Journal of Gastric Cancer最新文献

{"title":"Management Strategy of Non-curative ESD in Gastric Cancer: Curative Criteria, and the Critical Building Block for Determining Beyond It.","authors":"Hyuk Lee","doi":"10.5230/jgc.2025.25.e5","DOIUrl":"10.5230/jgc.2025.25.e5","url":null,"abstract":"<p><p>Endoscopic submucosal dissection is performed in cases of early gastric cancer, where the risk of lymph node metastasis (LNM) is expected to be negligible, and 12%-21% of these patients are deemed to have undergone non-curative resections based on pathological criteria. In such cases, decisions regarding additional treatments must be made to maximize curability, depending on the anticipated LNM risk. Well-established risk factors for LNM include lymphatic invasion, vascular invasion, deep submucosal invasion, positive vertical margins, and larger tumor size. When pathological factors associated with a clear LNM risk, such as lymphatic or deep submucosal invasion, are present, additional gastrectomy with lymph node dissection should be considered. Conversely, in cases involving only a positive horizontal margin, additional endoscopic treatment may be an effective therapeutic option as opposed to gastrectomy because of the negligible risk of LNM despite the potential risk of residual tumors. Endoscopic resection is particularly advantageous for determining complete resection. In addition to pathological curability, patient-specific factors, such as age and comorbidities, must be considered. Several retrospective cohort studies have shown that the cause of mortality among patients placed only on observation without additional treatment after non-curative resection is generally related to underlying conditions irrelevant to gastric cancer. Thus, it is crucial to assess both GC-specific mortality and all-cause mortality to finalize treatment decisions that help minimize such mortality. Therefore, new treatment algorithms that integrate pathological curability with patient-specific factors must be developed.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"25 1","pages":"210-227"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016743","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":"PD-L1 as a Biomarker in Gastric Cancer Immunotherapy.","authors":"Yunjoo Cho, Soomin Ahn, Kyoung-Mee Kim","doi":"10.5230/jgc.2025.25.e4","DOIUrl":"10.5230/jgc.2025.25.e4","url":null,"abstract":"<p><p>Combining chemotherapy with immune checkpoint inhibitors (ICIs) that target the programmed death-1 (PD-1) protein has been shown to be a clinically effective first-line treatment for human epidermal growth factor receptor 2 (HER2)-negative and -positive advanced or metastatic gastric cancer (GC). Currently, PD-1 inhibitors combined with chemotherapy are the standard treatment for patients with HER2-negative/positive locally advanced or metastatic GC. Programmed death-ligand 1 (PD-L1) expression, as assessed using immunohistochemistry (IHC), is a crucial biomarker for predicting response to anti-PD-1/PD-L1 agents in various solid tumors, including GC. In GC, the PD-L1 IHC test serves as a companion or complementary diagnostic test for immunotherapy, and an accurate interpretation of PD-L1 status is essential for selecting patients who may benefit from immunotherapy. However, PD-L1 IHC testing presents several challenges that limit its reliability as a biomarker for immunotherapy. In this review, we provide an overview of the current practices of immunotherapy and PD-L1 testing in GC. In addition, we discuss the clinical challenges associated with PD-L1 testing and its future use as a biomarker for immunotherapy. Finally, we present prospective biomarkers currently under investigation as alternative predictors of immunotherapy response in GC.