World Journal Of Gastrointestinal Oncology[JOURNAL]
Sun
200 papers
Folate receptor-positive circulating tumor cells might function as potential biomarkers for hepatocellular carcinoma.
Zhang ZY, Zhou M, Liu JJ … +1 more , Zhang W
World J Gastrointest Oncol · 2025 Nov · PMID 41281492 · Full text
BACKGROUND: Early metastasis and recurrence are risk factors that negatively affect the prognosis of advanced hepatocellular carcinoma (HCC). Alpha fetoprotein (AFP) is currently the most prevalent serum biomarker for de...
BACKGROUND: Early metastasis and recurrence are risk factors that negatively affect the prognosis of advanced hepatocellular carcinoma (HCC). Alpha fetoprotein (AFP) is currently the most prevalent serum biomarker for detecting HCC and predicting tumor recurrence. However, its sensitivity and specificity are not sufficient, especially in patients who are AFP negative. AIM: To detect folate receptor (FR)-positive circulating tumor cells (CTCs) and explore their role in the diagnosis and staging of HCC. METHODS: This work is a retrospective study that included 128 consecutive patients with benign or malignant disease of the liver from 2020 to 2021. FR + CTCs were collected from 3 mL of peripheral blood immunomagnetic depletion of leukocytes. After ligand-target polymerase chain reaction, the number of FR + CTCs was measured. Receiver operating characteristic curves were used to determine the threshold of sensitivity and specificity of FR + CTCs. The Youden index was used to identify the optimal cutoff point and diagnostic efficiency of FR + CTCs counts. Univariate and multivariate Cox proportional hazards regression analyses were performed to evaluate the associations of biomarkers or clinical parameters with disease-free survival (DFS). RESULTS: The FR + CTCs counts showed excellent diagnostic efficacy in patients with HCC, with high sensitivity (0.905) and specificity (0.773) compared with patients with benign disease. Compared with that of the AFP level, the area under the receiver operating characteristic curve of the FR + CTC count is significantly greater (0.900 compared with 0.730, < 0.05). FR + CTC levels were significantly correlated with macrovascular invasion, tumor size, tumor number, and extrahepatic tumor stage in HCC patients. FR + CTC counts were correlated with DFS in HCC patients after R0 resection. Univariate analysis of DFS revealed that the FR + CTC count, tumor number, Barcelona Clinic Liver Cancer stage and extrahepatic metastasis status were correlated with DFS. Multivariate analysis of DFS revealed that the FR + CTC count and tumor number were correlated with DFS. CONCLUSION: Ligand-target polymerase chain reaction is a sensitive tool for quantifying the number of FR + CTCs in HCC patients. These findings could provide new insight for stratifying HCC patients and predicting the recurrence of HCC.
Treatment of recurrent hepatocellular carcinoma: The current standards and future perspectives.
Elsayed MOK
World J Gastrointest Oncol · 2025 Nov · PMID 41281491 · Full text
Hepatocellular carcinoma (HCC) remains one of the commonest cancers worldwide with an overall poor prognosis and survival rates. The rising incidence of liver disease, in particular non-alcoholic fatty liver disease, wil...
Hepatocellular carcinoma (HCC) remains one of the commonest cancers worldwide with an overall poor prognosis and survival rates. The rising incidence of liver disease, in particular non-alcoholic fatty liver disease, will account for a continued increase in the rates of liver cancer. The recurrence of HCC has been reported across the different etiologies of liver disease. Unlike primary HCC, there is no agreed consensus or guidance as to the optimum management of recurrent HCC (RHCC). Furthermore, the management of RHCC may prove more challenging compared to primary liver cancer, given the smaller residual liver volume and functions in settings following surgery or transplantation. Various modalities exist for the treatment of primary HCC including resection, liver transplantation, loco-regional and systemic therapies. Nevertheless, the role of such modalities remains unclear in the management of RHCC. In this article, we aim to review the different approaches of the current standards for the management of RHCC. We will also shed some light on the future perspectives in this field.
Myc-associated zinc finger protein drives colorectal cancer metastasis through activating ubiquitin like with ring finger protein one.
Mao HQ, Yu FC, Hu DQ … +1 more , Zhang LJ
World J Gastrointest Oncol · 2025 Nov · PMID 41281490 · Full text
BACKGROUND: Colorectal cancer (CRC) is one of the most common causes of cancer mortality worldwide. The transcription factor Myc-associated zinc finger protein (MAZ) has been implicated in cancer progression. However, it...
