Clinics and research in hepatology and gastroenterology最新文献

{"title":"Access to care and the Hispanic paradox among Hispanic patients with hepatocellular carcinoma","authors":"Patrick L. Quinn ,&nbsp;Fode Tounkara ,&nbsp;Marcel Grau Rodríguez ,&nbsp;Kunika Chahal ,&nbsp;Shah Saiyed ,&nbsp;Goutam Gutta ,&nbsp;Connor Hannon ,&nbsp;Angela Sarna ,&nbsp;Alex Kim ,&nbsp;Jordan M. Cloyd ,&nbsp;Yamilé Molina ,&nbsp;Jan Kitajewski ,&nbsp;Aslam Ejaz","doi":"10.1016/j.clinre.2024.102519","DOIUrl":"10.1016/j.clinre.2024.102519","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the disproportionate impact of hepatocellular carcinoma (HCC) on Hispanic patients, reported outcomes are limited, particularly among subpopulations. Our study aimed to evaluate outcomes in access to care and survival among racial and ethnic Hispanic subpopulations.</div></div><div><h3>Methods</h3><div>The National Cancer Database was utilized to identify patients diagnosed with HCC between 2004 and 2020. The independent variables of interest were racial/ethnic groups, with the Hispanic population disaggregated by race and Hispanic heritage. The primary outcomes were the presentation of early versus late-stage HCC, undergoing a curative-intent procedure, time to treatment, and overall survival. Logistic regression was performed with adjustments made for demographic, clinical, and socioeconomic variables.</div></div><div><h3>Results</h3><div>Among 211,988 patients with HCC identified, 12.3 % (<em>n</em> = 26,085) were classified as Hispanic. In comparison with NHW patients, South/Central American patients had the lowest odds of early-stage presentation (OR=0.91; <em>p</em> = 0.1), Cuban patients had the lowest odds of undergoing a curative-intent procedure (OR=0.72; <em>p</em> = 0.04), and Mexican patients had the highest odds of delayed treatment (OR=1.45; <em>p</em> &lt; 0.001). Hispanics had a longer median survival at 19 months than NHW patients (15 months, <em>p</em> &lt; 0.001), with Hispanic Black (HR 0.59, <em>p</em> &lt; 0.001) and Dominican (HR 0.56, <em>p</em> &lt; 0.001) patients having the lowest mortality risk among Hispanic subpopulations.</div></div><div><h3>Discussion</h3><div>Despite decreased resection rates and increased likelihood of delayed treatment, Hispanics had improved survival across its subpopulations in comparison to NHW patients, further highlighting the Hispanic paradox.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 2","pages":"Article 102519"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of dapagliflozin compared to pioglitazone in diabetic and non-diabetic patients with non-alcoholic steatohepatitis: A randomized clinical trial","authors":"Mona S. Abdel Monem ,&nbsp;Abdulmoneim Adel ,&nbsp;Maggie M. Abbassi ,&nbsp;Doaa H. Abdelaziz ,&nbsp;Mohamed Hassany ,&nbsp;Maissa El Raziky ,&nbsp;Nirmeen A. Sabry","doi":"10.1016/j.clinre.2025.102543","DOIUrl":"10.1016/j.clinre.2025.102543","url":null,"abstract":"<div><h3>Background</h3><div>Non-alcoholic steatohepatitis (NASH) is a serious end-stage spectrum of non-alcoholic fatty liver disease (NAFLD) with associated high risk of hepatic and extrahepatic complications. Several studies showed the significant beneficial effect of dapagliflozin on body composition, hepatic and metabolic parameters on NAFLD/NASH patients. The study aimed to investigate the efficacy and safety of dapagliflozin in both diabetic and non-diabetic biopsy-proven NASH patients; compared to pioglitazone.</div></div><div><h3>Methods</h3><div>This was a four-group, prospective, randomized, parallel, open label study in which 100 biopsy-proven NASH patients were selected, stratified to diabetics and non-diabetics and randomized with 1:1 allocation to either 30 mg pioglitazone or 10 mg dapagliflozin, once daily for 24 weeks. Histological evaluation, anthropometric measures, hepatic, metabolic biochemical markers, fibrosis non-invasive markers, quality of life (QOL) and medications adverse events were examined.