Journal of Gastrointestinal Cancer最新文献

{"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}

{"title":"Mortality Trends of Biliary Tract Cancers in the United States, 1999-2023: a CDC-WONDER Analysis.","authors":"Jianguo Chen, Guangwei Yang, Xiaodong Sun","doi":"10.1007/s12029-026-01537-4","DOIUrl":"10.1007/s12029-026-01537-4","url":null,"abstract":"<p><strong>Background: </strong>Biliary tract cancers (BTCs) comprise a heterogeneous group of malignancies, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder cancer, ampulla of Vater tumors, and other or unspecified BTCs. We examined population-level BTC mortality trends and disparities in the US from 1999 to 2023.</p><p><strong>Methods: </strong>Deaths among adults aged ≥ 35 years were obtained from CDC WONDER using ICD-10 codes C22.1, C23, C24.0, C24.1, C24.8, and C24.9. AAMRs per 100,000 were calculated and assessed using Joinpoint regression, with stratification by sex, race/ethnicity, age, census region, and urbanization level. Urbanization analyses used standardized data through 2020.</p><p><strong>Results: </strong>From 1999 to 2023, 226,056 BTC deaths were recorded. Annual deaths increased from 6,121 to 13,637, and the AAMR increased from 4.37 to 6.10 per 100,000 (AAPC, 2.22%; 95% CI, 1.95%-2.50%; P < 0.001), with acceleration after 2007. The Non-Hispanic Black population exhibited the fastest increase in mortality among racial/ethnic groups, with an AAPC of 3.20%, whereas Hispanics had the highest AAMR in 2023. The 35-44-year age group showed the fastest increase despite low mortality (AAPC, 3.77%). In 2023, the Midwest had the highest AAMR, at 5.50 per 100,000, followed by the West at 5.32 per 100,000. In standardized urbanization-stratified data through 2020, metropolitan areas had a higher AAMR than nonmetropolitan areas (4.65 vs. 4.30 per 100,000). Subtype-specific analyses showed that intrahepatic cholangiocarcinoma accounted for the largest proportion of deaths (132,830; 58.76%) and had an increasing AAMR from 1.82 to 4.17 per 100,000, whereas gallbladder cancer accounted for 51,720 deaths (22.88%) and had a declining AAMR from 1.46 to 0.98 per 100,000. Extrahepatic bile duct cancer, ampulla of Vater cancer, and other/unspecified BTCs contributed 18,669, 5,135, and 17,702 deaths, respectively, highlighting that pooled BTC estimates may mask divergent subtype patterns. These opposite iCCA and GBC patterns supported separate subtype reporting rather than interpretation of the pooled BTC estimate alone in this study.</p><p><strong>Conclusions: </strong>BTC mortality among US adults aged ≥ 35 years increased from 1999 to 2023, with demographic, geographic, urbanization-related, and subtype-specific heterogeneity. These findings support subtype-aware surveillance, early detection, and equitable resource allocation.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584487","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 Impact of the Number of Colorectal Liver Metastases At the Time of Presentation Among Patients Undergoing Surgery.","authors":"Hisashi Murakami, Masaru Matsumura, Yasutaka Kuno, Takuma Okada, Satoshi Okubo, Masaji Hashimoto, Junichi Shindoh","doi":"10.1007/s12029-026-01543-6","DOIUrl":"10.1007/s12029-026-01543-6","url":null,"abstract":"<p><strong>Background: </strong>The prognostic impact of tumor number among surgically treated colorectal liver metastases (CLMs) remains incompletely understood, particularly in patients with extensive disease.</p><p><strong>Methods: </strong>We retrospectively analyzed 303 patients who underwent initial hepatectomy for CLMs between 2008 and 2024. Prognostic factors for overall survival (OS) were evaluated using multivariable Cox regression analysis. Estimated mortality hazard at three and five years after surgery was modeled according to the number of liver lesions.</p><p><strong>Results: </strong>Tumor number (hazard ratio [HR], 1.02; 95% confidence interval [CI], 1.00-1.03; P = 0.025), positive primary nodal status (HR, 1.39; 95% CI 1.04-1.87; P = 0.029), and extrahepatic disease (HR, 1.60; 95% CI, 1.13-2.25; P = 0.007) were independently associated with OS. Mortality hazard gradually increased with increasing tumor number, particularly between 5-30 lesions, although the increase was modest. Among patients with ≥ 10 CLMs, median OS was 39.0 months.</p><p><strong>Conclusions: </strong>Tumor number was associated with prognosis after hepatectomy, but increasing tumor burden did not result in a steep increase in mortality hazard. Tumor number alone should not preclude surgical consideration in selected patients.