BACKGROUND: Colorectal cancer (CRC) is one of the most common causes of cancer mortality worldwide. The transcription factor Myc-associated zinc finger protein (MAZ) has been implicated in cancer progression. However, its precise function and mechanisms in CRC remain unclear. AIM: To investigate the role and mechanism of the MAZ/ubiquitin-like with PHD and RING finger domains 1 (UHRF1)/esophageal cancer-related gene 4 (ECRG4) axis in CRC metastasis. METHODS: Western blot, quantitative reverse transcription polymerase chain reaction (PCR) and transwell were performed to evaluate the impact of MAZ knockdown on CRC cell migration and invasion. A xenograft tumor metastasis model was established by injecting MAZ-deficient CRC cells into nude mice to assess metastatic potential. Dual-luciferase reporter assay was performed to determine the role of MAZ and its downstream target, UHRF1. Chromatin immunoprecipitation-quantitative PCR and methylation-specific PCR were used to analyze whether UHRF1 regulated ECRG4 through DNA methylation. RESULTS: MAZ was highly upregulated in CRC cells and promoted CRC migration, invasion, epithelial-mesenchymal transition (EMT) and metastasis. Mechanistically, MAZ transcriptionally activated UHRF1, which in turn led to DNA methylation of ECRG4. Knockdown of MAZ suppressed CRC migration and invasion was reversed by overexpression of UHRF1. Loss of UHRF1 upregulated ECRG4, inhibited EMT, and reduced cell migration and invasion. However, simultaneous knockdown of ECRG4 partially reversed these effects. CONCLUSION: MAZ promotes CRC cell migration, invasion, and EMT by transcriptionally activating UHRF1, which downregulates ECRG4 through DNA methylation.
Emerging non-invasive imaging biomarkers of Ki-67 in pancreatic cancer: Toward predictive precision oncology.
Wu YX, Tian R, Li XW … +3 more , Guo JY, Tang JF, Zhou CF
World J Gastrointest Oncol · 2025 Nov · PMID 41281489 · Full text
The proliferative index of Ki-67 in pancreatic ductal adenocarcinoma (PDAC) exhibits strong correlations with tumor progression and prognosis, holding significant clinical implications. Yang employed contrast-enhanced u...
The proliferative index of Ki-67 in pancreatic ductal adenocarcinoma (PDAC) exhibits strong correlations with tumor progression and prognosis, holding significant clinical implications. Yang employed contrast-enhanced ultrasound (CEUS) to indirectly evaluate neovascularization in pancreatic cancer lesions. Specific CEUS parameters demonstrated significant diagnostic value in assessing Ki-67 expression. The falling slope 50% achieved an area under the curve of 0.838. Meanwhile, the rise slope 10%-90% exhibited superior overall diagnostic accuracy (area under the curve = 0.863), showing a sensitivity of 0.92 and a moderate specificity of 0.759. These values demonstrate specificity in differentiating between low and high Ki-67 expression groups. This study effectively addresses the critical need for a non-invasive assessment of pancreatic cancer aggressiveness Ki-67 expression. These findings strongly support the translational potential of CEUS biomarkers for non-invasive Ki-67 assessment and treatment stratification in PDAC. While Yang demonstrated exhibited encouraging methodologies, its retrospective design, modest sample size, and single-center nature may impede generalizability, pending validation in multi-institutional cohorts. We recommend expanding the sample size to enhance representativeness and adopting prospective studies integrating multimodal imaging techniques, such as magnetic resonance imaging and positron emission tomography to improve diagnostic reliability. This study is the first to integrate insights from CEUS, magnetic resonance imaging, and positron emission tomography for Ki-67 expression assessment in PDAC. Building on this innovation, we focus this article on recent advances in the clinical diagnosis of pancreatic cancer, aiming to provide insights for advancing research in this field.
Patient-derived organoids for the personalized treatment of pancreatic neuroendocrine tumor with liver metastases: A case report.
Yang XM, Sun W, He YG … +5 more , Peng XH, You N, Tang YC, Zheng L, Huang XB
World J Gastrointest Oncol · 2025 Nov · PMID 41281488 · Full text
BACKGROUND: Liver metastases are very common in pancreatic neuroendocrine tumors (pNETs). When surgical resection is possible, it is typically associated with survival benefits in patients with pNET and liver metastases....
BACKGROUND: Liver metastases are very common in pancreatic neuroendocrine tumors (pNETs). When surgical resection is possible, it is typically associated with survival benefits in patients with pNET and liver metastases. Patient-derived organoids are a powerful preclinical platform that show great potential for predicting treatment response, and they have been increasingly applied in precision medicine and cancer research. CASE SUMMARY: A 51-year-old man was admitted to the hospital with the chief complaint of intermittent dull pain in the upper abdomen for over 3 years. Computerized tomography showed multiple space-occupying lesions in the liver and a neoplasm in the pancreatic body. Pathological results suggested a grade 3 pancreas-derived hepatic neuroendocrine tumor. In combination with relevant examinations, the patient was diagnosed with pNET with liver metastases (grade 3). Transarterial chemoembolization was initially performed with oxaliplatin and 5-fluorouracil, after which the chemotherapy regimen was switched to liposomal irinotecan and cisplatin for a subsequent perfusion, guided by organoid-based drug sensitivity testing. Following interventional treatment, the tumor had decreased in size. However, due to poor treatment compliance and the patient's preference for surgical management, multiple resections were performed. Postoperatively, liposomal irinotecan combined with cisplatin was continuously admnistered. To date, the patient has survived 18 months with tumor presence, and tumor markers have returned to normal. CONCLUSION: This case suggests that patient-derived organoids can aid in the optimization of therapeutic decisions in pNET patients with liver metastases to guide personalized treatment and improve survival outcomes.
