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Risk of Ischemic Stroke in Relation to Helicobacter pylori Infection and Eradication Status: A Large-Scale Prospective Observational Cohort Study. 缺血性中风风险与幽门螺杆菌感染和根除状态的关系:大规模前瞻性观察队列研究》。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 Epub Date: 2024-05-07 DOI: 10.5009/gnl230458
Eun-Bi Jeon, Nayoung Kim, Beom Joon Kim, In-Chang Hwang, Sang Bin Kim, Ji-Hyun Kim, Yonghoon Choi, Yu Kyung Jun, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Soyeon Ahn

Background/aims: : A few studies have suggested the association between Helicobacter pylori (HP) infection and ischemic stroke. However, the impact of HP eradication on stroke risk has not been well evaluated. This study aimed to assess the influence of HP eradication on the incidence of ischemic stroke, considering the potential effect of sex.

Methods: : This prospective observational cohort study was conducted at Seoul National University Bundang Hospital, from May 2003 to February 2023, and involved gastroscopy-based HP testing. Propensity score (PS) matching was employed to ensure balanced groups by matching patients in the HP eradicated group (n=2,803) in a 3:1 ratio with patients in the HP non-eradicated group (n=960). Cox proportional hazard regression analysis was used to evaluate the risk of ischemic stroke.

Results: : Among 6,664 patients, multivariate analysis after PS matching indicated that HP eradication did not significantly alter the risk of ischemic stroke (hazard ratio, 0.531; 95% confidence interval, 0.221 to 1.270; p=0.157). Sex-specific subgroup analyses, both univariate and multivariate, did not yield statistically significant differences. However, Kaplan-Meier analysis revealed a potential trend: the females in the HP eradicated group exhibited a lower incidence of ischemic stroke than those in the HP non-eradicated group, although this did not reach statistical significance (p=0.057).

Conclusions: : This finding suggests that HP eradication might not impact the risk of ischemic stroke. However, there was a trend showing that females potentially had a lower risk of ischemic stroke following HP eradication, though further investigation is required to establish definitive evidence.

背景/目的: :一些研究表明幽门螺杆菌(HP)感染与缺血性中风之间存在关联。然而,根除幽门螺杆菌对中风风险的影响尚未得到很好的评估。本研究旨在评估根除幽门螺杆菌对缺血性中风发病率的影响,同时考虑性别的潜在影响:这项前瞻性观察性队列研究于 2003 年 5 月至 2023 年 2 月在首尔国立大学盆唐医院进行,涉及基于胃镜的 HP 检测。研究采用倾向评分(PS)匹配法,将HP根除组患者(2803人)与HP未根除组患者(960人)按3:1的比例进行匹配,以确保组间平衡。采用 Cox 比例危险回归分析评估缺血性中风的风险:在 6664 名患者中,PS 匹配后的多变量分析表明,根除 HP 并未显著改变缺血性中风的风险(危险比为 0.531;95% 置信区间为 0.221 至 1.270;P=0.157)。单变量和多变量性别亚组分析均未发现统计学上的显著差异。然而,卡普兰-梅耶尔分析显示了一种潜在的趋势:根除 HP 组的女性缺血性中风发病率低于未根除 HP 组,但未达到统计学意义(P=0.057):这一发现表明,根除 HP 可能不会影响缺血性中风的风险。然而,有趋势表明,女性在根除 HP 后发生缺血性中风的风险可能较低,但要确定确切的证据还需要进一步的调查。
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引用次数: 0
Achieving Sufficient Therapeutic Outcomes of Surgery in Elderly Hepatocellular Carcinoma Patients through Appropriate Selection. 通过适当选择,使老年肝细胞癌患者的手术取得充分的治疗效果。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 DOI: 10.5009/gnl240279
Han Ah Lee
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引用次数: 0
Discordance Rate and Risk Factor of Other Diagnostic Modalities for Small Bowel Tumors Detected by Device-Assisted Enteroscopy: A Korean Association for the Study of Intestinal Disease (KASID) Multicenter Study. 设备辅助肠镜检查发现小肠肿瘤的不一致率和其他诊断方式的风险因素:韩国肠道疾病研究协会(KASID)多中心研究。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 Epub Date: 2024-05-10 DOI: 10.5009/gnl240030
Jihye Park, Jin Su Kim, Joo Hye Song, Kwangwoo Nam, Seong-Eun Kim, Eui Sun Jeong, Jae Hyun Kim, Seong Ran Jeon

Background/aims: Despite advances in imaging and endoscopic technology, diagnostic modalities for small bowel tumors are simultaneously performed. We investigated the discrepancy rate between each modality and predictive factors of discrepancy in patients with definite small bowel tumors.