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"25 1","pages":"177-191"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017012","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":"Function Preserving Gastrectomy and Quality of Life.","authors":"Jeesun Kim, Hyuk-Joon Lee","doi":"10.5230/jgc.2025.25.e7","DOIUrl":"10.5230/jgc.2025.25.e7","url":null,"abstract":"<p><p>Advances in gastric cancer screening have enabled earlier detection, shifting the focus of treatment toward preserving patients' quality of life (QoL). Function-preserving gastrectomy (FPG), including pylorus-preserving gastrectomy, proximal gastrectomy, and sentinel node navigation surgery, represents a paradigm shift in the surgical management of early gastric cancer. These techniques aim to balance oncological safety with the preservation of gastric function, mitigating postgastrectomy syndromes such as dumping syndrome, bile reflux, and nutritional deficiencies. QoL assessment tools, including EORTC QLQ-STO22, KOQUSS-40, and PGSAS-45, have become integral for evaluating patient-reported outcomes, providing insights into physical, emotional, and functional recovery. Although current evidence underscores the benefits of FPG, most studies are limited to East Asia, highlighting the need for multinational trials to validate these findings globally. FPG has demonstrated comparable short- and long-term oncological outcomes to conventional gastrectomy. Enhanced nutritional recovery and reduced gastrointestinal sequelae make FPG increasingly attractive. However, its widespread adoption is challenged by technical complexity, resource intensity, and the need for adequate surgical experience. The integration of advanced technologies, such as robotic surgery and artificial intelligence, coupled with personalized approaches, is expected to further optimize FPG outcomes. This review underscores the critical role of standardized QoL assessments, collaborative research, and technological innovations in advancing FPG as a cornerstone of patient-centered gastric cancer care.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"25 1","pages":"247-260"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015655","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":"Updated Review of Proximal Gastrectomy for Gastric Cancer or Cancer of the Gastroesophageal Junction.","authors":"Tomoyuki Irino, Manabu Ohashi, Masaru Hayami, Rie Makuuchi, Motonari Ri, Takeshi Sano, Toshiharu Yamaguchi, Souya Nunobe","doi":"10.5230/jgc.2025.25.e12","DOIUrl":"https://doi.org/10.5230/jgc.2025.25.e12","url":null,"abstract":"<p><p>Proximal gastrectomy (PG) has reemerged as a viable surgical option for managing proximal gastric cancer and gastroesophageal junction cancer, particularly for early-stage tumors, offering potential advantages over total gastrectomy (TG). This review examines the evolution of PG, emphasizing surgical techniques and outcomes. Although PG was initially abandoned due to postoperative complications such as reflux esophagitis, advances in reconstruction methods, such as the double-flap technique and double-tract reconstruction, have significantly improved patient quality of life and reduced complications. Modern techniques focus on preserving gastric function, enhancing postoperative nutritional status, and minimizing morbidity, especially compared to TG. However, debates persist regarding the optimal extent of lymphadenectomy, oncological safety, and the risk of metachronous gastric cancer after surgery. Various international guidelines support PG for specific cases, particularly where lymph node involvement is limited, and functional preservation is prioritized. Despite promising survival and quality-of-life outcomes, certain risks, such as anastomotic stenosis and metachronous cancer, remain. The role of PG in treating cancer of the gastroesophageal junction continues to be investigated, with ongoing studies further clarifying its effectiveness. The evolving techniques and increased focus on patient-centered outcomes suggest a renewed role of PG in the surgical management of gastric cancer.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"25 1","pages":"228-246"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017016","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":"Oxyntic Gland Neoplasms - From Adenoma to Advanced Gastric Cancer: A Review of 29 Cases.","authors":"Gi Hwan Kim, Jun Su Lee, Jeong Hoon Lee, Young Soo Park","doi":"10.5230/jgc.2024.24.e30","DOIUrl":"10.5230/jgc.2024.24.e30","url":null,"abstract":"<p><strong>Purpose: </strong>Oxyntic gland neoplasm (OGN) is a rare condition that can be classified as oxyntic gland adenoma (OGA) or gastric adenocarcinoma of fundic-gland type (GA-FG). GA-FG primarily presents as early gastric cancer, with only a few reported cases of advanced gastric cancer (AGC). We aimed to investigate the clinicopathological features of OGN and describe an aggressive variant.