Journal of Gastrointestinal Cancer最新文献

{"title":"The Impact of Early Versus Delayed Chemotherapy on Survival in Patients with Colorectal Cancer after Surgery: A Systematic Review and Meta-Analysis.","authors":"Chaoyang Wang, KeJia Liu, YaGuang Han, ShuXin Xue","doi":"10.1007/s12029-026-01555-2","DOIUrl":"10.1007/s12029-026-01555-2","url":null,"abstract":"<p><strong>Objective: </strong>This study systematically evaluates the impact of the initiation time of postoperative chemotherapy on overall survival (OS) in patients with colorectal cancer, providing evidence to guide clinical decisions on chemotherapy timing.</p><p><strong>Methods: </strong>Following PRISMA and MOOSE guidelines, PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched up to February 2025. Cohort studies comparing early versus delayed postoperative chemotherapy were included. Two researchers independently performed literature screening, data extraction, and quality assessment. Review Manager 5.3 was used, with hazard ratios (HRs) and 95% confidence intervals (CIs) as effect measures. Random- or fixed-effects models were applied based on heterogeneity, and subgroup and sensitivity analyses were conducted.</p><p><strong>Results: </strong>Eleven studies involving 72,873 patients were included. Pooled results showed that delayed chemotherapy significantly increased the risk of death (HR = 1.32, 95% CI: 1.20-1.45, P < 0.00001). Heterogeneity was high (I² = 88%), and sensitivity analyses confirmed the robustness of the findings. Subgroup analysis, using an 8-week cutoff, revealed that patients who initiated chemotherapy within ≤ 8 weeks had significantly better survival than those who started > 8 weeks (HR = 1.47, 95% CI: 1.14-1.91, P = 0.003).</p><p><strong>Conclusion: </strong>Delayed postoperative chemotherapy markedly increases mortality risk. Initiating adjuvant chemotherapy within 8 weeks after surgery is recommended to achieve optimal survival benefits.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648565","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":"Four-Year Survival Outcomes of Personalized Total Neoadjuvant Therapy Versus Chemotherapy During the 'Wait Period' Versus Standard Chemoradiotherapy for Locally Advanced Rectal Cancer.","authors":"Sergei Bedrikovetski, Zachary Bunjo, Ishraq Murshed, James W Moore, Tarik Sammour","doi":"10.1007/s12029-026-01551-6","DOIUrl":"10.1007/s12029-026-01551-6","url":null,"abstract":"<p><strong>Purpose: </strong>Total Neoadjuvant Therapy (TNT) is increasingly replacing standard chemoradiotherapy (sCRT) for the treatment of locally advanced rectal cancer (LARC). Data on the use of personalized TNT (pTNT) regimens tailored to patient disease characteristics remain scarce. Accordingly, this study aimed to assess long-term outcomes of pTNT in patients with LARC.</p><p><strong>Methods: </strong>This was a secondary analysis of a multicentre retrospective cohort study. Patients treated with pTNT between 2019 and 2022 were compared to a historical cohort from the WAIT trial (2012-2014), which included extended chemotherapy during the interval period (xCRT) or sCRT followed by adjuvant chemotherapy. The main outcomes were 4-year disease-free survival (DFS) and overall survival (OS).</p><p><strong>Results: </strong>Forty patients treated with pTNT were matched with 49 patients from the WAIT trial (25 xCRT, 24 sCRT). All WAIT trial patients underwent surgery, whereas 27 (67.5%) pTNT patients underwent surgery and 13 (32.5%) were managed non-operatively. Median follow-up was 48 months. No significant differences were observed in 4-year DFS (pTNT 70% vs. xCRT 68% vs. sCRT 75%, P = 0.764) or OS (pTNT 82.5% vs. xCRT 80% vs. sCRT 83.3%, P = 0.907). Within the pTNT group, patients with an oCR had significantly higher OS compared to those without oCR (95.2% vs. 68.4%, P = 0.021).</p><p><strong>Conclusion: </strong>Our findings suggest that pTNT achieves comparable survival outcomes to xCRT and sCRT in patients with LARC, despite higher rates of non-operative management. These findings should be interpreted cautiously given the exploratory nature of the analysis and limited sample size. Larger studies with longer follow-up are required to validate these early data.