World journal of clinical oncology最新文献

{"title":"Predictors of survival in gastric mucosa-associated lymphoid tissue lymphoma: An updated surveillance, epidemiology, and end results-based analysis of age and gender disparities.","authors":"Ayrton I Bangolo, Khaled Sharaan, Behzad Amoozgar, Shruti Wadhwani, Lili Zhang, Nikita Wadhwani, Vignesh K Nagesh, Jay Mehta, Rishabh Goyal, Gia DeRose, Sarvarinder Gill, Courtney Christoforo, Swapnika Mallipeddi, Selbin Boban, Shubham Madan, Budoor Alqinai, Timophyll Yh Fong, Simcha Weissman, Pierre Fwelo","doi":"10.5306/wjco.v16.i6.106408","DOIUrl":"10.5306/wjco.v16.i6.106408","url":null,"abstract":"<p><strong>Background: </strong>Mucosa-associated lymphoid tissue (MALT) lymphoma is a subtype of extranodal marginal zone lymphoma, typically occurring in mucosal sites such as the stomach, salivary glands, and lungs. This study aims to analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.</p><p><strong>Aim: </strong>To analyze the demographic and clinicopathologic characteristics of patients with gastric MALT lymphoma in the United States and evaluate the interaction between age and gender on survival outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database, which included 2453 patients diagnosed with MALT lymphoma from 2010 to 2021. Data were analyzed for demographic factors, tumor characteristics, treatment modalities, and survival outcomes. A Cox proportional hazards regression model was used to identify predictors of overall mortality and cancer-specific mortality.</p><p><strong>Results: </strong>The study predominantly included Non-Hispanic White patients (62.78%), with nearly equal gender distribution (50.31% females, 49.69% males), and most diagnoses occurring in individuals aged 60-79 years. The majority of tumors were localized (80.07%). Multivariate analysis identified older age, male gender, advanced tumor stage, and socioeconomic factors-such as annual income and marital status-as independent predictors of mortality. No significant interaction between age and gender on mortality outcomes was observed.</p><p><strong>Conclusion: </strong>Sociodemographic factors, including advanced age, male gender, annual income, and marital status, as well as advanced tumor stage, significantly impacted survival outcomes in patients with MALT lymphoma. Radiotherapy was associated with a reduction in overall mortality. Early detection is crucial for optimizing outcomes, as localized disease responds well to available treatment modalities.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"106408"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529858","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":"Comprehensive review of Bayesian network applications in gastrointestinal cancers.","authors":"Min-Na Zhang, Meng-Ju Xue, Bao-Zhen Zhou, Jing Xu, Hong-Kai Sun, Ji-Han Wang, Yang-Yang Wang","doi":"10.5306/wjco.v16.i6.104299","DOIUrl":"10.5306/wjco.v16.i6.104299","url":null,"abstract":"<p><p>Gastrointestinal cancers, including esophageal, gastric, colorectal, liver, gallbladder, cholangiocarcinoma, and pancreatic cancers, pose a significant global health challenge due to their high mortality rates and poor prognosis, particularly when diagnosed at advanced stages. These malignancies, characterized by diverse clinical presentations and etiologies, require innovative approaches for improved management. Bayesian networks (BN) have emerged as a powerful tool in this field, offering the ability to manage uncertainty, integrate heterogeneous data sources, and support clinical decision-making. This review explores the application of BN in addressing critical challenges in gastrointestinal cancers, including the identification of risk factors, early detection, treatment optimization, and prognosis prediction. By integrating genetic predispositions, lifestyle factors, and clinical data, BN hold the potential to enhance survival rates and improve quality of life through personalized treatment strategies. Despite their promise, the widespread adoption of BN is hindered by challenges such as data quality limitations, computational complexities, and the need for greater clinical acceptance. The review concludes with future research directions, emphasizing the development of advanced BN algorithms, the integration of multi-omics data, and strategies to ensure clinical applicability, aiming to fully realize the potential of BN in personalized medicine for gastrointestinal cancers.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"104299"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529921","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":"Advances in neoadjuvant therapy for pancreatic cancer: Current trends and future directions.","authors":"Shi-Tao Wu, Li Zhu, Xiao-Ling Feng, Li Yang, Guo-Wei Chen, Yan Jiang, Ting-Fang Huang, Hao-Yu Wang, Fang Li","doi":"10.5306/wjco.v16.i6.105849","DOIUrl":"10.5306/wjco.v16.i6.105849","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) remains one of the most challenging malignancies, with poor survival rates due to late-stage diagnosis and limited treatment options. Neoadjuvant therapy (NAT), which involves chemotherapy or chemoradiation prior to surgical resection, has emerged as a promising approach to improve resectability and overall survival (OS). The integration of advanced imaging techniques and biomarkers for evaluating the