Methods: Data of patients with definite small bowel tumors who underwent both device-assisted enteroscopy (DAE) and computed tomography (CT) were retrieved from web-based enteroscopy registry database in Korea. Predictive risk factors associated with discrepancy were analyzed using logistic regression analysis.

Results: Among 998 patients, 210 (21.0%) were diagnosed with small bowel tumor using DAE, in 193 patients with definite small bowel tumor, DAE and CT were performed. Of these patients, 12 (6.2%) showed discrepancy between examinations. Among 49 patients who underwent DAE and video capsule endoscopy (VCE) examination, 13 (26.5%) showed discrepancy between examinations. No significant independent risk factors were associated with concordance between DAE and CT in multivariate logistic regression analysis among the patients. In a multivariate logistic regression analysis, red blood cell transfusion was negatively associated with concordance between DAE and VCE in patients with small bowel tumor (odds ratio, 0.163; 95% confidence interval, 0.026 to 1.004; p=0.050).

Conclusions: For small bowel tumors, the discrepancy rate between DAE and CT was 6.2%, and 26.5% between DAE and VCE. Despite developments in cross-sectional imaging (VCE and DAE modalities), discrepancies still exist. For small bowel bleeding that require significant transfusion while showing insignificant VCE findings, DAE should be considered as the next diagnostic approach, considering the possibility of missed small bowel tumor.

背景/目的:尽管成像和内窥镜技术不断进步,但小肠肿瘤的诊断方式仍是同时进行的。我们研究了每种诊断方式之间的差异率以及差异的预测因素:方法:我们从韩国基于网络的肠镜登记数据库中检索了同时接受设备辅助肠镜(DAE)和计算机断层扫描(CT)检查的确诊小肠肿瘤患者的数据。采用逻辑回归分析法分析了与差异相关的预测性风险因素:998例患者中,210例(21.0%)通过DAE诊断为小肠肿瘤,193例确诊为小肠肿瘤的患者同时进行了DAE和CT检查。在这些患者中,有 12 人(6.2%)的检查结果不一致。在 49 名接受 DAE 和视频胶囊内镜(VCE)检查的患者中,有 13 人(26.5%)的检查结果不一致。在多变量逻辑回归分析中,患者中没有明显的独立风险因素与 DAE 和 CT 的一致性相关。在多变量逻辑回归分析中,输红细胞与小肠肿瘤患者 DAE 和 VCE 的一致性呈负相关(几率比 0.163;95% 置信区间 0.026 至 1.004;P=0.050):对于小肠肿瘤,DAE 和 CT 的差异率为 6.2%,DAE 和 VCE 的差异率为 26.5%。尽管横断面成像(VCE 和 DAE 模式)有所发展,但差异仍然存在。对于需要大量输血但 VCE 检查结果不明显的小肠出血患者,考虑到漏诊小肠肿瘤的可能性,应将 DAE 作为下一步诊断方法。
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引用次数: 0
A Novel Retractable Robotic Device for Colorectal Endoscopic Submucosal Dissection. 用于结直肠内镜黏膜下剥离术的新型可伸缩机器人设备
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 Epub Date: 2024-05-07 DOI: 10.5009/gnl230280
Sang Hyun Kim, Chanwoo Kim, Bora Keum, Junghyun Im, Seonghyeon Won, Byung Gon Kim, Kyungnam Kim, Taebin Kwon, Daehie Hong, Han Jo Jeon, Hyuk Soon Choi, Eun Sun Kim, Yoon Tae Jeen, Hoon Jai Chun, Joo Ha Hwang

Background/aims: : Appropriate tissue tension and clear visibility of the dissection area using traction are essential for effective and safe endoscopic submucosal dissection (ESD). In this study, we developed a retractable robot-assisted traction device and evaluated its performance in colorectal ESD.

