World Journal Of Gastrointestinal Oncology[JOURNAL]
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200 papers
Machine learning approaches to early detection of delayed wound healing following gastric cancer surgery.
Kirkik D, Ozadenc HM, Kalkanli Tas S
World J Gastrointest Oncol · 2026 Jan · PMID 41607759 · Full text
Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization, increases costs, and undermines patient recovery. In An 's recent study, the autho...
Delayed wound healing following radical gastrectomy remains an important yet underappreciated complication that prolongs hospitalization, increases costs, and undermines patient recovery. In An 's recent study, the authors present a machine learning-based risk prediction approach using routinely available clinical and laboratory parameters. Among the evaluated algorithms, a decision tree model demonstrated excellent discrimination, achieving an area under the curve of 0.951 in the validation set and notably identifying all true cases of delayed wound healing at the Youden index threshold. The inclusion of variables such as drainage duration, preoperative white blood cell and neutrophil counts, alongside age and sex, highlights the pragmatic appeal of the model for early postoperative monitoring. Nevertheless, several aspects warrant critical reflection, including the reliance on a postoperative variable (drainage duration), internal validation only, and certain reporting inconsistencies. This letter underscores both the promise and the limitations of adopting interpretable machine learning models in perioperative care. We advocate for transparent reporting, external validation, and careful consideration of clinically actionable timepoints before integration into practice. Ultimately, this work represents a valuable step toward precision risk stratification in gastric cancer surgery, and sets the stage for multicenter, prospective evaluations.
Muscle mass correlates with rocuronium distribution volume and guides dose optimization in obese colorectal cancer patients.
Li ZW, Liu Z, Liu SQ
World J Gastrointest Oncol · 2026 Jan · PMID 41607758 · Full text
BACKGROUND: Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic c...
BACKGROUND: Perioperative anesthesia management of obese patients presents significant challenges as traditional total body weight-based dosing fails to achieve optimal anesthetic effects due to altered pharmacokinetic characteristics including abnormal drug distribution and clearance. Rocuronium exhibits markedly different distribution patterns in obese patients, with conventional weight correction methods inadequately addressing individual muscle mass variations that critically influence drug distribution. AIM: To investigate the quantitative relationship between skeletal muscle index (SMI) and rocuronium distribution volume in obese colorectal cancer patients, establish a population pharmacokinetic model, and develop individualized dosing strategies based on muscle mass. METHODS: A retrospective cohort study was conducted, including 100 obese patients (body mass index ≥ 30 kg/m) who underwent elective radical colorectal cancer surgery at our hospital from June 2023 to January 2025. Skeletal muscle mass was measured using InBody260 body composition analyzer and SMI was calculated to assess muscle mass, with male SMI < 7.0 kg/m and female SMI < 5.7 kg/m as diagnostic criteria for sarcopenia. Plasma rocuronium concentrations were detected by liquid chromatography-tandem mass spectrometry/mass spectrometry, and nonlinear mixed-effect modeling was used to establish population pharmacokinetic modeling. Stepwise regression was used to screen covariates, and dosing regimens were optimized through Monte Carlo simulation. The primary endpoint was targeted plasma concentration achievement rate, and the secondary endpoint was postoperative residual muscle relaxation incidence. RESULTS: Among 100 patients, 35 (35.0%) had sarcopenia and 65 (65.0%) did not. Patients in the sarcopenia group were older (64.1 ± 9.8 years 54.2 ± 10.9 years, < 0.001) and had significantly lower SMI (6.2 ± 0.8 kg/m 8.4 ± 1.2 kg/m, < 0.001). SMI showed strong positive correlation with rocuronium steady-state distribution volume ( = 0.718, < 0.001) and moderate negative correlation with clearance ( = -0.502, < 0.001). A two-compartment population pharmacokinetic model was successfully established, with SMI being the most important covariate affecting central compartment distribution volume (△OFV = -41.2, < 0.001). Model validation showed bootstrap successful convergence rate of 92.3%, and 92.1% of observed values fell within prediction intervals in predicted concentration versus predicted concentration. The SMI-based individualized dosing regimen improved target exposure achievement rate from 82.0% in traditional regimen to 93.5% ( = 0.009), and reduced postoperative residual muscle relaxation incidence from 13.0% to 3.5% ( = 0.018). The sarcopenia group showed the most significant improvement in achievement rate, from 71.4% to 93.8% ( = 0.017). CONCLUSION: SMI shows strong correlation with rocuronium distribution volume in obese colorectal cancer patients and is a key factor affecting drug distribution. SMI-based individualized dosing strategies can significantly improve target exposure achievement rate and reduce postoperative residual muscle relaxation incidence, providing scientific evidence for precision anesthesia management in obese patients.
