Journal of Gastrointestinal Cancer最新文献

{"title":"Long-Term Association Between GLP-1 Receptor Agonist Use and Incident Pancreatic Cancer: A Propensity Score-Matched Retrospective Cohort Study Using the TriNetX Network.","authors":"Muhammad Ali Ibrahim Kazi, Junaid Khan, Syed Musa Mufarrih, Maham Siddiqui, Huzaifa Ul Haque Ansari, Muhammad Ahmed, Imran Qureshi, Abdulhameed Al-Sabban, Nihaal Prashant Karnik, Andrew Gilman, Sanmeet Singh, Andrew Canakis","doi":"10.1007/s12029-026-01523-w","DOIUrl":"10.1007/s12029-026-01523-w","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for type 2 diabetes mellitus (T2DM) and obesity. Whether GLP-1 RA use is associated with altered long-term pancreatic cancer risk remains uncertain, with conflicting evidence from prior observational studies. We aimed to evaluate the association between initiation of GLP-1 RA therapy and incident pancreatic cancer risk compared with six classes of antidiabetic agents.</p><p><strong>Methods: </strong>We conducted a retrospective, new-user cohort study using the TriNetX global federated electronic health record network. Adults with T2DM initiating GLP-1RA therapy were compared with incident users of insulin, metformin, dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, sulfonylureas, and thiazolidinediones in six separate propensity score-matched analyses (1:1, greedy nearest-neighbor algorithm, caliper 0.1 pooled standard deviations). Matching was performed on 39 baseline covariates,, including demographics, comorbidities, procedures, and medication exposures. The primary outcome was incident pancreatic cancer (ICD-10-CM C25) occurring between 365 and 7,300 days after the index prescription. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression.</p><p><strong>Results: </strong>After propensity score matching, GLP-1 RA users compared with insulin users had a lower hazard of pancreatic cancer (HR 0.43, 95% CI 0.35, 0.53; absolute risk: GLP-1 RA 0.15% vs. insulin 0.11%; absolute risk difference [ARD] 0.04% points). In contrast, users of metformin (HR 1.39, 95% CI 1.16, 1.66; ARD 0.04% points), sulfonylureas (HR 1.37, 95% CI 1.13, 1.65; ARD 0.07% points), thiazolidinediones (HR 1.30, 95% CI 1.001, 1.678; ARD 0.15% points) and DPP-4i (HR 1.31; 95% CI 1.06, 1.61; ARD 0.08% points) had significantly higher hazards of pancreatic cancer compared with GLP-1 RA users. No significant difference was observed between GLP-1 RA users and users of SGLT2 inhibitors (HR 1.08, 95% CI 0.87, 1.34).</p><p><strong>Conclusions: </strong>In this large, real-world, propensity score-matched analysis, the direction and magnitude of the association between GLP-1 RA use and pancreatic cancer risk varied by comparator agent. GLP-1 RA use was associated with a lower hazard of pancreatic cancer relative to metformin, sulfonylureas, thiazolidinediones, and DPP-4i while no significant difference relative to SGLT2i, and a higher hazard relative to insulin.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977030","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":"Postoperative ctDNA-Guided Adjuvant Therapy in Resected Colorectal Cancer: A Systematic Review and Meta-analysis of Prognostic Validity Versus Treatment-Decision Utility.","authors":"Zheng Han, Yan Zhang, Qingjie Tian, Hongcheng Zhu, Hongwei Wang, Changzai Li","doi":"10.1007/s12029-026-01578-9","DOIUrl":"10.1007/s12029-026-01578-9","url":null,"abstract":"<p><p>Postoperative circulating tumor DNA (ctDNA) is a strong marker of molecular residual disease after curative-intent colorectal cancer resection, but prognostic validity alone does not establish treatment-decision utility. We performed a PRISMA 2020 systematic review and meta-analysis with search coverage through March 31, 2026, separating randomized ctDNA-guided treatment-decision evidence from prospective prognostic cohorts, platform-trial evidence, implementation evidence, and ongoing trials. Thirty-eight reports or programs were included in the evidence map, and seven independent prospective cohorts contributed