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Three-field vs two-field lymphadenectomy in thoracic ESCC patients: a multicenter randomized study (NST 1503) 胸部 ESCC 患者的三野与两野淋巴结切除术:一项多中心随机研究(NST 1503)
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2025.01.002
Yousheng Mao , Shuoyan Liu , Yongtao Han , Shiping Guo , Chun Chen , Shugeng Gao , Anlin Hao , Hongbing Duan , Wentao Fang , Renquan Zhang , Zhentao Yu , Xiangning Fu , Xiaofei Li , Qun Wang , Lijie Tan , Zhigang Li , Yin Li , Zhirong Zhang , Wenqiang Wei , Yan Fang , Jie He

Background

3-field lymph node dissection (3FL) frequently lead to much more perioperative complications than 2-field lymph node dissection (2FL). This study was designed as a non-inferiority trial to evaluate whether 3FL could be omitted without compromising overall survival (OS) and disease-free survival (DFS) in the patients with resectable thoracic esophageal squamous cell cancer (ESCC) and negative right recurrent laryngeal nerve lymph nodes (RRLN-LNs).

Methods

cT1b-3N0–1M0 thoracic ESCC patients were managed in 3 arms during open or minimally invasive McKeown esophagectomy according to the results of frozen section examination for RRLN-LNs: if positive, direct 3FL (RRLN[+]-3FL); if negative, 2FL (RRLN[-]-2FL) or 3FL (RRLN[-]-3FL) by randomization.

Results

Based on frozen section, of the 829 finally recruited patients, 121 (13.6 %) had positive RRLN-LNs and direct 3FL (RRLN[+]-3FL); 766 had negative RRLN-LNs and were randomized into the RRLN [-]-2FL (386 cases) or RRLN[-]-3FL (380 cases) group. The cervical LN metastasis rate in the RRLN[+]-3FL group (28.9 %) was significantly higher than that in the RRLN[-]-3FL group (8.3 %) (P<0.001). The 5-year OS and DFS were 72.2 % and 65.1 % in the RRLN[-]-3FL group and 68.8 % and 62.8 % in the RRLN[-]-2FL group (OS, P = 0.163; DFS, P = 0.378), versus 50.3 % and 41.2 % in the RRLN[+]-3FL group (both P<0.001), respectively.

Conclusions

Additional cervical lymphadenectomy can be avoided in the patients with middle or lower thoracic ESCC and negative RRLN-LNs by frozen section treated by upfront surgery.
Trial Registration: ClinicalTrials.gov Identifier NCT02448953.
{"title":"Three-field vs two-field lymphadenectomy in thoracic ESCC patients: a multicenter randomized study (NST 1503)","authors":"Yousheng Mao ,&nbsp;Shuoyan Liu ,&nbsp;Yongtao Han ,&nbsp;Shiping Guo ,&nbsp;Chun Chen ,&nbsp;Shugeng Gao ,&nbsp;Anlin Hao ,&nbsp;Hongbing Duan ,&nbsp;Wentao Fang ,&nbsp;Renquan Zhang ,&nbsp;Zhentao Yu ,&nbsp;Xiangning Fu ,&nbsp;Xiaofei Li ,&nbsp;Qun Wang ,&nbsp;Lijie Tan ,&nbsp;Zhigang Li ,&nbsp;Yin Li ,&nbsp;Zhirong Zhang ,&nbsp;Wenqiang Wei ,&nbsp;Yan Fang ,&nbsp;Jie He","doi":"10.1016/j.jncc.2025.01.002","DOIUrl":"10.1016/j.jncc.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>3-field lymph node dissection (3FL) frequently lead to much more perioperative complications than 2-field lymph node dissection (2FL). This study was designed as a non-inferiority trial to evaluate whether 3FL could be omitted without compromising overall survival (OS) and disease-free survival (DFS) in the patients with resectable thoracic esophageal squamous cell cancer (ESCC) and negative right recurrent laryngeal nerve lymph nodes (RRLN-LNs).</div></div><div><h3>Methods</h3><div>cT1b-3N0–1M0 thoracic ESCC patients were managed in 3 arms during open or minimally invasive McKeown esophagectomy according to the results of frozen section examination for RRLN-LNs: if positive, direct 3FL (RRLN[+]-3FL); if negative, 2FL (RRLN[-]-2FL) or 3FL (RRLN[-]-3FL) by randomization.</div></div><div><h3>Results</h3><div>Based on frozen section, of the 829 finally recruited patients, 121 (13.6 %) had positive RRLN-LNs and direct 3FL (RRLN[+]-3FL); 766 had negative RRLN-LNs and were randomized into the RRLN [-]-2FL (386 cases) or RRLN[-]-3FL (380 cases) group. The cervical LN metastasis rate in the RRLN[+]-3FL group (28.9 %) was significantly higher than that in the RRLN[-]-3FL group (8.3 %) (<em>P</em>&lt;0.001). The 5-year OS and DFS were 72.2 % and 65.1 % in the RRLN[-]-3FL group and 68.8 % and 62.8 % in the RRLN[-]-2FL group (OS, <em>P</em> = 0.163; DFS, <em>P</em> = 0.378), versus 50.3 % and 41.2 % in the RRLN[+]-3FL group (both <em>P</em>&lt;0.001), respectively.</div></div><div><h3>Conclusions</h3><div>Additional cervical lymphadenectomy can be avoided in the patients with middle or lower thoracic ESCC and negative RRLN-LNs by frozen section treated by upfront surgery.</div><div>Trial Registration: ClinicalTrials.gov Identifier NCT02448953.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 203-211"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Circulating tumor DNA as a biomarker of prognosis prediction in colorectal cancer: a systematic review and meta‐analysis
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2024.05.007
Qingxin Zhou , Xiaowei Chen , Baoqi Zeng , Meng Zhang , Nana Guo , Shanshan Wu , Hongmei Zeng , Feng Sun

