World journal of clinical oncology最新文献

Background: Enhanced recovery after surgery (ERAS) programs provide recommendations for an optimized management of patients undergoing surgery. An ERAS program tailored on surgery for retroperitoneal sarcomas (RPS) may improve patient outcomes and it has still not been established.

Aim: To determine how an ERAS program tailored to RPS surgery can be agreed upon, structured, and implemented.

Methods: Twenty-five candidate items from existing ERAS programs, potentially relevant for RPS surgery, were identified via literature review and expert input. These were included in a questionnaire refined through cognitive interviews and pilot testing. Expert sarcoma surgeons rated each item's relevance and feasibility on a 6-point scale. The survey was recirculated after one year. Intra-observer reproducibility, inter-observer concordance, and agreement with the modal value of the most experienced participants were analyzed.

Results: Thirteen sarcoma surgeons from 6 centers participated in the survey. Although surgeons agreed on several items, their overall concordance was low. After recirculating the survey, the intra-observer reproducibility was low. Interestingly, the median concordance with the reference increased for relevance and decreased for feasibility.

Conclusion: Despite interest in ERAS for RPS, surgeon concordance on item relevance and feasibility remains low, underscoring the need for collaborative efforts toward a standardized, consensus-based protocol.

Colorectal cancer (CRC) is a leading cause of cancer-related mortality, primarily due to tumor metastasis. A recent study in the World Journal of Gastrointestinal Oncology identifies charged multivesicular body protein 7 (CHMP7) as a key prognostic factor in CRC. The study showed that CHMP7 expression is significantly lower in patients with CRC with metastasis and in highly metastatic cell lines, correlating with clinical factors like normal tissue, metastatic tumors, pathologic stage, and lymphatic invasion. Higher CHMP7 expression was linked to improved overall survival, highlighting its potential as a predictive biomarker. Gene Set Enrichment Analysis also suggests the role of CHMP7 in metastasis-related pathways, paving the way for further mechanistic studies. This finding challenges current CRC management strategies and calls for larger, prospective studies to validate the role of CHMP7. As a potential target for novel diagnostics and therapies, CHMP7 could advance personalized medicine in CRC, bridging molecular insights with clinical outcomes to improve patient prognosis.

Background: Non-small cell lung cancer (NSCLC) is frequently characterized by poor response to cisplatin (DDP)-based chemotherapy, with increasing evidence suggesting that inflammatory cytokines in the tumor microenvironment contribute to chemoresistance.

Aim: To investigate the role of inflammatory cytokines in DDP resistance and to effect of IL-6 inhibition on chemosensitivity in NSCLC.

Methods: Twenty NSCLC patients were grouped into DDP-sensitive or DDP-resistant cohorts based on their clinical response. Cytokine levels in tumor tissues and NSCLC cell lines, including DDP-resistant A549/DDP and SK-MES-1/DDP, were quantified using enzyme-linked immunosorbent assay. To verify the effects of interleukin (IL)-6 on DDP resistance, NSCLC and resistant cells were treated with IL-6 inhibitors tocilizumab (TCZ), followed by DDP treatment. Cell viability, apoptosis, migration and invasion were detected via cell counting kit-8, flow cytometry, scratch assay, and transwell, respectively.

Results: IL-6, IL-8, and tumor necrosis factor-α levels were significantly elevated in DDP-resistance tissues and cell models compared to sensitive controls (P < 0.05). TCZ treatment significantly reduced the half-maximal inhibitory concentration of DDP in resistant cells, induced apoptosis, and hindered migration and invasion (P < 0.05). IL-6 and IL-8 were identified as key cytokines associated with DDP resistance.

Conclusion: These findings demonstrated that IL-6 and related cytokines contribute to DDP resistance in NSCLC. IL-6 inhibition restores chemosensitivity and may serve as a promising therapeutic strategy in resistant NSCLC.

Pancreatic cancer (PC) remains a highly lethal malignancy worldwide. Increasing evidence indicates that inflammation is a critical factor in the pathogenesis of pancreatic ductal adenocarcinoma (PDAC). Inflammatory cell infiltration within the PDAC tumor microenvironment promotes tumor growth and metastasis, while both local and systemic chronic inflammation is associated with an elevated risk of developing the disease. Given that the same immune cell populations are involved in mediating both inflammatory and immune responses, there exists a close interrelationship between inflammation and immunity in the context of PDAC. Various studies have reported the relationship between inflammation and PC. This review article provided a comprehensive summary of the roles of erythrocyte sedimentation rate, plasma viscosity, procalcitonin, calprotectin, haptoglobin, serum amyloid A, ferritin, and fibrinogen in the pathophysiological mechanisms underlying PC.

Gallbladder cancer (GBC) is a lethal biliary tract malignancy, which is infrequent in most developed countries, but common in many developing countries in specific geographical regions of the world. Non-specific symptoms leading to late diagnosis is one of the primary factors contributing to poor prognosis in GBC. An understanding of the complex relationship between molecular genetics and epidemiological variances in the incidence rates of GBC is thus of utmost importance. Present review summarizes recent updates on population-specific dysregulated genetic expressions in the genesis of GBC, highlighting the pattern of ethno-geographic variations and on advances in targeted therapies conducted till date; points out the lacunae that deserve further attention and suggest possible new directions for future clinical trials in GBC. The review calls for the need of genetic screening of each GBC patients and for more extensive clinical trials on targeted therapies to move towards the goal of personalized medicine, bringing about more favourable survival outcomes.