Combined multidetector computed tomography and gastrointestinal endoscopy for gastric cancer screening, preoperative staging, and lymph node metastasis detection.
Ye LP, Zhang YP, Chen G … +4 more , Wu YX, He CL, Wang D, Mei Q
World J Gastrointest Oncol · 2026 Jan · PMID 41607757 · Full text
BACKGROUND: Early screening, preoperative staging, and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer (GC). AIM: To evaluate the diagnostic value of combined multidetector co...
BACKGROUND: Early screening, preoperative staging, and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer (GC). AIM: To evaluate the diagnostic value of combined multidetector computed tomography (MDCT) and gastrointestinal endoscopy for GC screening, preoperative staging, and lymph node metastasis detection, thereby providing a reference for clinical diagnosis and treatment. METHODS: In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed. According to the inclusion and exclusion criteria, 102 patients were finally enrolled in the analysis. All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention. Preoperative clinical staging and lymph node metastasis findings were compared with pathological results. RESULTS: The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%, specificity of 97.06%, accuracy of 98.04%, positive predictive value of 98.53%, and negative predictive value of 97.06% for diagnosing GC. These factors were all significantly higher than those of MDCT or endoscopy alone ( < 0.05). The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06% and 92.65%, respectively, outperforming MDCT alone (86.76% and 79.41%) and endoscopy alone (85.29% and 70.59%) ( < 0.05). Among 68 patients with confirmed GC, 50 (73.53%) were pathologically diagnosed with lymph node metastasis. The accuracy for detecting lymph node metastasis was 66.00% with endoscopy, 76.00% with MDCT, and 92.00% with the combined approach, all with statistically significant differences ( < 0.05). CONCLUSION: The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC, provided greater consistency in preoperative staging, and improved the detection of lymph node metastasis, thereby demonstrating significant clinical utility.
Clinical applications of indocyanine green fluorescence for the treatment of hepatocellular carcinoma.
Piccolo G, Barabino M, Benuzzi L … +2 more , Formisano G, Bianchi PP
World J Gastrointest Oncol · 2026 Jan · PMID 41607756 · Full text
Over the past ten years, numerous papers have been published on the use of indocyanine green (ICG) fluorescence in liver surgery for hepatocellular carcinoma (HCC). There are many different applications. The first involv...
Over the past ten years, numerous papers have been published on the use of indocyanine green (ICG) fluorescence in liver surgery for hepatocellular carcinoma (HCC). There are many different applications. The first involves targeting superficial tumors in patients with macronodular cirrhosis and an irregular liver surface. In a minimally invasive setting, the lack of tactile feedback on the hepatic surface makes detecting subcapsular HCC with ultrasound alone challenging. ICG fusion images can mimic the tactile feedback of the hand and act as an ultrasound booster. ICG fluorescence can be used to evaluate tumor residues after minimally invasive thermal ablation. ICG fluorescence imaging can also be used to identify the grade of HCC early on and evaluate the microinvasive component.
Gut microbiota and the colorectal cancer tumor microenvironment: From carcinogenic mechanisms to therapeutic opportunities.
Chen ZK, Zhao JW, Wang YG … +2 more , Wang C, Shi M
World J Gastrointest Oncol · 2026 Jan · PMID 41607755 · Full text
Colorectal cancer (CRC) is ranked as the third most common tumor globally, representing approximately 10% of all cancer cases, and is the second primary cause of cancer-associated mortality. Existing therapeutic approach...