Objective

Circulating tumor DNA (ctDNA) is increasingly being used as a potential biomarker in colorectal cancer (CRC) patients. However, the role of ctDNA in CRC prognosis prediction remains unclear. The objective is to systematically assess the clinical value of ctDNA in colorectal cancer prognosis prediction throughout the treatment cycle.

Methods

PubMed, Web of Science, Embase, Cochrane Library, Scopus, and clinical trials.gov database was searched from January 2016 to April 2023. Observational studies and randomized clinical trials reporting on ctDNA and prognostic outcomes in CRC patients were included. Pooled hazard risk ratios (HRs) were calculated for the primary outcomes, relapse-free survival (RFS), and overall survival (OS). Random-effects models were preferred considering the potential heterogeneity.

Results

Sixty-five cohort studies were included. Association between ctDNA and shorter RFS or OS was significant, especially after the full-course treatment recommended by the guidelines (HR = 8.92 [ 95 % CI: 6.02–13.22], P < 0.001, I2 = 73 %; HR = 3.05 [ 95 % CI: 1.72–5.41], P < 0.001, I2 = 48 %) for all types of CRC patients. Despite the presence of heterogeneity, subgroup analyses showed that the cancer type and ctDNA detection assays may be the underlying cause. Besides, ctDNA may detect recurrence earlier than radiographic progression, but no uniform sampling time point between studies might bring bias. However, ctDNA detection did not appear to correlate with pathological complete response achievement in patients with locally advanced rectal cancer.