</p><p><strong>Materials and methods: </strong>We investigated a total of 29 cases, including a patient with double primary cases, diagnosed with OGN or differentiated-type adenocarcinoma with GA-FG morphology, between November 2016 and April 2022. We analyzed 54 pathological specimens and reviewed their clinicopathological, endoscopic, and histological features. The lesions were reclassified as OGA or GA-FG, and immunohistochemical (IHC) staining for MUC-5AC and MUC-6 was performed on available resected GA-FG cases.</p><p><strong>Results: </strong>The median patient age was 65 years and males accounted for 58.6% of patients. Most cases occurred in the body horizontally (69.0%) and on the greater curvature side cross-sectionally (48.3%). Endoscopically, type 0-IIa (41.4%) and a subepithelial tumor-like appearance (24.1%) were the most common findings. Histologically, there were 8 cases of OGA (27.6%) and 21 cases of GA-FG (72.4%). In GA-FG, MUC-6 was positive in 13 cases (81.3%), whereas MUC-5AC was positive in 8 cases (50.0%). Three cases presented as AGCs.</p><p><strong>Conclusions: </strong>Although OGNs are generally considered low-grade, they can present as AGCs and may exhibit features of lymphovascular or perineural invasion. Recognizing the clinicopathological features and accurately diagnosing OGN are important for providing adequate treatment.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"24 4","pages":"378-390"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395605","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":"Erratum: Real-World Application of Artificial Intelligence for Detecting Pathologic Gastric Atypia and Neoplastic Lesions.","authors":"Young Hoon Chang, Cheol Min Shin, Hae Dong Lee, Jinbae Park, Jiwoon Jeon, Soo-Jeong Cho, Seung Joo Kang, Jae-Yong Chung, Yu Kyung Jun, Yonghoon Choi, Hyuk Yoon, Young Soo Park, Nayoung Kim, Dong Ho Lee","doi":"10.5230/jgc.2024.24.e33","DOIUrl":"10.5230/jgc.2024.24.e33","url":null,"abstract":"<p><p>This corrects the article on p. 327 in vol. 24, PMID: 38960891.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"24 4","pages":"480"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395587","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":"Reply: Comment on The Necessity of Guidance: Optimizing Adjuvant Therapy for Stage II/III MSI-H Gastric Cancer Through the Interplay of Evidence, Clinical Judgment, and Patient Preferences.","authors":"In-Ho Kim, Wonyoung Choi, Hye Sook Han","doi":"10.5230/jgc.2024.24.e40","DOIUrl":"10.5230/jgc.2024.24.e40","url":null,"abstract":"","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"24 4","pages":"353-355"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395606","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":"Erratum: Textbook Outcome of Delta-Shaped Anastomosis in Minimally Invasive Distal Gastrectomy for Gastric Cancer in 4,505 Consecutive Patients.","authors":"Seul-Gi Oh, Suin Lee, Ba Ool Seong, Chang Seok Ko, Sa-Hong Min, Chung Sik Gong, Beom Su Kim, Moon-Won Yoo, Jeong Hwan Yook, In-Seob Lee","doi":"10.5230/jgc.2024.24.e31","DOIUrl":"10.5230/jgc.2024.24.e31","url":null,"abstract":"<p><p>This corrects the article on p. 341 in vol. 24, PMID: 38960892.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"24 4","pages":"479"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395588","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":"Long-term Oncologic Outcomes of Robotic Total Gastrectomy for Advanced Gastric Cancer.","authors":"Jawon Hwang, Ki-Yoon Kim, Sung Hyun Park, Minah Cho, Yoo Min Kim, Hyoung-Il Kim, Woo Jin Hyung","doi":"10.5230/jgc.2024.24.e38","DOIUrl":"10.5230/jgc.2024.24.e38","url":null,"abstract":"<p><strong>Purpose: </strong>Although laparoscopic distal gastrectomy has rapidly replaced open distal gastrectomy, laparoscopic total gastrectomy (LTG) is less frequently performed owing to technical difficulties. Robotic surgery could be an appropriate minimally invasive alternative to LTG because it alleviates the technical challenges posed by laparoscopic procedures. However, few studies have compared the oncological safety of robotic total gastrectomy (RTG) with that of LTG, especially for advanced gastric cancer (AGC). Herein, we aimed to assess the oncological outcomes of RTG for AGC and compare them with those of LTG.