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562321","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":"Circulating Tumor DNA Sequencing for Early Diagnosis and Detection of Treatment Response, Minimal Residual Disease, and Recurrence in Gastroesophageal Cancer.","authors":"Mikkel Møller Henriksen, Alexander Venzel Rudbeck, Sönke Detlefsen, Michael Bau Mortensen, Per Pfeiffer, Torben A Kruse, Mads Thomassen","doi":"10.1007/s12029-026-01530-x","DOIUrl":"10.1007/s12029-026-01530-x","url":null,"abstract":"<p><p>Gastroesophageal cancers (GEC) have high mortality rates with poor prognosis, especially at late stages. This is partly due to unspecific symptoms at early stages, early treatment resistance, and recurrence after curative-intent treatment. Circulating tumor DNA (ctDNA) has gained attention for early cancer diagnosis and longitudinal monitoring. This narrative review summarizes the recent developments of genomic ctDNA analysis for early GEC diagnosis and longitudinal monitoring across 57 relevant studies. For early diagnosis, several studies combined genomic ctDNA analysis with other ctDNA approaches or serum biomarkers. These approaches achieved high sensitivities and specificities in cancer detection within GEC while accurately predicting the tissue of origin, The use of genomic ctDNA analysis has also been studied for longitudinal monitoring of GEC patients during and after various treatment regimens. Studies have shown that ctDNA dynamics is highly consistent with treatment response and disease progression. CtDNA could frequently detect disease progression before conventional methods, thereby displaying its potential application in longitudinal monitoring. Genomic ctDNA analysis could also detect recurrence after curative-intent treatment and, in many cases, before clinical detection. However, ctDNA has low abundance in total cell-free DNA during low-burden disease. Additionally, methodological variation in ctDNA processing and quantification complicates interpretation across studies.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549299","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":"First-Line Immunotherapy Versus Chemotherapy in MSI-H/dMMR Metastatic Colorectal Cancer: A Systematic Review and Meta-Analysis of Phase III Studies.","authors":"Wala Ben Kridis, Afef Khanfir","doi":"10.1007/s12029-026-01535-6","DOIUrl":"10.1007/s12029-026-01535-6","url":null,"abstract":"<p><strong>Background: </strong>Metastatic colorectal cancer (mCRC) with microsatellite instability-high or mismatch repair deficiency (MSI-H/dMMR) demonstrates limited responsiveness to conventional cytotoxic chemotherapy but increased susceptibility to immune checkpoint inhibition. Although randomized phase III trials have shown superiority of immune checkpoint inhibitors (ICIs) in the first-line setting, a comprehensive synthesis of survival outcomes across key molecular and clinical subgroups remains warranted.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized, open-label, phase III trials comparing first-line ICI-based therapy with standard chemotherapy in MSI-H/dMMR mCRC. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Prespecified subgroup analyses evaluated outcomes according to BRAF mutation status, KRAS/NRAS mutation status, and primary tumor location. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using random-effects models. Safety outcomes were analyzed using Mantel-Haenszel fixed-effect models. Statistical heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>Two phase III trials (KEYNOTE-177 and CheckMate-8HW), including more than 600 patients, were eligible. ICI-based therapy significantly improved PFS compared with chemotherapy (pooled HR 0.61; 95% CI, 0.51-0.73; I²=0%) and demonstrated a significant OS benefit (pooled HR 0.77; 95% CI, 0.63-0.94; I²=0%). Immunotherapy was associated with lower rates of overall and grade ≥ 3 adverse events, despite more frequent immune-related toxicities.</p><p><strong>Conclusions: </strong>First-line ICI-based therapy provides significant and consistent survival benefits across BRAF-mutated and wild-type tumors, KRAS/NRAS-mutated and wild-type disease, and both right- and left-sided primary tumors, supporting its role as the standard of care for MSI-H/dMMR mCRC.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520550","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":"Neoadjuvant Imatinib Therapy in Rectal Gastrointestinal Stromal Tumors: A Comprehensive Narrative Review of Tumor Downsizing, Sphincter Preservation, Transanal Surgical Platforms, Functional Outcomes, and Survival.","authors":"Naga Praneeth Raja, Nagapavani Kandagari","doi":"10.1007/s12029-026-01531-w","DOIUrl":"10.1007/s12029-026-01531-w","url":null,"abstract":"<p><p>Rectal gastrointestinal stromal tumors (GISTs) represent approximately 5-8.5% of all GISTs and pose unique surgical challenges due to the confined pelvic anatomy and proximity to the anal sphincter complex. Historically, radical surgery - including abdominoperineal resection (APR) or pelvic exenteration - was frequently required for complete tumor clearance, resulting in permanent colostomy and significant functional morbidity. The introduction of imatinib mesylate, a selective tyrosine kinase inhibitor (TKI) targeting KIT and PDGFRA, has fundamentally transformed the management