Conclusion

ctDNA detection was significantly associated with poorer prognosis. The potential applications in prognostic prediction are promising and remain to be evaluated in other fields.
{"title":"Circulating tumor DNA as a biomarker of prognosis prediction in colorectal cancer: a systematic review and meta‐analysis","authors":"Qingxin Zhou ,&nbsp;Xiaowei Chen ,&nbsp;Baoqi Zeng ,&nbsp;Meng Zhang ,&nbsp;Nana Guo ,&nbsp;Shanshan Wu ,&nbsp;Hongmei Zeng ,&nbsp;Feng Sun","doi":"10.1016/j.jncc.2024.05.007","DOIUrl":"10.1016/j.jncc.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>Circulating tumor DNA (ctDNA) is increasingly being used as a potential biomarker in colorectal cancer (CRC) patients. However, the role of ctDNA in CRC prognosis prediction remains unclear. The objective is to systematically assess the clinical value of ctDNA in colorectal cancer prognosis prediction throughout the treatment cycle.</div></div><div><h3>Methods</h3><div>PubMed, Web of Science, Embase, Cochrane Library, Scopus, and clinical trials.gov database was searched from January 2016 to April 2023. Observational studies and randomized clinical trials reporting on ctDNA and prognostic outcomes in CRC patients were included. Pooled hazard risk ratios (HRs) were calculated for the primary outcomes, relapse-free survival (RFS), and overall survival (OS). Random-effects models were preferred considering the potential heterogeneity.</div></div><div><h3>Results</h3><div>Sixty-five cohort studies were included. Association between ctDNA and shorter RFS or OS was significant, especially after the full-course treatment recommended by the guidelines (HR = 8.92 [ 95 % CI: 6.02–13.22], <em>P</em> &lt; 0.001, <em>I<sup>2</sup></em> = 73 %; HR = 3.05 [ 95 % CI: 1.72–5.41], <em>P</em> &lt; 0.001, <em>I<sup>2</sup></em> = 48 %) for all types of CRC patients. Despite the presence of heterogeneity, subgroup analyses showed that the cancer type and ctDNA detection assays may be the underlying cause. Besides, ctDNA may detect recurrence earlier than radiographic progression, but no uniform sampling time point between studies might bring bias. However, ctDNA detection did not appear to correlate with pathological complete response achievement in patients with locally advanced rectal cancer.</div></div><div><h3>Conclusion</h3><div>ctDNA detection was significantly associated with poorer prognosis. The potential applications in prognostic prediction are promising and remain to be evaluated in other fields.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 167-178"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A novel risk stratification system for primary small-cell carcinoma of the esophagus: indication for prognostication and staging
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2025.02.003
Yong Yang , Jing Yu , Silin Chen , Xiaomin Wang , Furong Wu , Cheng Huang , Yuping Lin , Tianlan Tang , Tiantian Gao , Zewei Zhang , Yiping Zhang , Liyan Wang , Junqiang Chen , Zhenyang Zhang , Weijie Wang , Jiangbo Lin , Ying Wang , Yuanji Xu , Lei Zhao

Background

Primary small cell carcinoma of the oesophagus (PSCCE) is a gastrointestinal tumour of rare onset. The current study was to investigate the role of a novel risk stratification system (RSS) for PSCCE.

Methods

The study included patients with PSCCE attending any of five medical institutions in China in 2008–2021, four of which served as a training set (n = 422) for construction of the RSS while the other served as a separate cohort (n = 256) for validation of the model. The RSS was established based on covariates associated with overall survival (OS) with a two-sided P-value of < 0.05 in multivariable regression. Survival discrimination of RSS was assessed.

Results

In the training cohort, multivariate regression analysis revealed age, Eastern Cooperative Oncology Group score, and initial lymph node metastasis to be independent prognostic factors for OS in non-distant metastatic PESCC; concurrent hepatic metastasis was the only significant predictor of distant metastatic PESCC. Accordingly, the RSS was developed and could classify patients into four subgroups: low-risk localized disease (LLD, defined as non-distant metastasis PESCC without risk factors, n = 58); high-risk localized disease (HLD, defined as non-distant metastasis PESCC with ≥ 1 risk factor, n = 199); low-risk metastatic disease (LMD, defined as metastatic PESCC without concomitant liver metastases, n = 103); and high-risk metastatic disease (HMD, definded as metastatic disease with synchronous liver metastases, n = 63). Three-year OS rates were 52.5%, 29.5%, 14.4%, and 5.7% for LLD, HLD, LMD, and HMD, respectively. When compared with the tumor-node-metastasis (TNM) system, RSS showed a consistently superior ability to predict OS in both the training and validation cohorts.