Colorectal cancer (CRC) is ranked as the third most common tumor globally, representing approximately 10% of all cancer cases, and is the second primary cause of cancer-associated mortality. Existing therapeutic approaches demonstrate limited efficacy against CRC, partially due to the immunosuppressive tumor microenvironment (TME). In recent years, substantial evidence indicates that dysbiosis of the gut microbiota and its metabolic products is closely associated with the initiation, progression, and prognostic outcomes of CRC. In this minireview, we systematically elaborate on how these microbes and their metabolites directly impair intestinal epithelial integrity, activate cancer-associated fibroblasts, remodel tumor vasculature, and critically, sculpt an immunosuppressive landscape by modulating T cells, dendritic cells, and tumor-associated macrophages. We highlight the translational potential of targeting the gut microbiota, including fecal microbiota transplantation, probiotics, and engineered microbial systems, to reprogram the TME and overcome resistance to immunotherapy and chemotherapy. A deeper understanding of the microbiota-TME axis is essential for developing novel diagnostic and therapeutic paradigms for CRC.
Rectal neuroendocrine tumors: Update.
Khayyat M, Khayyat YM
World J Gastrointest Oncol · 2026 Jan · PMID 41607754 · Full text
Rectal neuroendocrine tumors (NETs) are increasingly detected and are the most common gastrointestinal NET sites. Often discovered incidentally during endoscopy, most are small, well differentiated, and have an excellent...
Rectal neuroendocrine tumors (NETs) are increasingly detected and are the most common gastrointestinal NET sites. Often discovered incidentally during endoscopy, most are small, well differentiated, and have an excellent prognosis. Local resection is typically considered curative. Several guidelines, namely the European Neuroendocrine Tumor Society guidelines 2023, National Comprehensive Cancer network 2025, and the Polish Network of Neuroendocrine Tumors (2017) emphasize the use of endoscopic and endoscopic ultrasound staging to select the appropriate therapy, ranging from resection to advanced techniques for larger or metastatic diseases, highlighting the need for an accurate initial assessment.
Tight junction proteins: Gatekeepers turned facilitators in the pathogenesis of gastric adenocarcinoma.
Selvam S, Vairappan B
World J Gastrointest Oncol · 2026 Jan · PMID 41607753 · Full text
Gastric cancer (GC) is the fifth most prevalent malignancy worldwide and remains a leading cause of cancer-related mortality. Major risk factors for GC include infection, increasing age, high dietary salt intake, and di...
Gastric cancer (GC) is the fifth most prevalent malignancy worldwide and remains a leading cause of cancer-related mortality. Major risk factors for GC include infection, increasing age, high dietary salt intake, and diets deficient in vegetables and fruits. Due to the often subtle and nonspecific early symptoms, coupled with the lack of routine screening programs, a significant proportion of GC cases are diagnosed at advanced stages. The etiology of GC is multifactorial, and diagnosis is confirmed histologically through endoscopic biopsy, followed by staging computed tomography, positron emission tomography, staging laparoscopy, and endoscopic ultrasound. Treatment strategies typically involve a multidisciplinary approach including chemotherapy, surgical resection, radiotherapy, and emerging immunotherapeutic options. Despite advances in diagnostic and therapeutic modalities, the prognosis of advanced GC remains poor, with high rates of recurrence and metastasis. In recent years, increasing attention has been given to the role of tight junction (TJ) proteins in the pathogenesis and progression of GC. TJ proteins, critical components of epithelial barrier function, have been implicated in various stages of gastric carcinogenesis, from intestinal metaplasia to invasion and metastasis. Infection and inflammation, particularly due to , disrupt TJ integrity, compromising the gastric mucosal barrier and facilitating neoplastic transformation. This review synthesizes current evidence from PubMed, EMBASE, Google Scholar, ScienceDirect, SpringerLink, and other reputable databases to provide a comprehensive overview of the involvement of TJ proteins in GC. By elucidating the molecular interplay between TJ dysregulation and gastric tumorigenesis, this work aims to highlight the potential of TJ proteins as novel diagnostic biomarkers and therapeutic targets in GC management.
Clinicopathologic features of SMARCB1/INI1-deficient pancreatic undifferentiated rhabdoid carcinoma: A case report and review of literature.
Yao WQ, Ma XY, Wang GH
World J Gastrointest Oncol · 2026 Jan · PMID 41607752 · Full text
BACKGROUND: SMARCB1/INI1-deficient pancreatic undifferentiated rhabdoid carcinoma is a highly aggressive tumor, and spontaneous splenic rupture (SSR) as its presenting manifestation is rarely reported among pancreatic ma...
