Journal of Gastrointestinal Cancer最新文献

Background/aims: Comprehensive data on hepatocellular carcinoma (HCC) in South Asia remains limited. This systematic review and meta-analysis describe characteristics and risk factors associated with HCC among South Asian adults.

Methods: We surveyed PubMed/MEDLINE and Scopus for articles on descriptive studies on HCC in South Asia. The search terms included "hepatocellular carcinoma" AND "South Asia" AND individual South Asian countries ("Afghanistan", "Bangladesh", "Bhutan", "India", "Maldives", "Nepal", "Pakistan", and "Sri Lanka"). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. All the selected studies fulfilled the diagnostic criteria for HCC. We used the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies to assess the quality of the studies. The data extracted from the selected studies were used to produce pooled estimates for the HCC characteristics and associations.

Results: Only 28 publications (Bangladesh-1, India-16, Nepal-2, Pakistan-7, Sri Lanka-2) were selected. HCC is more common in men (81%) and is diagnosed around the age of 56 years in South Asia. Most cases (82%) develop in patients with cirrhosis. Chronic HBV infection (27%) is the leading risk factor, followed by chronic HCV infection (21%) and alcohol-related liver disease (21%). HCC is often detected at advanced stages (BCLC-B 29% and BCCL-C 43%), presenting as large (5-10 cm in 57%), single tumours with frequent blood vessel involvement (39%). Sorafenib (33%) is the most common treatment, followed by TACE (22%). The median overall survival is 17.3 months.

Conclusions: Hepatocellular carcinoma occurs more often among males and in the sixth decade of life. Most cases develop in patients with cirrhosis due to HBV, HCV or alcohol excess. Hepatocellular carcinoma presents at an advanced stage as an aggressive disease, with a median overall survival of one and a half years in South Asia.

Hepatic adenomas (HAs) are relatively common benign liver tumors that carry small risks of hemorrhage and malignant transformation, both of which increase with tumor size. While traditionally linked to estrogen-containing oral contraceptives (OCPs), other risk factors including obesity have been associated with HA formation and growth. Treatment strategies depend on the risk of malignant transformation or hemorrhage, tumor size, histological subtype, and patient-specific factors. While traditionally, surgical resection has been the standard recommendation for large, symptomatic, or high-risk tumors, several non-operative strategies are now available to minimize morbidity and optimize outcomes. Active surveillance is recommended for patients with small (< 5 cm), asymptomatic HAs without other risk factors. Loco-regional therapies, including transarterial embolization and radiofrequency ablation, have been used effectively, particularly for small tumors. Mounting evidence suggests that interventions aimed at weight loss, either through lifestyle modifications or bariatric surgery, are efficacious in reducing HA size. Recent data support expanding non-operative management for even large tumors (> 5 cm), as they can respond to lifestyle interventions. Several subgroups of patients warrant special consideration, such as pregnant patients, males, and patients with hepatic adenomatosis. A personalized, multidisciplinary approach remains essential as non-operative strategies continue to expand along with emerging targeted therapies.

Background: BRAF V600E-mutated colorectal cancer (CRC) is associated with poor prognosis and resistance to standard chemotherapy. Emerging evidence, including the BEACON trial and subsequent real-world studies, suggests that triple therapy targeting BRAF oncoprotein, epidermal growth factor receptor (EGFR), and MEK improves clinical outcomes.

Objective: To evaluate the survival, treatment response, and safety outcomes associated with triple therapy comprising encorafenib, cetuximab, and binimetinib in patients with BRAF V600E-mutated CRC.

Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines. A comprehensive search of PubMed, Cochrane Central, and ClinicalTrials.gov was performed until October 2024. Proportional outcomes were pooled using inverse-variance logit-transformed random-effects models, and time-to-event outcomes were synthesized using a random-effects survival meta-analysis. Hetrogenity was quantified using I ² statistics. Primary outcomes included overall survival (OS), progression-free survival (PFS), and objective response rate (ORR), while secondary outcomes focused on safety and adverse events.

Results: Six studies (one randomized trial, one phase II trial, and four cohort studies) involving 487 patients were included. The pooled 12-month OS rate was 44% (95% CI: 29-66%), with a median OS of 9.75 months (95% CI: 7.22-15.69). The 12-month PFS rate was 13% (95% CI, 7-24%), and the median PFS was 4.89 months (95% CI: 4.22-6.46). The ORR was 35% (95% CI: 27-44%), including a 5% complete response rate and a 32% partial response rate. Grade ≥ 3 adverse events occurred in 46% of the patients, most commonly acneiform dermatitis and diarrhea.

Conclusion: Triple therapy with encorafenib, cetuximab, and binimetinib offers meaningful improvements in survival and tumor response in BRAF V600E-mutated CRC, although the toxicity remains substantial. Optimizing patient selection and managing adverse events are critical for broader clinical use.

Background: Schistosomiasis is linked to the development of colorectal cancer and is associated with increased colorectal cancer mortality. However, there is limited research on whether schistosomiasis with egg deposition influences the clinicopathologic features and prognosis of patients with gastric cancer (GC).

Objective: To investigate the effects of pathologically confirmed schistosomal egg deposition on the clinicopathologic features and prognosis of GC patients.

Methods: 5,001 patients receiving radical GC surgery performed at Yijishan Hospital of Wannan Medical College from January 2012 to January 2023 were retrospectively analyzed. The patients were categorized into two groups: the schistosomiasis combined with gastric cancer (S-GC) group and the conventional gastric cancer (C-GC) group, based on their medical history and postoperative pathology reports. Survival analysis for each group was conducted using the Kaplan-Meier method, while Cox regression modeling was employed for univariate and multifactorial prognostic analysis.

Results: Of the 5001 GC patients included in the study, 189 cases had S-GC versus 4812 C-GC cases. S-GC group patients were older, predominantly male, and exhibited a greater prevalence of lesions located in the lower third of the stomach compared to those in the C-GC group(all P < 0.05). Multifactorial Cox regression analysis identified N stage and tumor deposits as independent risk factors influencing the prognosis of GC, whereas schistosomiasis with egg deposition did not appear to have a significant impact(HR 0.892, 95% CI 0.637-1.249, P > 0.05).

Conclusion: S-GC patients are more commonly elderly and male. Chronic schistosomiasis infection, as evidenced by pathologically confirmed residual calcified eggs, was not associated with the prognosis of GC patients.