Conclusion

The RSS is a reliable stratification model that could be used to optimize treatment for PESCC.
{"title":"A novel risk stratification system for primary small-cell carcinoma of the esophagus: indication for prognostication and staging","authors":"Yong Yang ,&nbsp;Jing Yu ,&nbsp;Silin Chen ,&nbsp;Xiaomin Wang ,&nbsp;Furong Wu ,&nbsp;Cheng Huang ,&nbsp;Yuping Lin ,&nbsp;Tianlan Tang ,&nbsp;Tiantian Gao ,&nbsp;Zewei Zhang ,&nbsp;Yiping Zhang ,&nbsp;Liyan Wang ,&nbsp;Junqiang Chen ,&nbsp;Zhenyang Zhang ,&nbsp;Weijie Wang ,&nbsp;Jiangbo Lin ,&nbsp;Ying Wang ,&nbsp;Yuanji Xu ,&nbsp;Lei Zhao","doi":"10.1016/j.jncc.2025.02.003","DOIUrl":"10.1016/j.jncc.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Primary small cell carcinoma of the oesophagus (PSCCE) is a gastrointestinal tumour of rare onset. The current study was to investigate the role of a novel risk stratification system (RSS) for PSCCE.</div></div><div><h3>Methods</h3><div>The study included patients with PSCCE attending any of five medical institutions in China in 2008–2021, four of which served as a training set (n = 422) for construction of the RSS while the other served as a separate cohort (n = 256) for validation of the model. The RSS was established based on covariates associated with overall survival (OS) with a two-sided <em>P</em>-value of &lt; 0.05 in multivariable regression. Survival discrimination of RSS was assessed.</div></div><div><h3>Results</h3><div>In the training cohort, multivariate regression analysis revealed age, Eastern Cooperative Oncology Group score, and initial lymph node metastasis to be independent prognostic factors for OS in non-distant metastatic PESCC; concurrent hepatic metastasis was the only significant predictor of distant metastatic PESCC. Accordingly, the RSS was developed and could classify patients into four subgroups: low-risk localized disease (LLD, defined as non-distant metastasis PESCC without risk factors, n = 58); high-risk localized disease (HLD, defined as non-distant metastasis PESCC with ≥ 1 risk factor, n = 199); low-risk metastatic disease (LMD, defined as metastatic PESCC without concomitant liver metastases, n = 103); and high-risk metastatic disease (HMD, definded as metastatic disease with synchronous liver metastases, n = 63). Three-year OS rates were 52.5%, 29.5%, 14.4%, and 5.7% for LLD, HLD, LMD, and HMD, respectively. When compared with the tumor-node-metastasis (TNM) system, RSS showed a consistently superior ability to predict OS in both the training and validation cohorts.</div></div><div><h3>Conclusion</h3><div>The RSS is a reliable stratification model that could be used to optimize treatment for PESCC.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 212-220"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The global progress and quality assessment of research on the association between circulating tumor DNA and clinical prognosis: a systematic review
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2024.10.002
Meng Zhang , Xiaowei Chen , Qingxin Zhou , Nana Guo , Baoshan Cao , Hongmei Zeng , Wanqing Chen , Feng Sun

Objective

Circulating tumor DNA (ctDNA) has shown potential as a prognostic biomarker in patients with solid tumors. This study aimed to systematically summarize the global application of ctDNA in the prognostic management of solid tumor patients and to evaluate the quality of the current studies.

Methods

PubMed, Web of Science, Embase, Cochrane Library, Scopus, and clinical trials.gov databases were searched to collect cohort studies on ctDNA in the prognosis of solid tumor patients from January 2016 to May 2022. The language was limited to English. Information including general information, participants and cancer characteristics, ctDNA and outcome information were extracted. The quality of the studies was assessed using the Newcastle–Ottawa Scale checklist.

Results

A total of 214 studies were included in the final analysis, encompassing 21,076 patients. The number of studies has increased annually from 2016 to 2022. The most common types of solid tumors studied were colorectal cancer (27.10 %), lung cancer (20.09 %), pancreatic cancer (16.82 %), and breast cancer (14.02 %). The top three journals by number of publications had an impact factor in 2023 greater than 10. Of the studies, the median sample size was 69 (interquartile range: 41–111), 69.81 % had a sample size <100, 68.92 % had a median/mean age ≥60 years, and 74.05 % were from developed countries. Multi-center studies accounted for 40.36 %. Additionally, 29.82 % of the studies had a bias risk score ≤6. Only 16.67 % of studies on liver cancer had a bias risk score >6. The primary criteria not met by the studies included “Adequacy of follow-up of cohorts” (33.33 %), “Assessment of outcome” (32.16 %) and “Representativeness of the exposed cohort” (27.49 %).