</div></div><div><h3>Results</h3><div>Dapagliflozin showed a comparable histological effect to pioglitazone in both diabetic and non-diabetic patients (P&gt;0.05). As assessed by transient elastography, it also showed a comparable effect on liver fibrosis grade improvement from baseline in diabetics (P=0.287) versus a significant superiority in non-diabetics (P=0.018). Dapagliflozin showed a significant superiority in all anthropometric measures (P&lt;0.001) and QOL (P&lt;0.05) among both diabetics and non-diabetics. There was a significant interaction between interventions and diabetes status on change from baseline of hepatic and metabolic panel collectively (P=0.023) in favor to dapagliflozin among diabetics.</div></div><div><h3>Conclusion</h3><div>Compared to pioglitazone, dapagliflozin had a comparable effect histologically, superior effect biochemically among diabetics and superior effect on liver fibrosis, steatosis and insulin resistance among non-diabetics.</div></div><div><h3>Trial Registration</h3><div>The study was registered on clinicaltrials.gov, identifier number NCT05254626.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102543"},"PeriodicalIF":2.6,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower gastrointestinal bleeding from colonic varices of unknown origin","authors":"Jitendra Jonnagaddala ,&nbsp;Sabah Ahmed ,&nbsp;Jamil Mahmoud El Chayeb","doi":"10.1016/j.clinre.2025.102536","DOIUrl":"10.1016/j.clinre.2025.102536","url":null,"abstract":"<div><div>Gastrointestinal bleeding; Colonic varices; Lower gastrointestinal bleeding</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102536"},"PeriodicalIF":2.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported outcomes in mothers with chronic hepatitis B infection: A cross-sectional analysis","authors":"Shi OuYang ,&nbsp;Yueying Deng ,&nbsp;Yawen Geng ,&nbsp;Xiaoli Yuan ,&nbsp;Tingting Peng ,&nbsp;Junchao Qiu ,&nbsp;Zhirong Xiao ,&nbsp;Shengguang Yan ,&nbsp;Haitao Deng ,&nbsp;Xiaotong Peng ,&nbsp;Calvin Q. Pan","doi":"10.1016/j.clinre.2025.102537","DOIUrl":"10.1016/j.clinre.2025.102537","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>The health-related quality of life (HRQoL) during pregnancy has not been well-lidated in mothers with chronic hepatitis B (CHB). We aim to compare patient-reported outcomes (PROs) in CHB mothers with those of healthy mothers during pregnancy.</div></div><div><h3>Methods</h3><div>Between 4/16/2023 and 7/31/2023, we invited consecutive CHB and healthy mothers to complete the self-administered 36-item Short Form Survey (SF-36) and the Chronic Liver Disease Questionnaire (CLDQ) for PRO assessment. Pairwise comparisons of PRO scores between groups were performed using chi-square tests. Covariates for worse PROs were further analyzed by the multiple linear regression model to identify the independent predictors</div></div><div><h3>Results</h3><div>Among 257 participants (CHB: healthy control was 100:157), the mean (SD) age was 29.6 (3.4), and the majority completed the PRO assessment at the gestational weeks of 16–24. When compared to healthy mothers, CHB mothers had a significant impairment of PROs in the CLDQ domain of worry (6.97±0.16 vs 5.83±0.99, <em>p</em>&lt;0.05) and the SF-36 domain of social functioning (95.33±10.00 vs 91.67±16.37, <em>p</em>&lt;0.05). The subgroup analyses in CHB mothers showed HBV DNA &gt;200,000 IU/mL associated with significantly worse PROs. The multivariate analyses identified CHB infection, severe nausea or vomiting, poor living conditions, and spousal negative attitude as independent predictors of HRQoL impairment.</div></div><div><h3>Conclusion</h3><div>This study suggests that CHB infection during pregnancy negatively impacted HRQoL, particularly in worry and social functioning domains. CHB infection was an independent predictor for PRO impairments. Further integration of monitoring and intervention on HRQoL impairment should be considered when managing CHB mothers during pregnancy.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102537"},"PeriodicalIF":2.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of immunotherapy on the care patterns and outcomes of patients with advanced hepatocellular carcinoma","authors":"Aryanna Sousa ,&nbsp;Qusai Al Masad ,&nbsp;Paola Pena ,&nbsp;N. Joseph Espat ,&nbsp;Abdul S. Calvino ,&nbsp;Ponnandai Somasundar ,&nbsp;Thaer Abdelfattah ,&nbsp;Steve Kwon","doi":"10.1016/j.clinre.2025.102542","DOIUrl":"10.1016/j.clinre.2025.102542","url":null,"abstract":"<div><h3>Background</h3><div>Modern immunotherapy with checkpoint inhibitors revolutionized cancer treatment and outcomes. This study aims to demonstrate how immunotherapy has impacted the national landscape of systemic treatment and palliative care in advanced hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>Retrospective cohort selecting patients from the U.S.