response to NAT is crucial for optimizing therapeutic strategies and surgical outcomes. However, challenges related to the heterogeneity of treatment protocols and the need for predictive biomarkers remain, highlighting the necessity for further clinical trials. The aim is to evaluate the impact of NAT on surgical outcomes and predictive markers in pancreatic cancer. A comprehensive review of the literature was conducted to evaluate the impact of NAT on surgical resectability, survival outcomes, and the role of imaging and biomarkers in assessing therapeutic response. Studies examining the efficacy of NAT in patients with PDAC, the predictive value of serum biomarkers such as carbohydrate antigen 19-9 (CA 19-9), and the utility of advanced imaging modalities such as positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG-PET/CT) were included. NAT has demonstrated significant benefits in downstaging tumors, increasing margin-negative (R0) resection rates, and reducing micrometastatic disease. The use of serum CA 19-9 Levels as a biomarker for response evaluation and imaging modalities such as FDG-PET/CT and magnetic resonance imaging has proven valuable in predicting therapeutic efficacy and guiding surgical planning. Studies have shown that significant reductions in CA 19-9 Levels and favorable metabolic responses on imaging are associated with higher R0 resection rates and longer survival. Furthermore, the integration of multimodal imaging and biomarker assessment has enabled better stratification of patients and more personalized treatment strategies. NAT significantly improves surgical outcomes and survival in patients with resectable and borderline resectable PDAC. Advanced imaging techniques and biomarkers such as CA 19-9 play pivotal roles in evaluating the response to therapy and guiding surgical decision-making. Future research should focus on addressing variability in treatment strategies and developing more reliable predictive biomarkers.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"105849"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529916","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":"Changing paradigms in evaluating adrenal incidentalomas: Bayesian evaluation of [¹⁸F]Fluorodeoxyglucose positron emission tomography use, honed on adrenocortical carcinoma.","authors":"Ioannis Ilias, Georgios Meristoudis","doi":"10.5306/wjco.v16.i6.106511","DOIUrl":"10.5306/wjco.v16.i6.106511","url":null,"abstract":"<p><p>We present the diagnostic performance of [¹⁸F]Fluorodeoxyglucose positron emission tomography (FDG PET) for adrenal incidentalomas based on lesion size and unenhanced computed tomography (CT) density in Hounsfield units (HU), following current literature and guidelines. A 20 HU cutoff can be applied to differentiate potentially benign from malignant lesions, particularly in ruling in or out adrenocortical carcinoma. While FDG PET provides valuable metabolic information, its likelihood ratios for a positive (LR+) or negative (LR-) result do not exceed the robust diagnostic thresholds of > 10.0 or < 0.1, respectively. This suggests that positron emission tomography alone is insufficient for definitive characterization and should be integrated with CT or magnetic resonance imaging to leverage their complementary anatomical and functional imaging strengths for optimal diagnostic accuracy.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"106511"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529917","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":"Inclusion criteria for liver transplantation in patients with colorectal liver metastases: How to make the best selection?","authors":"Maja Cigrovski Berkovic, Anna Mrzljak, Fabio Melandro, Quirino Lai","doi":"10.5306/wjco.v16.i6.106629","DOIUrl":"10.5306/wjco.v16.i6.106629","url":null,"abstract":"<p><p>The selection of patients with colorectal cancer liver metastases (CRLM) for liver transplantation (LT) represents a significant challenge, requiring a balance between oncological outcomes and organ scarcity. Recent advancements in transplantation outcomes for CRLM have prompted the establishment of rigorous selection criteria to optimize patient survival and graft utilization. This review examines the key criteria used to select candidates for LT in this setting, with a focus on oncological factors, patient characteristics, and response to therapy. Eligible candidates are typically those with non-resectable liver-only CRLM, demonstrating controlled primary tumor disease. Tumor biology is a critical determinant, excluding patients exhibiting high-risk molecular features such as <i>BRAF</i> or <i>RAS</i> mutations. Furthermore, candidates must show a favorable response to systemic chemotherapy, with either tumor stability or reduction in size and no extrahepatic progression during a defined treatment period. Specific tumor burden scores, such as the Oslo score or criteria based on the number and size of lesions, aid in stratifying candidates with acceptable recurrence risks. Other factors, including age, performance status, and absence of significant comorbidities, are also pivotal. Long-term follow-up data highlight the importance of stringent patient selection, showing superior 5-year survival in patients meeting these criteria compared to those who do not. In conclusion, strict selection criteria based on tumor biology, systemic disease control, and patient-specific factors ensure optimized outcomes for LT in CRLM patients, marking a pivotal step toward broader clinical acceptance of this novel approach.