Conclusions

The prognostic value of ctDNA in patients with solid tumors is gaining increasing attention, leading to a steady rise in the number of studies. However, many studies still suffer from small sample sizes and a lack of representativeness. Furthermore, details regarding ctDNA detection methods and results reporting are often insufficiently described. There is an urgent need to improve the quality of such research.
{"title":"The global progress and quality assessment of research on the association between circulating tumor DNA and clinical prognosis: a systematic review","authors":"Meng Zhang ,&nbsp;Xiaowei Chen ,&nbsp;Qingxin Zhou ,&nbsp;Nana Guo ,&nbsp;Baoshan Cao ,&nbsp;Hongmei Zeng ,&nbsp;Wanqing Chen ,&nbsp;Feng Sun","doi":"10.1016/j.jncc.2024.10.002","DOIUrl":"10.1016/j.jncc.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>Circulating tumor DNA (ctDNA) has shown potential as a prognostic biomarker in patients with solid tumors. This study aimed to systematically summarize the global application of ctDNA in the prognostic management of solid tumor patients and to evaluate the quality of the current studies.</div></div><div><h3>Methods</h3><div>PubMed, Web of Science, Embase, Cochrane Library, Scopus, and clinical trials.gov databases were searched to collect cohort studies on ctDNA in the prognosis of solid tumor patients from January 2016 to May 2022. The language was limited to English. Information including general information, participants and cancer characteristics, ctDNA and outcome information were extracted. The quality of the studies was assessed using the Newcastle–Ottawa Scale checklist.</div></div><div><h3>Results</h3><div>A total of 214 studies were included in the final analysis, encompassing 21,076 patients. The number of studies has increased annually from 2016 to 2022. The most common types of solid tumors studied were colorectal cancer (27.10 %), lung cancer (20.09 %), pancreatic cancer (16.82 %), and breast cancer (14.02 %). The top three journals by number of publications had an impact factor in 2023 greater than 10. Of the studies, the median sample size was 69 (interquartile range: 41–111), 69.81 % had a sample size &lt;100, 68.92 % had a median/mean age ≥60 years, and 74.05 % were from developed countries. Multi-center studies accounted for 40.36 %. Additionally, 29.82 % of the studies had a bias risk score ≤6. Only 16.67 % of studies on liver cancer had a bias risk score &gt;6. The primary criteria not met by the studies included “Adequacy of follow-up of cohorts” (33.33 %), “Assessment of outcome” (32.16 %) and “Representativeness of the exposed cohort” (27.49 %).</div></div><div><h3>Conclusions</h3><div>The prognostic value of ctDNA in patients with solid tumors is gaining increasing attention, leading to a steady rise in the number of studies. However, many studies still suffer from small sample sizes and a lack of representativeness. Furthermore, details regarding ctDNA detection methods and results reporting are often insufficiently described. There is an urgent need to improve the quality of such research.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 156-166"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Indoleamine 2,3-dioxygenase 1-mediated immune suppressive status is positively associated with brain metastasis in patients with non-small cell lung cancer
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2024.12.004
Weiwei Chen , Li Yang , Victor Ho-fun Lee , Liangliang Xu , Lingyu Ma , Zhenghao Ye , Wanli Xu , Caining Zhao , Danyang Zheng , Karrie Mei-Yee Kiang , Stella Sun , Yuan Qu , Jiandong Zha , Dazhi Pang , Yan Zhang , Zhibing Liang , Wenchu Lin , Jinliang Zhang , Jitian Zhang , Min Luo , Feng-Ming (Spring) Kong

Background

Indoleamine 2,3-dioxygenase (IDO1) activity, measured by kynurenine/tryptophan (K:T) ratio, is known for its association with distant metastasis and overall survival (OS) in patients with non-small cell lung cancer (NSCLC). Here, we aimed to examine whether IDO1 activity is correlated with OS in NSCLC patients with brain metastasis (Bramet) and has negative effect on modulating the anti-tumor functions of immune cells.

Methods

This study was a part of a prospective clinical trial in circulating biomarkers. Blood or tissues from eligible participants were collected for measurement of kynurenine, tryptophan, immune cell subtype, scRNA-seq analysis, and untargeted metabolomics analysis.

Results

A total of 195 patients were enrolled. The median kynurenine to tryptophan (K:T) ratio was 0.18, with consistent values observed among patients with NSCLC Bramet and those without (0.18 and 0.11, respectively). Notably, student's t-test analysis revealed significantly higher kynurenine concentrations in stage IV patients compared to those in stage I (2.3 vs 1.7 µM, P < 0.001). In patients with Bramet, both kynurenine concentrations and K:T ratios were significantly elevated in comparison with those of extra-cerebral metastasis (2.7 vs 1.9 µM, P < 0.001; 0.12 vs 0.095, P = 0.028; respectively). Single-cell analysis further validated a high level of IDO1 expression in stage IV tumors or Bramet lesions, particularly in macrophages, regulated by chemokines such as CXCL11. Additionally, K:T ratios exhibited significant associations with Treg cell percentages and OS in patients with Bramet (P = 0.039). Treatment with kynurenine led to the upregulation of immune-suppressive molecules, including PD-1, in T cells. Finally, untargeted metabolomics analysis further identified that, apart from the IDO1 metabolic pathway, other metabolites, such as those involved in phospholipid pathways, were also implicated in Bramet.

