Journal of Gastrointestinal Cancer最新文献

{"title":"Final Results of ERBIMOX: A Randomized Phase II Study of Modified FOLFOX7 With or Without Cetuximab as First-Line Treatment for KRAS Wild-type Metastatic Colorectal Cancer.","authors":"Karin Potthoff, Norbert Marschner, Lothar Müller, Stephan Sahm, Christian Lerchenmüller, Reinhard Depenbusch, Emil Boller, Beate Niemeier, Ute Zirrgiebel, Hans Tesch","doi":"10.1007/s12029-025-01260-6","DOIUrl":"10.1007/s12029-025-01260-6","url":null,"abstract":"<p><strong>Background: </strong>The combination of FOLFOX/FOLFIRI with an EGFR-antibody (cetuximab/panitumumab) is a first-line standard for RAS wild-type metastatic colorectal cancer (mCRC). The OPTIMOX stop-and-go regimen, which reduces oxaliplatin-induced neuropathy, and fluorouracil/folinic acid (FU/FA) were standard maintenance-therapies in the pre-antibody era. Whether an EGFR-antibody adds value to the OPTIMOX strategy in the RAS wild-type setting remains unknown.</p><p><strong>Methods: </strong>In the open-label, randomized, multicenter phase II ERBIMOX trial, patients with KRAS wild-type mCRC received either first-line induction-therapy with 8 cycles of mFOLFOX7 followed by maintenance-therapy with FU/FA (OPTIMOX arm) or mFOLFOX7 + cetuximab followed by FU/FA + cetuximab (ERBIMOX arm). Primary objective was to demonstrate superiority of additional cetuximab to mFOLFOX7 during induction/maintenance-therapy. Primary endpoint was objective response rate (ORR). Secondary endpoints included progression-free survival (PFS), overall survival (OS) and safety. The trial is registered at EudraCT (No.2006-002744-28).</p><p><strong>Results: </strong>From 2006-2011, 138 patients with KRAS wild-type mCRC from 23 German sites were randomly assigned to either OPTIMOX (N = 63) or ERBIMOX (N = 75). ORR numerically favored the ERBIMOX arm (64.0% vs. 54.0%, P = 0.3071). Median PFS (ERBIMOX vs. OPTIMOX) was 9.6 vs. 8.8 months (P = 0.7612), median OS 25.6 vs. 30.9 months (P = 0.5821). Most common grade 3/4 adverse events (AEs) were skin reactions (21.9% vs. 2.1%) and gastrointestinal disorders (13.5% vs. 9.5%). No cetuximab-related deaths occurred.</p><p><strong>Conclusion: </strong>In treatment-naïve KRAS wild-type mCRC, adding cetuximab to mFOLFOX7 resulted in numerically higher ORR than mFOLFOX alone, but no statistically significant differences in ORR, PFS or OS; probably because of the premature stop due to poor recruitment. The safety profile was as expected, with few discontinuations.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"141"},"PeriodicalIF":1.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505910","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":"Pretreatment Skeletal Muscle Index and Survival Outcomes in Non-Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis.","authors":"Clifford Atuiri, Isaac Che Ngang, Daniel Appiah, Armel Landry Batchi-Bouyou, Kayode Ademola Matthew, Abel Zemedkun Girma, Lawrence Sentongo Katumba, Leslie Tasha Mbapah, Semere Bekena","doi":"10.1007/s12029-025-01267-z","DOIUrl":"10.1007/s12029-025-01267-z","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle index (SMI), a measure of muscle mass derived from pretreatment imaging, has emerged as a potential prognostic factor in cancer. Its role in non-metastatic colorectal cancer (CRC), where curative treatment is possible, remains underexplored.</p><p><strong>Purpose: </strong>To evaluate the association between pretreatment SMI and survival outcomes, specifically overall survival (OS) and disease-free survival (DFS), in patients with non-metastatic CRC through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched PubMed, Embase, SCOPUS, Web of Science, Cochrane Library, and ClinicalTrials.gov from inception to March 24, 2025, for studies reporting SMI (measured via CT scan at L3) and survival outcomes in non-metastatic CRC. Studies were assessed for quality using the Newcastle-Ottawa Scale (NOS). Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was evaluated with the I² statistic.