Journal of Gastrointestinal Cancer最新文献

{"title":"Serum GFAP as a Potential Biomarker for Chemotherapy-Associated Cognitive Impairment in Elderly Patients with Gastrointestinal Cancers: An Exploratory Study.","authors":"Ozgur Tanriverdi, Ummuhani Ozel-Turkcu","doi":"10.1007/s12029-025-01323-8","DOIUrl":"https://doi.org/10.1007/s12029-025-01323-8","url":null,"abstract":"<p><strong>Introduction: </strong>Chemotherapy-associated cognitive impairment (CACI) is a common yet underdiagnosed condition among elderly cancer patients. Glial fibrillary acidic protein (GFAP), a marker of astrocytic activation, has emerged as a potential indicator of neuroinflammation.</p><p><strong>Materials and methods: </strong>This observational case-control study included 41 elderly patients with stage II-III colon, gastric, or pancreatic cancer who received 12 cycles of adjuvant chemotherapy, and 30 age- and sex-matched healthy controls. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline, mid-treatment, and 3 months post-treatment. Quality of life was evaluated using the Functional Assessment of Cancer Therapy-General (FACT-G). Serum GFAP and C-reactive protein (CRP) levels were measured at baseline and follow-up.</p><p><strong>Results: </strong>Post-treatment MMSE scores significantly declined in the patient group (mean = 24.87 ± 2.14 vs. baseline = 26.92 ± 0.99, p < 0.001), with 51% of patients showing cognitive impairment. GFAP levels increased significantly in cognitively impaired patients (from 374.64 ± 142.14 to 464.79 ± 181.94 ng/ml, p < 0.001), while ROC analysis identified a GFAP cut-off of 337 ng/ml with 94.74% sensitivity and 92.48% specificity for predicting CACI. Logistic regression showed that both elevated follow-up GFAP levels were independent predictors of CACI.</p><p><strong>Discussion: </strong>Elevated serum follow-up GFAP levels are significantly associated with cognitive impairment following chemotherapy in elderly patients with gastrointestinal cancers, suggesting a role for astrocytic activation in CACI pathogenesis. GFAP may serve as a promising biomarker for risk stratification and early intervention.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"196"},"PeriodicalIF":1.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232792","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":"The Prognostic Significance of Platelet-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte in Colorectal Cancer: a Meta-Analysis.","authors":"Xin Meng, Cong Wang, Xin Xu, Ning Zhang, Xiaoqin Wang","doi":"10.1007/s12029-025-01322-9","DOIUrl":"https://doi.org/10.1007/s12029-025-01322-9","url":null,"abstract":"<p><strong>Background: </strong>This comprehensive review sought to investigate the correlation between PLR and LMR with overall longevity (OS), recurrence-free interval (DFS), and malignancy-related survival (CSS) among individuals diagnosed with colorectal carcinoma.</p><p><strong>Methods: </strong>A comprehensive review of relevant studies was carried out using prominent digital repositories to locate research articles that provided hazard estimates (HRs) for PLR and LMR in individuals diagnosed with colorectal cancer. Potential publication bias was examined through graphical funnel plot assessments, while additional subgroup analyses were conducted based on patient demographics and consideration of C-index.</p><p><strong>Results: </strong>Nineteen studies were included for PLR and OS analysis, showing that high PLR was associated with increased mortality risk (HR = 1.23, 95%CI = 1.04-1.44, p = 0.01). For LMR and OS, 14 studies were analyzed, indicating that low LMR was linked to higher mortality risk (HR = 1.63, 95%CI = 1.29-2.06, p < 0.0001). Subgroup analyses showed stronger associations in the western population and studies with C-index adjustments. Regarding DFS, no significant association was found with PLR (HR = 1.14, 95%CI = 0.93-1.40, p = 0.21), while low LMR increased recurrence risk (HR = 1.31, 95%CI = 1.15-1.48, p < 0.0001). High PLR and low LMR were associated with worse CSS, with no significant heterogeneity observed.</p><p><strong>Conclusion: </strong>Elevated PLR and reduced LMR are linked to unfavorable survival prospects in individuals with colon malignancy.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"197"},"PeriodicalIF":1.