of rectal GIST. Neoadjuvant imatinib therapy achieves significant tumor downsizing (25-46% reduction), reduces mitotic activity, and enables sphincter-preserving surgery in patients who would otherwise require radical resection. The concurrent evolution of transanal endoscopic platforms - including transanal endoscopic microsurgery (TEM), transanal minimally invasive surgery (TAMIS), and robotic TAMIS (R-TAMIS) - has further expanded the possibilities for organ preservation, achieving R0 resection rates of 89-100% with favorable functional outcomes and preserved fecal continence. Emerging evidence also suggests improvements in distant recurrence-free survival, disease-specific survival, and overall survival compared with upfront surgery. This comprehensive narrative review examines the rationale, efficacy, response assessment, surgical implications, the role of transanal surgical platforms, functional outcomes, quality of life, survival outcomes, and current guideline recommendations for neoadjuvant imatinib in rectal GIST.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470957","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":"Quality‑of‑Life Outcomes of Appendicostomy-Colostomy Integration in Abdominoperineal Resection: A Multicenter Prospective Cohort Study.","authors":"Mina Alvandipour, Atousa Mortazavi Milani, Asal Khodabakhsh, Masoudeh Masoud Bahnamiri, Mahmoud Manouchehri Amoli, Mohammad Javad Najafi","doi":"10.1007/s12029-026-01532-9","DOIUrl":"10.1007/s12029-026-01532-9","url":null,"abstract":"<p><strong>Background: </strong>Abdominoperineal resection (APR) for very low rectal cancer often causes long-term QoL issues due to a permanent colostomy and pelvic morbidity. Dual-stoma techniques, like appendicostomy-enabled irrigation, might enhance bowel control and psychosocial recovery, but these methods need more study in large prospective cohorts.</p><p><strong>Objective: </strong>Appendicostomy with abdominal colostomy during APR improves long-term QoL without increasing complications.</p><p><strong>Methods: </strong>A ten-year prospective cohort study across three Iranian colorectal centers involved 130 participants undergoing standardized APR with dual-stoma formation, including a permanent colostomy and appendicostomy. QoL was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and the colorectal cancer-specific module (QLQ-CR29) at 12, 18, and 24 months. Missing responses were addressed through multiple imputation. Nonparametric methods like Mann-Whitney, Kruskal-Wallis, and Spearman's correlation evaluated trends and disparities across domains and sociodemographic variables.</p><p><strong>Results: </strong>The mean QoL score was 81.5 ± 11.3. Functional domains, including cognitive (94.6 ± 12.5), role (89.5 ± 13.5), and physical (85.0 ± 12.1), remained consistently high. CR29 scores indicated strong body image (75.9 ± 16.0), minimal stoma-related embarrassment (29.5 ± 21.0), and maintained sexual function (74.9 ± 24.6 among active respondents). Issues concerning appendicostomy management were minimal, with 91.5% of participants reporting ease of use; no severe complications were observed. Persistent concerns included financial burden (35.6 ± 23.2) and mild peri-stomal symptoms.</p><p><strong>Conclusion: </strong>Dual-stoma APR with appendicostomy is a safe, feasible, and associated with favorable physical, psychosocial, and functional QoL outcomes.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470979","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":"Routine Lymph Node Dissection in the Surgical Treatment of Primary Liver Tumors: a Systematic Review and Meta-Analysis.","authors":"Britte L Buisman, Lucas Goense, Frederik J H Hoogwater, Maarten W Nijkamp, Inne H M Borel Rinkes, Jeroen Hagendoorn, Jelmer E Oor","doi":"10.1007/s12029-026-01516-9","DOIUrl":"10.1007/s12029-026-01516-9","url":null,"abstract":"<p><strong>Purpose: </strong>The incidence of LNM and survival outcomes following routine lymph node dissection (LND) in patients undergoing resection of hepatocellular carcinoma (HCC), intrahepatic- (ICC) and perihilar cholangiocarcinoma (PCC) has not been well-defined. This systematic review and meta-analysis analyzes the incidence of LNM and survival outcomes following routine LND independently of pre-or intraoperative suspicion of LNM following resection of HCC, ICC, and PCC.</p><p><strong>Methods: </strong>The PubMed database was searched from database inception until March, 2025. Random-effects meta-analysis of the incidence of LNM and hazard ratios (HRs) of overall survival (OS) were conducted for each malignancy.</p><p><strong>Results: </strong>Forty studies were included. Routine LND was performed in 5 872 patients. The pooled incidence of LNM following routine LND was 5% among 601 HCC patients, 37% among 2 565 ICC patients, and 39% among 2 706 PCC patients. Presence of LNM was associated with worse OS in ICC (HR: 2.46, 95% CI 1.66-3.65) and PCC (HR: 2.01, 95% CI 1.74-2.33) patients.