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IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/S1521-6918(24)00024-6
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引用次数: 0
Management of high risk T1 gastric adenocarcinoma following endoscopic resection 内镜切除术后高风险 T1 胃腺癌的管理
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101887
Jéssica Chaves , Diogo Libânio , Pedro Pimentel-Nunes
{"title":"Management of high risk T1 gastric adenocarcinoma following endoscopic resection","authors":"Jéssica Chaves ,&nbsp;Diogo Libânio ,&nbsp;Pedro Pimentel-Nunes","doi":"10.1016/j.bpg.2024.101887","DOIUrl":"10.1016/j.bpg.2024.101887","url":null,"abstract":"<div><p><span>Endoscopic submucosal dissection<span> has revolutionized the treatment of early gastric cancer. However, cases that do not meet the curability criteria have a higher risk of </span></span>lymph node metastasis and salvage surgery is still considered the next treatment approach to increase the chance of cure. Nevertheless, not all high-risk resections entail the same level of risk, emphasizing the utmost importance of individualized stratification for further treatment. In this review, we aim to examine the current evidence concerning the management following a high-risk non-curative resection, highlighting the existing approaches, while also presenting upcoming strategies that attempt to improve patient outcomes, minimize adverse events, and provide a tailored management.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139644660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of high risk T1 esophageal adenocarcinoma following endoscopic resection 内镜切除术后高风险 T1 食管腺癌的处理方法
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101882
Philippe Leclercq , Raf Bisschops , Jacques J.G.H.M. Bergman , Roos E. Pouw
{"title":"Management of high risk T1 esophageal adenocarcinoma following endoscopic resection","authors":"Philippe Leclercq ,&nbsp;Raf Bisschops ,&nbsp;Jacques J.G.H.M. Bergman ,&nbsp;Roos E. Pouw","doi":"10.1016/j.bpg.2024.101882","DOIUrl":"10.1016/j.bpg.2024.101882","url":null,"abstract":"<div><p>High-risk T1 esophageal adenocarcinoma (HR-T1 EAC) is defined as T1 cancer, with one or more of the following histological criteria: submucosal invasion, poorly or undifferentiated cancer, and/or presence of lympho-vascular invasion. Esophagectomy has long been the only available treatment for these HR-T1 EACs and was considered necessary because of a presumed high risk of lymph node metastases up to 46%. However, endoscopic submucosal disscection have made it possible to radically remove HR-T1 EAC, irrespective of size, while leaving the esophageal anatomy intact. Parallel to this development, new publications demonstrated that the risk of lymph node metastases for HR-T1 EAC may be even &lt;24%. Therefore, indications for endoscopic treatment of HR-T1 EAC are being reconsidered and current research aims at finding the optimal management strategy for this indication, where watchful waiting may proof to be an acceptable strategy in selected patients. In this review, we will discuss the latest developments in this field.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139669059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management after non-curative endoscopic resection of T1 rectal cancer T1 直肠癌非根治性内窥镜切除术后的处理方法
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101895
Hao Dang, Daan A. Verhoeven, Jurjen J. Boonstra, Monique E. van Leerdam
{"title":"Management after non-curative endoscopic resection of T1 rectal cancer","authors":"Hao Dang,&nbsp;Daan A. Verhoeven,&nbsp;Jurjen J. Boonstra,&nbsp;Monique E. van Leerdam","doi":"10.1016/j.bpg.2024.101895","DOIUrl":"10.1016/j.bpg.2024.101895","url":null,"abstract":"<div><p>Since the introduction of population-based screening, increasing numbers of T1 rectal cancers are detected and removed by local endoscopic resection. Patients can be cured with endoscopic resection alone, but there is a possibility of residual tumor cells remaining after the initial resection. These can be located intraluminally at the resection site or extraluminally in the form of (lymph node) metastases. To decrease the risk of residual cells progressing towards more advanced disease, additional treatment is usually needed. However, with the currently available risk stratification models, it remains challenging to determine who should and should not be further treated after non-curative endoscopic resection. In this review, the different management strategies for patients with non-curatively treated T1 rectal cancers are discussed, along with the available evidence for each strategy and relevant considerations for clinical decision making. Furthermore, we provide practical guidance on the management and surveillance following non-curative endoscopic resection of T1 rectal cancer.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521691824000143/pdfft?md5=db68317b9ccbdd8d245b0694536ea500&pid=1-s2.0-S1521691824000143-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139954127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Curative criteria for endoscopic treatment of oesophageal squamous cell cancer 食道鳞状细胞癌内镜治疗的治愈标准