to the prognostic meta-analysis. Postoperative ctDNA positivity was associated with increased recurrence risk (pooled hazard ratio, 7.60; 95% CI, 4.70-12.31), with substantial heterogeneity (I²=80.6%) and a wide prediction interval (1.60-36.25). Decision evidence was scenario-specific: DYNAMIC supports consideration of selective stage II colon cancer de-escalation, whereas DYNAMIC-III did not establish non-inferiority for routine stage III de-escalation. Current evidence does not support routine empiric escalation for MRD-positive disease. Postoperative ctDNA should therefore be interpreted as a powerful risk-stratification tool whose treatment-changing role remains limited to selected clinical contexts.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976989","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":"Radiomics-Driven Imaging Biomarkers for Predicting Chemoradiotherapy Response in Locally Advanced Rectal Cancer.","authors":"Jawad Ali Memon, Mohammad Sibtain Shah, Zubair Ali Memon, Uzma Malik","doi":"10.1007/s12029-026-01592-x","DOIUrl":"10.1007/s12029-026-01592-x","url":null,"abstract":"<p><strong>Purpose: </strong>Pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC) predicts excellent prognosis, yet conventional morphological MRI achieves only 52-71% sensitivity. Radiomics models show promising discrimination, but performance variation across platforms limits clinical translation.</p><p><strong>Methods: </strong>This prospective cohort study enrolled 615 LARC patients (cT3-T4 or cN+) across four centers. Centers 1-3 contributed the development cohort (n = 405); Center 4 was the sole external validation site, contributing mutually exclusive 1.5T (n = 98; 19 pCR, 19.4%) and 3T (n = 112; 24 pCR, 21.4%) cohorts. Baseline MRI yielded 107 radiomics features (42 retained). Clinical-only, radiomics-only and combined models predicting pCR (ypT0N0) were fitted by LASSO logistic regression in Python, with ComBat harmonization estimated on development data only, DeLong testing, calibration assessment and decision curve analysis.</p><p><strong>Results: </strong>Development pCR prevalence was 20.0% (81/405). The combined model achieved AUC 0.887 (95% CI 0.846-0.928; sensitivity 87.7% [71/81], specificity 84.6% [274/324]) versus radiomics-only 0.842 and clinical-only 0.723 (DeLong p < 0.001). External validation gave AUC 0.821 at 1.5T and 0.908 at 3T. ComBat improved 1.5T discrimination (ΔAUC + 0.060, p = 0.041) but did not abolish the field-strength gradient. Calibration slopes were 0.91-0.96. At a 15% threshold probability the combined model showed the highest net benefit (0.135). pCR predicted 3-year disease-free survival 98.8% versus 66.0% (p < 0.001).</p><p><strong>Conclusions: </strong>Combined radiomics-clinical models discriminate pCR across MRI platforms. Because external validation was confined to one center and no management decision followed model output, these findings are hypothesis-generating and require prospective interventional verification.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982593","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":"Induction FLOT Chemotherapy Prior to Neoadjuvant Chemoradiotherapy in the Treatment of Lower Esophageal and Proximal Gastric Adenocarcinoma: A Phase II, Single-Arm Clinical Trial.","authors":"Seyed Amir Aledavood, Zohreh Pishevar, Kazem Anvari, Ehsan Soltani, Ali Emadi Torghabe, Seyed Alireza Javadinia, Soudeh Arastouei, Sare Hosseini","doi":"10.1007/s12029-026-01589-6","DOIUrl":"10.1007/s12029-026-01589-6","url":null,"abstract":"<p><strong>Goal: </strong>Selecting the most effective treatment strategy for patients with distal esophageal and proximal gastric adenocarcinoma remains a clinical challenge. Although existing evidence supports the use of adjuvant therapies, the optimal sequencing of these treatments is still debated. Given that distant metastasis is the most common cause of death in this patient population, early initiation of systemic therapy may theoretically improve survival. This study aimed to evaluate the effectiveness of using the FLOT chemotherapy regimen as induction therapy before neoadjuvant chemoradiotherapy in treating distal esophageal and proximal gastric cancer.