Methods: : An experienced endoscopist performed ESD 18 times on an ex vivo porcine colon using the robot and 18 times using the conventional method. The outcome measures were procedure time, dissection speed, procedure-related adverse events, and blind dissection rate.

Results: : Thirty-six colonic lesions were resected from ex vivo porcine colon samples. The total procedure time was significantly shorter in robot-assisted ESD (RESD) than in conventional ESD (CESD) (20.1±4.1 minutes vs 34.3±8.3 minutes, p<0.05). The submucosal dissection speed was significantly faster in the RESD group than in the CESD group (36.8±9.2 mm2/min vs 18.1±4.7 mm2/min, p<0.05). The blind dissection rate was also significantly lower in the RESD group (12.8%±3.4% vs 35.1%±3.9%, p<0.05). In an in vivo porcine feasibility study, the robotic device was attached to a colonoscope and successfully inserted into the proximal colon without damaging the colonic wall, and ESD was successfully performed.

Conclusions: : The dissection speed and safety profile improved significantly with the retractable RESD. Thus, our robotic device has the potential to provide simple, effective, and safe multidirectional traction during colonic ESD.

背景/目的利用牵引力获得适当的组织张力和清晰可见的解剖区域对于有效和安全地进行内镜粘膜下剥离(ESD)至关重要。在这项研究中,我们开发了一种可伸缩的机器人辅助牵引装置,并对其在结直肠ESD中的性能进行了评估:一名经验丰富的内镜医师使用机器人和传统方法分别对猪结肠进行了18次ESD操作。结果: :从活体猪结肠样本中切除了 36 个结肠病灶。机器人辅助ESD(RESD)的总手术时间明显短于传统ESD(CESD)(20.1±4.1分钟 vs 34.3±8.3分钟,p2/min vs 18.1±4.7 mm2/min):结论:使用可伸缩式 RESD 后,解剖速度和安全性显著提高。因此,我们的机器人设备有望在结肠ESD过程中提供简单、有效和安全的多向牵引。
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引用次数: 0
From Plate to Stomach: Exploring the Dietary Influence on Gastric Cancer. 从盘子到胃:探索饮食对胃癌的影响。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 DOI: 10.5009/gnl240264
Tae-Se Kim, Jun Haeng Lee
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引用次数: 0
Daily Diet and Nutrition Risk Factors for Gastric Cancer Incidence in a Japanese Population. 日本人口胃癌发病率的日常饮食和营养风险因素。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 Epub Date: 2024-02-23 DOI: 10.5009/gnl230354
Ayaka Takasu, Takuji Gotoda, Sho Suzuki, Chika Kusano, Chiho Goto, Hideki Ishikawa, Hirofumi Kogure

Background/aims: : Nutritional factors associated with gastric cancer (GC) are not completely understood. We aimed to determine the effect of nutrient intake on the incidence of GC.

Methods: : This was a post hoc analysis of a prospective trial that evaluated modalities for GC screening in participants aged 30 to 74 years living in high-risk areas for GC in Japan between June 2011 and March 2013. The patients were followed up for GC incidence for 6 years. All participants completed a self-administered food frequency questionnaire (FFQ) upon enrollment before GC screening. Daily nutrient intake was calculated from the FFQ and dichotomized at each cutoff value using receiver operating characteristic analysis. Risk factors associated with GC incidence were investigated in terms of nutrient intake and participant characteristics using Cox proportional hazards regression analysis.

Results: : Overall, 1,147 participants were included in this analysis. The median age was 62 years, and 50.7% of the participants were men. The median follow-up period was 2,184 days. GC was detected in 25 participants during the follow-up. Multivariate Cox proportional hazards regression analysis revealed that the intake of sodium (adjusted hazards ratio [aHR], 3.905; 95% confidence interval [CI], 1.520 to 10.035; p=0.005) and vitamin D (aHR, 2.747; 95% CI, 1.111 to 6.788, p=0.029) were positively associated with GC incidence, whereas the intake of soluble dietary fiber (aHR, 0.104; 95% CI, 0.012 to 0.905; p=0.040) was inversely associated with GC incidence.