Comparing early surgical outcomes between total neoadjuvant therapy and standard long course chemoradiotherapy for rectal cancer.
Jabbar SAA, Choo ALE, Wong NW … +2 more , Ngu JC, Teo NZ
World J Gastrointest Oncol · 2025 Nov · PMID 41281487 · Full text
BACKGROUND: Total neoadjuvant therapy (TNT) has been proposed as an advancement over standard long-course chemoradiotherapy (LCCRT) for the treatment of locally advanced rectal cancer (LARC). It has been suggested that T...
BACKGROUND: Total neoadjuvant therapy (TNT) has been proposed as an advancement over standard long-course chemoradiotherapy (LCCRT) for the treatment of locally advanced rectal cancer (LARC). It has been suggested that TNT enhances resectability, improves treatment compliance, increases the rate of pathological complete response, and reduces the risk of systemic recurrence. However, concerns have been raised that the prolonged interval to surgery associated with TNT, particularly in regimens such as the Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation (RAPIDO) protocol, may exacerbate fibrosis, leading to more technically challenging resections and poorer surgical outcomes. AIM: To compare the early surgical outcomes of LARC patients treated with TNT-RAPIDO LCCRT. METHODS: A single-center, retrospective cohort study was conducted of patients with LARC treated with TNT-RAPIDO or standard LCCRT followed by surgical resection between 2014 and 2024. A total of 99 patients with LARC were analyzed, including 29 treated with TNT-RAPIDO and 70 treated with standard LCCRT. Demographics, clinicopathological characteristics and early post-operative outcomes were compared between both groups. RESULTS: Both groups were comparable in terms of demographics and clinicopathological characteristics. The median interval from initiation of neoadjuvant therapy to surgery was significantly longer in the TNT group compared to the LCCRT group (29.5 weeks 19.5 weeks, < 0.001). Operative time and intraoperative complications were comparable. While the TNT group had a significantly higher lymph node harvest (40.7 23.4, < 0.001), the number of positive nodes was not significantly different. R0 resection rates were similar (93.1% 90%, = 0.625). There was no difference in post-operative morbidity and 30-day mortality between both groups. The TNT group had a significantly shorter total stoma duration (27.1 weeks 42.5 weeks, = 0.013) and a lower rate of permanent stoma formation (13.8% 35.7%, = 0.013). CONCLUSION: Compared with LCCRT, TNT-RAPIDO does not compromise operative time, complication rates, or oncological quality of resection and may confer a shorter total stoma duration and a lower permanent stoma rate.
Management of peritoneal metastases from colorectal cancer and small bowel adenocarcinoma in patients with inflammatory bowel disease.
Paramythiotis D, Tsavdaris D, Geropoulos G … +2 more , Sacchet DA, Psarras K
World J Gastrointest Oncol · 2025 Nov · PMID 41281486 · Full text
Patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer, which may ultimately result in peritoneal metastases (PM). PM in patients with IBD is by nature difficult to treat du...
Patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer, which may ultimately result in peritoneal metastases (PM). PM in patients with IBD is by nature difficult to treat due to the chronic inflammation and immunosuppression inherent in IBD. This minireview compiled existing evidence on management approaches to PM in patients with IBD, including surgical procedures, systemic treatment, and novel therapies. A literature review was conducted by searching PubMed and Scopus through June 2025 for studies addressing PM in IBD-associated colorectal or small bowel cancer. Literature specific to PM in IBD is sparse, comprising primarily two small retrospective cohort series comparing outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with and without IBD. These studies indicated that in high-volume centers with careful preoperative optimization perioperative morbidity and mortality rates for patients with IBD undergoing CRS/HIPEC were similar to those without IBD. However, median overall survival (approximately 19.6-24.0 months) and disease-free survival were consistently shorter and rates of early peritoneal recurrence were higher in patients with IBD. Although CRS/HIPEC can be performed safely in selected patients with IBD and PM, long-term oncologic outcomes appear inferior compared to populations without IBD, likely reflecting later-stage presentation, distinct tumor biology, and IBD-related factors.
Innovative insights into gut microbiota modulation in colorectal cancer: From microbial dysbiosis to therapeutic strategies.