BACKGROUND: SMARCB1/INI1-deficient pancreatic undifferentiated rhabdoid carcinoma is a highly aggressive tumor, and spontaneous splenic rupture (SSR) as its presenting manifestation is rarely reported among pancreatic malignancies. CASE SUMMARY: We herein report a rare case of a 59-year-old female who presented with acute left upper quadrant abdominal pain without any history of trauma. Abdominal imaging demonstrated a heterogeneous splenic lesion with hemoperitoneum, raising clinical suspicion of SSR. Emergency laparotomy revealed a pancreatic tumor invading the spleen and left kidney, with associated splenic rupture and dense adhesions, necessitating resection of the distal pancreas, spleen, and left kidney. Histopathology revealed a biphasic malignancy composed of moderately differentiated pancreatic ductal adenocarcinoma and an undifferentiated carcinoma with rhabdoid morphology and loss of SMARCB1 expression. Immunohistochemical analysis confirmed complete loss of SMARCB1/INI1 in the undifferentiated component, along with a high Ki-67 index (approximately 80%) and CD10 positivity. The ductal adenocarcinoma component retained SMARCB1/INI1 expression and was positive for CK7 and CK-pan. Transitional zones between the two tumor components suggested progressive dedifferentiation and underlying genomic instability. The patient received adjuvant chemotherapy with gemcitabine and nab-paclitaxel and maintained a satisfactory quality of life at the 6-month follow-up. CONCLUSION: This study reports a rare case of SMARCB1/INI1-deficient undifferentiated rhabdoid carcinoma of the pancreas combined with ductal adenocarcinoma, presenting as SSR - an exceptionally uncommon initial manifestation of pancreatic malignancy.
Sonazoid-contrast-enhanced ultrasound for the histological diagnosis of hepatocellular carcinoma.
Liu RB, Xin JY, Huang Z … +1 more , Li KY
World J Gastrointest Oncol · 2026 Jan · PMID 41607751 · Full text
BACKGROUND: The treatment technology of liver cancer is progressing. In addition to traditional surgical resection, combined therapies of immunotherapy based on immune checkpoint inhibitors, chemotherapy, and transcathet...
BACKGROUND: The treatment technology of liver cancer is progressing. In addition to traditional surgical resection, combined therapies of immunotherapy based on immune checkpoint inhibitors, chemotherapy, and transcatheter arterial chemoembolization for hepatocellular carcinoma are more and more widely used. Accurate preoperative diagnosis of liver cancer will provide important information for comprehensive treatment and prognosis evaluation of liver cancer. Sonazoid-contrast-enhanced ultrasound is not only helpful for the qualitative diagnosis of liver lesions, but also has great potential in the diagnosis of histological differentiation of liver cancer. AIM: To assess the differentiation of hepatocellular carcinoma (HCC) by utilizing the parameters and imaging features of Sonazoid-contrast-enhanced ultrasound (CEUS). METHODS: A retrospective analysis was conducted on the CEUS data of 239 lesions through case-control study. These patients received Sonazoid-CEUS within one week before surgery and were confirmed as HCC by postoperative pathology. Within the cases, patients were further categorized into well-differentiated and poorly-differentiated group. Time-intensity curves of the region of interest in both arterial and Kupffer phases were generated, allowing for the acquisition of quantitative parameters to assess the diagnostic efficacy in distinguishing lesions between these two groups and determining an appropriate cut-off value. RESULTS: Univariate analysis showed that the absolute value of enhancement intensity (EIAV), intensity ratio (IR) and intensity difference (ID) in Kupffer phase were statistically different between the groups with different degree ( = 0.015, = 0.000, = 0.000). The sensitivity and specificity were 40.2%, 82.4%, 80.4% and 78.1%, 86.9% and 74.5%, respectively, for differentiating HCC lesions with EIAV ≥ 56.384 dB, IR ≥ 1.215 and ID ≥ 9.184 dB. The area under the receiver operating characteristic curve were 0.590, 0.877, 0.815. There was no significant difference in the parameters of arterial phase, including peak time, initial growth time, rise time and the absolute value of peak intensity of lesions between the two groups ( > 0.05). Multivariate analysis showed that the level of alpha-fetoprotein (AFP) and IR were risk factors for poor differentiation ( = 0.001). CONCLUSION: Among the parameters of Sonazoid-CEUS, IR in Kupffer phase exhibits superior diagnostic efficacy with high sensitivity and specificity in the diagnose of pathological differentiation of HCC. Combined with preoperative AFP level, a more accurate diagnosis will be obtained. Compared with portal vein phase, Kupffer phase showed the ability to identify HCC lesions more sensitive. These findings hold significant guiding implications and reference value for clinical practice.