Conclusions: : Daily high intake of sodium and vitamin D and low soluble dietary fiber intake are associated with GC incidence.

背景/目的: :与胃癌(GC)相关的营养因素尚不完全清楚。我们旨在确定营养摄入对胃癌发病率的影响:这是一项前瞻性试验的事后分析,该试验评估了 2011 年 6 月至 2013 年 3 月期间日本胃癌高风险地区 30 至 74 岁人群的胃癌筛查方式。对这些患者的 GC 发病率进行了为期 6 年的随访。所有参与者在接受 GC 筛查前都填写了一份自填式食物频率问卷 (FFQ)。根据 FFQ 计算出每日营养素摄入量,并使用接收器操作特征分析法对每个临界值进行二分。利用考克斯比例危险回归分析法,从营养素摄入量和参与者特征的角度研究了与胃癌发病率相关的风险因素:共有 1,147 名参与者参与了此次分析。中位年龄为 62 岁,50.7% 的参与者为男性。随访时间中位数为 2,184 天。在随访期间,有 25 名参与者检测出 GC。多变量考克斯比例危险回归分析显示,钠摄入量(调整危险比 [aHR],3.905;95% 置信区间 [CI],1.520 至 10.035;p=0.005)和维生素 D 摄入量(aHR,2.747;95% 置信区间 [CI],1.111至6.788,p=0.029)与GC发病率呈正相关,而可溶性膳食纤维的摄入量(aHR,0.104;95% CI,0.012至0.905;p=0.040)与GC发病率呈反相关:结论:每日钠和维生素 D 的高摄入量以及可溶性膳食纤维的低摄入量与 GC 发病率有关。
{"title":"Daily Diet and Nutrition Risk Factors for Gastric Cancer Incidence in a Japanese Population.","authors":"Ayaka Takasu, Takuji Gotoda, Sho Suzuki, Chika Kusano, Chiho Goto, Hideki Ishikawa, Hirofumi Kogure","doi":"10.5009/gnl230354","DOIUrl":"10.5009/gnl230354","url":null,"abstract":"<p><strong>Background/aims: </strong>: Nutritional factors associated with gastric cancer (GC) are not completely understood. We aimed to determine the effect of nutrient intake on the incidence of GC.</p><p><strong>Methods: </strong>: This was a <i>post hoc</i> analysis of a prospective trial that evaluated modalities for GC screening in participants aged 30 to 74 years living in high-risk areas for GC in Japan between June 2011 and March 2013. The patients were followed up for GC incidence for 6 years. All participants completed a self-administered food frequency questionnaire (FFQ) upon enrollment before GC screening. Daily nutrient intake was calculated from the FFQ and dichotomized at each cutoff value using receiver operating characteristic analysis. Risk factors associated with GC incidence were investigated in terms of nutrient intake and participant characteristics using Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>: Overall, 1,147 participants were included in this analysis. The median age was 62 years, and 50.7% of the participants were men. The median follow-up period was 2,184 days. GC was detected in 25 participants during the follow-up. Multivariate Cox proportional hazards regression analysis revealed that the intake of sodium (adjusted hazards ratio [aHR], 3.905; 95% confidence interval [CI], 1.520 to 10.035; p=0.005) and vitamin D (aHR, 2.747; 95% CI, 1.111 to 6.788, p=0.029) were positively associated with GC incidence, whereas the intake of soluble dietary fiber (aHR, 0.104; 95% CI, 0.012 to 0.905; p=0.040) was inversely associated with GC incidence.</p><p><strong>Conclusions: </strong>: Daily high intake of sodium and vitamin D and low soluble dietary fiber intake are associated with GC incidence.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"602-610"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139930862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of Palliative Chemotherapy for Ampulla of Vater Adenocarcinoma: A Multicenter Cohort Study. 膀胱腺癌姑息化疗的疗效:一项多中心队列研究
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 Epub Date: 2023-12-22 DOI: 10.5009/gnl230164
Dong Kee Jang, So Jeong Kim, Hwe Hoon Chung, Jae Min Lee, Seung Bae Yoon, Jong-Chan Lee, Dong Woo Shin, Jin-Hyeok Hwang, Min Kyu Jung, Yoon Suk Lee, Hee Seung Lee, Joo Kyung Park