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620353","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":"Factors Associated with Improved Survival for Stage I and II Pancreatic Adenocarcinoma Utilizing the National Cancer Database.","authors":"Christiana Youssef, Courtney Day, Aaron Spaulding, Alfredo Verastegui Davila, Mary Tice, Cornelius Thiels, Zhi Ven Fong, John A Stauffer, Katherine E Poruk","doi":"10.1007/s12029-026-01545-4","DOIUrl":"10.1007/s12029-026-01545-4","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer related death in the United States. While Stage I and II PDAC represent the most treatable and potentially curative stages, most patients do not survive past 5 years of treatment. We sought to understand factors associated with long term survival in early-stage PDAC to improve outcomes and reduce disparities.</p><p><strong>Methods: </strong>The National Cancer Database (NCDB) was queried for Stage I and II PDAC patients treated between 2012 and 2021. Patients were only included if they had a documented survival information. Comparisons between patients alive or deceased at 1, 3 and 5 years were evaluated using Wilcoxon, Chi-square, and Cochran-Armitage trend tests where appropriate. A multivariable Cox proportional hazards model (MVA) was used to evaluate factors associated with overall survival (OS).</p><p><strong>Results: </strong>We analyzed 43,398 patients with Stage I (n = 21,938) and Stage II (n = 21,460) PDAC. One-, three-, and five-year survival rates were 75.2%, 30.3%, and 12.8% for Stage I, and 68.6%, 23.4%, and 10.5% for Stage II, respectively. Across both stages, improved survival was significantly associated with younger age, lower Charlson-Deyo comorbidity score, Asian race, private insurance, higher income and education levels, and tumor location in the pancreatic body or tail (all p < 0.0001). Higher tumor grade, Black race, Medicaid or uninsured status, and treatment at community-level facilities were associated with significantly worse outcomes. Multivariable analysis confirmed these variables as independent predictors of one-, three-, and five-year survival. Despite early-stage diagnosis, marked disparities in long-term survival persisted based on race, insurance, and socioeconomic status.</p><p><strong>Conclusion: </strong>Long-term survival for Stage I and II PDAC remains limited, despite diagnosis at an early and potentially curative stage. This highlights the need to not only focus on screening mechanisms for early diagnosis, but to address disparities and expand access to high-quality care that limit long term survival in this cohort. These results support ongoing investment in early detection, equitable treatment delivery, and research into tailored therapeutic strategies.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620280","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":"Oligoprogression in Advanced Gastric and Gastroesophageal Junction Cancer: Integrating Local Therapy, Systemic Treatment Continuation, and Biomarker Reassessment.","authors":"Tamotsu Sagawa, Masahiro Hirakawa, Hiroyuki Nagashima, Koshi Fujikawa","doi":"10.1007/s12029-026-01549-0","DOIUrl":"10.1007/s12029-026-01549-0","url":null,"abstract":"<p><strong>Purpose: </strong>To critically evaluate oligoprogression in advanced gastric and gastroesophageal junction (GEJ) cancer and propose a practical multidisciplinary framework integrating local therapy, systemic treatment decisions, and biomarker reassessment.</p><p><strong>Methods: </strong>We reviewed direct gastric/GEJ evidence and clearly distinguished it from evidence extrapolated from oligometastatic disease and other tumor types.</p><p><strong>Results: </strong>No prospective comparative study has demonstrated that local treatment with continuation of systemic therapy improves survival specifically in gastric/GEJ oligoprogression. In carefully selected patients, local treatment may be considered to delay the next systemic therapy, prevent or relieve symptoms, maintain local control, or preserve quality of life. Tissue rebiopsy or circulating tumor DNA analysis may be useful when technically obtainable and likely to change management. HER2 reassessment has established clinical relevance after HER2-directed treatment, whereas repeat assessment of CLDN18.2, PD-L1, FGFR2b, and other emerging targets remains exploratory. A negative plasma circulating tumor DNA result does not exclude resistant disease, particularly in low-volume, peritoneal, or central nervous system progression.