Patients with hepatocellular carcinoma achieving a complete response to sorafenib: Three case reports and review of literature.
Lučev H, Adžić G, Pleština S … +1 more , Prejac J
World J Gastrointest Oncol · 2026 Jan · PMID 41607750 · Full text
BACKGROUND: Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma (HCC) since 2008. While radiological complete responses are extremely rare, improved supportive care and multidisciplinary a...
BACKGROUND: Sorafenib has been the conventional treatment for advanced hepatocellular carcinoma (HCC) since 2008. While radiological complete responses are extremely rare, improved supportive care and multidisciplinary approaches in clinical practice may explain the recent increase in case reports and retrospective series documenting such responses. CASE SUMMARY: This case series describes 3 patients with advanced HCC who achieved durable complete responses using first-line sorafenib therapy, even in the presence of portal vein thrombosis or extrahepatic spread, and highlights the potential for sustained remission in selected patients. Dermatologic toxicity and non-viral etiology may correlate with favorable outcomes; however, reliable predictive biomarkers for sorafenib response are lacking. CONCLUSION: Future research into the etiology and molecular differences in HCC is necessary to develop more personalized therapy options.
Colossal well-differentiated liposarcoma of the small bowel mesentery: A case report.
Tian Y, Liu GQ, Li CF … +2 more , Tian QM, Qiao S
World J Gastrointest Oncol · 2026 Jan · PMID 41607749 · Full text
BACKGROUND: Well-differentiated small bowel mesenteric liposarcoma (LPS) is rare, with high malignancy, poor prognosis, and high preponderance to local recurrence. CASE SUMMARY: Here we described a 71-year-old male, who...
BACKGROUND: Well-differentiated small bowel mesenteric liposarcoma (LPS) is rare, with high malignancy, poor prognosis, and high preponderance to local recurrence. CASE SUMMARY: Here we described a 71-year-old male, who complains of persistent abdominal distension for a month. The clinical manifestation is a huge abdominal mass occupying almost the entire abdomen. Physical examination indicated palpable massive mass in the abdomen, hard texture, indefinable boundary, poor mobility. The abdominal enhanced computed tomography at another hospital scan showed multiple abdominal masses originating from the small bowel mesentery. Abdominal and pelvic magnetic resonance imaging at our hospital showed multiple masses in the abdominal and pelvic cavities, indicating that the tumor originated from the mesentery or peritoneum. Results of exploratory laparotomy indicated that the tremendous mass primarily results from the mesentery of the small intestine, occupying the entire abdominal cavity in a polymorphic and lobulated shape. The patient underwent complete surgical resection of the tumor, and the weight of the tumor was approximately 11 kg. The histopathological examination of the resected specimens confirmed the diagnosis of well-differentiated LPS of the small bowel mesentery. CONCLUSION: Completed surgical resection was cornerstone, and histopathological and molecular confirmations were crucial. The necessity of adjuvant therapy should be phrased as a potential consideration to improve patient's survival time.
-related non-coding RNAs in gastric cancer screening: Emerging evidence and translational challenges.
Lv ZP, Sultan MH, Wang YG
World J Gastrointest Oncol · 2026 Jan · PMID 41607748 · Full text
Gastric cancer (GC) has high morbidity and mortality worldwide. Due to the absence of noticeable symptoms, diagnosing GC at an early stage is very difficult, which consequently leads to advanced GC and poor prognosis. Ef...
Gastric cancer (GC) has high morbidity and mortality worldwide. Due to the absence of noticeable symptoms, diagnosing GC at an early stage is very difficult, which consequently leads to advanced GC and poor prognosis. Effective biomarkers are essential for prolonging patients' survival. () infection represents the most significant risk factor for GC, with nearly all cases linked to this infection. Many non-coding RNAs (ncRNAs) are dysregulated in -infected GC, indicating that ncRNAs may serve as biomarkers of early-stage GC. In this editorial, we discuss the study by Chen Although previous studies have identified roles for miR-136 in gastric cancer proliferation, apoptosis, and invasion, none have specifically explored its relationship with -associated gastric carcinogenesis.
Revisiting multi-region 16S sequencing in gastric cancer.