</p><p><strong>Results: </strong>Seventeen studies, comprising 16,031 patients, were included. Low SMI was associated with a 28% higher risk of overall mortality (pooled HR for OS: 1.28, 95% CI: 1.04-1.57, p = 0.02) and a 23% higher risk of recurrence/progression (pooled HR for DFS: 1.23, 95% CI: 1.02-1.49, p = 0.02). Heterogeneity was high reflecting variability in SMI cutoffs and study designs.</p><p><strong>Conclusion: </strong>Low pretreatment SMI is a significant predictor of poorer OS and DFS in non-metastatic CRC. Its routine assessment via existing CT scans could enhance risk stratification and guide interventions to improve outcomes. High study heterogeneity warrants further research to standardize measurement thresholds and clarify its clinical utility.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"143"},"PeriodicalIF":1.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505911","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":"Adjuvant Chemotherapy for Gastric Cancer may Worsen Prognosis in Elderly Women: Retrospective Analysis of Individual Patient Data from the CLASSIC Study.","authors":"Fumitaka Noji, Hideki Yoshioka, Ryota Jin, Hiroto Hatakeyama, Hiromi Sato, Akihiro Hisaka","doi":"10.1007/s12029-025-01239-3","DOIUrl":"10.1007/s12029-025-01239-3","url":null,"abstract":"<p><strong>Purpose: </strong>This research aimed to identify significant prognostic factors that interact with the treatment effect of capecitabine and oxaliplatin (CapeOX), based on individual patient data from the CLASSIC study (NCT00411229), which evaluated the efficacy of adjuvant chemotherapy for gastric cancer.</p><p><strong>Methods: </strong>Stepwise variable selection of prognostic factors was performed using the Cox proportional hazards model, with patient data from 519 CapeOX-treated and 514 untreated patients.</p><p><strong>Results: </strong>For all-cause mortality, older women (≥ 55 years) with a serum albumin level ≥ 4.0 g/dL were identified as significant prognostic factors interacting with CapeOX treatment, and unexpectedly, the treatment was associated with poor outcomes in this group. The prognostic significance of serum albumin levels was primarily attributed to the particularly poor survival outcomes observed in untreated patients with serum albumin < 4.0 g/dL. Tumor stage and lymph node status were prognostic factors that interacted with treatment for disease-free survival (DFS). The results showed that in patients with tumor stage (T) ≥ T3 and lymph node metastasis (N) < N2, improvement in DFS with CapeOX was not significant.</p><p><strong>Conclusion: </strong>As this was a post-hoc analysis, the results should be interpreted as hypothesis-generating rather than definitive. Nevertheless, the findings suggest the need for a more detailed consideration of patient baseline characteristics when determining the adjuvant chemotherapy strategy for gastric cancer.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"142"},"PeriodicalIF":1.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505909","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":"Mixed Neuroendocrine and Non-neuroendocrine Tumor of Pancreato-Biliary Origin Treated Successfully with Peptide Receptor Radionuclide Therapy.","authors":"Kalyan Mansukhbhai Shekhda, Tu Vinh Luong, Daniel Krell, Shaunak Navalkissoor, Anna Paterson, Martyn Caplin","doi":"10.1007/s12029-025-01261-5","DOIUrl":"10.1007/s12029-025-01261-5","url":null,"abstract":"<p><strong>Purpose: </strong>Mixed neuroendocrine and non-neuroendocrine neoplasms (MiNENs) are rare neoplasms composed of morphologically distinguishable neuroendocrine (NE) and non-neuroendocrine components, each representing at least 30% of the tumor volume. The NE component must be substantiated by immunohistochemistry. MiNENs generally have a poor prognosis, with a more aggressive component dictating overall survival and prognosis. Owing to its rarity, there are no specific validated treatment guidelines available for these tumors, and they are generally treated with surgery if possible. However, surgically unresectable or advanced tumors are generally treated with chemotherapy.