</p><p><strong>Conclusion: </strong>Management should remain individualized and multidisciplinary, with explicit recognition that the proposed framework is provisional and that a survival benefit from local therapy with systemic treatment continuation remains unproven.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620274","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":"Effects of Malnutrition on In-Hospital and Discharge Outcomes Among Young Adults Hospitalized with Gastrointestinal Cancers: National Estimates from the United States.","authors":"Manas Pustake, Lakshmi Kattamuri, Shubhangi Deoker, Kunal Sharma, Abhizith Deoker","doi":"10.1007/s12029-026-01525-8","DOIUrl":"10.1007/s12029-026-01525-8","url":null,"abstract":"<p><strong>Purpose: </strong>Protein-energy malnutrition (PEM) is common in gastrointestinal (GI) cancers and may worsen inpatient outcomes. Contemporary national data describing the impact of PEM among young adults with GI malignancies are limited.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using HCUP NIS data from 2018 to 2021. We identified hospitalizations of adults aged 18 to 39 years with GI cancers using ICD 10 CM codes C15 to C26. We defined PEM using ICD-10-CM diagnosis codes recorded during the index hospitalization; therefore, PEM reflects clinically documented/coded malnutrition rather than the full burden of nutritional risk or clinically undiagnosed malnutrition. Primary outcomes were in hospital mortality and discharge disposition. Secondary outcomes were LOS and total hospital charges. We used survey weighted multivariable logistic and linear regression to estimate adjusted associations, accounting for age, sex, race or ethnicity, payer, income quartile, admission type, calendar year, and age adjusted CCI.</p><p><strong>Results: </strong>Among 58,910 weighted hospitalizations of young adults with gastrointestinal cancers, 11,915 (20.2%) had protein-energy malnutrition (PEM). Compared with those without PEM, hospitalizations with PEM had a higher burden of advanced disease and acute illness, including a greater prevalence of metastatic disease (71.8% vs. 53.1%), and experienced worse unadjusted outcomes, including higher in-hospital mortality (8.4% vs. 3.2%), longer length of stay (10.43 vs. 5.63 days), and higher total hospital charges ($133,790 vs. $83,702). In adjusted analyses, PEM was independently associated with increased odds of in-hospital mortality (aOR 2.13, 95% CI 1.72-2.56; p < 0.001) and higher odds of non-home discharge (aOR 1.67, 95% CI 1.47-1.89; p < 0.001). PEM was also associated with substantially greater resource utilization, including an adjusted increase of 4.49 hospital days (β + 4.492; SE 0.248; p < 0.001) and $53,513 higher total hospital charges (β +$53,512.6; SE $5,527.6; p < 0.001).</p><p><strong>Conclusion: </strong>PEM affected one in five hospitalizations among young adults with GI cancers and was independently associated with increased mortality, non-home discharge, LOS, and hospital charges. These findings support routine inpatient nutritional assessment and early intervention in this high risk population.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592042","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":"Pathological Complete Response Following mFOLFOX6 Plus Zolbetuximab and Conversion Surgery in Initially Unresectable CLDN18.2-Positive Advanced Gastric Cancer: A Case Report.","authors":"Tamotsu Sagawa, Shutaro Oiwa, Masahiro Hirakawa, Nozomi Minagawa, Makoto Yoshida, Riku Miyaishi, Atsushi Uesugi, Yutaro Okazaki, Kentaro Kawamura, Yoshiaki Maeda, Hiroyuki Nagashima, Koshi Fujikawa","doi":"10.1007/s12029-026-01546-3","DOIUrl":"10.1007/s12029-026-01546-3","url":null,"abstract":"<p><p>Zolbetuximab plus platinum-fluoropyrimidine chemotherapy has