</p><p><strong>Methods: </strong>In this single-arm, phase II clinical trial, patients with resectable, locally advanced adenocarcinoma of the distal esophagus and proximal stomach (T1-T4b, N0-N3, M0) who presented at two teaching hospitals affiliated with Mashhad University of Medical Sciences (Imam Reza and Omid Hospitals, Mashhad, Iran) were screened for eligibility. Eligible patients received two cycles of induction FLOT chemotherapy. This was followed by neoadjuvant chemoradiotherapy consisting of weekly paclitaxel and carboplatin, with a total radiotherapy dose of 45-50.4 Gy delivered in 1.8-2 Gy/fraction. Surgery was performed 4-6 weeks after completion of chemoradiotherapy. The primary endpoint was pathological tumor response.</p><p><strong>Results: </strong>Among the 57 enrolled patients, 40 (70.2%) underwent surgical resection and pathological evaluation (mean age: 56.5 ± 8.9 years, range: 24-64). Based on abdominal CT and/or endoscopic ultrasound (EUS), most tumors were staged as T3 (23 patients, 40.4%) and N1 (26 patients, 45.6%). Induction FLOT was administered to all patients, with 51 patients (89.5%) completing both cycles. Additionally, the majority received more than four weekly cycles of concurrent chemoradiotherapy (42 patients, 73.6%). Pathological examination of surgical specimens revealed a complete pathological response (pCR) in 11 patients (27.5%), partial response in 10 (25%), minimal response in 12 (30%), and poor response in 7 (17.5%). The neoadjuvant regimen was generally well tolerated, with most patients experiencing either no side effects or only Grade 1 hematologic or gastrointestinal toxicity.</p><p><strong>Conclusion: </strong>Induction FLOT chemotherapy followed by neoadjuvant chemoradiotherapy appears to be a safe and well-tolerated treatment strategy for patients with distal esophageal and proximal gastric adenocarcinoma, yielding complete pathological response in approximately one-third of surgically treated and pathologically evaluable patients.</p><p><strong>Trial registration: </strong>IRCT20210706051800N1 on 20,220,919.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977028","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":"Association of Cachexia-Related Status With Treatment Outcomes in Advanced Gastric Cancer Receiving First-Line Therapy With or Without Nivolumab.","authors":"Hironori Fujii, Daichi Watanabe, Yunami Yamada, Itaru Yasufuku, Wakana Chikaishi, Akitaka Makiyama, Atsuko Hayakawa, Mika Kitahora, Atsuko Tomida, Hirotoshi Iihara, Ryo Kobayashi, Nobuhisa Matsuhashi, Akio Suzuki","doi":"10.1007/s12029-026-01591-y","DOIUrl":"10.1007/s12029-026-01591-y","url":null,"abstract":"<p><strong>Purpose: </strong>The clinical significance of longitudinal cachexia-related status during first-line therapy for advanced gastric cancer remains unclear in the era of nivolumab-containing chemotherapy. We evaluated its association with outcomes according to nivolumab use.</p><p><strong>Methods: </strong>We retrospectively analyzed 121 patients with HER2-negative unresectable advanced or recurrent gastric cancer who received first-line oxaliplatin- plus fluoropyrimidine-based chemotherapy between 2017 and 2024. Modified Glasgow Prognostic Score (mGPS) 2 status and modified European Palliative Care Research Collaborative (EPCRC)-defined cachexia status were assessed as time-dependent covariates. Progression-free survival (PFS) and overall survival (OS) were analyzed using time-dependent Cox proportional hazards models.