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232745","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 Impact of Cachexia in Patients Undergoing Radical Resection for Colorectal Cancer: A Retrospective Study.","authors":"Hideki Tanda, Masatsune Shibutani, Yuki Seki, Tsuyoshi Nishiyama, Hiroaki Kasashima, Tatsunari Fukuoka, Kiyoshi Maeda","doi":"10.1007/s12029-025-01320-x","DOIUrl":"https://doi.org/10.1007/s12029-025-01320-x","url":null,"abstract":"<p><strong>Purpose: </strong>Tumor progression is influenced by both tumor-intrinsic and host-related factors. Among the latter, cachexia-a multifactorial syndrome involving progressive skeletal muscle loss-has garnered increasing attention for its prognostic relevance. However, objective assessment of cachexia remains difficult. The cachexia index (CXI) has emerged as a novel biomarker for its evaluation. This study aimed to assess the relationship between cachexia and long-term prognosis following curative surgery for colorectal cancer (CRC) using a modified index.</p><p><strong>Methods: </strong>We retrospectively analyzed 298 patients who underwent curative colorectal cancer resection at Osaka City University Hospital between January 2017 and December 2019. A modified version of CXI, termed the P-CXI, was calculated using the psoas muscle index (cm²/m²), serum albumin (g/dL), and neutrophil-to-lymphocyte ratio (NLR): P-CXI = (psoas muscle index × albumin) / NLR. Patients were stratified into high and low P-CXI groups. Prognostic value for relapse-free survival (RFS) and overall survival (OS) was evaluated using univariate and multivariate Cox regression analyses.</p><p><strong>Results: </strong>The low P-CXI group (n = 170) had significantly shorter RFS and OS compared to that of the high P-CXI group (p = 0.001 and p < 0.001, respectively). Multivariate analysis identified low P-CXI as an independent poor prognostic factor for RFS (HR: 2.627, 95% CI 1.363-5.063, p = 0.004) and OS (HR: 5.370, 95% CI 1.806-15.96, p = 0.002), along with older age, T4 tumors, and elevated CA 19-9.</p><p><strong>Conclusion: </strong>Cachexia, as quantified by P-CXI, was significantly associated with worse long-term outcomes after curative CRC resection. P-CXI may serve as a simple and objective prognostic marker.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"195"},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212962","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 Review of Transarterial Chemoembolization Plus Systemic Therapy in Advanced Hepatocellular Carcinoma.","authors":"Arif Akyildiz, Betul Gok Yavuz, Rashad Ismayilov, Muge Buyukaksoy, Sena Sozen, Joe Ramzi Eid, Rony Avritscher, Lee Sunyoung, Suayib Yalcin, Ahmed O Kaseb","doi":"10.1007/s12029-025-01306-9","DOIUrl":"https://doi.org/10.1007/s12029-025-01306-9","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the fifth most common cancer worldwide. For patients with unresectable, localized, intermediate-stage HCC, the standard treatment is transarterial chemoembolization (TACE).</p><p><strong>Methods: </strong>Given the recent advances in systemic treatments for HCC with immunotherapy and targeted therapies, several studies have explored the potential benefits of combining TACE with systemic therapy, owing to the possible synergistic effects. This review analyzes recent clinical studies of patients with unresectable HCC who received TACE in combination with different classes of systemic therapies.</p><p><strong>Conclusion: </strong>Collectively, these studies suggest that combining TACE with systemic therapy may enhance treatment response and improve survival outcomes.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"194"},"PeriodicalIF":1.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181970","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":"Latent Profile Analysis and Influencing Factors of Fear of Progression in Patients after Endoscopic Submucosal Dissection for Early Gastric Cancer.","authors":"Jianping Zhu, Jianping Song, Hui Ni, Qun Ni, Yanmei Chen","doi":"10.1007/s12029-025-01318-5","DOIUrl":"https://doi.org/10.1007/s12029-025-01318-5","url":null,"abstract":"<p><strong>Purpose: </strong>Fear of progression (FOP) leads to poor clinical outcomes in patients with gastric cancer. This study aimed to clarify the profiles and factors that influence FOP among patients after endoscopic submucosal dissection (ESD) for early gastric cancer.