emerged as an important first-line treatment option for patients with claudin 18.2 (CLDN18.2)-positive, HER2-negative advanced gastric or gastroesophageal junction adenocarcinoma. However, pathological complete response after zolbetuximab-based induction therapy followed by conversion surgery has rarely been documented, particularly in patients with peritoneal dissemination and malignant ascites. A man in his early 50s with Eastern Cooperative Oncology Group performance status 0 was referred to our hospital with scirrhous-type gastric cancer. Initial evaluation revealed initially unresectable advanced gastric cancer with peritoneal dissemination and cytologically confirmed malignant ascites. Gastric biopsy showed poorly differentiated adenocarcinoma with signet-ring cell features. The tumor was HER2 IHC 1+, strongly CLDN18.2-positive by the VENTANA CLDN18 (43-14 A) RxDx Assay, with 90% of viable tumor cells showing 2+/3 + membranous staining, proficient mismatch repair, and PD-L1 CPS ≥ 10. First-line mFOLFOX6 plus zolbetuximab was administered every 2 weeks without dose reduction or treatment delay. After six cycles, computed tomography and esophagogastroduodenoscopy showed marked improvement. After nine cycles, conversion surgery with total gastrectomy, D2 lymph node dissection, and Roux-en-Y reconstruction was performed. Intraoperative lavage cytology was negative. Final pathology showed ypT0N0, 0/20 lymph nodes, and TRG 1a/Grade 3, consistent with pathological complete response. This case suggests that mFOLFOX6 plus zolbetuximab may induce deep radiological, endoscopic, cytological, and pathological responses and may enable R0 conversion surgery in carefully selected patients with CLDN18.2-positive initially unresectable advanced gastric cancer.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592029","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":"Minimally Invasive vs. Open Pancreaticoduodenectomy for Distal Cholangiocarcinoma: A Systematic Review and Meta-analysis.","authors":"Danyal Bakht, Azmir Ali Khan, Hafsa Hashmi, Maaz Amir, Ubaid Ur Rehman, Affaf Mahmood, Mehrab Naeem, Muhammad Ahmad Raza, Fatima Naeem, Arbab Sarfraz, Sulman Ismail, Khadija Tanvir, Mian Maroof Shah Bahadri, Abdul Haseeb Hasan, Fahad Saleem, Syed Faqeer Hussain Bokhari, Ahmad Hassan","doi":"10.1007/s12029-026-01541-8","DOIUrl":"10.1007/s12029-026-01541-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Distal cholangiocarcinoma (dCCA) is a rare but aggressive biliary malignancy arising from the distal bile duct with significant clinical burden. Pancreaticoduodenectomy (minimally invasive or open) remains the only potentially curative treatment for dCCA. However, the comparative safety and oncologic adequacy of minimally invasive versus open pancreaticoduodenectomy remains unclear, creating an evidence gap that this systematic review addresses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This systematic review and meta-analysis aimed to compare perioperative outcomes and oncologic effectiveness of MIPD versus OPD in patients undergoing surgery for distal cholangiocarcinoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature search of PubMed, Embase, Cochrane Library, and Science Direct was conducted through April 2025 in accordance with PRISMA guidelines. Eligible studies included cohort studies, randomized controlled trials, and case-control studies comparing MIPD (laparoscopic or robotic) with OPD in dCCA. Data regarding operative parameters, oncologic outcomes, perioperative morbidity, and mortality were extracted. Meta-analysis was performed using Review Manager 5.4, applying fixed- or random-effects models based on heterogeneity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven retrospective cohort studies comprising 1,803 patients (775 MIPD vs. 1,028 OPD) were included. MIPD was associated with significantly lower blood loss (WMD - 100.86 mL, 95% CI - 107.27 to - 94.46; I² = 90%; p &lt; 0.001) and shorter hospital stay (WMD - 2.46 days, 95% CI - 4.08 to - 0.84; I² = 89%; p = 0.003), but longer operative time (WMD 52.60 min, 95% CI 16.82 to 88.39; I² = 99%; p = 0.004). There was no significant difference in major