</p><p><strong>Methods: </strong>We report a case of an elderly woman who was referred to the neuroendocrine tumor (NET) unit following incidental findings of liver lesions found on cardiac magnetic resonance imaging (MRI) performed for an asymptomatic heart murmur. Histology from the liver biopsy revealed MiNEN with up to 60% grade 2 (Ki67: 19%) well-differentiated NET and up to 30% well-differentiated to moderately differentiated adenocarcinoma of possible pancreato-biliary origin; intrahepatic ductal primary could not be excluded. Her 18-fluoro-deoxyglucose positron emission tomography (FDG-PET) revealed no FDG-avid lesions, and a ⁶⁸Gallium 1,4,7,10-tetraazacyclododecane-tetraacetic acid Tyr3-octreotate (⁶⁸ Ga-DOTATATE)-PET scan revealed multiple areas of intensely DOTATATE-avid liver lesions. Due to the absence of any primary imaging findings, the patient was diagnosed with MiNEN of possible pancreato-biliary origin.</p><p><strong>Results: </strong>She was started on lanreotide 120 mg every 28 days for 6 months, with no response to the treatment. Subsequently, the patient was treated with four cycles of ¹⁷⁷Lutetium-DOTATATE (Lutathera®) peptide receptor radionuclide therapy (PRRT). She tolerated the treatment well, with no significant side effects. MRI at the end of treatment revealed a partial response to treatment.</p><p><strong>Conclusion: </strong>PRRT is currently not used in treatment protocols for the management of MiNENs; however, it could be considered a treatment option in patients with MiNENs, where there is a predominant component of well-differentiated NETs with ⁶⁸ Ga-DOTATATE avid lesions.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"140"},"PeriodicalIF":1.6,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475579","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 Bibliometric Analysis of Prediction Models for HCC: Current Trends and Future Prospects.","authors":"Dong Li, Jingchao Sun, Xifeng Fu, Fei Gao","doi":"10.1007/s12029-025-01249-1","DOIUrl":"10.1007/s12029-025-01249-1","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumor, with rising incidence and mortality rates posing a significant threat to global public health. Accurate prediction of liver cancer occurrence and progression is essential for improving patient prognosis. This study uses bibliometric methods to analyze the current state and future trends in liver cancer prediction research.</p><p><strong>Methods: </strong>A search was conducted in the Web of Science (WOS) database on October 22, 2023, identifying 1092 articles on liver cancer prediction. These articles were quantitatively analyzed using CiteSpace 6.2 software, with a focus on research hotspots, authors, countries, and keywords.</p><p><strong>Results: </strong>The study involved 114 countries, 4254 institutions, and 280 journals, with 48,788 citations. China (826 papers) and the USA (96 papers) dominate the field. Leading institutions include Sun Yat-sen University, Fudan University, Zhejiang University, and Yonsei University. The most cited journals were Hepatology (2209 citations) and Journal of Hepatology (946 citations). Frontiers in Oncology had the highest H-index (14). Key authors include Kim Seung Up (23 papers) and Ahn Sang Hoon (H-index = 14). Early research focused on risk factors and staging, while recent studies emphasize DNA methylation, immune microenvironments, and tumor metastasis. Future research will focus on multi-omics data integration and AI-driven predictive model optimization.</p><p><strong>Conclusion: </strong>This study provides a comprehensive overview of liver cancer prediction research, highlighting key trends and the potential of multi-omics data and machine learning to enhance predictive models and clinical outcomes.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"139"},"PeriodicalIF":1.