-based National Cancer Database (NCDB) with clinical stages T3b/T4 and stage IV HCC from 2010 to 2021. We performed a multivariable analysis using the Cox proportional hazard for overall survival (OS) comparisons and a logistic regression model to study immunotherapy use.</div></div><div><h3>Results</h3><div>Immunotherapy use increased from 0.27 % in 2010 to 33.80 % in 2021. The median OS survival (in months) was 2 for untreated patients, 7.20 for chemotherapy, and 7.46 for immunotherapy. There was a better OS with immunotherapy (HR 0.59, 95 % CI 0.56–0.62). Systemic therapy for palliation increased from 14.41 % in 2010 to 25.32 % in 2021. Compared to surgical palliation, radiation (HR 0.61, 95 % CI 0.52–0.71) and systemic palliative (HR 0.59, 95 % CI 0.51–0.69) therapies improved OS.</div></div><div><h3>Conclusion</h3><div>From 2010 to 2021, there was a significant increase in the use of immunotherapy, parallel to a large shift toward systemic therapy use for palliative care in patients with advanced HCC. Immunotherapy was associated with a significant OS benefit in the palliative setting.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102542"},"PeriodicalIF":2.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goose bump stomach","authors":"Vincent Zimmer","doi":"10.1016/j.clinre.2025.102534","DOIUrl":"10.1016/j.clinre.2025.102534","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102534"},"PeriodicalIF":2.6,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Droplet digital PCR technique is ultrasensitive for the quantification of covalently closed circular DNA in the blood of chronic HBV-infected patients","authors":"Ravinder Singh ,&nbsp;Gayatri Ramakrishna ,&nbsp;Manoj Kumar Sharma ,&nbsp;Rahul Kumar ,&nbsp;Ekta Gupta ,&nbsp;Archana Rastogi ,&nbsp;Pranay Tanwar ,&nbsp;Shiv Kumar Sarin ,&nbsp;Nirupama Trehanpati","doi":"10.1016/j.clinre.2025.102531","DOIUrl":"10.1016/j.clinre.2025.102531","url":null,"abstract":"<div><h3>Background</h3><div>Covalently closed circular DNA (cccDNA) is a stable, episomal form of HBV DNA. cccDNA is a true marker for the intrahepatic events in controlled CHB infection. Quantifying cccDNA is critical for monitoring disease progression, and efficacy of anti-viral therapies.</div></div><div><h3>Methods</h3><div>To standardize the method, total HBV DNA was isolated from HepAD38 cells and digested with three exonuclease enzymes to remove linear and relaxed circular HBV DNA. Purified cccDNA quantification used ddPCR with specific primers. Treatment-naive chronic hepatitis B virus patients (nCHBV, n=36) with detectable HBV DNA and HBsAg were grouped by HBsAg levels: Group I (HBsAg^lo &lt; 2000 IU/ml, n=11) and Group II (HBsAg^hi &gt; 2000 IU/ml, n=25). cccDNA, HBV DNA and HBsAg were quantified in plasma and compared between groups. Correlation with clinical/histopathological features was done.</div></div><div><h3>Results</h3><div>Non-digested 3.6^{^}10⁶ tet^-ve HepAD38 cells showed 316 copies/µl of total viral DNA. After digesting the linear, integrated, and relaxed circular DNA with triple enzymes, 15 copies/µl of cccDNA were detected. Similarly, after DNA digestion, HBsAg^lo patients showed a median of 8.5 copies/µl (IQR 2.75-9.75 copies/µl), and HBsAg^hi gave a median of 11 copies/µl (IQR 4-16 copies/µl) but with no significant difference between groups (p=0.093). Further, HBsAg^lo patients with low cccDNA copy numbers showed significantly higher fibrosis grades than HBsAg^hi (p=0.036).</div></div><div><h3>Conclusions</h3><div>We conclude that employing a combined approach utilizing three exonucleases, cccDNA-specific primers, and ddPCR enables the detection of cccDNA copies even in patients exhibiting low levels of HBsAg and HBV DNA. This integrated method offers additional validation as a surrogate diagnostic tool.