complications (Clavien-Dindo ≥ III) (OR 0.97, 95% CI 0.74-1.28; p = 0.85) or postoperative mortality (OR 0.46, 95% CI 0.16-1.33; I² = 56%; p = 0.15) between groups. Importantly, long-term oncologic outcomes were also comparable between groups, with no significant differences observed in overall survival (HR 0.90, 95% CI 0.77-1.05; p = 0.19) or disease-free survival (HR 0.98, 95% CI 0.83-1.16; p = 0.83). No survival disadvantage was demonstrated for MIPD compared with OPD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;MIPD appears to be a safe and feasible alternative to OPD for selected patients with distal cholangiocarcinoma, offering perioperative benefits without compromising oncologic outcomes. Importantly, available evidence also demonstrates no compromise in long-term oncologic outcomes, with comparable overall and disease-free survival between MIPD and OPD. However, given the rarity of dCCA, stand-alone randomized controlled trials are unlikely to be feasible. Future evidence should therefore focus on stratifying dCCA patients within ongoing or future multicenter trials of minimally invasive pancreaticoduodenectomy for periampullary malignancies, as well as prospective international registry-based studies with mandatory re","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592088","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":"Prioritizing Chemotherapy in Total Neoadjuvant Therapy Improves pCR Rate in Locally Advanced Rectal Cancer in Countries with Limited Radiotherapy Access: A Randomized Controlled Trial.","authors":"Zahra Taheri, Elaheh Emadi, Ali Mohammad Esfandiary Rad, James S Welsh, Yasaman Mohebbifar, Saeed Jalili Bazel, Alireza Noferesti, Maedeh Hamrah Siyani, Danial Fazilat-Panah, Freshte Foroughi, Pejman Porouhan, Babak PeyroShabany, Seyed Alireza Javadinia, Roham Salek","doi":"10.1007/s12029-026-01539-2","DOIUrl":"10.1007/s12029-026-01539-2","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoradiotherapy (NCRT) for locally advanced rectal cancer (LARC) is frequently delayed in resource-limited settings due to restricted access to radiotherapy. Total neoadjuvant therapy (TNT), which starts with chemotherapy, may offer a practical alternative. This randomized trial compared TNT with the conventional NCRT‑first approach.</p><p><strong>Methods: </strong>202 patients with LARC were randomized to receive either TNT (neoadjuvant chemotherapy followed by NCRT, then surgery) or conventional treatment (NCRT followed by adjuvant chemotherapy and surgery). The primary endpoint was pathological complete response (pCR); treatment-related toxicity and overall survival (OS) were predefined secondary outcomes.</p><p><strong>Results: </strong>A total of 202 patients with LARC (101 per arm) were enrolled and analyzed. The TNT group achieved a significantly higher pCR rate than the conventional group (55.4% vs. 42.57%, p = 0.023). Sphincter preservation, resection margins, and surgical complications were similar between groups. Among treatment-related toxicities, thrombocytopenia was less frequent in the TNT group (5.0% vs. 12.87%, p = 0.048), whereas dysuria was more common (15.8% vs. 5.94%, p = 0.024); other adverse events were comparable. OS remained an exploratory secondary endpoint and did not differ significantly between groups at the time of analysis (p = 0.109).</p><p><strong>Conclusion: </strong>TNT may represent a feasible and well-tolerated treatment strategy, particularly in settings where access to radiotherapy is delayed. The improvement in pCR supports its potential oncologic value; however, survival outcomes remain immature and require confirmation in larger studies with longer follow-up.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592104","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":"Place of Death Among Early-Onset Colorectal Cancer Decedents in the United States, 1999-2020: National Trends and Disparities.","authors":"Xuewu Zhang, Xujia Wang, Yongmei Hu, Zhangyu Jia, Junyi Li, An Jiang","doi":"10.1007/s12029-026-01544-5","DOIUrl":"10.1007/s12029-026-01544-5","url":null,"abstract":"<p><strong>Purpose: </strong>Place of death is a key population-level indicator of where end-of-life care occurs. We examined place-of-death trends and sociodemographic disparities among U.S. early-onset colorectal cancer (EOCRC) decedents.