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"106629"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529846","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":"Regulation of matrix metalloproteinase-13 in cancer: Signaling pathways and non-coding RNAs in tumor progression and therapeutic targeting.","authors":"Deekshaa Chidambaram, Velan Subashini, Muthuvairaprasath Nanthanalaxmi, Iyyappan Saranya, Nagarajan Selvamurugan","doi":"10.5306/wjco.v16.i6.105996","DOIUrl":"10.5306/wjco.v16.i6.105996","url":null,"abstract":"<p><p>Matrix metalloproteinases (MMPs) are essential enzymes involved in extracellular matrix degradation and remodeling. Such processes are integral to normal tissue homeostasis and several pathological conditions such as cancer. Among these MMPs, MMP-13 plays a key role in cancer progression, driving tumor invasion, metastasis, and angiogenesis. Despite significant advancements in understanding its biology, therapeutic targeting of MMP-13 remains challenging owing to its complex and multifaceted regulatory mechanisms. Recent studies have underscored the pivotal role of non-coding RNAs (ncRNAs), including long ncRNAs, microRNAs, and circular RNAs, in modulating MMP-13 expression. This review provides a comprehensive analysis of MMP-13 regulation by several signaling pathways, the influence of ncRNAs on these signaling pathways, and MMP-13 expression during cancer progression and metastasis. Furthermore, we explored the clinical relevance of ncRNA-mediated regulatory networks, highlighting their potential as diagnostic biomarkers and therapeutic targets in various cancers. By unraveling these regulatory mechanisms, this review offers valuable insights into innovative strategies for cancer diagnosis and treatment and emphasizes the translational significance of ncRNA-mediated MMP-13 regulation in oncology.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"105996"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529860","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":"Updates in the diagnosis and management of ductal adenocarcinoma of the pancreas.","authors":"Efstathios T Pavlidis, Ioannis N Galanis, Theodoros E Pavlidis","doi":"10.5306/wjco.v16.i6.105601","DOIUrl":"10.5306/wjco.v16.i6.105601","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) is characterized by high aggressiveness, poor prognosis, and unsatisfactory survival rates. The incidence of PDAC is increasing annually, and thus, the number of deaths due to PDAC is increasing worldwide. Modern imaging modalities, including multidetector computed tomography, magnetic resonance imaging-cholangiopancreatography, endoscopic retrograde cholangiopancreatography, positron emission tomography-computed tomography, endoscopic ultrasound and tumor markers, have made significant contributions to the diagnosis of pancreatic cancer. However, early diagnosis remains challenging despite progress in liquid biopsy (tumor DNA, tumor parts or cells), miRNAs, genomic analysis, MTA (metastasis-associated) proteins or circulating cancer-derived exosomes. Early diagnosis and radical surgical excision offer a unique chance of long-term survival in patients with an otherwise poor prognosis. However, surgery alone is insufficient, and multimodal treatment is needed. Novel treatment modalities, <i>i.e.</i>, immunotherapy, vaccines, targeted gene therapy, extracellular vesicles (particularly exosomes), new chemotherapy, novel radiotherapy and angiogenesis-restricting biological agents, were applied with promising outcomes. It seems that the biological mechanisms underlying the disease determine the effectiveness of any therapeutic effort. Thus, further research at the molecular level must focus on novel treatments to prevent the growth, invasion, and spread of cancer cells.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"105601"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529864","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":"Clinical significance of the transcription factor (SOX11) expression in the bone marrow of acute myeloid leukemia patients.","authors":"Rania S Abdel Aziz, Enas M Radwan, Abdelhamid M Fouad, Mona S Abdellateif, Sally Elfishawi","doi":"10.5306/wjco.v16.i6.107271","DOIUrl":"10.5306/wjco.v16.i6.107271","url":null,"abstract":"<p><strong>Background: </strong>The prognosis for acute myeloid leukemia (AML) remains poor, underscoring the need for a deeper understanding of its underlying molecular mechanisms.</p><p><strong>Aim: </strong>To assess the significance of <i>SOX11</i> gene expression in the clinical features, response to treatment, and survival outcomes of adult patients with AML.</p><p><strong>Methods: </strong>This retrospective study enrolled 102 adults with AML. <i>SOX11</i> gene expression in bone marrow samples was measured using real-time PCR. Data were correlated to the patients' clinical features, response to treatment, and survival rates.</p><p><strong>Results: </strong>Increased <i>SOX11</i> expression was significantly associated with the presence of the <i>FLT3-ITD</i> mutation (<i>P</i> < 0.001), the FAB-M2 subtype (<i>P</i> = 0.008), and cytogenetic abnormalities (<i>P</i> = 0.011). However, no significant association was found between SOX11 expression and other clinical laboratory parameters, complete remission, disease-free survival, or overall survival.