Background/aims: : Palliative chemotherapy (PC) is not standardized for patients with advanced ampulla of Vater adenocarcinoma (AA). This multicenter, retrospective study evaluated first-line PC outcomes in patients with AA.

Methods: : Patients diagnosed with AA between January 2010 and December 2020 who underwent PC were enrolled from 10 institutions. Overall survival (OS) and progression-free survival (PFS) according to the chemotherapy regimen were analyzed.

Results: : Of 255 patients (mean age, 64.0±10.0 years; male, 57.6%), 14 (5.5%) had locally advanced AA and 241 (94.5%) had metastatic AA. Gemcitabine plus cisplatin (GP) was administered as first-line chemotherapy to 192 patients (75.3%), whereas capecitabine plus oxaliplatin (CAPOX) was administered to 39 patients (15.3%). The median OS of all patients was 19.8 months (95% confidence interval [CI], 17.3 to 22.3), and that of patients who received GP and CAPOX was 20.4 months (95% CI, 17.2 to 23.6) and 16.0 months (95% CI, 11.2 to 20.7), respectively. The median PFS of GP and CAPOX patients were 8.4 months (95% CI, 7.1 to 9.7) and 5.1 months (95% CI, 2.5 to 7.8), respectively. PC for AA demonstrated improved median outcomes in both OS and PFS compared to conventional bile duct cancers that included AA.

Conclusions: : While previous studies have shown mixed prognostic outcomes when AA was analyzed together with other biliary tract cancers, our study unveils a distinct clinical prognosis specific to AA on a large scale with systemic anticancer therapy. These findings suggest that AA is a distinct type of tumor, different from other biliary tract cancers, and AA itself could be expected to have a favorable response to PC.