Demirli Atici S
World J Gastrointest Oncol · 2025 Nov · PMID 41281485 · Full text
Colorectal cancer (CRC) is increasingly recognized as a multifactorial disease influenced by hereditary, environmental, and microbial factors. This article explores recent insights into the role of gut microbiota dysbios...
Colorectal cancer (CRC) is increasingly recognized as a multifactorial disease influenced by hereditary, environmental, and microbial factors. This article explores recent insights into the role of gut microbiota dysbiosis in CRC pathogenesis and progression. Key differences in microbial composition, characterized by enrichment of pro-carcinogenic species such as and and depletion of beneficial commensals like have been identified alongside changes in microbial metabolites such as short-chain fatty acids and secondary bile acids. We discuss immune system modulation by the microbiota, formation of bacterial biofilms, and the activation of host pathways such as the urea cycle during tumorigenesis. Special attention is given to therapeutic innovations, including microbiota-informed precision modelling, synthetic biology-based engineered probiotics, and evolving alternatives to fecal microbiota transplantation. These integrative strategies represent promising tools in the era of personalized oncology for CRC.
Secular trend in universal hepatocellular carcinoma prevention: Taiwan, Poland, and Belgium experience.
Huang ZZ, Żmudka K, Ruggiano V … +5 more , Hsu WL, Liu J, Chiang CJ, Chen YC, Wang V
World J Gastrointest Oncol · 2025 Nov · PMID 41281484 · Full text
BACKGROUND: Liver cancer poses a significant public health threat. The difference between disease patterns and national policies is crucial to elucidating factors influencing hepatocellular carcinoma (HCC) incidence. AIM...
BACKGROUND: Liver cancer poses a significant public health threat. The difference between disease patterns and national policies is crucial to elucidating factors influencing hepatocellular carcinoma (HCC) incidence. AIM: To investigate the secular trend and disease pattern of liver cancer in Taiwan, Poland, and Belgium. METHODS: This population-based cohort study presents the incidence, period, and cohort effects in HCC incidence between 2000 and 2019 in Taiwan, Poland, and Flanders, Belgium. Data on HCC were obtained from cancer registry data from Taiwan, Poland, and regional data from Belgium. Age-standardized incidence rates (ASIRs), annual percentage changes, and age-period-cohort analyses were conducted by sex and period. RESULTS: Taiwan's ASIR decreased from 2000 to 2019 (males: 55.17 to 43.42, females: 21.91 to 16.20, per 100000). In Poland, ASIR declined from 2000 to 2019 (males: 3.21 to 2.77, females: 1.95 to 1.32, per 100000). However, Flanders experienced an increase in ASIR from 2000 to 2019 (males: 2.66 to 5.63, females: 1.40 to 2.20, per 100000). In Taiwan, the cohort effect rate ratio increased from 1915 to 1935 (males: 1.02 to 1.36, females: 1.04 to 1.54) and decreased from 1935 to 1989 (males: 1.36 to 0.22, females: 1.54 to 0.20). In Poland, rate ratios consistently decreased (males: 1.75 to 0.25, females: 3.46 to 0.26). Flanders exhibited an increase in both males (0.14 to 2.52, 1915 to 1975) and females (0.53 to 3.66, 1915 to 1989). CONCLUSION: Taiwan and Poland's declining ASIR may be due to effective hepatitis B virus immunization and viral hepatitis therapy. Flanders' persistent increase may be tied to higher HCC risk in high hepatitis C virus risk populations.
fusions as novel oncogenic drivers in gastrointestinal stromal tumors: Two case reports and review of literature.
Hong YY, Shou CH, Yang WL … +4 more , Wang XD, Zhang Q, Liu XS, Yu JR
World J Gastrointest Oncol · 2025 Nov · PMID 41281483 · Full text
BACKGROUND: Gastrointestinal stromal tumors (GISTs) are generally characterized by driver mutations in or . However, the molecular landscape of wild-type GISTs remains complex, posing significant therapeutic challenges....
BACKGROUND: Gastrointestinal stromal tumors (GISTs) are generally characterized by driver mutations in or . However, the molecular landscape of wild-type GISTs remains complex, posing significant therapeutic challenges. Recent evidence has indicated alterations in as potential oncogenic drivers in patients with various cancers. However, the role of these drivers in GIST pathogenesis remains underexplored. CASE SUMMARY: We retrospectively evaluated two patients with GIST, diagnosed between August 2021 and July 2022, harboring mutations through hybrid capture-based next-generation sequencing (NGS). We analyzed their clinicopathological characteristics, treatment response, and long-term follow-up data. Both patients, a 47-year-old man (case 1) and a 43-year-old woman (case 2), underwent successful surgical resection and received adjuvant imatinib therapy. They achieved sustained remission with a median follow-up of 28 months. Notably, the NGS revealed novel rearrangements, an -/intergenic- fusion in case 1 and -/- fusions in case 2 without canonical or mutations. Both patients exhibited a favorable response to standard imatinib treatment. CONCLUSION: Our findings provided preliminary evidence that novel fusions might act as primary oncogenic drivers in a rare subset of / wild-type GISTs. These cases highlight the importance for comprehensive genomic profiling and suggest that fibroblast growth factor receptor-targeted inhibitors could be a potential therapeutic strategy for advanced or imatinib-resistant diseases, warranting further investigation in larger cohorts.
rearrangements in advanced colorectal cancer patients and their relationship with disease characteristics.
