World Journal of Gastrointestinal Oncology最新文献

{"title":"Shifting paradigm in locally advanced resectable gastric and gastroesophageal junction cancers.","authors":"Nabil Ismaili","doi":"10.4251/wjgo.v18.i2.113150","DOIUrl":"10.4251/wjgo.v18.i2.113150","url":null,"abstract":"<p><p>Gastric cancer (GC) is the fifth most common cancer and the fifth leading cause of cancer-related mortality worldwide. The management of resectable locally advanced GC evolved with the introduction of adjuvant chemoradiotherapy in some regions, notably following the INT-0116 trial. A subsequent major advance was perioperative chemotherapy with epirubicin, cisplatin, and fluorouracil, which significantly improved 5-year overall survival compared to surgery alone. More recently, the fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) regimen demonstrated superior outcomes compared to epirubicin, cisplatin, and fluorouracil. Despite this advancement, nearly half of all patients (46%) experience disease recurrence within three years, underscoring a significant unmet need. In a recent real-world study by Wang <i>et al</i>, which assessed perioperative sintilimab plus oxaliplatin and S-1 chemotherapy <i>vs</i> chemotherapy alone in non-metastatic GC, the authors reported significantly improved pathological response rates and overall survival with the combination. Additionally, the safety profile showed a lower frequency of high-grade adverse events. However, this study has limitations, including its retrospective design and the use of a chemotherapy backbone (oxaliplatin and S-1) considered less effective than FLOT based on phase III evidence. Recent data from the phase III MATTERHORN trial support the addition of durvalumab to FLOT, showing significant improvements in pathological complete response and event-free survival. Based on the cumulative evidence, adding immunotherapy to perioperative chemotherapy improves outcomes for patients with resected GC and may constitute a new standard of care once confirmatory data mature and regulatory approvals are granted.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"113150"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of Fuzheng Jiedu Xiaoyong granules in advanced colorectal cancer (spleen deficiency and stasis toxin syndrome).","authors":"Hai-Yun Qin, Zheng Li, Pei-Wei Cong, Dan Mi, Feng-Zhen Li, Xin Hu, Guo-Xin Li","doi":"10.4251/wjgo.v18.i2.113922","DOIUrl":"10.4251/wjgo.v18.i2.113922","url":null,"abstract":"<p><strong>Background: </strong>The management of advanced colorectal cancer (CRC) is challenging due to limited treatment efficacy and the significant toxicities and resistance associated with chemotherapy. Traditional Chinese medicine offers potential therapeutic benefits through mechanisms such as inhibiting tumor proliferation, modulating immunity, and preventing angiogenesis. Fuzheng Jiedu Xiaoyong granules (FZJDXYG) has shown promising clinical results, including enhanced immune function and reduced chemotherapy-related toxicities.</p><p><strong>Aim: </strong>To validate the efficacy and safety of FZJDXYG and determine its effects on immune function in patients with advanced CRC.</p><p><strong>Methods: </strong>In this multi-center, double-blind, randomized, placebo-controlled trial, 78 eligible patients were randomly assigned at a ratio of 1:1 to the treatment group (receiving FZJDXYG plus standard care) or the control group (receiving placebo plus standard care) for 12 weeks.</p><p><strong>Results: </strong>The treatment group experienced significant reductions in carcinoembryonic antigen and carbohydrate antigen 19-9 levels (both <i>P</i> < 0.05), with significantly greater reductions in these two markers compared to the control group (both <i>P</i> < 0.05). Immunologically, the treatment group exhibited significant increases in CD3+ and CD4+ cell counts and CD4+/CD8+ ratio, and decreased CD8+ levels, with all changes superior to those in the control group (all <i>P</i> < 0.05). The Karnofsky Performance Status score was also significantly higher in the treatment group (<i>P</i> < 0.05). Crucially, the incidence of adverse events was significantly lower in the treatment group than in the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>FZJDXYG effectively ameliorates clinical symptoms, enhances immune function, and reduces chemotherapy-induced toxicities in patients with advanced CRC with spleen deficiency and stasis toxin syndrome.