背景/目的: :晚期瓦特氏腺癌(AA)患者的姑息化疗(PC)尚未标准化。这项多中心回顾性研究评估了AA患者的一线PC疗效:2010年1月至2020年12月期间确诊为AA并接受PC治疗的患者来自10家医疗机构。根据化疗方案分析总生存期(OS)和无进展生存期(PFS):255名患者(平均年龄为64.0±10.0岁,男性占57.6%)中,14人(5.5%)为局部晚期AA,241人(94.5%)为转移性AA。192名患者(75.3%)接受了吉西他滨加顺铂(GP)一线化疗,39名患者(15.3%)接受了卡培他滨加奥沙利铂(CAPOX)一线化疗。所有患者的中位OS为19.8个月(95%置信区间[CI],17.3至22.3),接受GP和CAPOX治疗的患者的中位OS分别为20.4个月(95%置信区间[CI],17.2至23.6)和16.0个月(95%置信区间[CI],11.2至20.7)。GP和CAPOX患者的中位PFS分别为8.4个月(95% CI,7.1至9.7)和5.1个月(95% CI,2.5至7.8)。与包括AA的传统胆管癌相比,PC治疗AA患者的OS和PFS中位预后均有所改善:尽管之前的研究显示,将AA与其他胆管癌放在一起分析时,预后结果不一,但我们的研究揭示了AA在大规模全身抗癌治疗中的独特临床预后。这些研究结果表明,AA是一种有别于其他胆道癌的独特肿瘤类型,AA本身有望对PC产生良好的反应。
{"title":"Outcomes of Palliative Chemotherapy for Ampulla of Vater Adenocarcinoma: A Multicenter Cohort Study.","authors":"Dong Kee Jang, So Jeong Kim, Hwe Hoon Chung, Jae Min Lee, Seung Bae Yoon, Jong-Chan Lee, Dong Woo Shin, Jin-Hyeok Hwang, Min Kyu Jung, Yoon Suk Lee, Hee Seung Lee, Joo Kyung Park","doi":"10.5009/gnl230164","DOIUrl":"10.5009/gnl230164","url":null,"abstract":"<p><strong>Background/aims: </strong>: Palliative chemotherapy (PC) is not standardized for patients with advanced ampulla of Vater adenocarcinoma (AA). This multicenter, retrospective study evaluated first-line PC outcomes in patients with AA.</p><p><strong>Methods: </strong>: Patients diagnosed with AA between January 2010 and December 2020 who underwent PC were enrolled from 10 institutions. Overall survival (OS) and progression-free survival (PFS) according to the chemotherapy regimen were analyzed.</p><p><strong>Results: </strong>: Of 255 patients (mean age, 64.0±10.0 years; male, 57.6%), 14 (5.5%) had locally advanced AA and 241 (94.5%) had metastatic AA. Gemcitabine plus cisplatin (GP) was administered as first-line chemotherapy to 192 patients (75.3%), whereas capecitabine plus oxaliplatin (CAPOX) was administered to 39 patients (15.3%). The median OS of all patients was 19.8 months (95% confidence interval [CI], 17.3 to 22.3), and that of patients who received GP and CAPOX was 20.4 months (95% CI, 17.2 to 23.6) and 16.0 months (95% CI, 11.2 to 20.7), respectively. The median PFS of GP and CAPOX patients were 8.4 months (95% CI, 7.1 to 9.7) and 5.1 months (95% CI, 2.5 to 7.8), respectively. PC for AA demonstrated improved median outcomes in both OS and PFS compared to conventional bile duct cancers that included AA.</p><p><strong>Conclusions: </strong>: While previous studies have shown mixed prognostic outcomes when AA was analyzed together with other biliary tract cancers, our study unveils a distinct clinical prognosis specific to AA on a large scale with systemic anticancer therapy. These findings suggest that AA is a distinct type of tumor, different from other biliary tract cancers, and AA itself could be expected to have a favorable response to PC.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"729-736"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138829319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of Factors Predicting the Real-World Efficacy of Atezolizumab and Bevacizumab in Patients with Advanced Hepatocellular Carcinoma. 预测阿特珠单抗和贝伐珠单抗对晚期肝细胞癌患者实际疗效的因素分析
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 Epub Date: 2024-06-27 DOI: 10.5009/gnl240085
Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Yong-Han Paik

Background/aims: Atezolizumab and bevacizumab have shown promising results for the treatment of advanced hepatocellular carcinoma (HCC) in clinical trials. In this study, the real-world efficacy and safety of atezolizumab and bevacizumab in treating advanced HCC were evaluated.

Methods: In this retrospective study of patients at a Korean tertiary cancer center, 111 patients with Barcelona Clinic Liver Cancer stage B or C HCC received atezolizumab and bevacizumab as first-line therapy from May 2022 to June 2023. We assessed the progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and adverse events.

Results: Patients with Barcelona Clinic Liver Cancer stage C HCC and Child-Pugh class A liver function were included in the study. The median PFS was 6.5 months, with an ORR of 27% and a DCR of 63%. Several factors, including the albumin-bilirubin grade, age, C-reactive protein and α-fetoprotein in immunotherapy score, macrovascular invasion, lung metastases, and combined radiotherapy, were found to significantly influence PFS (p<0.05). Patients with peritoneal seeding showed an higher ORR. The safety profile was consistent with that observed in clinical trials.

Conclusions: Atezolizumab and bevacizumab demonstrated real-world efficacy in the treatment of advanced HCC, with ORRs and DCRs aligning with those observed in clinical trials. Variations in PFS and ORR based on specific risk factors highlight the potential of atezolizumab and bevacizumab in precision medicine for advanced HCC.