Tur R, Abad M, Filipovich E … +4 more , Rivas MB, Rodriguez M, Montero JC, Sayagués JM
World J Gastrointest Oncol · 2025 Nov · PMID 41281482 · Full text
BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer-related death, largely due to limited treatment options in advanced stages. Genomic alterations in advanced CRC (aCRC) are complex and not fully c...
BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer-related death, largely due to limited treatment options in advanced stages. Genomic alterations in advanced CRC (aCRC) are complex and not fully characterized, with only 30% of patients benefiting from targeted therapies. AIM: To investigate the molecular heterogeneity of primary aCRC in order to identify clinically relevant genomic alterations. METHODS: We conducted a retrospective molecular analysis of 73 consecutive patients with histologically confirmed primary aCRC (stage pT4a-b). All molecular findings were correlated with available clinicopathological data. In addition, we performed survival analyses using publicly available datasets and tools. RESULTS: Genetic abnormalities identified in primary tumors were most frequently mutations in tumor protein p53 (58% of cases), Kirsten rat sarcoma viral oncogene homolog (52%), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (25%), B-Raf kinase (11%) and fibroblast growth factor receptor 3 (8%), as well as R-spondin 3 () fusions (8%). Alterations in the tumor protein p53 and neuroblastoma RAS viral oncogene homolog genes were predominantly observed in tumors from the left colon, whereas B-Raf kinase mutations and fusions were more frequently detected in the right or transverse colon. We also show a strong association between the presence of rearrangements and patients with small tumors, normal carcinoembryonic antigen levels, and microsatellite stable tumors. Furthermore, aCRC patients with protein tyrosine phosphatase receptor type k:: fusions exhibited a higher mortality rate. Elevated gene expression levels were also significantly correlated with poorer OS across two large, independent CRC cohorts. CONCLUSION: This study identifies a relatively high incidence of rearrangements in aCRC and a strong association with clinical features. Furthermore, we find that fusions are associated with poorer OS.
Evaluation of pancreatic adenocarcinoma with tumor budding and lymphocytic infiltration as prognostic marker.
Jagtap SV, Jagtap SS
World J Gastrointest Oncol · 2025 Nov · PMID 41281481 · Full text
Pancreatic ductal adenocarcinoma (PDAC) is the most prevalent type of pancreatic neoplasm. It is a highly aggressive lethal malignancy related to its delayed in diagnosis and limited response to treatments. The incidence...
Pancreatic ductal adenocarcinoma (PDAC) is the most prevalent type of pancreatic neoplasm. It is a highly aggressive lethal malignancy related to its delayed in diagnosis and limited response to treatments. The incidence and mortality of pancreatic cancer have been increasing over the years. Tumor budding is a proven independent, adverse prognostic factor in PDAC. It is helpful for improvement of prognosis in PDAC in early and precise diagnostic modalities. Tumor budding should be conveyed in pathology reports and taken into account by future oncologic staging systems.
Early cancer diagnosis interpretable two-layer machine learning of plasma extracellular vesicle long RNA.
Liu SC, Zhang H
World J Gastrointest Oncol · 2025 Nov · PMID 41281480 · Full text
BACKGROUND: The early diagnosis rate of pancreatic ductal adenocarcinoma (PDAC) is low and the prognosis is poor. It is important to develop an interpretable noninvasive early diagnostic model in clinical practice. AIM:...