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333252","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":"Rising Incidence of Total and Early-Onset Colorectal Cancer: A Global Perspective on Burden, Risk Factors, and Projections to 2031.","authors":"Jia-Xin Nie, Qin Xie, Yan Yuan, Mei-Yuan Liu, Ji-Ke Du, Nan Li, Qing-Feng Zou","doi":"10.1007/s12029-025-01257-1","DOIUrl":"https://doi.org/10.1007/s12029-025-01257-1","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of colorectal cancer in those under 50 has significantly increased in recent decades. This study assesses the burden of colorectal cancer (CRC) and early-onset colorectal cancer (EO-CRC), along with associated risk factors, using data from the Global Burden of Disease (GBD) 2021, and projects incidence and mortality rates for 2031.</p><p><strong>Methods: </strong>Data on prevalence, incidence, mortality, disability-adjusted life years (DALYs), and risk factors were retrieved from the GBD 2021. The average annual percentage changes (AAPCs) were calculated using joinpoint regression analysis, and projections to 2031 were made with Autoregressive Integrated Moving Average (ARIMA) models.</p><p><strong>Results: </strong>The number of new CRC cases globally was 2,194,143, of which EO-CRC accounted for 211,890 cases. Both CRC (AAPC 0.20) and EO-CRC (AAPC 0.99) demonstrated global increases from 1990 to 2021, with EO-CRC showing a sharper rise. The most significant increases in EO-CRC incidence, mortality, and DALYs occurred in America. Projected EO-CRC incidence and mortality rates for 2031 are 6.70 and 2.57 per 100,000 individuals, respectively. Major risk factors for CRC and EO-CRC DALYs included diets low in milk and calcium, high red meat intake, and elevated BMI.</p><p><strong>Conclusions: </strong>This study highlights the growing EO-CRC burden, particularly in America, emphasizing the need for targeted interventions to address dietary and lifestyle risk factors. Projections indicate a continued rise in EO-CRC incidence and mortality by 2031, underscoring the urgency for public health action to mitigate this trend. The occurrence of colorectal cancer in those under 50 has significantly increased globally from 1990 to 2021, with notable regional variations. Our study assesses the current burden of CRC and EO-CRC using data from the Global Burden of Disease 2021, identifies associated risk factors, and projects incidence and mortality trends through 2031 using ARIMA models. These findings offer a precise measurement of the EO-CRC burden and underscore the necessity of identifying and addressing at-risk people to effectively mitigate this escalating health concern.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"138"},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317079","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":"Clinical Efficacy and Safety of Apatinib Combined with Irinotecan in HER2-negative Patients with Advanced Gastric or Gastroesophageal Junction Adenocarcinoma after First-Line Treatment Failure: A Single-Arm, Single-Center Retrospective Study.","authors":"Jiajia Huang, Jianjun Peng, Ertao Zhai, Ran Wei, Chen Qian, Jialin Li, Shirong Cai, Jinping Ma","doi":"10.1007/s12029-025-01259-z","DOIUrl":"10.1007/s12029-025-01259-z","url":null,"abstract":"<p><strong>Background: </strong>In this study, the clinical efficacy and safety of apatinib combined with irinotecan in HER2-negative patients with first-line treatment failure for advanced gastric adenocarcinoma and gastroesophageal junction (GEJ) adenocarcinoma were evaluated.</p><p><strong>Methods: </strong>We performed a single-arm, retrospective study at one tertiary hospital in Guangzhou, China. Eligible patients aged 28-77 years with histologically confirmed HER2-negative advanced gastric cancer who had previously received first-line treatment were included. The patients received irinotecan (180 mg/m² intravenously once every 3 weeks) plus oral apatinib (500 mg once daily on days 1-21 of each 3-week cycle), until disease progression, unacceptable toxicity, or death. The primary endpoints were progression-free survival (PFS) and overall survival (OS), which were calculated via the Kaplan‒Meier method.