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 147 and 204 patients who underwent RTG and LTG for AGC, respectively, between 2007 and 2020. Long-term outcomes were compared using inverse probability of treatment weighting (IPTW).</p><p><strong>Results: </strong>After IPTW, the 2 groups exhibited similar clinicopathological features. The 5-year overall survival was comparable between the 2 groups (88.5% [95% confidence interval {CI}, 79.4%-93.7%] after RTG and 87.3% [95% CI, 80.1%-92.0%]) after LTG; log-rank P=0.544). The hazard ratio (HR) for death after RTG compared with that after LTG was 0.73 (95% CI, 0.40-1.33; P=0.304). The 5-year relapse-free survival was also similar between the 2 groups (75.7% [95% CI, 65.2%-83.4%] after RTG and 76.4% [95% CI, 67.9%-83.0%] after LTG; log-rank P=0.850). The HR for recurrence after RTG compared with that after LTG was 0.93 (95% CI, 0.60-1.46; P=0.753).</p><p><strong>Conclusions: </strong>Our findings revealed that RTG and LTG for AGC had similar long-term outcomes. RTG is an oncologically safe alternative to LTG and has technical advantages.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"24 4","pages":"451-463"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395602","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":"Development and Feasibility Assessment of Mobile Application-Based Digital Therapeutics for Postoperative Supportive Care in Gastric Cancer Patients Following Gastrectomy.","authors":"Ji-Hyeon Park, Hyuk-Joon Lee, JeeSun Kim, Yo-Seok Cho, Sunjoo Lee, Seongmin Park, Hwinyeong Choe, Eunhwa Song, Youngran Kim, Seong-Ho Kong, Do Joong Park, Byung-Ho Nam, Han-Kwang Yang","doi":"10.5230/jgc.2024.24.e37","DOIUrl":"10.5230/jgc.2024.24.e37","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop and assess the feasibility and effectiveness of digital therapeutics for supportive care after gastrectomy.</p><p><strong>Materials and method: </strong>The study included 39 patients with gastric cancer who underwent minimally invasive gastrectomy and were able to use a mobile application (app) on their smartphones. The developed research app automatically calculates and provides daily targets for calorie and protein intake based on the patient's body mass index (BMI). Patients recorded their daily diets, weights, and symptoms in the app and completed special questionnaires to assess the feasibility of the app in real-world clinical practice.</p><p><strong>Results: </strong>At the 10-week follow-up, the mean questionnaire scores for ease of learning, usability, and effectiveness of the app (primary endpoint) were 2.32±0.41, 2.35±0.43, and 2.4±0.39 (range: 0-3), respectively. Patients were classified as underweight (<18.5, n=4), normal (18.5-24.9, n=24), or overweight (≥25.0, n=11) according to predischarge BMI. Underweight patients showed higher compliance with app usage and a higher rate of achieving the target calorie and protein intake than normal weight and overweight patients (98% vs. 77% vs. 81%, p=0.0313; 102% vs. 75% vs. 61%, P=0.0111; 106% vs. 79% vs. 64%, P=0.0429). Two patients transitioned from underweight to normal weight (50.0%), one patient (4.3%) transitioned from normal weight to underweight, and two patients (22.2%) transitioned from overweight to normal weight.</p><p><strong>Conclusions: </strong>The mobile app is feasible and useful for postoperative supportive care in terms of ease of learning, usability, and effectiveness. Digital therapeutics may be an effective way to provide supportive care for postgastrectomy patients, particularly in terms of nutrition.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04800991.</p>","PeriodicalId":56072,"journal":{"name":"Journal of Gastric Cancer","volume":"24 4","pages":"420-435"},"PeriodicalIF":3.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395586","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}