BACKGROUND: The early diagnosis rate of pancreatic ductal adenocarcinoma (PDAC) is low and the prognosis is poor. It is important to develop an interpretable noninvasive early diagnostic model in clinical practice. AIM: To develop an interpretable noninvasive early diagnostic model for PDAC using plasma extracellular vesicle long RNA (EvlRNA). METHODS: The diagnostic model was constructed based on plasma EvlRNA data. During the process of establishing the model, EvlRNA-index was introduced, and four algorithms were adopted to calculate EvlRNA-index. After the model was successfully constructed, performance evaluation was conducted. A series of bioinformatics methods were adopted to explore the potential mechanism of EvlRNA-index as the input feature of the model. And the relationship between key characteristics and PDAC were explored at the single-cell level. RESULTS: A novel interpretable machine learning framework was developed based on plasma EvlRNA. In this framework, a two-layer classifier was established. A new concept was proposed: EvlRNA-index. Based on EvlRNA-index, a cancer diagnostic model was established, and a good diagnostic effect was achieved. The accuracy of PDACandCPvsHealth-Probabilistic PCA Index-SVM (PDAC and chronic pancreatitis health-probabilistic principal component analysis index-support vector machine) (1-18) was 91.51%, with Mathew's correlation coefficient 0.7760 and area under the curve 0.9560. In the second layer of the model, the accuracy of PDACvsCP-Probabilistic PCA Index-RF (PDAC chronic pancreatitis-probabilistic principal component analysis index-random forest) (2-17) was 93.83%, with Mathew's correlation coefficient 0.8422 and area under the curve 0.9698. Forty-nine PDAC-related genes were identified, among which 16 were known, inferring that the remaining ones were also PDAC-related genes. CONCLUSION: An interpretable two-layer machine learning framework was proposed for early diagnosis and prediction of PDAC based on plasma EvlRNA, providing new insights into the clinical value of EvlRNA.
Reassessing the role of lymph node dissection in pancreatic cancer surgery: Balancing oncologic control and immune function preservation.
Xu YH, Jiao Y
World J Gastrointest Oncol · 2025 Nov · PMID 41281479 · Full text
Lymph node dissection (lymphadenectomy) remains a critical component of pancreatic cancer surgery, contributing to accurate staging and guiding adjuvant therapy. The debate between standard and extended lymphadenectomy p...
Lymph node dissection (lymphadenectomy) remains a critical component of pancreatic cancer surgery, contributing to accurate staging and guiding adjuvant therapy. The debate between standard and extended lymphadenectomy persists, with evidence showing no significant survival advantage of extended dissection over the standard approach. Extended lymphadenectomy, while increasing the number of lymph nodes retrieved, is associated with longer operative times, greater blood loss, and higher morbidity. More importantly, lymph nodes serve as critical immune hubs, and excessive removal may compromise systemic immune surveillance, which is vital in the context of emerging immunotherapies for pancreatic cancer. This minireview synthesizes the oncological and immunological perspectives on lymphadenectomy, advocating for a personalized approach to lymph node management in pancreatic cancer surgery, focusing on balancing oncologic outcomes with immune preservation.
Artificial intelligence powered radiomics model for the assessment of colorectal tumor immune microenvironment.
Kumar S
World J Gastrointest Oncol · 2025 Nov · PMID 41281478 · Full text
Zhou 's investigation on the creation of a non-invasive deep learning (DL) method for colorectal tumor immune microenvironment evaluation using preoperative computed tomography (CT) radiomics published in the is thoroug...
Zhou 's investigation on the creation of a non-invasive deep learning (DL) method for colorectal tumor immune microenvironment evaluation using preoperative computed tomography (CT) radiomics published in the is thorough and scientific. The study analyzed preoperative CT images of 315 confirmed colorectal cancer patients, using manual regions of interest to extract DL features. The study developed a DL model using CT images and histopathological images to predict immune-related indicators in colorectal cancer patients. Pathological (tumor-stroma ratio, tumor-infiltrating lymphocytes infiltration, immunohistochemistry, tumor immune microenvironment and immune score) parameters and radiomics (CT imaging and model construction) data were combined to generate artificial intelligence-powered models. Clinical benefit and goodness of fit of the models were assessed using receiver operating characteristic, area under curve and decision curve analysis. The developed DL-based radiomics prediction model for non-invasive evaluation of tumor markers demonstrated potential for personalized treatment planning and immunotherapy strategies in colorectal cancer patients. The study, involving a small group from a single medical center, lacks inclusion/exclusion criteria and should include clinicopathological features for valuable therapeutic practice insights in colorectal cancer patients.
Effect of antiviral therapy on 3-year recurrence and prognosis of hepatocellular carcinoma after curative radiofrequency ablation.
Xu BG, Zhang X, Liu F … +4 more , Li FH, Zhang X, Xiang HL, Liang J
World J Gastrointest Oncol · 2025 Nov · PMID 41281477 · Full text
BACKGROUND: The impact of entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide fumarate (TAF) on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatoc...