</p><p><strong>Results: </strong>Between Feb 21, 2019, and Aug 14, 2023, 79 patients met the inclusion criteria. The median PFS was 3.20 months (95% CI, 1.57‒4.83), and the median OS was 7.60 months (95% CI, 5.11‒10.10). According to RECIST version 1.1, 15 patients (18.99%) achieved an objective response, and 31 patients (39.24%) achieved disease control. In terms of the safety profile, 72.2% of patients experienced treatment-emergent adverse events of any grade, among whom, 59.5% of patients experienced grade 1-2 adverse events and 12.7% of patients experienced grade 3-4 adverse events.</p><p><strong>Conclusion: </strong>Apatinib combined with irinotecan demonstrates modest efficacy with manageable safety profiles in HER2-negative patients with advanced gastric or GEJ adenocarcinoma for whom first-line treatment has failed. Further prospective studies are warranted.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"137"},"PeriodicalIF":1.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309992","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":"Prognostic Impact of Thoracic Extra-regional Lymph Node Metastasis Defined By the 12th Japanese Classification Following Definitive Radiotherapy for Esophageal Squamous Cell Carcinoma.","authors":"Masahiro Inada, Kiyoshi Nakamatsu, Junki Fukuda, Naoko Ishida, Saori Tatsuno, Takuya Uehara, Hiroshi Doi, Makoto Hosono, Yukinori Matsuo","doi":"10.1007/s12029-025-01258-0","DOIUrl":"https://doi.org/10.1007/s12029-025-01258-0","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the prognostic impact of thoracic extra-regional lymph node metastasis (M1b-LYM, determined by the 12th edition of the Japanese Classification of Esophageal Cancer) in definitive radiotherapy for esophageal squamous cell carcinoma.</p><p><strong>Methods: </strong>Eighty-six consecutive patients who underwent definitive radiotherapy for esophageal squamous cell carcinoma between 2017 and 2022 at our institute were included in this retrospective study. Progression-free survival (PFS), overall survival (OS), distant metastasis (DM), and loco-regional recurrence (LR) were compared between patients with and without M1b-LYM using Kaplan-Meier or cumulative incidence function analysis.</p><p><strong>Results: </strong>Among the 86 patients, 15 had M1b-LYM metastasis (the M1b( +) group) and 71 had no M1b-LYM metastasis (the M1b(-) group). The median follow-up period was 38 months. The 2-year PFS, OS, cumulative incidence of DM, and cumulative incidence of LR for the M1b(-) group versus M1b( +) group were 41% vs 20% (p = 0.129), 58% vs 47% (p = 0.172), 31% vs 33% (p = 0.906), and 31% vs 60% (p = 0.0369), respectively. Multivariate analysis showed that M1b( +) was associated with higher LR (p = 0.0350), T stage was associated with poorer PFS (p = 0.0138), and omitting chemotherapy was associated with poorer PFS (p = 0.0160) and OS (p < 0.01).</p><p><strong>Conclusion: </strong>The presence of thoracic extra-regional lymph node metastasis was associated with poor loco-regional control but not distant metastasis or survival in esophageal squamous cell carcinoma patients after definitive radiotherapy.</p><p><strong>Trial registration number: </strong>This study was retrospectively registered on 21 June 2024 (R06-053).</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"136"},"PeriodicalIF":1.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293838","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":"Response Prediction to Neoadjuvant Chemoradiotherapy in Rectal Cancer Based on Systemic Inflammatory Markers (NLR, PLR, and LMR).","authors":"Roger Beltrati Coser, Caio Sergio R Nahas, Alex Jones Flores Cassenote, Omar S T Ghani, Rafaela B B Pinheiro, Sergio Carlos Nahas, Carlos Frederico S Marques","doi":"10.1007/s12029-025-01255-3","DOIUrl":"https://doi.org/10.1007/s12029-025-01255-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate whether systemic inflammatory markers-neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)-can predict tumor response to neoadjuvant chemoradiotherapy (nCRT) in patients with rectal cancer.