背景/目的:在临床试验中,阿替珠单抗和贝伐珠单抗治疗晚期肝细胞癌(HCC)取得了良好的效果。本研究评估了阿特珠单抗和贝伐珠单抗治疗晚期肝细胞癌的实际疗效和安全性:在这项针对韩国三级癌症中心患者的回顾性研究中,从2022年5月到2023年6月,111名巴塞罗那临床肝癌B期或C期HCC患者接受了阿特珠单抗和贝伐单抗作为一线治疗。我们评估了无进展生存期(PFS)、总反应率(ORR)、疾病控制率(DCR)和不良事件:研究纳入了巴塞罗那临床肝癌C期HCC患者和Child-Pugh A级肝功能患者。中位PFS为6.5个月,ORR为27%,DCR为63%。研究发现,白蛋白-胆红素分级、年龄、免疫治疗中的C反应蛋白和α-胎儿蛋白评分、大血管侵犯、肺转移和联合放疗等因素对PFS有显著影响(结论:阿特珠单抗和贝伐珠单抗在晚期HCC治疗中显示出实际疗效,ORR和DCR与临床试验中观察到的结果一致。基于特定风险因素的PFS和ORR差异凸显了阿特珠单抗和贝伐珠单抗在晚期HCC精准医疗中的潜力。
{"title":"Analysis of Factors Predicting the Real-World Efficacy of Atezolizumab and Bevacizumab in Patients with Advanced Hepatocellular Carcinoma.","authors":"Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Dong Hyun Sinn, Geum-Youn Gwak, Moon Seok Choi, Joon Hyeok Lee, Yong-Han Paik","doi":"10.5009/gnl240085","DOIUrl":"10.5009/gnl240085","url":null,"abstract":"<p><strong>Background/aims: </strong>Atezolizumab and bevacizumab have shown promising results for the treatment of advanced hepatocellular carcinoma (HCC) in clinical trials. In this study, the real-world efficacy and safety of atezolizumab and bevacizumab in treating advanced HCC were evaluated.</p><p><strong>Methods: </strong>In this retrospective study of patients at a Korean tertiary cancer center, 111 patients with Barcelona Clinic Liver Cancer stage B or C HCC received atezolizumab and bevacizumab as first-line therapy from May 2022 to June 2023. We assessed the progression-free survival (PFS), overall response rate (ORR), disease control rate (DCR), and adverse events.</p><p><strong>Results: </strong>Patients with Barcelona Clinic Liver Cancer stage C HCC and Child-Pugh class A liver function were included in the study. The median PFS was 6.5 months, with an ORR of 27% and a DCR of 63%. Several factors, including the albumin-bilirubin grade, age, C-reactive protein and α-fetoprotein in immunotherapy score, macrovascular invasion, lung metastases, and combined radiotherapy, were found to significantly influence PFS (p<0.05). Patients with peritoneal seeding showed an higher ORR. The safety profile was consistent with that observed in clinical trials.</p><p><strong>Conclusions: </strong>Atezolizumab and bevacizumab demonstrated real-world efficacy in the treatment of advanced HCC, with ORRs and DCRs aligning with those observed in clinical trials. Variations in PFS and ORR based on specific risk factors highlight the potential of atezolizumab and bevacizumab in precision medicine for advanced HCC.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"709-718"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can Epigenetic and Gastric Microbiome Markers Predict the Risk of Helicobacter pylori-Negative Gastric Cancer? 表观遗传学和胃微生物标志物能否预测幽门螺旋杆菌阴性胃癌的风险?
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 DOI: 10.5009/gnl240280
Cheol Min Shin
{"title":"Can Epigenetic and Gastric Microbiome Markers Predict the Risk of <i>Helicobacter pylori</i>-Negative Gastric Cancer?","authors":"Cheol Min Shin","doi":"10.5009/gnl240280","DOIUrl":"10.5009/gnl240280","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"553-555"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Challenges and Advancements in Palliative Chemotherapy for Ampullary Adenocarcinoma. 瘤腺癌姑息化疗的挑战与进步
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-07-15 DOI: 10.5009/gnl240283
Eui Joo Kim
{"title":"Challenges and Advancements in Palliative Chemotherapy for Ampullary Adenocarcinoma.","authors":"Eui Joo Kim","doi":"10.5009/gnl240283","DOIUrl":"10.5009/gnl240283","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"18 4","pages":"560-561"},"PeriodicalIF":3.4,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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