BACKGROUND: The impact of entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide fumarate (TAF) on long-term recurrence and overall survival in patients with hepatitis B cirrhosis-related hepatocellular carcinoma (HCC) who undergo curative radiofrequency ablation (RFA) remains unclear. AIM: To compare the 3-year recurrence and survival rates among HCC patients receiving these three first-line oral anti-hepatitis B virus (anti-HBV) agents after RFA. METHODS: This retrospective cohort study included patients with hepatitis B cirrhosis who were initially diagnosed with HCC at Tianjin Third Central Hospital, China, from August 2018 to December 2020, and had complete clinical data. All patients were followed up for at least 144 weeks. Cox regression analysis was performed to identify independent risk factors for HCC recurrence. Recurrence-free survival was analyzed using Kaplan-Meier curves, and Cox regression models were constructed after adjusting for gamma-glutamyl transferase, alpha-fetoprotein, and Barcelona Clinic Liver Cancer staging. RESULTS: A total of 319 patients receiving oral anti-HBV therapy were divided into three groups: ETV group ( = 191), TDF group ( = 76), and TAF group ( = 52). At 6 and 12 months, there were no significant differences in recurrence rates between the groups. However, at 24 and 36 months, the TDF and TAF groups exhibited significantly lower recurrence rates compared with the ETV group [24 months: TDF, hazard ratio (HR) = 0.51, 95% confidence interval (CI): 0.29-0.91, = 0.022; TAF, HR = 0.54, 95%CI: 0.28-1.03, = 0.046; 36 months: TDF, HR = 0.57, 95%CI: 0.35-0.93, = 0.025; TAF, HR = 0.54, 95%CI: 0.31-0.96, = 0.037]. The 3-year mortality rates were similar across the three groups (ETV: 21.47%, TDF: 18.42%, TAF: 23.08%; = 0.790). CONCLUSION: Among patients with hepatitis B cirrhosis-related HCC, TDF and TAF are associated with lower 2-year and 3-year HCC recurrence rates after curative RFA treatment compared with ETV. However, there were no significant differences in 3-year mortality rates between the ETV, TDF, and TAF groups.
Refractory esophageal stenosis after endoscopic submucosal dissection for esophageal cancer managed with multiple dilations: A case report.
Yang SH, Ren HF, Chen X … +2 more , Wang R, Zhang MG
World J Gastrointest Oncol · 2025 Nov · PMID 41281476 · Full text
BACKGROUND: Esophageal cancer is a clinically common malignant tumor of the digestive system. In 2022, it ranked fifth among the leading causes of cancer-related deaths in China. Its predominant symptom is dysphagia, and...
BACKGROUND: Esophageal cancer is a clinically common malignant tumor of the digestive system. In 2022, it ranked fifth among the leading causes of cancer-related deaths in China. Its predominant symptom is dysphagia, and approximately 30%-40% of patients are prone to developing postoperative recurrent stenosis, necessitating repeated esophageal dilation, which significantly affects patients' quality of life. The self-dilation technique, performed by patients, enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis. CASE SUMMARY: We report the case of a 61-year-old man who underwent repeated esophageal dilations following endoscopic submucosal dissection. During his eighth hospital admission, a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique, facilitate early identification of nursing concerns and complications, and provide transitional care following discharge. The patient reported a high level of satisfaction during the hospital stay. During the 6-month follow-up after discharge, the patient's quality of life improved, with a substantial reduction in dysphagia. The esophageal stricture was successfully dilated from 5 mm to 6 mm, the interval between readmissions was prolonged, and the patient's weight increased from 49 kg to 50 kg. CONCLUSION: The establishment of a multidisciplinary case management team, combined with the implementation of a self-help balloon dilation technique, early identification and management of nursing issues and complications, and personalized extended care, can significantly enhance patient satisfaction during hospitalization, improve quality of life, and extend the interval between readmissions. These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.
Clinicopathological characteristics and surgical value of primary gastrointestinal lymphoma.
Yang CX, Xu LX, Liu J … +4 more , Qiao HL, Dong ZW, Jiang D, Gu GL
World J Gastrointest Oncol · 2025 Nov · PMID 41281475 · Full text
BACKGROUND: Primary gastrointestinal lymphoma (PGIL) is a relatively uncommon clinical entity, exhibiting distinctive features including occult primary sites, nonspecific clinical presentations, and considerable diagnost...
BACKGROUND: Primary gastrointestinal lymphoma (PGIL) is a relatively uncommon clinical entity, exhibiting distinctive features including occult primary sites, nonspecific clinical presentations, and considerable diagnostic and therapeutic difficulties. Consequently, comprehensive clinical investigations into its clinicopathological characteristics and surgical intervention value are warranted to enhance diagnostic and therapeutic proficiency. AIM: To investigate the clinicopathological characteristics and surgical significance of PGIL from a surgical perspective, providing a theoretical basis for optimizing diagnostic and therapeutic strategies. METHODS: This study included 50 cases of PGIL treated by the General Surgery Department of the Chinese PLA Air Force Medical Center from June 2001 to March 2025. Data were extracted from the Electronic Medical Record system for retrospective analysis. A retrospective analysis was conducted on their epidemiological, clinical manifestations, imaging, pathological features, and treatment outcomes. Descriptive statistics were applied for data summarization, with continuous variables presented as frequencies and percentages. Correlations between variables were assessed using the Spearman rank correlation coefficient. RESULTS: All cases had the gastrointestinal tract as the primary site. Abdominal pain was the most common initial symptom (52.0%), with 80.0% of patients experiencing pain during the course of the disease, and 38.0% experiencing hematochezia/melena or anemia. Computed tomography diagnosis exhibited a high overall sensitivity (94.3%); the endoscopic detection rate was 91.5%. Diffuse large B-cell lymphoma was the most common subtype (52.0%). The improvement rate was higher in the surgery combined with chemotherapy group than in the chemotherapy only group. The incidence of postoperative complications was 26.5%, all occurring in patients with tumors > 5 cm. CONCLUSION: Diffuse large B-cell lymphoma is the primary PGIL subtype. Imaging and endoscopic biopsy are diagnostic essentials. Surgery aids in resection, complication management, and pathologic diagnosis. Multidisciplinary, individualized strategies are recommended, necessitating further prospective molecular studies.