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"113922"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning in lower gastrointestinal cancer detection: Advances in endoscopic, radiologic, and histopathologic diagnostics.","authors":"Tanisha Sehgal, Tanvi Joshi, Rishi Chowdhary, Omesh Goyal, Shivam Kalra, Rohit Goyal, Varna Taranikanti, Ashita Rukmini Vuthaluru, Manjeet Kumar Goyal","doi":"10.4251/wjgo.v18.i2.115974","DOIUrl":"10.4251/wjgo.v18.i2.115974","url":null,"abstract":"<p><p>Gastrointestinal (GI) cancers, particularly colorectal cancer, continue to be a major contributor to global cancer-related morbidity and mortality. Despite significant advancements in screening protocols and treatment strategies, early detection remains a clinical challenge due to the limitations of conventional diagnostic tools, which often suffer from inter-observer variability, limited sensitivity, and time-intensive procedures. In recent years the integration of artificial intelligence (AI), especially deep learning (DL) techniques, into medical diagnostics has opened new frontiers for enhancing detection accuracy, speed, and consistency across clinical domains. This review explores the transformative impact of DL-based AI models in detecting lower GI cancers, focusing on three key diagnostic modalities: Endoscopy; radiology; and histopathology. In endoscopic practice convolutional neural networks are used to detect and classify colorectal polyps in real-time, significantly reducing miss rates and aiding non-specialist endoscopists in decision-making. In radiology DL algorithms trained on computed tomography and magnetic resonance imaging data are valuable for automated lesion detection, segmentation, and staging, often outperforming conventional imaging. Histopathological analysis, traditionally reliant on manual examination, is now accelerated by DL models capable of processing whole-slide images to identify architectural distortions and cellular anomalies with high reproducibility and diagnostic accuracy. This review evaluates DL model performance, including sensitivity, specificity, and area under the curve and addresses technical and ethical challenges, including dataset diversity, interpretability, and integration into healthcare workflows. Ultimately, the convergence of AI and clinical medicine has the potential to improve diagnostic outcomes and personalized care for patients with lower GI cancers.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115974"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical value of geriatric nutritional risk index and pan-immune-inflammation value in locally advanced gastric cancer receiving neoadjuvant chemotherapy.","authors":"Wen-Tao Zhong, Shi-Kang Ding, Ru-Yin Li, Cheng-Yu Liu, Hong-Yun Huang, Jian-Chun Yu","doi":"10.4251/wjgo.v18.i2.115387","DOIUrl":"10.4251/wjgo.v18.i2.115387","url":null,"abstract":"<p><strong>Background: </strong>Metabolism and nutrition status play an important role in the development of cancer. However, whether inflammation and malnutrition related indicators can predict the efficacy of neoadjuvant chemotherapy (NACT) and the prognosis of gastric cancer has not been addressed.</p><p><strong>Aim: </strong>To evaluate the predictive value of malnutrition as determined by the geriatric nutritional risk index (GNRI) and inflammation represented by the pan-immune-inflammation value (PIV) for the response to NACT patients' prognosis in locally advanced gastric cancer (LAGC).</p><p><strong>Methods: </strong>We retrospectively analyzed 147 LAGC patients who underwent radical resection after NACT. The PIV, and GNRI were compared according to whether receiving nutritional intervention during NACT. The prognostic values of GNRI and PIV were assessed using time-dependent receiver operating characteristic curve analysis, log-rank tests, and Cox regression analysis.</p><p><strong>Results: </strong>Nutritional intervention could improve nutrition status and reduce inflammation during NACT in LAGC patients. Multivariate analysis showed that GNRI (hazard ratio = 0.956, 95% confidence interval: 0.923-0.991, <i>P</i> = 0.013), PIV (hazard ratio = 1.002, 95% confidence interval: 1-1.005, <i>P</i> = 0.041) were independent predictors for OS. Significant differences of overall survival and disease-free survival according to GNRI (<i>P</i> < 0.001) and PIV (<i>P</i> < 0.001) were observed between the low and high groups. The GNRI-PIV score constructed with GNRI and PIV had a higher area under the curve and was significantly associated with pathological tumor regression response.</p><p><strong>Conclusion: </strong>GNRI and PIV are useful predictive biomarkers in patients with LAGC receiving NACT, and nutritional supplement can improve patients' status. The GNRI-PIV score may contribute to a more personalized and holistic approach for LAGC patients underwent NACT.