</p><p><strong>Results: </strong>The cohort included 69 patients in the non-nivolumab group and 52 in the nivolumab-containing group. Median age was 71 years, 76 patients (63%) were male, and baseline mGPS 2 was present in 37 patients (31%). The cumulative proportion of patients who met the mGPS 2 criterion by 6 months was 55% in the non-nivolumab group and 57% in the nivolumab-containing group. Time-dependent mGPS 2 status was not significantly associated with PFS (hazard ratio [HR], 1.49; 95% confidence interval [CI], 0.69-3.20; P = 0.30), but was associated with shorter OS (HR, 2.17; 95% CI, 1.15-4.10; P = 0.017). No statistically significant interaction between time-dependent mGPS 2 status and nivolumab use was observed for PFS or OS. Time-dependent modified EPCRC-defined cachexia status was not significantly associated with PFS or OS.</p><p><strong>Conclusions: </strong>Time-dependent mGPS 2 status during first-line therapy was associated with shorter OS, but not PFS.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944932","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":"Trastuzumab Deruxtecan (T-DXd) in HER2-Positive Advanced Gastric and Gastroesophageal Junction Cancer: Evidence, Sequencing, Patient Selection, and Clinical Decision-Making.","authors":"Tamotsu Sagawa, Masahiro Hirakawa, Hiroyuki Nagashima, Koshi Fujikawa","doi":"10.1007/s12029-026-01590-z","DOIUrl":"10.1007/s12029-026-01590-z","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a clinically oriented review of trastuzumab deruxtecan (T-DXd) in HER2-positive advanced gastric or gastroesophageal junction adenocarcinoma, focusing on evidence, post-progression HER2 reassessment, second-line sequencing, patient selection, regional implementation, and toxicity management.</p><p><strong>Methods: </strong>This narrative review integrates pivotal DESTINY-Gastric trials, HER2 reassessment studies, realworld cohorts, safety analyses, pathology guidance, and regulatory documents available through August 2026.</p><p><strong>Results: </strong>DESTINY-Gastric04 established T-DXd as a preferred second-line treatment after progression on trastuzumab-containing therapy, improving median overall survival versus ramucirumab plus paclitaxel (14.7 vs 11.4 months; hazard ratio 0.70). HER2 expression is heterogeneous and dynamic; postprogression reassessment is therefore recommended whenever feasible using biopsy-specific scoring criteria. The 494 of 1,088 patients randomized in DESTINY-Gastric04 should not be interpreted as a 55% HER2-loss rate because screening attrition was multifactorial. T-DXd is preferred when HER2 positivity is retained, whereas ramucirumab plus paclitaxel remains appropriate when HER2 loss is documented. When HER2 status is unconfirmed, treatment should be individualized, recognizing regional regulatory differences. Older patients require careful toxicity assessment, particularly for interstitial lung disease (ILD)/pneumonitis. Grade 2 or higher ILD requires permanent discontinuation; grade 1 reinitiation must follow the applicable regional label.</p><p><strong>Conclusion: </strong>T-DXd is a preferred second-line option for post-progression HER2-positive advanced gastric or gastroesophageal junction cancer, but optimal use requires careful HER2 reassessment and regionappropriate safety management. Evidence after T-DXd failure, ctDNA-guided selection, and sequential CLDN18.2-directed therapy remains limited and requires prospective validation.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929702","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":"Predictors of Hepatic Decompensation Post-Y90 Treatment in Hepatocellular Carcinoma: New Insights into Segmental TARE and Post-Treatment Dosimetry.","authors":"Ali Afrasiabi, Bahareh Gholami, Andrew M Moon, Alex Villalobos, Johannes L Du Pisanie, Bryan Harris, Hyeon Yu, David Mauro, Paolo Varela, Michael Mohnasky, Sandra Gad, Nima Kokabi","doi":"10.1007/s12029-026-01542-7","DOIUrl":"10.1007/s12029-026-01542-7","url":null,"abstract":"<p><strong>Background: </strong>Transarterial radioembolization (TARE) with yttrium-90 (Y-90) microspheres is an established treatment for unresectable hepatocellular carcinoma (HCC). Although segmental TARE offers a favorable safety profile, hepatic decompensation remains a clinically important complication. This study aimed to identify clinical, laboratory, and post-treatment dosimetric predictors of hepatic decompensation following segmental Y-90 TARE.