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 262 patients who underwent ESD for early gastric cancer. The convenience sampling method was used to select patients in the gastroenterology outpatient departments of two Grade III and Class A hospitals in Zhejiang Province as survey subjects. A general information questionnaire and the Fear of Progression Questionnaire-Short Form, Perceived Social Support Scale, Herth Hope Index, Brief Illness Perception Questionnaire, and Medical Coping Modes Questionnaire were used to collect the data. Latent profile analysis was used to explore the latent profiles of FOP in patients after ESD for early gastric cancer.</p><p><strong>Results: </strong>A total of 262 patients were included in the study. Male patients accounted for 59.2% of the cohort, while those aged 50-59 years constituted 52.7%. Pathological type showed that 65.3% of patients had well-differentiated adenocarcinoma. Latent profile analysis identified two subgroups of FOP: low FOP (55.3%) and high FOP (44.7%). Patients who were female, younger, had no religious belief, and had a lower Herth Hope Index and a higher avoidance dimension score and a higher submission dimension score were prone to severe FOP.</p><p><strong>Conclusion: </strong>Research indicates that female patients, younger patients, those without religious beliefs, individuals with lower hope scores, and patients employing avoidance or compliance coping strategies are more prone to severe FOP. Physicians and nurses should pay close attention to these characteristics and provide early intervention.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"193"},"PeriodicalIF":1.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137816","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":"Efficacy and Safety of Dual Therapy with HER2-inhibitors (Pertuzumab and Trastuzumab) in Gastric or Gastroesophageal Tumors: A Systematic Review and Meta-analysis.","authors":"Geraldo Lucas Lopes Costa, João Victor Ramos da Cruz, José Roberto Alves, Saint Clair Vieira de Oliveira, Leticia Vieira Dos Santos Ribeiro, Arthur Henrique Gohr, Daniella Serafin Couto Vieira","doi":"10.1007/s12029-025-01310-z","DOIUrl":"10.1007/s12029-025-01310-z","url":null,"abstract":"<p><strong>Background: </strong>The benefit of adding dual HER2 inhibition with Pertuzumab (P) and Trastuzumab (T) to chemotherapy (cT) in HER2-positive gastric or gastroesophageal junction (GEJ) cancer is not yet fully elucidated.</p><p><strong>Methods: </strong>A systematic search of PubMed, Cochrane Central, Embase, Web of Science, SciELO, and LILACS identified clinical trials investigating adjuvant or neoadjuvant regimens combining (P), (T) and (cT). Hazard ratios (HRs) and odds ratios (ORs) for binary endpoints were calculated, with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Four clinical trials comprising a total of 1,225 patients were included. Dual HER2 blockade plus (cT) showed a significant benefit in survival analysis (HR 0.77, 95% CI 0.69-0.86), especially in terms of overall survival (HR 0.78, 95% CI 0.61-0.99) and progression-free survival (HR 0.73, 95% CI 0.62-0.85). Pathological response rates were higher compared with (cT) alone (OR 1.62, 95% CI 0.98-2.66). Treatment was associated with an increased overall adverse event rate (OR 1.48, 95% CI 1.32-1.66), particularly any-grade diarrhea, hypokalemia, fatigue, and pulmonary infection. Serious adverse events, including deaths and complications, were not significantly different (OR 0.87, 95% CI 0.51-1.49).</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis of clinical trials demonstrates that adding (P), (T) and (cT) improves survival and pathological response in HER2-positive gastric and GEJ tumors, with a manageable safety profile.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"191"},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113356","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":"Survival Outcomes of Patients with BRAF V600E-Mutant Resectable Extrahepatic Colorectal Oligometastases After Upfront Metastasectomy.","authors":"Takashi Mori, Shin Kobayashi, Yuichiro Tsukada, Motohiro Kojima, Daichi Kitaguchi, Hiro Hasegawa, Koji Ikeda, Yuji Nishizawa, Naoto Gotohda, Hideaki Bando, Masahiro Tsuboi, Masaaki Ito, Takayuki Yoshino","doi":"10.1007/s12029-025-01315-8","DOIUrl":"https://doi.org/10.1007/s12029-025-01315-8","url":null,"abstract":"<p><strong>Purpose: </strong>The negative impact of the BRAF V600E mutation (mBRAF) on survival outcomes has been reported for metastatic colorectal cancer (mCRC), but the role of mBRAF testing in resectable extrahepatic cases remains unclear. This study aimed to assess survival outcomes in patients with extrahepatic mCRC harboring mBRAF who underwent upfront metastasectomy, compared with patients with unresectable mBRAF tumors.