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101894
Toshiro Iizuka
{"title":"Curative criteria for endoscopic treatment of oesophageal squamous cell cancer","authors":"Toshiro Iizuka","doi":"10.1016/j.bpg.2024.101894","DOIUrl":"10.1016/j.bpg.2024.101894","url":null,"abstract":"<div><p>Endoscopic treatment of early oesophageal squamous cell carcinoma is widely accepted. ESD (Endoscopic Submucosal Dissection), which allows en bloc resection regardless of size, provides resected specimens that facilitate histological evaluation of curability. In the histological investigation, the determination of tumor depth, lymphovascular involvement, and lateral and vertical margins play a great role in the assessment of curability. The diagnosis of lymphovascular invasion, in particular, is enhanced by the addition of immunostaining. The long-term outcome of ESD is comparable to that of oesophagectomy, and ESD may be the first-line treatment for early-stage oesophageal cancer due to its fewer complications. Surveillance after curative resection is also imperative because oesophageal cancer is often characterized by the concept of field cancerization, which results in metachronous multiple primary lesions.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multimodal treatment with endoscopic ablation and systemic therapy for cholangiocarcinoma 胆管癌的内镜消融和系统治疗多模式疗法
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101893
Zaheer Nabi , Michał Żorniak , D Nageshwar Reddy
{"title":"Multimodal treatment with endoscopic ablation and systemic therapy for cholangiocarcinoma","authors":"Zaheer Nabi ,&nbsp;Michał Żorniak ,&nbsp;D Nageshwar Reddy","doi":"10.1016/j.bpg.2024.101893","DOIUrl":"10.1016/j.bpg.2024.101893","url":null,"abstract":"<div><p>Cholangiocarcinoma (CCA) are primary malignancies of biliary system and usually unresectable at the time of diagnosis. As a consequence, majority of these cases are candidates for palliative care. With the advances in chemotherapeutic agents and multidisciplinary care, the survival rate has improved in cases with inoperable malignant biliary obstruction. As a consequence, there is a need to provide effective and durable palliative care in these patients. The main role of endoscopic palliation in the vast majority of CCA includes biliary stenting for obstructive jaundice. Recent advances in the endoscopic palliation and multimodal approach appear promising in imparting durable relief of symptoms. Use of radiofrequency ablation, photodynamic therapy and intraluminal brachytherapy has been shown to improve the survival rates as well as the patency of biliary stents. Infact, intraductal ablation may act synergistically with chemotherapy by modulating tumour signalling pathways and immune microenvironment.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139928192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Curative criteria for endoscopic treatment of gastric cancer 胃癌内镜治疗的治愈标准
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101884
João A. Cunha Neves , Pedro G. Delgado-Guillena , Patrícia Queirós , Diogo Libânio , Enrique Rodríguez de Santiago
{"title":"Curative criteria for endoscopic treatment of gastric cancer","authors":"João A. Cunha Neves ,&nbsp;Pedro G. Delgado-Guillena ,&nbsp;Patrícia Queirós ,&nbsp;Diogo Libânio ,&nbsp;Enrique Rodríguez de Santiago","doi":"10.1016/j.bpg.2024.101884","DOIUrl":"10.1016/j.bpg.2024.101884","url":null,"abstract":"<div><p><span><span><span>Endoscopic treatment, particularly </span>endoscopic submucosal dissection, has become the primary treatment for early gastric cancer. A comprehensive optical assessment, including </span>white light endoscopy<span>, image-enhanced endoscopy, and magnification, are the cornerstones for clinical staging and determining the resectability of lesions. This paper discusses factors that influence the indication for endoscopic resection and the likelihood of achieving a curative resection. Our review stresses the critical need for interpreting the histopathological report in accordance with clinical guidelines and the imperative of tailoring decisions based on the patients' and lesions’ characteristics and preferences. Moreover, we offer guidance on managing complex scenarios, such as those involving non-curative resection. Finally, we identify future research avenues, including the role of artificial intelligence in estimating the depth of invasion and the urgent need to refine predictive scores for </span></span>lymph node metastasis and metachronous lesions.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139669623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic resection of residual rectal neoplasia after definitive chemoradiotherapy for rectal cancer 直肠癌明确化放疗后的直肠残余肿瘤内窥镜切除术