Luo L, Huang G, Yang H … +1 more , Chi H
World J Gastrointest Oncol · 2026 Jan · PMID 41607747 · Full text
Wu recently applied multi-region 16S rRNA sequencing to characterize the gastric cancer microbiome, demonstrating improved taxonomic resolution and detection sensitivity over conventional single-region approaches. While...
Wu recently applied multi-region 16S rRNA sequencing to characterize the gastric cancer microbiome, demonstrating improved taxonomic resolution and detection sensitivity over conventional single-region approaches. While the study represents a valuable methodological step forward, it remains limited by single-center design, lack of quantitative calibration, and insufficient control for contamination and inter-laboratory variability. This editorial critically appraises these methodological gaps and emphasizes that future efforts must focus on harmonized, consensus-driven workflows to ensure reproducibility and clinical reliability. The translational potential of multi-region 16S lies in moving from descriptive microbial profiling to actionable clinical integration, particularly for recurrence prediction, treatment-response monitoring, and perioperative complication risk assessment. By addressing these methodological, economic, and ethical challenges, the field can advance toward evidence-based and clinically deployable microbiome-guided precision oncology.
Predictive model based on magnetic resonance imaging for chemotherapy response in colorectal cancer: Toward a radiologic biopsy approach.
Klabukov ID, Smirnova A, Kondrasheva I … +2 more , Baranovskii DS, Yatsenko E
World J Gastrointest Oncol · 2026 Jan · PMID 41607746 · Full text
We read with great interest the investigation of Kang related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients w...
We read with great interest the investigation of Kang related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients with gene mutations. The authors focused on decision-making based on the integration of tumor differentiation, signal intensity ratio, margin distance, and magnetic resonance imaging-detected lymph node metastasis. Indeed, these multiparameter predictive models could also be used for diagnosis as an alternative to invasive tissue examination methods. However, progress in this field enables us to shift the paradigm to radiology biopsies, particularly given the nonlinear effects of various radiation sources.
Opportunities and challenges of artificial intelligence-assisted endoscopy and high-quality data for esophageal squamous cell carcinoma.
Kurisaki K, Kobayashi S, Akashi T … +6 more , Nakao Y, Fukumoto M, Tasaki K, Adachi T, Eguchi S, Kanetaka K
World J Gastrointest Oncol · 2026 Jan · PMID 41607745 · Full text
This review comprehensively summarized the potential of artificial intelligence (AI) in the management of esophageal cancer. It highlighted the significance of AI-assisted endoscopy in Japan where endoscopy is central to...
This review comprehensively summarized the potential of artificial intelligence (AI) in the management of esophageal cancer. It highlighted the significance of AI-assisted endoscopy in Japan where endoscopy is central to both screening and diagnosis. For the clinical adaptation of AI, several challenges remain for its effective translation. The establishment of high-quality clinical databases, such as the National Clinical Database and Japan Endoscopy Database in Japan, which covers almost all cases of esophageal cancer, is essential for validating multimodal AI models. This requires rigorous external validation using diverse datasets, including those from different endoscope manufacturers and image qualities. Furthermore, endoscopists' skills significantly affect diagnostic accuracy, suggesting that AI should serve as a supportive tool rather than a replacement. Addressing these challenges, along with country-specific legal and ethical considerations, will facilitate the successful integration of multimodal AI into the management of esophageal cancer, particularly in endoscopic diagnosis, and contribute to improved patient outcomes. Although this review focused on Japan as a case study, the challenges and solutions described are broadly applicable to other high-incidence regions.
Solid dispersion of BIBR1532: A potent therapeutic for oesophageal squamous cancer.
Zhang XJ, Deng NX, Zhang HQ … +4 more , Cen JZ, Zheng ZX, Guo MQ, Huang ZW
World J Gastrointest Oncol · 2026 Jan · PMID 41607744 · Full text
This letter addresses challenges in the clinical translation of BIBR1532, a promising telomerase inhibitor, for the treatment of esophageal squamous cell carcinoma (ESCC). BIBR1532 exerts its anti-cancer effect by activa...