</p><p><strong>Methods: </strong>In this retrospective cohort study, 102 patients with HCC who underwent segmental Y-90 TARE between 2015 and 2025 were analyzed. Baseline demographic, clinical, laboratory, and imaging data were collected. Hepatic decompensation was defined as new-onset ascites, new or worsening hepatic encephalopathy, or total bilirubin > 3× the upper limit of normal within 2-4 months after TARE, in the absence of radiographic tumor progression. Post-treatment dosimetry was performed using SPECT/CT images. Univariate and multivariable logistic regression models were used to identify predictors of hepatic decompensation.</p><p><strong>Results: </strong>Hepatic decompensation occurred in 14 patients (13.7%). On univariate analysis, decompensation was associated with baseline hypoalbuminemia (< 3.5 g/dL), higher MELD and ALBI scores, Child-Pugh class B/C, INR ≥ 1.2, lower white blood cell count, and higher alkaline phosphatase levels. Because target doses and normal-parenchyma tolerances differ between microsphere types, post-treatment dosimetry and volumetry were analyzed separately by platform. In the glass microsphere cohort, patients who developed decompensation received a lower mean absorbed dose to the treated segment (236 Gy vs. 411 Gy, p = 0.03), whereas no significant dosimetric or volumetric differences were observed in the resin microsphere cohort. In multivariable analysis, baseline hypoalbuminemia (< 3.5 g/dL) was the only independent predictor of hepatic decompensation (OR = 7.98, 95% CI 1.16-80.39, p = 0.04).</p><p><strong>Conclusion: </strong>In this retrospective cohort, hepatic decompensation following segmental Y-90 TARE appeared more strongly associated with impaired baseline hepatic reserve than with the post-treatment dosimetry parameters evaluated. Baseline hypoalbuminemia is a strong independent predictor of early hepatic decompensation and should be carefully considered during patient selection for radioembolization.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929710","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":"Geographic and Ethnic Variation in Early-onset Colorectal Cancer: A Contemporary Scoping Review of Epidemiologic, Molecular, and Survival Patterns.","authors":"Adhari ALZaabi, Mohammed ALHabsi, Ali ALHabsi, Almaqdad ALAmri","doi":"10.1007/s12029-026-01558-z","DOIUrl":"10.1007/s12029-026-01558-z","url":null,"abstract":"<p><strong>Background: </strong>Early-onset colorectal cancer (EOCRC), defined as diagnosis at ≤ 50 years, has shown rising incidence globally. However, geographic variation, molecular characteristics, and survival patterns remain heterogeneously reported. We conducted a scoping review to map contemporary evidence on epidemiologic, molecular, and survival differences in EOCRC across regions.</p><p><strong>Methods: </strong>A scoping review was performed in accordance with PRISMA-ScR and Joanna Briggs Institute methodology. PubMed and Scopus were searched for studies published between January 2019 and March 2024. Eligible observational studies reported epidemiologic, molecular, or survival outcomes in EOCRC and included geographic or racial/ethnic stratification. Data were synthesized descriptively due to methodological heterogeneity.</p><p><strong>Results: </strong>Forty-six studies from 22 countries were included with evidence concentrated in Asia (n = 13) and North America (n = 13); Africa, Latin America, and South/Southeast Asia were markedly underrepresented. Across studies, EOCRC was more frequently associated with MSI/dMMR tumors (6.0-33.3%) and lower BRAF V600E prevalence than late-onset colorectal cancer (LOCRC) (typically 2.0-10.0%). Limited sequencing-based studies reported relative enrichment of CMS1 and CTNNB1 alterations in selected younger cohorts. Survival differences between EOCRC and LOCRC were heterogeneous across study populations, clinical settings, and reported endpoints. Some metastatic registry cohorts reported longer median overall survival among EOCRC patients, whereas advanced-stage disease was associated with poorer outcomes. Some studies also reported poorer outcomes among very-young EOCRC subgroups, although evidence for this association was limited and heterogeneous. Across studies reporting stage-specific outcomes, survival was consistently poorer with advanced-stage disease.