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102531"},"PeriodicalIF":2.6,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial dysfunction in drug-induced hepatic steatosis: Recent findings and current concept","authors":"Annie Borgne-Sanchez ,&nbsp;Bernard Fromenty","doi":"10.1016/j.clinre.2025.102529","DOIUrl":"10.1016/j.clinre.2025.102529","url":null,"abstract":"<div><div>Mitochondrial activity is necessary for the maintenance of many liver functions. In particular, mitochondrial fatty acid oxidation (FAO) is required for energy production and lipid homeostasis. This key metabolic pathway is finely tuned by the mitochondrial respiratory chain (MRC) activity and different transcription factors such as peroxisome proliferator-activated receptor α (PPARα). Many drugs have been shown to cause mitochondrial dysfunction, which can lead to acute and chronic liver lesions. While severe inhibition of mitochondrial FAO would eventually cause microvesicular steatosis, hypoglycemia, and liver failure, moderate impairment of this metabolic pathway can induce macrovacuolar steatosis, which can progress in the long term to steatohepatitis and cirrhosis. Drugs can impair mitochondrial FAO through several mechanisms including direct inhibition of FAO enzymes, sequestration of coenzyme A and <span>l</span>-carnitine, impairment of the activity of one or several MRC complexes and reduced PPARα expression. In drug-induced macrovacuolar steatosis, non-mitochondrial mechanisms can also be involved in lipid accumulation including increased <em>de novo</em> lipogenesis and reduced very-low-density lipoprotein secretion. Nonetheless, mitochondrial dysfunction and subsequent oxidative stress appear to be key events in the progression of steatosis to steatohepatitis. Patients suffering from metabolic dysfunction-associated steatotic liver disease (MASLD) and treated with mitochondriotoxic drugs should be closely monitored to reduce the risk of acute liver injury or a faster transition of steatosis to steatohepatitis. Therapies based on the mitochondrial cofactor <span>l</span>-carnitine, the antioxidant N-acetylcysteine, or thyromimetics might be useful to prevent or treat drug-induced mitochondrial dysfunction, steatosis, and steatohepatitis.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 3","pages":"Article 102529"},"PeriodicalIF":2.6,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969898","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":"Expansion of interventional endoscopy and day-case procedures: A nationwide longitudinal study of gastrointestinal endoscopy in France","authors":"Hervé-Pierre Toudic ,&nbsp;Marie Morvan ,&nbsp;Noémi Reboux ,&nbsp;Stanislas Chaussade ,&nbsp;Olivier Gronier ,&nbsp;Stéphane Koch ,&nbsp;David Bernardini ,&nbsp;Emmanuel Coron ,&nbsp;Michel Robaszkiewicz ,&nbsp;Lucille Quénéhervé","doi":"10.1016/j.clinre.2024.102505","DOIUrl":"10.1016/j.clinre.2024.102505","url":null,"abstract":"<div><h3>Background</h3><div>An accurate assessment of the evolution of GI endoscopy volumes is warranted to identify long-term trends and to help anticipate training, infrastructure and human resource needs. The main objective of this longitudinal study was to evaluate the evolution of GI endoscopy in France.</div></div><div><h3>Methods</h3><div>This retrospective study consisted of a cross-sectional analysis repeated each year from 2008 to 2018 using data from a national health database related to hospital admissions. All day-case and hospital stays presenting at least one of the 119 GI endoscopy procedures were extracted.</div></div><div><h3>Results</h3><div>This study showed an increase in day-case and hospital stays including a GI endoscopy procedure of 18.4 %. In addition, day-case endoscopy increased from 67.8 % to 76.9 % of hospital admissions. There was a 19.6 % increase in lower GI endoscopy, with in particular a 247 % increase in endoscopic mucosal resection. EUS and pancreaticobiliary and duodenal endoscopy have seen the most significant increases, 63 % and 70.2 % respectively; notably, therapeutic EUS increased by 476 %.</div></div><div><h3>Conclusion</h3><div>This study shows the good dynamics of GI endoscopy in a European country with a sustained increase over 11 years in day-case and hospital stays of patients undergoing a GI endoscopy while day-case endoscopy is taking on an increasingly important role.