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115387"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of integrated Chinese and Western medicine in advanced pancreatic cancer: A double-center retrospective cohort study.","authors":"Ying-Rui Wang, Jin-Qiu Wang, Xue-Jiao Chen, Yu Yan, Yu Zhang, Meng-Yi Li, Wei Wang, Tian-Yu Fan, Peng-Fei Jiao, Chao-Feng Zhou","doi":"10.4251/wjgo.v18.i2.114690","DOIUrl":"10.4251/wjgo.v18.i2.114690","url":null,"abstract":"<p><strong>Background: </strong>Advanced pancreatic cancer (PC) is associated with a poor prognosis. The integration of Chinese and Western medicine (ICWM) has shown promising clinical efficacy. Nonetheless, the existing body of research assessing the efficacy and safety of this integrative approach is limited, hindering the provision of robust evidence-based support for clinical decision-making.</p><p><strong>Aim: </strong>To assess the short-term and long-term efficacy and safety of ICWM compared with Western medicine (WM) as a standalone treatment for advanced PC.</p><p><strong>Methods: </strong>We enrolled 136 patients with advanced PC admitted to Henan Provincial Hospital of Traditional Chinese Medicine and Henan Provincial People's Hospital from 2019 to 2024. Patients were randomly assigned to the ICWM or WM group (<i>n</i> = 66 or <i>n</i> = 70, respectively) according to treatment modality. The long-term efficacy was evaluated using survival analyses. Short-term efficacy was assessed by analyzing the tumor response, serum tumor markers, and immune function before and after treatment. Treatment safety was assessed by monitoring bone marrow suppression and hepatic and renal function impairment.</p><p><strong>Results: </strong>The median overall survival was 12.91 months and 10.64 months in the ICWM and WM groups, while the median progression-free survival was 5.12 months and 3.55 months, respectively. The disease control rate was significantly higher in the ICWM group than that in the the WM group, while the myelosuppression was significantly milder. The serum tumor markers carbohydrate antigen (CA) 19-9 and CA125 showed a significant downward trend before and after treatment in the ICWM group, whereas only CA19-9 showed a significant decrease in the WM group. Post-treatment, both groups showed an upward trend in natural killer cells and CD3+, CD4+, and CD4+/CD8+ lymphocytes compared with pre-treatment, with the ICWM group exhibiting a more pronounced increase. The two groups showed no significant differences in hepatic and renal function impairment.</p><p><strong>Conclusion: </strong>ICWM extended survival in patients with advanced PC, improved long-term efficacy, controlled local lesions, reduced serum tumor markers, enhanced immune function, and improved short-term outcomes, with a favorable safety profile.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"114690"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does anesthesia choice shape oncologic destiny in gastric cancer surgery?","authors":"Oguzhan Arun, Funda Arun","doi":"10.4251/wjgo.v18.i2.115944","DOIUrl":"10.4251/wjgo.v18.i2.115944","url":null,"abstract":"<p><p>Anesthetic management in gastric cancer surgery has progressed from a technical necessity to a potential influencer of perioperative immune function and long-term oncologic outcomes. The perioperative period-marked by inflammation, stress responses, and immunosuppression-is increasingly seen as critical to cancer recurrence risk. This has prompted investigations into whether anesthetic agents could shape oncologic trajectories. The recent study by Wang <i>et al</i> contributes valuable data by comparing sevoflurane inhalation anesthesia and propofol-based total intravenous anesthesia in patients undergoing radical gastrectomy. While no significant differences were observed in survival outcomes, subtle variations in post-operative nausea and intraoperative hemodynamics raise important considerations about anesthetic-specific physiologic effects. This editorial reflects on these findings in the broader context of ongoing efforts to individualize perioperative care in oncology. It also underscores the need for future prospective studies integrating immune, molecular, and clinical endpoints to determine whether anesthetic techniques can play a meaningful role in long-term cancer control. As the field advances, anesthesia should no longer be viewed as a neutral backdrop but as a modifiable component of comprehensive cancer care. Determining when, how, and for whom an anesthetic technique matters remains an open but essential question.