</p><p><strong>Methods: </strong>Using CDC WONDER mortality data (1999-2020) for colorectal cancer decedents aged < 50 years, we analyzed the primary outcome of death at home/hospice facility vs. other settings. Trends were assessed with log-linked Poisson regression (annual percent change [APC]); subgroup associations were examined using multivariable logistic regression.</p><p><strong>Results: </strong>Of 75,428 EOCRC decedents, 54.1% died at home/hospice facilities. This proportion increased from 48.3% (1999) to 66.6% (2020) (APC: 1.87%, 95% CI: 1.72-2.03%). In adjusted analyses, Black (aOR: 0.56, 95% CI: 0.54-0.59) and Asian or Pacific Islander (aOR: 0.71, 95% CI: 0.66-0.77) decedents had lower odds of home/hospice death than White decedents. Decedents in the Northeast also had lower odds than those in the South (aOR: 0.74, 95% CI: 0.71-0.77). Separate analyses of home vs. hospice deaths from 2003 to 2020 indicated a sharp increase in hospice facility deaths, whereas the home death trend was sensitive to the inclusion of 2020.</p><p><strong>Conclusion: </strong>Non-acute-institutional deaths became more common among EOCRC decedents from 1999 to 2020, but significant racial and regional disparities persisted. These findings highlight the need to evaluate barriers to hospice access and community-based end-of-life care in this younger population.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592120","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":"Tools and Techniques of Endoscopic Radiofrequency Ablation in Pancreaticobiliary Diseases: A Narrative Review.","authors":"Aastha Bharwad, Janet Le, Nirav Thosani","doi":"10.1007/s12029-026-01536-5","DOIUrl":"10.1007/s12029-026-01536-5","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic radiofrequency ablation (RFA) has become an established minimally invasive option for patients with pancreaticobiliary tumors who are not candidates for resection or who have obstructing lesions of the bile duct or pancreas. This narrative review summarizes the devices, technique, and supporting clinical evidence for endoscopic RFA, organized by clinical indication rather than by device alone.</p><p><strong>Objective: </strong>RFA delivers high-frequency alternating current that produces localized thermal injury and coagulative necrosis. Two endoscopic delivery routes are in use: an ERCP-guided approach, which treats intraductal lesions such as malignant biliary strictures and ampullary tumors using bipolar endobiliary catheters, and an EUS-guided approach, which uses a monopolar needle electrode to ablate pancreatic parenchymal lesions, including solid tumors, neuroendocrine tumors, and pancreatic cysts and intraductal papillary mucinous neoplasms (IPMN). Hybrid needles that combine fine-needle aspiration with ablation are an emerging, still investigational, third category.</p><p><strong>Synthesis/results: </strong>Across the published series, technical success generally exceeds 90% for both approaches, with adverse event rates that are mostly low and dominated by self-limited abdominal pain, mild pancreatitis, or cholangitis; perforation and clinically significant bleeding are uncommon when established energy and safety-margin parameters are followed. A proposed, but still poorly characterized, immune-stimulating effect of ablation-induced tissue injury is discussed as a hypothesis rather than an established mechanism.</p><p><strong>Conclusions: </strong>Taken together, the available data support endoscopic RFA as a useful adjunct in the multidisciplinary management of pancreaticobiliary disease, but most of the supporting literature consists of small, single-arm, or retrospective series. Prospective, ideally randomized, studies with standardized energy protocols and longer follow-up are needed before the technique's role in routine practice, particularly for pancreatic cystic lesions and IPMN, can be considered settled.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592049","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}