on HCC mortality.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"203"},"PeriodicalIF":1.6,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292510","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":"Oligometastatic Gastric Cancer: Novel Considerations for Personalized Approach.","authors":"Gerasimia D Kyrochristou, Georgios D Lianos, Ilektra D Kyrochristou, Michail Mitsis, Konstantinos Vlachos","doi":"10.1007/s12029-025-01325-6","DOIUrl":"https://doi.org/10.1007/s12029-025-01325-6","url":null,"abstract":"<p><strong>Background: </strong>Metastatic disease traditionally classifies gastric cancer as stage M1, precluding surgical intervention and enrolling patients in palliative treatment protocols. This principle holds regardless of the number, the location, and the quantity of metastatic sites. \"Oligometastatic disease\" is an intermediate state between localized and widely spread gastric cancer.</p><p><strong>Methods: </strong>Locoregional treatments may offer long survival or even cure in highly selected cases. There are no evidence-based guidelines for the appropriate management of this clinical entity. Tailored strategic techniques are required to incorporate surgical treatment, when applicable, into the management protocols of these patients. The surgical approach (following neoadjuvant treatment) aiming at R0 resection of neoplasms that are technically or oncologically unresectable, or only borderline resectable at initial evaluation is defined as \"conversion therapy\".</p><p><strong>Results: </strong>The surgical approach aims at locoregional control of the disease, radical resection of all cancer sites, adequate lymph node cleansing and uncomplicated anastomosis. Disease progression is a clear indication of palliative treatment. In this article, we aim to provide an extensive literature search about current status of oligometastatic gastric disease multimodal treatment.</p><p><strong>Conclusions: </strong>Given the malignancy potential of gastric cancer, the decision for an operative approach should be made with strict criteria by experienced surgeons and rational oncologists.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"201"},"PeriodicalIF":1.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286042","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":"Comparing ICG-Guided vs. Conventional Laparoscopic Lymphadenectomy in Gastric Cancer: A Systematic Review and Meta-Analysis.","authors":"Abdullah Afridi, Maria Qadri, Fatima Sajjad, Hira Habib, Iqra Khan, Iqra Shahid, Yasir Saleem, Fazia Khattak, Farwa Nisa, Hanifullah Khan, Zaryab Bacha, Muhammad Abdullah Ali, Hafsa Khan, Muhammad Hamza Khan, Rizwan Afridi, Kamil Ahmad Kamil","doi":"10.1007/s12029-025-01327-4","DOIUrl":"https://doi.org/10.1007/s12029-025-01327-4","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer remains one of the leading causes of cancer-related mortality worldwide, with surgical intervention being a critical aspect of treatment. Lymphadenectomy plays a significant role in managing gastric cancer, with the extent of lymph node removal often influencing survival outcomes. Recent advancements in laparoscopic surgery have introduced the use of indocyanine green (ICG) fluorescence guidance to improve the accuracy and effectiveness of lymphadenectomy. However, the comparative efficacy of ICG-guided laparoscopic lymphadenectomy versus conventional techniques remains a topic of ongoing investigation.</p><p><strong>Aim: </strong>This study aims to evaluate the effectiveness and surgical outcomes of ICG-guided laparoscopic lymphadenectomy compared to conventional laparoscopic lymphadenectomy in patients with gastric cancer.</p><p><strong>Methods: </strong>A systematic review and meta-analysis, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements, was conducted (PROSPERO: CRD420251039604). A literature review was performed (sources: PubMed, Embase, and Cochrane Library databases; end-of-search date: April 22, 2025) and quality assessment was performed using the ROB 2 and Newcastle-Ottawa Scale. A random-effects model was used to pool the data for the meta-analyses.</p><p><strong>Results: </strong>A total of 3996 patients from ten studies were analyzed, with 1870 undergoing ICG-guided surgery and 2126 in the non-ICG group. ICG use was associated with significantly improved 1-year (RR = 1.04) and 2-year (RR = 1.09) overall survival, and a greater number of retrieved lymph nodes (MD = 6.00). While intraoperative blood loss was significantly reduced with ICG (MD =  - 14.44 mL), no significant differences were observed in metastatic lymph node count, postoperative complications, operative time, or hospital stay.</p><p><strong>Conclusions: </strong>ICG-guided surgery in gastric cancer is associated with improved short- and mid-term overall survival and enhanced lymph node retrieval. It also significantly reduces intraoperative blood loss without increasing postoperative complications, operative time, or hospital stay. These findings support the clinical value of ICG in improving surgical outcomes.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"202"},"PeriodicalIF":1.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286045","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":"C. difficile Infection in Colorectal Cancer: Risk Determinants, Outcomes, and Evolving Management Approaches.","authors":"Mustafa Khalid AbdulJabbar, Susan Saab Manfi Al-Rawi, Bilal Khaleel Midhin, Roghayeh Mohammadzadeh, Raad N Hasan, Mobina Kouhzad, Nasrin Alanchari, Erta Rajabi","doi":"10.1007/s12029-025-01321-w","DOIUrl":"https://doi.org/10.1007/s12029-025-01321-w","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) ranks as the third most prevalent cancer globally and poses a considerable public health challenge; concurrently, Clostridioides difficile infection (CDI) represents a significant hospital-acquired infection, with a rising incidence observed among cancer patients.</p><p><strong>Aim: </strong>To examine the relationship between CDI and CRC, it will address the risk factors associated with CDI in patients with CRC, clinical outcomes, recent findings regarding the influence of CDI on CRC, and the current strategies for management.