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115944"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pioneering efficient deep learning architectures for enhanced hepatocellular carcinoma prediction and clinical translation.","authors":"Sami Akbulut, Cemil Colak","doi":"10.4251/wjgo.v18.i2.113870","DOIUrl":"10.4251/wjgo.v18.i2.113870","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality worldwide and is often diagnosed at advanced stages, reducing opportunities for curative treatment. Current screening tools, including ultrasonography with or without alpha-fetoprotein, lack sufficient sensitivity for early detection. Deep learning (DL) has emerged as a transformative approach, capable of detecting subtle, high-dimensional patterns in ultrasonography, computed tomography, magnetic resonance imaging, histopathological whole-slide images, and electronic health records. Convolutional neural networks, recurrent neural networks, and Transformer-based models have achieved strong performance in classification, segmentation, and risk prediction tasks, with sensitivities and specificities frequently above 89% and 90%. In some applications, DL has matched or even exceeded expert interpretation. However, the high computational cost and limited feasibility in real-time, resource-constrained settings remain major barriers to adoption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To overcome these challenges, recent studies emphasize efficiency-oriented strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Lightweight architectures such as MobileNet and EfficientNet, model compression through pruning and quantization, and data-efficient methods like self-supervised pretraining and targeted augmentation enable smaller and faster models without major loss of accuracy. Hybrid or pseudo-3D approaches that summarize volumetric information from sequential slices further reduce computational load, while multimodal fusion of imaging, clinical, and omics data extends applications beyond detection toward personalized prognostication and treatment guidance. These developments highlight that efficiency is essential for real-world deployment, not merely a technical refinement. Nonetheless, significant gaps remain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Most studies are retrospective, single-center, and limited in sample size, underscoring the need for rigorous external validation across multicenter cohorts and prospective trials assessing patient-relevant outcomes. Bias and fairness audits are critical to ensure equitable performance across demographic and etiological groups, while privacy-preserving strategies such as federated learning are required to harness diverse datasets securely. Seamless integration into hospital workflows, including Picture Archiving and Communication Systems and Electronic Medical Records using standards such as substitutable medical applications reusable technologies on fast healthcare interoperability resources, together with clear regulatory frameworks and post-market monitoring, will be essential for safe and scalable clinical translation. In conclusion, efficient and explainable DL offers a promising path to earlier detection and more personalized therapy in HCC. Achieving this potential will require not only technical innovation but also disciplined ","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"113870"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing precision medicine in human epidermal growth factor receptor 2 negative gastric cancer: Insights from a novel nomogram for immunochemotherapy prognosis.","authors":"Abinash Nayak, Gunanidhi Sahoo, Sudhansu Sekhar Nishank","doi":"10.4251/wjgo.v18.i2.115401","DOIUrl":"10.4251/wjgo.v18.i2.115401","url":null,"abstract":"<p><p>Gastric cancer poses a significant global health burden, particularly in advanced human epidermal growth factor receptor 2-negative cases where prognosis remains poor despite advances in immunochemotherapy. The recent study by Yao <i>et al</i> introduces a nomogram model integrating programmed death ligand 1 expression, microsatellite status, tumor-node-metastasis stage, tumor differentiation, neutrophil-to-lymphocyte ratio, and C-reactive protein-albumin-lymphocyte index to predict progression-free and overall survival. This letter discusses the model's strengths, limitations, and its alignment with recent developments in biomarkers and therapies, emphasizing its potential for personalized medicine.