Precision medicine advances in pancreatic cancer driven by genomic and molecular alterations.
Li X, Jiao Y, Liu YH
World J Gastrointest Oncol · 2025 Nov · PMID 41281474 · Full text
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies with limited treatment efficacy. Advances in precision oncology, enabled by next-generation sequencing, have highlighted key molecular t...
Pancreatic ductal adenocarcinoma (PDAC) remains one of the most lethal malignancies with limited treatment efficacy. Advances in precision oncology, enabled by next-generation sequencing, have highlighted key molecular targets. Kirsten rat sarcoma viral oncogene homolog mutations, present in up to 90% of cases, drive aggressive biology, though most variants remain undruggable; allele-specific inhibitors and exosome-based RNA interference are under exploration. Breast cancer susceptibility gene 1/2 mutations occur in 4%-7% of patients, conferring sensitivity to platinum agents and poly(ADP-ribose) polymerase inhibitors. Other rare but actionable alterations - such as v-raf murine sarcoma viral oncogene homolog B1 (V600), neurotrophic tyrosine receptor kinase, fibroblast growth factor receptor 2, and RET fusions - show benefit in tumor-agnostic trials, broadening options for selected subgroups. Immunotherapy is limited, as high tumor mutational burden and mismatch repair deficiency are uncommon in PDAC, though predictive when present. Co-mutations in tumor protein p53, cyclin-dependent kinase inhibitor 2A, and SMAD4 further stratify prognosis and influence therapy response. Cross-cancer analyses underscore the necessity of PDAC-specific strategies despite shared genomic drivers. Collectively, these insights support routine germline and somatic testing, enrollment in biomarker-matched trials, and rational combination strategies, establishing molecular profiling as central to advancing precision treatment in pancreatic cancer.
Meta-analysis of the efficacy of neoadjuvant immunotherapy combined with radiotherapy and chemotherapy for locally advanced rectal cancer.
Yan WX, Yuan HQ, Xiong ZY … +6 more , Qin LJ, Wu J, He J, Mu J, Li J, Li N
World J Gastrointest Oncol · 2025 Nov · PMID 41281473 · Full text
BACKGROUND: Immunotherapy is an approved treatment for metastatic rectal cancer in patients with defective mismatch repair (MMR). AIM: To examine the clinical efficacy of neoadjuvant immunotherapy combined with radiother...
BACKGROUND: Immunotherapy is an approved treatment for metastatic rectal cancer in patients with defective mismatch repair (MMR). AIM: To examine the clinical efficacy of neoadjuvant immunotherapy combined with radiotherapy and chemotherapy for the treatment of locally advanced rectal cancer (LARC), with a focus on patients with proficient MMR (pMMR) and microsatellite stability. METHODS: Two researchers searched multiple databases for publications up to September 2024. All included publications examined neoadjuvant immunotherapy for LARC, and reported major pathological response (MPR), pathological complete response (pCR), clinical complete response (CCR), and rates of R0 resection and anus-preserving surgery. Meta-analysis, subgroup analysis, sensitivity analysis, and analysis of publication bias were performed. RESULTS: We included 15 publications (796 patients). The MPR, pCR, and CCR were significantly better in the group that received immunotherapy (all < 0.05), especially for patients with pMMR. In addition, the rate of R0 resection and anus-preserving surgery were also significantly greater in the group that received neoadjuvant immunotherapy (both < 0.05). Hematological toxicity and abnormal liver function were the most common clinical adverse events above grade 3. Most patients successfully completed the immunotherapy treatment. The incidence of immune-related adverse reactions was 0%-13.5%, and the severities of these events were generally considered acceptable. CONCLUSION: The addition of neoadjuvant immunotherapy improved the clinical remission rate of patients who had LARC with pMMR, and the treatment-related adverse reactions were generally acceptable. Neoadjuvant immunotherapy combined with radiotherapy and chemotherapy should be considered for patients with LARC.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe