Annals of Gastroenterological Surgery最新文献

{"title":"Super Subtotal Gastrectomy: A Novel Reconstruction Concept for Upper Gastric Cancer That Preserves the Fornix","authors":"Kohei Fujita,&nbsp;Hiroyuki Sagawa,&nbsp;Sunao Ito,&nbsp;Ryo Ogawa,&nbsp;Shuji Takiguchi","doi":"10.1002/ags3.70030","DOIUrl":"https://doi.org/10.1002/ags3.70030","url":null,"abstract":"<p>The incidence of upper-third gastric cancer is rising, necessitating proximal gastrectomy or total gastrectomy in most patients. However, surgical removal of the fornix, a major site for ghrelin secretion, often results in reduced appetite and weight loss post-surgery. To address this issue, we devised a resection approach aimed at preserving ghrelin secretory sites. Here, we introduce a novel technique for treating upper-third gastric cancer near the esophagogastric junction: super subtotal gastrectomy (SSTG). During distal gastrectomy assisted by robotics, lymph node dissection was performed. Endoscopic confirmation of the tumor site guided the design of the gastrectomy line. Using a linear stapler, the stomach was dissected from the greater curvature fold to the angle of His. The specimen was then extracted through a precise incision from the angle of His to the right side of the esophagus, partially resecting the esophagogastric junction. Suturing of the open lumens of the esophagus and stomach was performed to repair the remaining stomach. Closure of the diaphragmatic crus prevented esophageal hiatal hernia. Reconstruction was achieved through Roux-en-Y reconstruction. SSTG offers the advantage of maintaining an oral margin beyond the esophageal junction while preserving the fornix. In the SSTG group, the median operative time was 333 min (range: 257–354), with a blood loss of 79.5 mL (range: 20–141). No serious intraoperative complications were observed. Our proposed SSTG technique enables the preservation of the fornix even in cases of upper-third gastric cancer located closer to the esophagogastric junction than was previously possible.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"870-875"},"PeriodicalIF":2.9,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520112","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":"Essential Update 2023/2024: Multidisciplinary Treatment for Invasive Intraductal Papillary Mucinous Carcinoma","authors":"Seiko Hirono","doi":"10.1002/ags3.70029","DOIUrl":"https://doi.org/10.1002/ags3.70029","url":null,"abstract":"<p>Invasive intraductal papillary mucinous carcinoma (IPMC) has a high malignant potential, with surgical resection being the only potentially curative treatment. However, even after surgical resection, recurrence occurs frequently and the prognosis is poor once recurrence develops. While retrospective studies aiming to achieve long-term survival in invasive IPMC patients have been reported, the rarity of invasive IPMC has resulted in small-scale datasets, leading to low levels of evidence. Consequently, the utility of adjuvant therapy after surgery, neoadjuvant therapy (NAT) before surgery, and treatments for postoperative recurrence in invasive IPMC remains unclear, with treatment strategies varying by institution—ranging from surgical resection alone to approaches based on conventional pancreatic cancer treatment. Recently, several large-scale multicenter studies on invasive IPMC have been reported. These studies suggested that while adjuvant therapy after surgery may not be beneficial for all invasive IPMC patients, it could potentially extend survival in cases with advanced-stage disease. Regarding NAT before surgery for invasive IPMC, the number of reported cases is extremely limited, and no definitive evidence has been established. For postoperative recurrence of invasive IPMC, some studies have indicated that administering treatment may prolong survival. Although these large-scale studies have gradually clarified certain characteristics of invasive IPMC, they are all retrospective in nature, resulting in a low level of evidence. To achieve long-term survival for invasive IPMC patients, large-scale prospective multicenter studies are needed in the future.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"643-649"},"PeriodicalIF":2.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520007","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":"A severity-based tumor-superior mesenteric/portal vein interface grading criteria as a predictor of survival outcomes in pancreatic head ductal adenocarcinoma patients undergoing pancreaticoduodenectomy following neoadjuvant chemoradiotherapy","authors":"Benson Kaluba,&nbsp;Naohisa Kuriyama,&nbsp;Motonori Nagata,&nbsp;Takahiro Ito,&nbsp;Aoi Hayasaki,&nbsp;Takehiro Fujii,&nbsp;Yasuhiro Murata,&nbsp;Akihiro Tanemura,&nbsp;Masashi Kishiwada,&nbsp;Shugo Mizuno","doi":"10.1002/ags3.70002","DOIUrl":"https://doi.org/10.1002/ags3.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the ability of a new severity-based tumor-superior mesenteric/portal vein interface criteria to predict survival outcomes in pancreatic ductal adenocarcinoma patients undergoing pancreaticoduodenectomy after neoadjuvant chemoradiotherapy (CRT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two hundred and twenty-six post-CRT patients were enrolled and 22 had no tumor-SMV/PV contact, while the remaining 204 had. Based on correlation with overall survival (OS), circumferential (210 degrees) and contact length (25 mm) interface cut-off values were identified, then used to formulate no tumor-SMV/PV contact, non-severe, and severe interface criteria. Significant predictors of disease-free (DFS) and OS were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The severe group had significantly more UR-LA, cStage 3 cases, longer operation times, more intra-operative blood loss, R1 resection, and pPV invasion cases than the no tumor-contact and non-severe interface groups (<i>p</i> &lt; 0.001). Median DFS were 37.7 (no tumor-contact), 17.0 (non-severe), and 5.2 (severe) months and OS was 56.7, 29.9, and 12.0. Among tumor-contact patients, the interface criteria (84.7%) had a better specificity in predicting pPV invasion than tumor-contact length (76.9%) and tumor-circumferential interface (73.8%). Those with pPV invasion had shorter DFS (16.7 vs. 5.7) and OS (28.3 vs. 13.6) than those without pPV invasion. Significant independent predictors of both DFS and OS were the interface criteria, resection margins, and pPV invasion. Clinical and pathological lymph node involvement also influenced DFS, while circumferential interface and pathological tumor stage also impacted OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients can be stratified as no tumor-contact, non-severe, or severe interface cases and the criteria might be useful in preoperatively predicting not only survival but also intra-operative outcomes and pPV invasion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"842-860"},"PeriodicalIF":2.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520004","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":"Regional and patient characteristic disparities in the outcomes of minimally invasive surgery for colorectal cancer in Japan","authors":"Atsushi Hamabe,&nbsp;Arata Takahashi,&nbsp;Hiraku Kumamaru,&nbsp;Hiroshi Hasegawa,&nbsp;Koki Otsuka,&nbsp;Yoshihiro Kakeji,&nbsp;Ken Shirabe,&nbsp;Masafumi Inomata,&nbsp;Yuko Kitagawa,&nbsp;Ichiro Takemasa","doi":"10.1002/ags3.70007","DOIUrl":"https://doi.org/10.1002/ags3.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The use of minimally invasive surgery, including laparoscopic and robotic surgery, for gastrointestinal cancer has been rapidly increasing. This study aimed to clarify whether differences in minimally invasive surgery outcomes are associated with regional and patient characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 123 771 right hemicolectomy and 126 965 low anterior resection cases performed between 2013 and 2019 were selected from the National Clinical Database for analysis. Patients were stratified by regional and economic variables, and open and minimally invasive surgical outcomes were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In secondary medical regions characterized by urban settings and numerous designated cancer care hospitals, the observed 30-day mortality of low anterior resections was lower only in the minimally invasive surgery group. For right hemicolectomies in regions with many designated cancer care hospitals, the observed incidence of postoperative complications was also lower in the minimally invasive group. Residents of high-income areas undergoing low anterior resection had a lower frequency of 30-day reoperation regardless of the type of surgery and a lower 30-day mortality in the minimally invasive group. For both right hemicolectomy and low anterior resection, patients with longer travel distances had fewer postoperative complications and lower 30-day reoperation rates in the minimally invasive group than in the open surgery group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found regional and patient characteristic disparities in minimally invasive surgical outcomes; national policies should be implemented to address these inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"769-784"},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519823","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":"Short-term and long-term outcomes of self-expandable metallic stent placement versus creation of a diverting stoma for obstructive colorectal cancer: A systematic review and meta-analysis","authors":"Thanakorn Yingruxpund,&nbsp;Akihisa Matsuda,&nbsp;Takeshi Yamada,&nbsp;Chaiya Chansai,&nbsp;Hiroshi Yoshida","doi":"10.1002/ags3.70011","DOIUrl":"https://doi.org/10.1002/ags3.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>A diverting stoma (DS) is often used as a bridge to surgery in patients with obstructive colorectal cancer (OCRC). However, the self-expandable metallic stent (SEMS) has emerged as a less invasive option. This systematic review and meta-analysis compared the efficacy and safety of the SEMS with that of a DS for OCRC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An electronic literature search through to May 2024 was performed to identify studies that compared the SEMS and DS as a bridge to surgery in patients with OCRC. The primary outcomes were postoperative complications and mortality. Secondary outcomes included clinical success of decompression, surgical site infection, anastomotic leakage, bleeding, permanent stoma creation, locoregional recurrence, and 3-year overall survival. The data were pooled using a random-effects model. The results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five non-randomized studies that included 977 patients (SEMS, <i>n</i> = 427; DS, <i>n</i> = 550) were included. Postoperative complications (OR 0.78, 95% CI 0.60–1.01, <i>p</i> = 0.06) and mortality (OR 1.15, 95% CI 0.61–2.16, <i>p</i> = 0.67) were comparable between the groups. SEMS placement had a significantly lower clinical success of decompression but reduced the risk of surgical site infection (OR 0.45, 95% CI 0.27–0.77, <i>p</i> = 0.003). There was no significant between-group difference in frequency of anastomotic leakage (<i>p</i> = 0.68), bleeding (<i>p</i> = 0.94), permanent stoma formation (<i>p</i> = 0.95), locoregional recurrence (<i>p</i> = 0.31), or 3-year overall survival (<i>p</i> = 0.98).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although clinical success was inferior to DS, SEMS contributed to comparable outcomes including postoperative complications, mortality, and long-term outcomes, but significantly reduced SSI. These findings support the broader adoption of SEMS in clinical practice, particularly requiring minimized invasiveness and improving patient quality of life are prioritized.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"632-642"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519902","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":"Role of radiotherapy in surgical approaches to pancreatic cancer treatment: A narrative review","authors":"Satoshi Yasuda,&nbsp;Minako Nagai,&nbsp;Kota Nakamura,&nbsp;Yasuko Matsuo,&nbsp;Masayuki Sho","doi":"10.1002/ags3.70012","DOIUrl":"https://doi.org/10.1002/ags3.70012","url":null,"abstract":"<p>This review discusses the evolving role of radiotherapy (RT) in the surgical treatment of pancreatic ductal adenocarcinoma (PDAC). Despite advancements in multidisciplinary treatment, PDAC continues to present significant challenges in surgical treatment strategies. Neoadjuvant therapy, in combination with chemotherapy and RT, aims to improve patient outcomes by reducing tumor size, controlling local spread, and eradicating micrometastatic disease that cannot be detected at the time of diagnosis. Recent randomized trials have shown that both neoadjuvant chemoradiotherapy (NACRT) and neoadjuvant chemotherapy (NAC) improve surgical outcomes compared with upfront surgery. A network meta-analysis integrating multiple trials demonstrated that NACRT significantly improves overall survival compared to NAC (HR: 0.79, 95% CI: 0.64–0.98). NACRT has also shown advantage in local tumor control. For locally advanced PDAC, the role of RT in conversion therapy is being actively investigated. The integration of RT in treatment regimens requires careful consideration of its therapeutic benefits against potential adverse effects. Although experimental studies suggest potential immunological benefits of RT, clinical validation remains incomplete. Recent advances in radiation delivery techniques have improved the therapeutic ratio, although further clinical validation is needed. The optimal sequence and combination of these treatment modalities with surgical strategies continue to be evaluated in ongoing clinical trials. This review synthesizes evidence from recent clinical trials and previous studies to evaluate the effectiveness, challenges, and potential of RT in PDAC treatment, aiming to inform both current clinical practice and future research directions.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"418-428"},"PeriodicalIF":2.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949879","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 role of intraperitoneal chemotherapy in patients with pancreatic ductal adenocarcinoma concomitant with occult peritoneal dissemination: A multicenter retrospective study","authors":"Tomohisa Yamamoto,&nbsp;Toshio Shimokawa,&nbsp;Masamichi Hayashi,&nbsp;Masamichi Mizuma,&nbsp;Katsuhisa Hirano,&nbsp;Atsushi Oba,&nbsp;Toshimichi Asano,&nbsp;Hideyo Miyato,&nbsp;Makoto Yoshida,&nbsp;Ippei Matsumoto,&nbsp;Yasunari Kawabata,&nbsp;Katsunori Sakamoto,&nbsp;Fuyuhiko Motoi,&nbsp;Shigeto Ishii,&nbsp;Yuki Homma,&nbsp;Hiromitsu Maehira,&nbsp;Yutaro Matsunaga,&nbsp;Tetsuya Ikemoto,&nbsp;Masafumi Nakamura,&nbsp;Yuko Mataki,&nbsp;Tsuyoshi Notake,&nbsp;Keiichi Akahoshi,&nbsp;Hideki Takami,&nbsp;So Yamaki,&nbsp;Daisuke Hashimoto,&nbsp;Yasutoshi Kimura,&nbsp;Satoshi Hirano,&nbsp;Yosuke Inoue,&nbsp;Tsutomu Fujii,&nbsp;Michiaki Unno,&nbsp;Yasuhiro Kodera,&nbsp;Joji Kitayama,&nbsp;Sohei Satoi,&nbsp;the Study Group of Pancreatic Ductal Adenocarcinoma with Peritoneal Dissemination","doi":"10.1002/ags3.70001","DOIUrl":"https://doi.org/10.1002/ags3.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The effectiveness of intraperitoneal chemotherapy using paclitaxel (i.p.-PTX) in pancreatic ductal adenocarcinoma (PDAC) patients with peritoneal dissemination remains elusive. The aim of this study is to investigate the clinical outcome of patients treated with i.p.-PTX combined with systemic chemotherapy compared with current standard chemotherapy including gemcitabine plus nab-paclitaxel and FOLFIRINOX.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data of patients with peritoneal dissemination was retrospectively collected and analyzed (i.p.-PTX, <i>n</i> = 83; control, <i>n</i> = 86). Inverse probability of treatment-weighted analyses (IPTW) was used to balance baseline characteristics between two groups. Survival curves were estimated using Kaplan–Meier method, and the differences were compared using the log-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were noted in overall survival (14.9 vs. 15.5 months, <i>p</i> = 0.481) and progression free survival (9.5 vs. 9.1 months, <i>p</i> = 0.267) between i.p.-PTX and the control groups. Nevertheless, i.p.-PTX (9.9 months) significantly prolonged the median progression-free survival (PFS) time compared with the control (8.6 months), among the matched patients using IPTW (hazard ratio 0.666, <i>p</i> = 0.041). Moreover, subgroup analysis among the patients whose primary tumor were evaluated either as resectable or borderline resectable disease revealed significantly better overall survival in the i.p.-PTX group compared with the control group (21.3 vs. 14.7 months, hazard ratio; 0.532, <i>p</i> = 0.033). Conversion surgery was more frequently performed in the i.p.-PTX group than the control group (24% vs. 4%, <i>p</i> = 0.006).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The i.p. PTX regimen prolonged PFS but not overall survival, and subgroup analysis suggested the possibility of survival benefit in patients with occult peritoneal dissemination whose primary tumor was classified as resectable/borderline resectable disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"830-841"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520050","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":"Prognostic impact of postoperative fixed-point inflammation in patients with gastric cancer after curative gastrectomy: A validation cohort study","authors":"Ryota Matsui,&nbsp;Manabu Ohashi,&nbsp;Motonari Ri,&nbsp;Rie Makuuchi,&nbsp;Tomoyuki Irino,&nbsp;Masaru Hayami,&nbsp;Takeshi Sano,&nbsp;Souya Nunobe","doi":"10.1002/ags3.70006","DOIUrl":"https://doi.org/10.1002/ags3.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to determine the cutoff values of C-reactive protein (CRP) on postoperative day 3 to predict poor overall survival (OS) in men and women with gastric cancer after radical gastrectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included consecutive patients who underwent radical gastrectomy for primary pStages I–III gastric cancer between May 2006 and March 2017. The patients were randomly divided 6:4 into a training set, which examined the cutoff values for CRP, and a validation set, which validated the cutoff values. Patients with a CRP level higher than the cutoff value were defined as the high-CRP group, and those with a CRP level lower than the cutoff value were defined as the low-CRP group. We compared the OS of the high and low CRP groups using the log-rank test and identified prognostic factors using Cox proportional hazards regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We examined the cutoff values of CRP, which were 19.1 mg/dL for men and 8.1 mg/dL for women. The median follow-up duration was 66 months. The high-CRP group had poorer OS than the low-CRP group (<i>p</i> &lt; 0.001). Multivariate analyses showed that a high CRP level was an independent poor prognostic factor for OS in all patients (hazard ratio, 1.356; 95% confidence interval, 1.168–1.576; <i>p</i> &lt; 0.001), not only in patients without postoperative complications (<i>p</i> = 0.001) but also in patients with postoperative complications (<i>p</i> = 0.023).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that a high postoperative CRP was an independent poor prognostic factor for OS in patients with gastric cancer after radical gastrectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 4","pages":"698-710"},"PeriodicalIF":2.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144520051","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":"Interview with the World Class Authorities Frontiers of Cancer Research: An exclusive interview with Professor Luis Diaz","authors":"Haruna Takeda,&nbsp;Koshi Mimori,&nbsp;Masanobu Oshima,&nbsp;Ken Shirabe,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.70003","DOIUrl":"https://doi.org/10.1002/ags3.70003","url":null,"abstract":"<p>This manuscript provides an in-depth interview with Prof. Luis Diaz, Head of Oncology at Memorial Sloan Kettering Cancer Center and Editor-in-Chief of <i>Cancer Discovery</i>. A globally recognized leader in oncology, Prof. Diaz discusses the transformative impact of precision oncology, particularly the role of mismatch repair deficiency (dMMR) and microsatellite instability-high (MSI-H) biomarkers in immunotherapy. He highlights the groundbreaking success of PD-1 blockade therapies, such as dostarlimab, which have achieved unprecedented complete response rates in dMMR/MSI-H rectal cancer, emphasizing its tumor-agnostic potential. Prof. Diaz reflects on the evolution of cancer diagnostics, notably circulating tumor DNA (ctDNA) for minimal residual disease (MRD) detection, and its implications for treatment personalization and early detection. He also addresses the challenges and prospects of cancer prevention, advocating for innovative approaches such as immunoprevention and vaccines targeting tumor-specific pathways, like the HPV vaccine for cervical cancer. The interview underscores the importance of fundamental research in advancing cancer care and the necessity of interdisciplinary collaboration to address unresolved questions in tumor biology. By sharing his vision and pioneering achievements, Prof. Diaz inspires the next generation of clinicians and researchers to pursue bold innovations, ultimately aiming to enhance patient outcomes and revolutionize the future of oncology. This dialogue serves as a significant resource for understanding current trends and future directions in cancer research and treatment.</p>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"401-407"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949934","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 factors for pneumonia after endoscopic laryngopharyngeal surgery in cases with prior esophageal cancer treatment","authors":"Atsushi Nakao,&nbsp;Hirofumi Kawakubo,&nbsp;Masashi Takeuchi,&nbsp;Satoru Matsuda,&nbsp;Kazumasa Fukuda,&nbsp;Yuko Kitagawa","doi":"10.1002/ags3.12907","DOIUrl":"https://doi.org/10.1002/ags3.12907","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Study Aims</h3>\u0000 \u0000 <p>Endoscopic laryngopharyngeal surgery is an effective treatment for superficial laryngopharyngeal cancer, particularly in cases with prior esophageal cancer treatment. Despite its frequent application, reports on the risk factors for postoperative complications are limited. This study aimed to identify the risk factors for pneumonia after endoscopic laryngopharyngeal surgery and to examine the variations in pneumonia incidence among the types of prior esophageal cancer treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients who had a history of esophageal cancer treatment and subsequently underwent endoscopic laryngopharyngeal surgery for superficial pharyngolaryngeal cancer were retrospectively analyzed. We examined the association between postoperative pneumonia and several factors, including number of lesions; diameter of the resected lesion; and type of previous esophageal cancer treatment, such as endoscopic submucosal dissection, chemoradiotherapy, and esophagectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 79 patients who had a mean age of 67.4 years. Postoperative pneumonia occurred in 16.4%. Multivariate analysis showed that the pneumonia incidence significantly increased in cases with multiple lesions (OR 4.794, 95% CI 1.133–20.288, <i>p</i> = 0.033) and larger diameter of the resected lesion (OR 7.047, 95% CI 1.791–27.730, <i>p</i> = 0.005). Importantly, compared with other treatments, prior esophagectomy for esophageal cancer did not increase the pneumonia incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Multiple lesions and larger lesion diameter were the significant predictors of postoperative pneumonia. Moreover, endoscopic laryngopharyngeal surgery can be safely performed even in patients who have previously undergone esophageal cancer surgery, although careful monitoring remains necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8030,"journal":{"name":"Annals of Gastroenterological Surgery","volume":"9 3","pages":"456-463"},"PeriodicalIF":2.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ags3.12907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949872","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}