</p><p><strong>Conclusions: </strong>Contemporary evidence suggests that EOCRC differs from LOCRC in several reported molecular characteristics, whereas survival patterns remain heterogeneous and appear to be influenced primarily by stage at presentation. Geographic inequities in data availability and variability in molecular and survival reporting limit global generalizability. Standardized population-based studies from underrepresented regions are needed to clarify the relative contributions of tumor biology, stage distribution, and healthcare access to observed outcome differences.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919859","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":"Correction: Gastric Cancer Incidence in Iran: Trends and Projections to 2030 Based on Global Burden of Disease 2021 Estimates.","authors":"Fatemeh Shahbazi, Faezeh Heidari, Ali Khezriyan, Erfan Ayubi, Salman Khazaei, Ali Shojaeian","doi":"10.1007/s12029-026-01574-z","DOIUrl":"https://doi.org/10.1007/s12029-026-01574-z","url":null,"abstract":"","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912068","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":"Evidence Gap in Managing Lateral Pelvic Lymph Nodes in Rectal Cancer: a Systematic Review of Radiation Boost Strategies.","authors":"Sedat Alp Pinar, Tin-Ning Wong, Timothy Mitchell, Chia Yew Kong","doi":"10.1007/s12029-026-01580-1","DOIUrl":"10.1007/s12029-026-01580-1","url":null,"abstract":"<p><strong>Purpose: </strong>Lateral pelvic lymph node (LPLN) involvement is a significant predictor of local recurrence in patients with locally advanced rectal cancer (LARC). While lateral pelvic lymph node dissection (LPLND) is routinely used in some countries to manage suspicious nodes, it is associated with increased morbidity and is not widely adopted in Western practice. Radiation boost (dose escalation) to involved LPLNs during neoadjuvant chemoradiotherapy (nCRT) has emerged as a potential non-surgical alternative. Despite increasing adoption of radiation boost to clinically involved LPLNs, there remains limited evidence defining its safety, oncologic benefit, and role relative to LPLND.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, EMBASE, ClinicalTrials.gov, and Cochrane databases was conducted following PRISMA guidelines. Studies were included if they reported outcomes of radiation dose escalation specifically targeting radiologically suspicious LPLNs in the context of nCRT.</p><p><strong>Results: </strong>Ten retrospective cohort studies encompassing 482 radiation boosted patients were included. Boost doses ranged from 35.0 to 60.2 Gy. Rates of Grade 2-3 toxicity ranged from 28.0% to 39.3% across individual studies, with only one study reporting a single Grade 4 adverse event. Across individual studies, reported nodal response rates ranged from 62.3% to 100%. Comparative studies suggest that radiation boost may improve local control and reduce LPLN recurrence.</p><p><strong>Conclusion: </strong>Current retrospective evidence suggests that radiation dose escalation to involved LPLNs is a promising treatment strategy; however, the available data are limited by retrospective study designs and substantial clinical heterogeneity. Given the absence of prospective evidence and lack of consensus in current guidelines, an important evidence gap remains. Well-designed prospective trials are warranted to define the role of LPLN boost relative to LPLND.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13550032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905913","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}