This letter addresses challenges in the clinical translation of BIBR1532, a promising telomerase inhibitor, for the treatment of esophageal squamous cell carcinoma (ESCC). BIBR1532 exerts its anti-cancer effect by activating DNA damage response (ATR/CHK1 and ATM/CHK2) pathways and downregulating telomere-binding proteins. Although its therapeutic potential is limited by poor aqueous solubility, solid dispersion (SD) technology may overcome this obstacle. Systematic analysis using PubChem-derived simplified molecular input line entry system identifiers and artificial intelligence-driven FormulationDT platform evaluation (oral formulation feasibility index: 0.38) revealed that the SD technology, with superior scalability (32 approved products by 2021) and lower production risks, outperforms lipid-based formulations as an optimal dissolution strategy. Material analysis revealed hydroxypropyl methylcellulose (HPMC) as the optimal carrier with lower hygroscopicity, higher temperature and no intestinal targeting, thus enabling ESCC therapy. HPMC-based SD enhances BIBR1532 solubility and bioavailability for effective ESCC treatment. Future studies should focus on pilot tests for SD fabrication.
Advances in radiofrequency ablation for pancreatic cancer.
Peng SY, Li ZY, Cai HQ
World J Gastrointest Oncol · 2026 Jan · PMID 41607743 · Full text
Radiofrequency ablation (RFA), particularly endoscopic ultrasound-guided RFA (EUS-RFA), has emerged as a promising minimally invasive approach for the treatment of pancreatic cancer, especially in patients with locally a...
Radiofrequency ablation (RFA), particularly endoscopic ultrasound-guided RFA (EUS-RFA), has emerged as a promising minimally invasive approach for the treatment of pancreatic cancer, especially in patients with locally advanced or unresectable disease. This review outlines recent technological developments in EUS-RFA, including innovations in energy delivery systems, probe design, and real-time thermal monitoring, which have improved the precision and safety of the procedure. Clinical studies combining EUS-RFA with chemotherapy have demonstrated encouraging outcomes, with improvements in overall survival, progression-free survival, tumor necrosis, and symptom control compared to chemotherapy alone. Additionally, RFA-induced tumor antigen release and modulation of the tumor microenvironment suggest a potential synergistic role with immunotherapy. Despite its promise, the widespread adoption of EUS-RFA is limited by a lack of large-scale randomized controlled trials and standardized treatment protocols.
Enhanced recovery after surgery-based recovery room nursing improves perioperative safety in gastrointestinal tumor surgery.
Zhong WQ, Wu S, Jiang RX … +6 more , Chen SR, Li DY, Zhou J, Wu JX, Zeng RJ, Zhi H
World J Gastrointest Oncol · 2026 Jan · PMID 41607742 · Full text
BACKGROUND: Gastrointestinal (GI) tumors are among the most prevalent malignancies, and surgical intervention remains a primary treatment modality. However, the complexity of GI surgery often leads to prolonged recovery...
BACKGROUND: Gastrointestinal (GI) tumors are among the most prevalent malignancies, and surgical intervention remains a primary treatment modality. However, the complexity of GI surgery often leads to prolonged recovery and high postoperative complication rates, which threaten patient safety and functional outcomes. Enhanced recovery after surgery (ERAS) principles have been shown to improve perioperative outcomes through evidence-based, multidisciplinary care pathways. Despite its widespread adoption, there is a paucity of research focusing specifically on optimizing ERAS-guided nursing processes in the post-anesthesia care unit (PACU) and evaluating its impact on perioperative safety in patients undergoing GI tumor surgery. This study aimed to investigate whether an ERAS-based PACU nursing protocol could enhance recovery, reduce complications, and improve patient safety in this surgical population. AIM: To explore the impact of optimizing the recovery room nursing process based on ERAS on the perioperative safety of patients with GI tumors. METHODS: A total of 260 patients with GI tumors who underwent elective surgeries under general anesthesia in our hospital from August 2023 to August 2025 and were then observed in the recovery unit (PACU) were selected. They were randomly divided into the observation group (the PACU nursing process was optimized based on ERAS) and the control group (the conventional PACU nursing process was adopted) by the random number grouping method, with 130 cases in each group. The time of gastric tube removal, urinary catheter removal, defecation time, hospital stay, time of leaving the room after tube removal, retention time in the recovery room, occurrence of complications, satisfaction and readmission rate were compared between the two groups after entering the room. Compare the occurrence of adverse events in the PACU nursing process between the two groups. RESULTS: The time of gastric tube removal, urinary catheter removal, defecation time, hospital stay, retention time in the recovery room, total incidence of complications and readmission rate in the observation group were significantly lower than those in the control group, and the satisfaction rate was higher than that in the control group ( 0.05). The occurrence of adverse events in the PACU nursing process in the observation group was lower than that in the control group ( 0.05). CONCLUSION: Optimizing the PACU nursing process based on ERAS can effectively accelerate the recovery process of patients undergoing GI tumor surgery, reduce adverse events, improve nursing satisfaction, and at the same time, lower the incidence of adverse events in the PACU nursing process, providing a more refined management basis for clinical practice.