</p><p><strong>Conclusion: </strong><i>SOX11</i> expression may serve as a marker to identify specific subsets of AML patients who could benefit from intensive targeted chemotherapy.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"107271"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529919","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":"Phenotypic attributes and survival in mismatch repair deficient/microsatellite instability-high colorectal carcinomas.","authors":"Anurag Mehta, Divya Bansal, Rupal Tripathi, Vidya Anoop","doi":"10.5306/wjco.v16.i6.104243","DOIUrl":"10.5306/wjco.v16.i6.104243","url":null,"abstract":"<p><strong>Background: </strong>Mismatch repair deficient/microsatellite instability-high (MMR-D/MSI-H) colorectal cancers (CRCs) possess a distinctive genomic profile that results in a spectrum of phenotypic attributes setting them apart from their mismatch repair proficient (MMR-P) or microsatellite stable (MSS) counterparts. CRCs have several prognostic factors, including stage, tumor differentiation, location, lymphovascular and perineural invasion, tumor budding, tumor infiltrating lymphocytes, lymph node yield (LNY), and lymph node ratio (LNR).</p><p><strong>Aim: </strong>To determine the unique phenotypic characteristics of MMR-D/MSI-H CRCs and leverage the conventional wisdom of LNY and LNR with the distinctive characteristics of MMR-D/MSI-H CRCs.</p><p><strong>Methods: </strong>This retrospective analysis involved 223 stage I-III CRC patients who underwent surgical resection without neoadjuvant treatment. Clinical and histological features were obtained from patient records and by re-examining the hematoxylin and eosin-stained slides. MMR/MSI status was evaluated for all patients using either MMR immunohistochemistry or MSI testing.</p><p><strong>Results: </strong>Of the 223 patients in our study, 87 (39.01%) were MMR-D/MSI-H CRCs while 136 (60.99%) were MMR-P/MSS CRCs. The MMR-D/MSI-H CRCs exhibited significant statistical differences compared to the MMR-P/MSS CRCs in several factors, including location, stage, tumor budding, lymphovascular and perineural invasion, lymphocytic response, LNY, LNR, and size of uninvolved lymph nodes. LNY and LNR were significantly higher in MMR-D/MSI-H group compared with the MMR-P/MSS group (<i>P</i> = 0.003 and <i>P</i> < 0.001, respectively). Also, the interquartile range of the largest uninvolved lymph node was 1 cm (0.8 cm-1.2 cm) in MMR-D/MSI-H CRCs compared to 0.7 cm (0.6 cm-0.97 cm) in MMR-P/MSS CRCs. The overall survival for the MMR-P/MSS CRC group was 71% at five years, and the MMR-D/MSI-H CRC group was 92% at five years (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>MMR-D/MSI-H CRCs possess a unique genomic profile that leads to distinct phenotypic characteristics, including an enhanced immune response. This distinctive profile underscores the substantial prognostic and predictive value of MMR-D/MSI-H status in CRC.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"104243"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529857","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":"Swollen lymph node metastasis and survival in gastric cancer: Multi-institutional post-resection analysis.","authors":"Jing-Li Cui, Kai Zhao, Xiang-Li Li, Fei Wang, Yong-Sheng Yang, Xiao Zheng","doi":"10.5306/wjco.v16.i6.106228","DOIUrl":"10.5306/wjco.v16.i6.106228","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is frequently diagnosed at advanced stages, often with lymph node metastasis (LNM), which complicates prognosis. Swollen LNM (SLNM) in GC has been linked to poor outcomes, yet its prognostic value requires validation.</p><p><strong>Aim: </strong>To evaluate the prognostic significance of SLNM in GC patients undergoing curative-intent gastrectomy.</p><p><strong>Methods: </strong>A retrospective analysis included 507 GC patients with LNM, categorized by SLNM status into positive (SLNM present) and negative (SLNM absent) groups. Survival outcomes were compared between groups, including propensity score matching and multivariate analysis to assess the role of SLNM as an independent prognostic factor.</p><p><strong>Results: </strong>One hundred and thirty-nine (27.4%) patients exhibited SLNM, associated with significantly lower 5-year overall survival (OS) compared to non-SLNM patients (13.6% <i>vs</i> 35.8%, <i>P</i> < 0.001). After matching, SLNM-positive patients maintained worse OS rates (13.4% <i>vs</i> 21.2%, <i>P</i> = 0.006). Multivariate analysis confirmed SLNM as an independent prognostic factor (hazard ratio = 1.318, <i>P</i> = 0.031). Additionally, T4 stage, N3 stage, and neoadjuvant chemotherapy independently influenced survival outcomes for SLNM-positive patients. Those who received neoadjuvant chemotherapy demonstrated better prognosis.</p><p><strong>Conclusion: </strong>SLNM is an independent predictor of poor prognosis in GC. Neoadjuvant chemotherapy followed by D2 gastrectomy and adjuvant chemotherapy may offer survival benefits for patients with SLNM.</p>","PeriodicalId":23802,"journal":{"name":"World journal of clinical oncology","volume":"16 6","pages":"106228"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529862","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}