Conclusion

IDO1 metabolites may play immune-suppressive roles in NSCLC patients with Bramet.
{"title":"Indoleamine 2,3-dioxygenase 1-mediated immune suppressive status is positively associated with brain metastasis in patients with non-small cell lung cancer","authors":"Weiwei Chen ,&nbsp;Li Yang ,&nbsp;Victor Ho-fun Lee ,&nbsp;Liangliang Xu ,&nbsp;Lingyu Ma ,&nbsp;Zhenghao Ye ,&nbsp;Wanli Xu ,&nbsp;Caining Zhao ,&nbsp;Danyang Zheng ,&nbsp;Karrie Mei-Yee Kiang ,&nbsp;Stella Sun ,&nbsp;Yuan Qu ,&nbsp;Jiandong Zha ,&nbsp;Dazhi Pang ,&nbsp;Yan Zhang ,&nbsp;Zhibing Liang ,&nbsp;Wenchu Lin ,&nbsp;Jinliang Zhang ,&nbsp;Jitian Zhang ,&nbsp;Min Luo ,&nbsp;Feng-Ming (Spring) Kong","doi":"10.1016/j.jncc.2024.12.004","DOIUrl":"10.1016/j.jncc.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Indoleamine 2,3-dioxygenase (IDO1) activity, measured by kynurenine/tryptophan (K:T) ratio, is known for its association with distant metastasis and overall survival (OS) in patients with non-small cell lung cancer (NSCLC). Here, we aimed to examine whether IDO1 activity is correlated with OS in NSCLC patients with brain metastasis (Bramet) and has negative effect on modulating the anti-tumor functions of immune cells.</div></div><div><h3>Methods</h3><div>This study was a part of a prospective clinical trial in circulating biomarkers. Blood or tissues from eligible participants were collected for measurement of kynurenine, tryptophan, immune cell subtype, scRNA-seq analysis, and untargeted metabolomics analysis.</div></div><div><h3>Results</h3><div>A total of 195 patients were enrolled. The median kynurenine to tryptophan (K:T) ratio was 0.18, with consistent values observed among patients with NSCLC Bramet and those without (0.18 and 0.11, respectively). Notably, student's t-test analysis revealed significantly higher kynurenine concentrations in stage IV patients compared to those in stage I (2.3 vs 1.7 µM, <em>P</em> &lt; 0.001). In patients with Bramet, both kynurenine concentrations and K:T ratios were significantly elevated in comparison with those of extra-cerebral metastasis (2.7 vs 1.9 µM, <em>P</em> &lt; 0.001; 0.12 vs 0.095, <em>P</em> = 0.028; respectively). Single-cell analysis further validated a high level of IDO1 expression in stage IV tumors or Bramet lesions, particularly in macrophages, regulated by chemokines such as CXCL11. Additionally, K:T ratios exhibited significant associations with Treg cell percentages and OS in patients with Bramet (<em>P</em> = 0.039). Treatment with kynurenine led to the upregulation of immune-suppressive molecules, including PD-1, in T cells. Finally, untargeted metabolomics analysis further identified that, apart from the IDO1 metabolic pathway, other metabolites, such as those involved in phospholipid pathways, were also implicated in Bramet.</div></div><div><h3>Conclusion</h3><div>IDO1 metabolites may play immune-suppressive roles in NSCLC patients with Bramet.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 179-192"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ammonia-induced lysosomal and mitochondrial damage: a novel perspective on T cell-based cancer immunotherapy
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2025.01.004
Jianqiao Shentu , Hening Xu , Feng Zhu
{"title":"Ammonia-induced lysosomal and mitochondrial damage: a novel perspective on T cell-based cancer immunotherapy","authors":"Jianqiao Shentu ,&nbsp;Hening Xu ,&nbsp;Feng Zhu","doi":"10.1016/j.jncc.2025.01.004","DOIUrl":"10.1016/j.jncc.2025.01.004","url":null,"abstract":"","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 105-107"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lifetime risk of developing and dying from cancer in Henan Province, China: current status, temporal trends, and disparities
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2024.11.005
Qiong Chen, Shuzheng Liu, Yin Liu, Hongwei Liu, Hong Wang, Lanwei Guo, Huifang Xu, Xiaoli Guo, Xiaoyang Wang, Ruihua Kang, Liyang Zheng, Shaokai Zhang

Objective

To understand the current status and changing trends in the lifetime risk of residents in Henan Province, China to develop and die from cancer.