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted between January 2005 and December 2017. Of 109 patients who underwent initial metastasectomy for extrahepatic mCRC without preoperative chemotherapy, mBRAF, RAS mutations (mRAS), and wild-type RAS/BRAF (wtRAS/BRAF) were found in 6 (5.5%), 64 (58.7%), and 39 (35.8%) patients, respectively.</p><p><strong>Results: </strong>After a median follow-up of 39.5 months, patients with mBRAF had a median recurrence-free survival (RFS) of 4.4 months and overall survival (OS) of 40.6 months. In multivariate survival analysis, mBRAF status was the strongest independent predictor of poor survival, even after adjusting for conventional clinicopathological factors and other mutational statuses (RFS: HR 3.15, p = 0.035; OS: HR 3.85, p = 0.037). The OS after upfront metastasectomy in mBRAF cases was nearly identical to that of unresectable mCRC treated with systemic chemotherapy (HR 1.01, p = 0.99).</p><p><strong>Conclusion: </strong>Technically resectable extrahepatic oligometastases with mBRAF may be considered oncologically unresectable. Preoperative mBRAF testing should be considered for all patients with resectable extrahepatic mCRC, regardless of technical resectability.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"192"},"PeriodicalIF":1.6,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113403","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":"Post Capsule Endoscopy Small Bowel Cancer Rate-An Australian Data Linkage Analysis.","authors":"Paris Hoey, Naeman Goetz, Kimberley Ryan, Mark Appleyard, Florian Grimpen","doi":"10.1007/s12029-025-01313-w","DOIUrl":"10.1007/s12029-025-01313-w","url":null,"abstract":"<p><strong>Purpose: </strong>Small bowel (SB) capsule endoscopy (CE) is a well-established investigation for suspected SB pathology, but little research has evaluated the diagnostic miss rate of SB cancer. This Australian study sought to assess the risk of developing SB cancer within 36 months of a cancer-negative CE (PCSBC-3Y) using a novel root-cause analysis (RCA) method.</p><p><strong>Methods: </strong>Using a prospective CE database and data linkage with a population-based state cancer registry, the PCSBC-3Y rate was evaluated in consecutive patients undergoing CE between 2007 and 2019. SB cancers diagnosed or suspected from CE were defined as 'detected cancers', whilst those diagnosed within 36 months of a negative CE were defined as 'missed cancers'. Descriptive statistics summarised characteristics for all diagnosed SB cancers. All PCSBC-3Y cases were evaluated by RCA.</p><p><strong>Results: </strong>A total of 20 patients were diagnosed with SB cancer within 36 months of CE, comprising of 18 detected cancers and two missed cancers. The overall PCSBC-3Y rate was 10% (95% CI 2.6-28.7%). The two missed cancers included one jejunal gastrointestinal stromal tumour and one duodenal adenocarcinoma. RCA revealed both missed cancers to be unavoidable, as the SB was normal on two retrospective reviews of the CE video recordings.</p><p><strong>Conclusion: </strong>This study introduces the concept of measuring the PCSBC-3Y rate and a novel algorithm of RCA. In our quaternary referral CE cohort, the PCSBC-3Y rate was 10%. A subsequent RCA suggested that the two missed cancers were unavoidable.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"190"},"PeriodicalIF":1.6,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091875","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":"Diagnostic Utility of Serum CEA and Ca 19.9 as Triage Tools for Predicting Metastatic Disease in Gallbladder Cancer: A Sub-analysis from a Prospective Observational Study.","authors":"Kumar Vineet, Mayank Tripathi, Chandan Kumar, Satyendra Narayan Singh, Akash Srivastava, Gurupreet Singh Gill, Piyush Kant Shukla, Barun Kumar","doi":"10.1007/s12029-025-01317-6","DOIUrl":"10.1007/s12029-025-01317-6","url":null,"abstract":"<p><strong>Purpose: </strong>Gallbladder cancer is a highly aggressive malignancy with disproportionate incidence in the Gangetic belt of India. Early diagnosis is critical yet most patients present with advanced-stage disease. Serum tumor markers like CEA and Ca 19.9 are often elevated in gallbladder cancer, but their role in rapidly triaging patients for metastatic disease at presentation has not been prospectively validated in prospective cohort.