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102505"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750191","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":"Induction triplet chemotherapy in patients with rectal adenocarcinoma and synchronous metastases, an AGEO-FFCD study","authors":"Victoire Dabout ,&nbsp;Laurent Mineur ,&nbsp;David Tougeron ,&nbsp;Karine Le Malicot ,&nbsp;Claire Gallois ,&nbsp;Jean Marc Phelip ,&nbsp;Anthony Turpin ,&nbsp;Romain Cohen ,&nbsp;Benedicte Demoustier ,&nbsp;Vincent Hautefeuille ,&nbsp;Christophe Locher ,&nbsp;Charles-Briac Levaché ,&nbsp;Emmanuel Mitry ,&nbsp;Thierry Lecomte ,&nbsp;Fabien Brocard ,&nbsp;Deborah Hassid ,&nbsp;Marie Porte ,&nbsp;Gilles Breysacher ,&nbsp;Jean-Paul Lagasse ,&nbsp;Côme Lepage ,&nbsp;Jean-Baptiste Bachet","doi":"10.1016/j.clinre.2024.102514","DOIUrl":"10.1016/j.clinre.2024.102514","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Aim of the study&lt;/h3&gt;&lt;div&gt;The management of synchronous metastatic rectal cancer (SMRC) is complex and multimodal, involving chemotherapy, surgery and/or radiotherapy. The aim of this study was firstly to confirm the efficacy of the induction FOLFIRINOX, and secondly to evaluate the different therapeutic strategies and outcomes of patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Patients and methods&lt;/h3&gt;&lt;div&gt;This French study combined data from a prospective FFCD trial and a multicenter cohort. Patients included had SMRC and had undergone induction triplet chemotherapy. Two groups of patients were defined according to the resectability of metastases at baseline: resectable (Res) and unresectable (URes). The primary endpoint was the objective response rate.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;146 patients were included in 16 French centers and 65 patients in the FFCD1102 trial. In overall population the median age of patients was 59 years, 86% of tumors were of the lower or middle rectum, 33% were well-differentiated, 53% were &lt;em&gt;RAS&lt;/em&gt; mutated and 7% &lt;em&gt;BRAF&lt;/em&gt; mutated. Triplet induction was associated with 80% of objective response and 92% of disease control. After the induction phase, 69% and 48% of patients of Res and URes groups underwent rectal surgery, and secondary metastases resection was done in 79% and 39% of patients, respectively. Median overall survival (OS) for Res was 56.3 months (95% CI: 22.54-NA). Median OS for URes who had or not secondary metastases resection were 45.1 months (95% CI: 39.89-NA) and 21.1 months (95% CI 17.31–27.1), respectively. Patients with &lt;em&gt;BRAF&lt;/em&gt; mutated tumors were more likely to have unresectable disease, and had worse survivals than the patients with &lt;em&gt;RAS&lt;/em&gt; mutated or &lt;em&gt;RAS/BRAF&lt;/em&gt; wild-type.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Triplet induction chemotherapy is a treatment of choice in selected patients with SMRC, allowing to adapt the therapeutic strategy to the response and invasiveness of the various sites.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Structured abstract&lt;/h3&gt;&lt;div&gt;The management of metastatic rectal cancer is essentially based on three main therapeutic approaches: surgery, radiotherapy/chemoradiotherapy and chemotherapy. Induction triplet chemotherapy appears as a good choice for fit and young patients. It allows to adapt the therapeutic strategy to the response and invasiveness of the various sites. In this study dedicated to patients undergoing treatment for rectal cancer with synchronous metastases, FOLFIRINOX-based induction chemotherapy was associated with objective response rate of 77% and disease control rate of 92%. These results are similar with those of the FFCD 1102 trial and confirm the efficacy of induction chemotherapy with FOLFIRINOX with or without targeted therapy in these patients in daily routine practice. Surgery for metastases is a key factor in determining patient's outcome and triplet induction chemotherapy, associated with high response rates, enables a significant perce","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 1","pages":"Article 102514"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823781","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}