</p><p><strong>Results: </strong>Risk factors including gut microbiota dysbiosis, surgical interventions, chemotherapy, immunotherapy, prolonged hospitalization, and antibiotic exposure elevate susceptibility to CDI in CRC patients. Additionally, CDI correlates with more complex treatment regimens and longer hospital stays in this demographic. Furthermore, recent studies indicate that the incidence of CDI may increase the risk of CRC development.</p><p><strong>Conclusion: </strong>The prevention, diagnosis, and treatment of CDI in CRC patients are critical for enhancing outcomes. A comprehensive understanding of the bidirectional relationship between CDI and CRC can guide the development of management strategies for this important clinical issue.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"200"},"PeriodicalIF":1.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286323","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":"Primary Malignant Melanoma of the Oesophagus Treated With Immunotherapy: A Case Report and Scoping Review of the Literature.","authors":"Eve Hopping, Lauren Kennedy, Antonio Barbaro, Amanda Ireland, Nimit Singhal, Harsh Kanhere","doi":"10.1007/s12029-025-01311-y","DOIUrl":"https://doi.org/10.1007/s12029-025-01311-y","url":null,"abstract":"<p><strong>Purpose: </strong>Primary malignant melanoma of the oesophagus is extremely rare. Given this, there is a paucity of evidence to guide treatment decisions. Traditionally, treatment has included standard modalities of surgery, chemotherapy, and/or radiotherapy. Immunotherapy has revolutionised the treatment of cutaneous melanoma; however, molecular studies have provided conflicting results regarding whether the underlying mechanisms driving melanoma response to immunotherapy are reproduced in mucosal and, more specifically, oesophageal melanomas. The evidence base for treatment decisions in primary malignant melanoma of the oesophagus remains limited due to the small number of reported cases, with only 374 cases reported in the world literature up to 2022.</p><p><strong>Case report and literature review: </strong>We present the case of an 81-year-old Caucasian female patient, previously in good health aside from gastro-oesophageal reflux. The patient presented with dysphagia and proceeded to CT and endoscopy showing a large mid-to-distal oesophageal mass. Endoscopic biopsies revealed a poorly differentiated epithelioid malignancy, with immunohistochemical studies confirming melanoma. FDG-PET revealed metastatic deposits in the skeleton as well as mesenteric nodes. The patient was commenced on treatment with ipilimumab and nivolumab 18 days following diagnosis. Despite receiving only one cycle of immunotherapy, the patient demonstrated remarkable resolution of symptoms as well as complete resolution of PET-avidity of all local and metastatic disease and remains in remission 2 years following diagnosis. Scoping review of the literature identified just three case series and 18 case reports of patients with primary oesophageal melanoma treated with immunotherapy This case is now the third case reported in the literature of patients with oesophageal melanoma metastatic at diagnosis, who have entered long-term complete remission following sole treatment with immunotherapy and the only case to enter remission following a single cycle of treatment.</p><p><strong>Conclusion: </strong>We report our experience with one of the few reported cases of metastatic primary malignant melanoma of the oesophagus treated with immunotherapy, with encouraging results. We would encourage reporting of further cases in order to better understand the role of immunotherapy in oesophageal melanoma.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"199"},"PeriodicalIF":1.6,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280400","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":"Do Incretin-Based Therapies Influence the Risk of Cholangiocarcinoma in Type 2 Diabetes Patients? Insights from a Systematic Review and Meta-Analysis.","authors":"Eric Ricardo Yonatan, Louis Fabio Jonathan Jusni, Steven Alvianto, Nicolas Daniel Widjanarko, Steven Yulius Usman, Virly Nanda Muzellina","doi":"10.1007/s12029-025-01330-9","DOIUrl":"https://doi.org/10.1007/s12029-025-01330-9","url":null,"abstract":"<p><strong>Introduction: </strong>Incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), are widely used in the management of type 2 diabetes mellitus (T2DM). However, concerns have emerged regarding their potential association with an increased risk of cholangiocarcinoma (CCA), and current evidence remains inconclusive. This review aims to evaluate and clarify the association between incretin-based therapies and the risk of CCA in patients with T2DM.</p><p><strong>Methods: </strong>This review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025641616). A comprehensive search was performed across PubMed, ProQuest, EBSCOhost, Wiley, and SAGE databases. Eligible observational studies reporting the association between incretin-based therapies and CCA were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Pooled hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using RevMan with a random-effects model.</p><p><strong>Result: </strong>Four studies (three cohort and one case-control) were included. The pooled HRs showed no significant association between incretin-based therapies and CCA risk, with estimates of 1.07 (95% CI: 0.70-1.63) for GLP-1RAs and 1.05 (95% CI: 0.83-1.34) for DPP-4Is. Pooled RR analyses yielded similarly non-significant results. All included studies were assessed as having a low risk of bias according to the NOS.</p><p><strong>Conclusion: </strong>Incretin-based therapies do not significantly increase the risk of CCA in T2DM patients. Within the limitations of the available observational evidence, these findings provide reassurance regarding their safety profile, while highlighting the need for ongoing pharmacovigilance and further large-scale studies to confirm these results.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"198"},"PeriodicalIF":1.6,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274626","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}