Discrepancies between preoperative assessment and final pathological criteria in early gastric cancer.
Jize MY, Wu W, Ding SG … +1 more , Zhang J
World J Gastrointest Oncol · 2026 Jan · PMID 41607741 · Full text
BACKGROUND: Inappropriate selection of patients with early gastric cancer (EGC) for endoscopic submucosal dissection (ESD) may lead to non-curative resection, necessitating additional gastrectomy. Conversely, inappropria...
BACKGROUND: Inappropriate selection of patients with early gastric cancer (EGC) for endoscopic submucosal dissection (ESD) may lead to non-curative resection, necessitating additional gastrectomy. Conversely, inappropriate selection for gastrectomy may result in overtreatment, adversely affecting patients' quality of life. Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC. To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients', we specifically assess the suitability of Japanese guidelines in non-Japanese populations. This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan. AIM: To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies. METHODS: A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022. Cases were categorized into three groups: Same-estimated (preoperative therapeutic indication with postoperative pathological criteria matched), underestimated (preoperative ESD indication but postoperative surgical criteria), and overestimated (preoperative surgical indication but postoperative ESD criteria). The rate of discrepancy and associated risk factors were assessed. RESULTS: The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0% (321/430) and 76.0% (278/366), respectively. The overall discrepancy rate was 25.6% (204/796). Multivariate analysis identified tumor location in the upper-third stomach (odds ratio = 2.158, 95% confidence interval: 1.373-3.390, = 0.001) was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy (odds ratio = 2.005, 95% confidence interval: 1.036-3.879, = 0.039) was more likely to be overestimated. Significant differences were observed in tumor diameter ( < 0.001), depth of infiltration ( < 0.001), ulcerative findings ( < 0.001), and histologic type ( < 0.001) between preoperative and postoperative evaluations. CONCLUSION: The accuracy of preoperative EGC indications is 74.4%. Upper-third stomach and undifferentiated histology are primary discrepancy predictors. Upper-third tumors are prone to underestimation, while undifferentiated tumors are prone to overestimation.
Hepatic artery infusion chemotherapy for advanced hepatocellular carcinoma with obstructive jaundice: A case report and review of literature.
Zhang L, Xiao P, Shi LD … +2 more , Chen KX, Bing YF
World J Gastrointest Oncol · 2026 Jan · PMID 41607740 · Full text
BACKGROUND: Hepatocellular carcinoma (HCC) is a major type of liver cancer worldwide. In advanced stages, portal vein tumor thrombosis (PVTT) and jaundice are common, whereas obstructive jaundice (OJ) is relatively rare....
BACKGROUND: Hepatocellular carcinoma (HCC) is a major type of liver cancer worldwide. In advanced stages, portal vein tumor thrombosis (PVTT) and jaundice are common, whereas obstructive jaundice (OJ) is relatively rare. Both conditions markedly reduce survival and increase therapeutic complexity. Recently, hepatic artery infusion chemotherapy (HAIC) in combination with targeted immunotherapy has shown promise for advanced HCC. CASE SUMMARY: We report a 47-year-old male with advanced HCC complicated by PVTT and OJ, who was admitted with marked jaundice of the skin and sclera. Imaging revealed a large hepatic mass (14.5 cm × 11.3 cm) in the right lobe with associated portal vein tumor thrombus. The tertiary bile duct was only mildly dilated, making percutaneous transhepatic cholangiography drainage infeasible. The patient underwent reduced-dose HAIC, which resulted in significant tumor shrinkage and marked reduction in serum bilirubin. This improvement enabled sequential treatment with lenvatinib and camrelizumab. After six cycles, both liver function and alpha-fetoprotein levels improved. The patient achieved a progression-free survival of 20 months and an overall survival of 29 months. CONCLUSION: HAIC can treat high-bilirubin HCC with PVTT and OJ, allowing for subsequent targeted immunotherapy.
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