Methods

Lifetime risk was estimated using the Adjusted for Multiple Primaries (AMP) method, incorporating cancer incidence, mortality, and all-cause mortality data from 55 cancer registries in Henan Province, China. Estimates were calculated overall and stratified by gender and area. The annual percent change (APC) in lifetime risk from 2010 to 2020, stratified by gender and cancer site, was estimated using a log-linear model.

Results

In 2020, the lifetime risk of developing and dying from cancer was 30.19 % (95 % CI: 29.63 %–30.76 %) and 23.62 % (95 % CI: 23.28 %–23.95 %), respectively. These estimates were higher in men, with values of 31.22 % (95 % CI: 30.59 %–31.85 %) for developing cancer and 26.73 % (95 % CI: 26.29 %–27.16 %) for dying from cancer, compared with women, who had values of 29.02 % (95 % CI: 28.12 %–29.91 %) and 20.08 % (95 % CI: 19.51 %–20.64 %), respectively. There were also geographical differences, with higher estimates in urban areas compared with rural areas. Residents had the highest lifetime risk of developing lung cancer, with a rate of 6.94 %, followed by breast cancer (4.14 %), stomach cancer (3.95 %), esophageal cancer (3.75 %), and liver cancer (2.86 %). Similarly, the highest lifetime risk of dying from cancer was observed for the following sites: lung (5.99 %), stomach (3.60 %), esophagus (3.39 %), liver (2.78 %), and colorectum (1.55 %). Overall, the lifetime risk of developing cancer increased, with an APC of 0.75 % (P < 0.05). Varying trends were observed across different cancer sites. There were gradual decreases in nasopharynx, esophagus, stomach, and liver cancers. Conversely, increasing trends were noted for most other sites, with the highest APCs observed in thyroid, prostate, lymphoma, kidney, and gallbladder cancers.