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101896
Robert Klimkowski , Jakub Krzyzkowiak , Nastazja Dagny Pilonis , Krzysztof Bujko , Michal F. Kaminski
{"title":"Endoscopic resection of residual rectal neoplasia after definitive chemoradiotherapy for rectal cancer","authors":"Robert Klimkowski ,&nbsp;Jakub Krzyzkowiak ,&nbsp;Nastazja Dagny Pilonis ,&nbsp;Krzysztof Bujko ,&nbsp;Michal F. Kaminski","doi":"10.1016/j.bpg.2024.101896","DOIUrl":"10.1016/j.bpg.2024.101896","url":null,"abstract":"<div><p>The conventional approach to treating locally advanced rectal cancer, commonly defined as cT3 or cT4 primary tumors or with nodal metastases, involves chemoradiation (CRT) followed by surgical resection. There is a growing recognition of the potential for nonsurgical management following CRT or total neoadjuvant therapy (TNT), which allows for organ preservation. “Watch and wait” strategy may be considered if complete clinical response is achieved. In cases when adenoma or superficial cancer is present, a novel approach known as “salvage endoscopic resection of the residual disease” is emerging as a viable nonsurgical option for carefully selected patients. This review discusses available evidence and future potential for endoscopic management of residual neoplasia after oncological treatment of rectal cancer.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140017491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Curative criteria for endoscopic treatment of colorectal cancer 结直肠癌内窥镜治疗的治愈标准
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101883
Lucille Quénéhervé , Mathieu Pioche , Jérémie Jacques
{"title":"Curative criteria for endoscopic treatment of colorectal cancer","authors":"Lucille Quénéhervé ,&nbsp;Mathieu Pioche ,&nbsp;Jérémie Jacques","doi":"10.1016/j.bpg.2024.101883","DOIUrl":"10.1016/j.bpg.2024.101883","url":null,"abstract":"<div><p><span>As endoscopic treatment enables en bloc resection of T1 colorectal cancers, the risk of recurrence, often assimilated to the risk of </span>lymph node metastases<span>, must be assessed in order to offer patients an additional treatment if this risk is deemed significant. The curative criteria currently used by most guidelines are depth of invasion &lt;1 mm, well or moderately differentiated tumour, absence of lympho-vascular invasion, absence of significant budding and tumour-free resection margins. However, these factors must be assessed by qualified pathologists, as they are difficult to evaluate. Moreover, the combination of these factors leads to unnecessary surgery in over 80 % of patients whose tumours are classified as high risk. Refinement of current criteria and research into new tumour and immunological markers are needed to better predict the actual risk of our patients.</span></p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139590691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multimodal management of foregut neuroendocrine neoplasms 前肠神经内分泌肿瘤的多模式治疗
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-02-01 DOI: 10.1016/j.bpg.2024.101889
Yichan Zhou , James Weiquan Li , Noriya Uedo
{"title":"Multimodal management of foregut neuroendocrine neoplasms","authors":"Yichan Zhou ,&nbsp;James Weiquan Li ,&nbsp;Noriya Uedo","doi":"10.1016/j.bpg.2024.101889","DOIUrl":"10.1016/j.bpg.2024.101889","url":null,"abstract":"<div><p>The foregut, which includes the esophagus, stomach and duodenum, represents one of the most common sites for neuroendocrine neoplasms. These are highly heterogenous with different risk of progression depending on location, cell-type of origin, size, grade and other factors. Various endoscopic and imaging modalities exist to inform therapeutic decision-making, which may be in the form of surgical or endoscopic resection and medical therapy depending on the extent of the disease after diagnostic evaluation. This narrative review aims to explore the literature on the multimodal management of such foregut neuroendocrine neoplasms.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139668925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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