</p><p><strong>Conclusion: </strong>Routine LND should be performed during resection of ICC and PCC due to the high incidence of LNM and improved survival outcomes, but not during resection of HCC. The presence of LNM gives inferior survival outcomes in ICC and PCC patients.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471031","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":"Safety of Immune-Targeted Therapy in Patients with Hepatocellular Carcinoma in the Real-World.","authors":"Menghuan Song, Tianyue Feng, Ning Deng, Zhirong Yang, Yunfeng Lai, Carolina Oi Lam Ung, Hao Hu","doi":"10.1007/s12029-026-01534-7","DOIUrl":"10.1007/s12029-026-01534-7","url":null,"abstract":"<p><strong>Background: </strong>Combining immunotherapy with targeted therapy represents a promising trajectory for cancer treatment; however, safety profiles remain insufficient. This study aimed to characterize adverse events associated with immune-targeted regimens in hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>This study used Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), and Bayesian Confidence Propagation Neural Network (BCPNN) to detect signals of adverse events based on data from FDA Adverse Event Reporting System.</p><p><strong>Results: </strong>Signals of fulminant type-1 diabetes mellitus (ROR = 13.3, PRR = 13.2, IC = 3.7), myositis (8.5, 8.3, 3.1), encephalitis (8.4, 8.3, 3.0), and myocarditis (7.3, 7.2, 2.8) were identified in atezolizumab+bevacizumab. Immune-mediated hepatitis (5.6, 5.1, 2.4), hepatic encephalopathy (3.3, 3.0, 1.6), and uppergastrointestinal haemorrhage (4.3, 4.2, 2.1) were associated with pembrolizumab+lenvatinib. Signals of gastrointestinal haemorrhage (5.1, 4.8, 2.3) and malignant neoplasm progression (2.9, 2.7, 1.4) were in patients using atezolizumab+cabozantinib.</p><p><strong>Conclusion: </strong>This study delineated distinct profiles of adverse events associated with immunotargeted therapies, which serves as a critical reference for risk assessment and therapeutic selection. Though atezolizumab plus bevacizumab is recommended as first-line treatment for advanced HCC, potential severe immune-mediated adverse events affecting multiple organs suggested the importance of clinical vigilance. Extrapolation of pembrolizumab+lenvatinib and atezolizumab+cabozantinib from other cancers to HCC warrants caution in consideration of the associated bleeding risks and hepatic complications.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470968","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":"Preoperative CT Assessment of Portal Vein Contact Length Predicts Poor Prognosis in Resectable Pancreatic Head Cancer.","authors":"Shingo Kozono, Takaaki Tatsuguchi, Atsushi Fujii, Hirotaka Kuga, Keisuke Hirahata, Yuzo Shimokawa, Masayuki Hijioka, Masato Sakamoto, Sadafumi Tamiya, Toru Nakano","doi":"10.1007/s12029-026-01527-6","DOIUrl":"10.1007/s12029-026-01527-6","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether preoperative computed tomography (CT)-based tumor-portal/superior mesenteric vein (PV/SMV) contact angle and contact length predict pathological venous invasion and refine prognostic stratification in anatomically resectable pancreatic ductal adenocarcinoma (R-PDAC).</p><p><strong>Methods: </strong>We retrospectively reviewed 108 patients who underwent upfront pancreaticoduodenectomy without neoadjuvant chemotherapy for pancreatic head PDAC, including 101 anatomically resectable cases and 7 borderline resectable cases with PV involvement (BR-PV). Tumor-PV/SMV contact angle and contact length were measured on multidetector CT. Their associations with pathological PV/SMV invasion, PV/SMV resection, and overall survival (OS) were analyzed.</p><p><strong>Results: </strong>Both contact angle and contact length predicted pathological venous invasion, with optimal cutoff values of 90° for angle (AUC = 0.86) and 15 mm for length (AUC = 0.84), and both were significantly associated with pathological venous invasion and PV/SMV resection (all p < 0.001). In the subgroup with R-PDAC, however, only contact length provided meaningful prognostic stratification. Patients with contact length ≥ 15 mm had significantly worse OS than those with contact length < 15 mm (p = 0.0032) or no contact (p < 0.001), and their survival was comparable to that of BR-PV patients (p = 0.8548). In multivariable analysis, contact length ≥ 15 mm remained an independent adverse prognostic factor (HR 2.79, 95% CI 1.64-4.73, p < 0.001).</p><p><strong>Conclusion: </strong>Preoperative CT-based assessment of tumor-PV/SMV contact length may serve as a practical marker for identifying a high-risk subgroup within R-PDAC and may help refine selection of patients for neoadjuvant treatment.</p>","PeriodicalId":15895,"journal":{"name":"Journal of Gastrointestinal Cancer","volume":"57 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470995","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}