Colon cancer (CC) laterality (right vs left) is recognized as a key determinant of clinical outcomes and treatment decisions in metastatic CC. Right-sided CC (RCC) often presents in older individuals and is associated with higher rates of Kirsten rat sarcoma viral oncogene homolog and v-raf murine sarcoma viral oncogene homolog B1 mutations and deficient mismatch repair, leading to microsatellite instability-high status. Left-sided CC typically presents in younger individuals, demonstrates a more favorable prognosis, and is often Kirsten rat sarcoma viral oncogene homolog/neuroblastoma RAS viral oncogene homolog/v-raf murine sarcoma viral oncogene homolog B1 wild-type, making it more responsive to anti-epidermal growth factor receptor therapy. RCC typically responds poorly to anti-epidermal growth factor receptor agents; however, it may benefit from triplet chemotherapy (5-fluorouracil + leucovorin + oxaliplatin + irinotecan) with or without anti-angiogenic agents. Comprehensive molecular profiling remains challenging in low-resource settings due to limited access to advanced diagnostic tools. This review explores key epidemiological and molecular differences between RCC and left-sided CC. In the absence of complete genomic data, tumor sidedness can be a helpful guide for making treatment decisions. Here, we propose a practical algorithm that integrates basic immunohistochemistry to assess a tumor's mismatch repair status and laterality, potentially facilitating therapy selection in resource-constrained environments. Recognizing laterality-specific trends in prognosis and treatment response can improve personalized care and outcomes for patients with CC in these environments, highlighting the essential role of cost-effective biomarker strategies.

Non-coding RNAs, which do not encode proteins, significantly influence signal regulation. Circular RNAs (circRNAs), produced through a post-splicing mechanism, constitute a recently identified subset of non-coding RNAs distinguished by their multifunctional covalently closed loop structures. With an in-depth exploration of circRNAs' biological characteristics, their potential roles in gastrointestinal cancer have garnered significant attention. CircRNAs can significantly influence tumor initiation and progression. This review consolidates recent research progress on circRNAs in digestive system cancers such as esophageal, gastric, hepatic, pancreatic, and colorectal cancer. We explore the potential of circRNAs as biomarkers and therapeutic targets, alongside their roles in immune modulation and chemoresistance. This review seeks to offer a thorough understanding of circRNAs' implications in digestive system tumors by outlining the current research landscape and identifying existing challenges, thereby encouraging further exploration in this emerging field.

Molecular profiling of biliary tract cancers (BTCs) has paved the way for a broader range of therapeutic options, leading to improved survival outcomes. Given the challenges of tissue evaluation in BTCs, circulating tumor DNA (ctDNA) has emerged as a promising non-invasive biomarker for genomic profiling. Bile has been proven to be a reliable ctDNA source, demonstrating higher concordance with tumor tissue than plasma. More importantly, ctDNA provides valuable insights into both clonal evolution and treatment response, including the detection of resistance mechanisms and mutation clearance, which are often associated with disease control. Although its role in recurrence monitoring remains investigational, early studies suggest that ctDNA detection may precede radiological recurrences. This review examines recent advancements in ctDNA analysis for patients with BTC, highlighting key developments, current clinical implications, and ongoing challenges. Large-scale prospective studies are needed to validate the clinical utility of ctDNA and to support its integration into BTC management.

Treatment delays during radiotherapy for head and neck cancer (HNC) are a well-established factor negatively affecting clinical outcomes, with similar trends observed in other cancers. In this first part of a two-part review, we assessed the impact of overall treatment time (OTT) prolongation on locoregional control (LRC) and survival (SV) in cervical cancer (CC), prostate cancer (PC), and anal cancer (AC), while updating evidence for HNC. A comprehensive literature search was performed in evidence-based databases, including MEDLINE, identifying studies evaluating the relationship between OTT prolongation and outcomes. Particular attention was paid to the strength of evidence, distinguishing univariate analysis from multivariate analysis (MV-An). For CC, 37 articles were identified, with 88.8% reporting a detrimental impact on LRC and/or SV, mostly supported by MV-An. In AC, 15 studies were found, with 33.3% showing negative impacts, although with weaker evidence. For PC, 12 articles were reviewed, with 66.6% demonstrating detrimental effects mainly on LRC or biochemical control, and occasional associations with cancer-specific SV. Recent studies in HNC reinforced prior findings. When available, radiobiological parameters and practical recommendations are provided. In conclusion, strong evidence confirms that prolonged OTT worsens outcomes in HNC and CC, with less consistent but relevant effects in PC and AC.

Significant progress has been made in cancer control in China over the past decades, but one of the crucial issues remains the low proportions of early-stage diseases among the leading cancers. Subnational cancer control in China has diverse and specific features, especially in rural areas, where needs support to improve screening accessibility and medical intervention quality. Using cancer registry data from Yibin for a subnational observational study, urban-rural disparities in cancer incidence, mortality, and mortality indexes were analyzed. The crude incidence of all-site cancers was higher in urban districts. The crude mortality of all-site cancers was comparable between urban and rural areas, but the mortality index of all-site cancers was higher in rural areas. Awareness of cancer control both among public healthcare providers and the public should be enhanced to improve the early detection of cancers. In particular, more facilitated medical education and public health education are needed to improve domestic awareness of cancer control and increase the public awareness rate of core knowledge on cancer control. Massive and opportunistic screening and surveillance of high-risk subpopulations require more comprehensive encouragement and greater compliance. Therefore, increasing the detection rate of early-stage cancers is of paramount importance to substantially improve cancer survival rates in China.