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115401"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction for chronic atrophic gastritis using a random forest model: A multicenter study.","authors":"Hui Cao, Jing-Lue Han, Hao Wu, Shu-Ping Si, Li-Jia Ding, Lin Ji, Hua-Zhen Zhang, Jie Yin, Zhi-Yi Zhou, Yu-Nan Zhang, Zhi-Fa Lv, Wen-Ying Tian, Qiang Zhan, Hui Wang, Fang-Mei An","doi":"10.4251/wjgo.v18.i2.113959","DOIUrl":"10.4251/wjgo.v18.i2.113959","url":null,"abstract":"<p><strong>Background: </strong>Chronic atrophic gastritis (CAG) is a significant precancerous condition of gastric cancer (GC). CAG often lacks typical symptoms in its early stages, and clinical diagnosis relies on gastroscopy and pathological examination, which are invasive and have limitations such as poor patient compliance. Therefore, developing a noninvasive, simple, and generalizable prediction tool is crucial for the early identification of CAG.</p><p><strong>Aim: </strong>To construct and validate a CAG risk prediction model to achieve noninvasive and accurate identification of high-risk patients.</p><p><strong>Methods: </strong>This study included 1268 subjects from a GC screening program. Multimodal data, including serological marker, demographic, lifestyle, and family history data, were collected. Subjects were grouped by pathological biopsy results. Least absolute shrinkage and selection operator regression was used for feature selection. A model was constructed using the random forest algorithm, evaluated with metrics such as the area under the curve (AUC), and interpreted using the SHapley Additive exPlanation (SHAP) method. The model was validated in an independent external cohort, and a web-based prediction platform was developed using Shiny.</p><p><strong>Results: </strong>Six key features were ultimately included: Age, <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection status, pepsinogen I/II ratio (PGR), smoking history, alcohol consumption history, and family history of GC. The model achieved AUCs of 0.8542 and 0.8073 in the training and testing sets, respectively, and an AUC of 0.8505 in the external validation cohort, demonstrating good generalizability and stability. SHAP analysis indicated that <i>H. pylori</i> infection, age, and PGR were the most important variables influencing CAG risk. The final model was successfully embedded into a web-based platform for convenient clinical application.</p><p><strong>Conclusion: </strong>The random forest-based CAG prediction model is a highly accurate and interpretable tool with significant clinical utility in early screening and identifying high-risk patients.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"113959"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary esophageal metastasis ten years after curative resection of stage I rectal adenocarcinoma: A case report.","authors":"Yu Zhang, Zi-Xin Li, Dai-Yuan Ma, Fang Liu","doi":"10.4251/wjgo.v18.i2.113494","DOIUrl":"10.4251/wjgo.v18.i2.113494","url":null,"abstract":"<p><strong>Background: </strong>We report an exceptionally rare case of a solitary esophageal metastasis occurring in the tenth year after curative resection of stage I (pT2N0M0) rectal adenocarcinoma. This represents one of the longest reported intervals to esophageal metastasis from colorectal cancer, challenging the conventional understanding of metastatic potential of early-stage tumors.</p><p><strong>Case summary: </strong>A 42-year-old male underwent curative resection for rectal adenocarcinoma (pT2N0M0, stage I) in 2015. Ten years later (2025), he presented with progressive dysphagia. Imaging and endoscopy revealed a mid-esophageal tumor with mediastinal lymphadenopathy. Initial biopsy suggested primary esophageal adenocarcinoma. After two cycles of neoadjuvant immunochemotherapy, dysphagia worsened. However, a multidisciplinary team re-evaluation, utilizing comparative immunohistochemistry for the esophageal lesions and rectal specimens, confirmed the diagnosis as a solitary esophageal metastasis from rectal adenocarcinoma (<i>RAS</i> wild-type). The patient received involved-field radiotherapy with concurrent systemic therapy (capecitabine, oxaliplatin and cetuximab). Dysphagia significantly improved one week after radiotherapy initiation. Three-month follow-up imaging after radiotherapy demonstrated a partial response. The patient was on cetuximab maintenance.</p><p><strong>Conclusion: </strong>This case underscores the risk of early tumor recurrence or metastasis beyond standard follow-up windows thus long-term follow-up is necessary.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"113494"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}