</p><p><strong>Methods: </strong>A retrospective, single-center study included 396 patients with biopsy-proven rectal cancer (clinical stage T2-4NxM0 or any T N + M0) treated with curative intent. All patients underwent standardized nCRT, followed by either radical surgery with total mesorectal excision (TME) or non-operative management in cases of sustained complete clinical response (cCR). Pre-treatment NLR, PLR, and LMR were calculated from baseline blood counts. Tumor response was categorized using tumor regression grade (TRG): TRG 0 (complete response), TRG 1 (almost complete), TRG 2 (partial), and TRG 3 (no response).</p><p><strong>Results: </strong>Incomplete responders (TRG 1-3) had higher NLR (p < 0.001), PLR (p = 0.002), and carcinoembryonic antigen (CEA, p < 0.001), and were more frequently male (p = 0.021). Complete responders (TRG 0) were more associated with higher LMR (p < 0.001), elevated hemoglobin levels (p = 0.049), more comorbidities (p = 0.001), and greater use of antihypertensives (p = 0.012) and antiplatelet/anticoagulant drugs (p = 0.045). Risk estimates of incomplete response were as follows: NLR > 2.08 (RR 2.30, 95% CI 1.60-3.31), PLR > 129.36 (RR 1.79, 95% CI 1.25-2.05), and LMR > 2.67 (RR 0.42, 95% CI 0.26-0.66).</p><p><strong>Conclusion: </strong>Pre-treatment NLR, PLR, and LMR are predictors of response to nCRT in patients with rectal cancer. An NLR > 2.08 is an independent predictor of incomplete response to nCRT. These findings contribute a cost-effective and readily available tool to the rectal cancer management arsenal.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"134"},"PeriodicalIF":1.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275085","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":"Radiofrequency Ablation Technology in Liver Malignancies: A Systematic Review of Economic Evaluations.","authors":"Amirreza Taherkhani, Hoornaz Molana, Mahsa Taremi, Ghader Mohammadnezhad","doi":"10.1007/s12029-025-01256-2","DOIUrl":"10.1007/s12029-025-01256-2","url":null,"abstract":"<p><strong>Background: </strong>Liver malignancies, including hepatocellular carcinoma (HCC), present significant treatment challenges, with limited curative options available. Radiofrequency ablation (RFA) has emerged as a minimally invasive therapeutic approach for early-stage HCC, offering comparable survival benefits to surgical resections in some patients. However, the economic implications of RFA relative to other treatment modalities remain a critical factor in decision-making. This study systematically reviews economic evaluations of RFA to assess its viability in managing liver malignancies.</p><p><strong>Methods: </strong>A systematic review was conducted following the PRISMA guidelines. Databases, including PubMed, Scopus, Web of Science, and Google Scholar, were searched for economic evaluations of RFA published from 2015 onwards. Eligible studies compared RFA with other curative and palliative treatments, focusing on health-related economic outcomes. The primary outcome of the included studies was the incremental cost-effectiveness ratio (ICER).</p><p><strong>Results: </strong>Ten studies met the inclusion criteria, covering diverse healthcare systems and cost-effectiveness models. The results indicated that RFA is generally more cost-effective than percutaneous ethanol injection [incremental cost: $ - 917, incremental effectiveness: 0.34, ICER: $ - 2675] and laparoscopic hepatectomy [incremental costs: ¥ - 4702, incremental effectiveness: 0] but less cost-effective than microwave ablation [ICER: dominated], liver resection, and transplantation [ICER: between $23,916 and $113,530/QALY] at higher willingness-to-pay thresholds. Comparisons with stereotactic body radiotherapy and surgery yielded mixed results.</p><p><strong>Conclusions: </strong>RFA is a cost-effective treatment for small HCC tumors, particularly in resource-limited settings. However, its cost-effectiveness declines with increasing tumor size compared to liver transplantation. Further real-world economic evaluations and modeling studies are needed to confirm its affordability across different healthcare settings.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"56 1","pages":"135"},"PeriodicalIF":1.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275084","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}