</p><p><strong>Methods: </strong>This sub-analysis is part of a larger prospective observational study conducted at a tertiary cancer center in North India. A total of 1500 newly diagnosed, treatment-naïve or incidental gallbladder cancer patients were enrolled between September 2023 and May 2024. Serum CEA and Ca 19.9 levels were measured at baseline. Diagnostic thresholds were derived using the 75th percentile values stratified by obstructive jaundice status. Diagnostic accuracy for predicting metastatic disease was assessed using confusion matrices, ROC curves, and precision-recall analysis.</p><p><strong>Results: </strong>Of 1500 patients, 1203 (80.2%) presented with metastatic disease. Serum data were available for 1011 patients. Patients with metastatic disease had significantly higher marker levels (CEA: mean 288.4 vs. 22.9 ng/mL; Ca 19.9: 20,917 vs. 2241 U/mL). The model showed high specificity (89.1%) and positive predictive value (92.3%) with moderate AUC (0.74). Sensitivity was limited (40.3%), suggesting strong \"rule-in\" but weak \"rule-out\" capability.</p><p><strong>Conclusions: </strong>Elevated serum CEA and Ca 19.9 adjusted for jaundice status are strong indicators of metastatic gallbladder cancer at presentation. This real-world percentile-based approach offers a rapid, low-cost diagnostic adjunct for early triage in resource-limited settings. The findings provide context-sensitive thresholds that may aid timely treatment decisions in high-burden regions.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"189"},"PeriodicalIF":1.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069739","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":"Comparative Efficacy of Thermal Ablation and Surgical Resection in Patients with Colorectal Cancer Liver Metastasis: A Systematic Review and Meta-analysis.","authors":"Humam Shah, Naveed Ahmed Khan, Muhammad Imran Ullah, Umer Zaryab Khan, Uzair Irfan, Iftikhar Ahmad","doi":"10.1007/s12029-025-01314-9","DOIUrl":"10.1007/s12029-025-01314-9","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal cancer (CRC) often involves liver. However, the standard treatment for CRC with liver metastases (CRC-LM) is debatable. This meta-analysis compares the efficacy of ablation with surgical resection in CRC-LM patients.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed, ClinicalTrials.gov and Cochrane Library. Studies published during January 2020 to February 2025 and comparing any form of ablation with surgical resection in adult patients with CRC-LM were included. The primary outcomes were overall survival (OS), disease-free survival (DFS), while the secondary outcomes were recurrence patterns, length of hospital stay, and complication rates.</p><p><strong>Results: </strong>A total of 15 studies were included in the meta-analysis. The pooled analysis revealed a significant difference in OS favoring surgical resection (RR: 0.82, 95% CI: 0.73, 0.92, p = 0.001, I² = 33%), while DFS showed no significant difference between the groups (RR: 0.76, 95% CI: 0.38, 1.53, p = 0.44, I² = 85%). Hospital stay was significantly shorter in the ablation group (MD -1.44; 95% CI -2.18,-0.69; p = 0.0001; I² = 97%), and the rate of major complications was also significantly lower with ablation (RR 0.26; 95% CI 0.18-0.38; p < 0.00001; I² = 0%). Additionally, ablation and resection were comparable in terms of both local recurrence (RR 1.27; 95% CI 0.86-1.86; p = 0.23; I² = 38%) and appearance of new lesions (RR 0.98; 95% CI 0.75-1.29; p = 0.90; I² = 9%).</p><p><strong>Conclusion: </strong>Surgical resection offered superior OS compared to thermal ablation for CRC-LM patients. However, thermal ablation was associated with shorter hospital stay and fewer major complications, highlighting its value as a less invasive alternative in selected patients.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"188"},"PeriodicalIF":1.6,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058532","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}