Conclusion

The lifetime risks of developing and dying from cancer were 30.19 % and 23.62 %, respectively. Variations in cancer risk across different regions, genders, specific cancer sites, and over calendar years provide important information for cancer prevention and policy making in the population.
{"title":"Lifetime risk of developing and dying from cancer in Henan Province, China: current status, temporal trends, and disparities","authors":"Qiong Chen,&nbsp;Shuzheng Liu,&nbsp;Yin Liu,&nbsp;Hongwei Liu,&nbsp;Hong Wang,&nbsp;Lanwei Guo,&nbsp;Huifang Xu,&nbsp;Xiaoli Guo,&nbsp;Xiaoyang Wang,&nbsp;Ruihua Kang,&nbsp;Liyang Zheng,&nbsp;Shaokai Zhang","doi":"10.1016/j.jncc.2024.11.005","DOIUrl":"10.1016/j.jncc.2024.11.005","url":null,"abstract":"<div><h3>Objective</h3><div>To understand the current status and changing trends in the lifetime risk of residents in Henan Province, China to develop and die from cancer.</div></div><div><h3>Methods</h3><div>Lifetime risk was estimated using the Adjusted for Multiple Primaries (AMP) method, incorporating cancer incidence, mortality, and all-cause mortality data from 55 cancer registries in Henan Province, China. Estimates were calculated overall and stratified by gender and area. The annual percent change (APC) in lifetime risk from 2010 to 2020, stratified by gender and cancer site, was estimated using a log-linear model.</div></div><div><h3>Results</h3><div>In 2020, the lifetime risk of developing and dying from cancer was 30.19 % (95 % CI: 29.63 %–30.76 %) and 23.62 % (95 % CI: 23.28 %–23.95 %), respectively. These estimates were higher in men, with values of 31.22 % (95 % CI: 30.59 %–31.85 %) for developing cancer and 26.73 % (95 % CI: 26.29 %–27.16 %) for dying from cancer, compared with women, who had values of 29.02 % (95 % CI: 28.12 %–29.91 %) and 20.08 % (95 % CI: 19.51 %–20.64 %), respectively. There were also geographical differences, with higher estimates in urban areas compared with rural areas. Residents had the highest lifetime risk of developing lung cancer, with a rate of 6.94 %, followed by breast cancer (4.14 %), stomach cancer (3.95 %), esophageal cancer (3.75 %), and liver cancer (2.86 %). Similarly, the highest lifetime risk of dying from cancer was observed for the following sites: lung (5.99 %), stomach (3.60 %), esophagus (3.39 %), liver (2.78 %), and colorectum (1.55 %). Overall, the lifetime risk of developing cancer increased, with an APC of 0.75 % (<em>P</em> &lt; 0.05). Varying trends were observed across different cancer sites. There were gradual decreases in nasopharynx, esophagus, stomach, and liver cancers. Conversely, increasing trends were noted for most other sites, with the highest APCs observed in thyroid, prostate, lymphoma, kidney, and gallbladder cancers.</div></div><div><h3>Conclusion</h3><div>The lifetime risks of developing and dying from cancer were 30.19 % and 23.62 %, respectively. Variations in cancer risk across different regions, genders, specific cancer sites, and over calendar years provide important information for cancer prevention and policy making in the population.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 140-148"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The application of artificial intelligence in upper gastrointestinal cancers
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2024.12.006
Xiaoying Huang , Minghao Qin , Mengjie Fang , Zipei Wang , Chaoen Hu , Tongyu Zhao , Zhuyuan Qin , Haishan Zhu , Ling Wu , Guowei Yu , Francesco De Cobelli , Xuebin Xie , Diego Palumbo , Jie Tian , Di Dong
Upper gastrointestinal cancers, mainly comprising esophageal and gastric cancers, are among the most prevalent cancers worldwide. There are many new cases of upper gastrointestinal cancers annually, and the survival rate tends to be low. Therefore, timely screening, precise diagnosis, appropriate treatment strategies, and effective prognosis are crucial for patients with upper gastrointestinal cancers. In recent years, an increasing number of studies suggest that artificial intelligence (AI) technology can effectively address clinical tasks related to upper gastrointestinal cancers. These studies mainly focus on four aspects: screening, diagnosis, treatment, and prognosis. In this review, we focus on the application of AI technology in clinical tasks related to upper gastrointestinal cancers. Firstly, the basic application pipelines of radiomics and deep learning in medical image analysis were introduced. Furthermore, we separately reviewed the application of AI technology in the aforementioned aspects for both esophageal and gastric cancers. Finally, the current limitations and challenges faced in the field of upper gastrointestinal cancers were summarized, and explorations were conducted on the selection of AI algorithms in various scenarios, the popularization of early screening, the clinical applications of AI, and large multimodal models.
{"title":"The application of artificial intelligence in upper gastrointestinal cancers","authors":"Xiaoying Huang ,&nbsp;Minghao Qin ,&nbsp;Mengjie Fang ,&nbsp;Zipei Wang ,&nbsp;Chaoen Hu ,&nbsp;Tongyu Zhao ,&nbsp;Zhuyuan Qin ,&nbsp;Haishan Zhu ,&nbsp;Ling Wu ,&nbsp;Guowei Yu ,&nbsp;Francesco De Cobelli ,&nbsp;Xuebin Xie ,&nbsp;Diego Palumbo ,&nbsp;Jie Tian ,&nbsp;Di Dong","doi":"10.1016/j.jncc.2024.12.006","DOIUrl":"10.1016/j.jncc.2024.12.006","url":null,"abstract":"<div><div>Upper gastrointestinal cancers, mainly comprising esophageal and gastric cancers, are among the most prevalent cancers worldwide. There are many new cases of upper gastrointestinal cancers annually, and the survival rate tends to be low. Therefore, timely screening, precise diagnosis, appropriate treatment strategies, and effective prognosis are crucial for patients with upper gastrointestinal cancers. In recent years, an increasing number of studies suggest that artificial intelligence (AI) technology can effectively address clinical tasks related to upper gastrointestinal cancers. These studies mainly focus on four aspects: screening, diagnosis, treatment, and prognosis. In this review, we focus on the application of AI technology in clinical tasks related to upper gastrointestinal cancers. Firstly, the basic application pipelines of radiomics and deep learning in medical image analysis were introduced. Furthermore, we separately reviewed the application of AI technology in the aforementioned aspects for both esophageal and gastric cancers. Finally, the current limitations and challenges faced in the field of upper gastrointestinal cancers were summarized, and explorations were conducted on the selection of AI algorithms in various scenarios, the popularization of early screening, the clinical applications of AI, and large multimodal models.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 113-131"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advance and challenge of DNA methylation as cancer biomarkers for risk stratification, screening and early detection
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2024.12.007
Na Li , Kai Song , Hongda Chen , Min Dai
{"title":"Advance and challenge of DNA methylation as cancer biomarkers for risk stratification, screening and early detection","authors":"Na Li ,&nbsp;Kai Song ,&nbsp;Hongda Chen ,&nbsp;Min Dai","doi":"10.1016/j.jncc.2024.12.007","DOIUrl":"10.1016/j.jncc.2024.12.007","url":null,"abstract":"","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 108-112"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Changes in cancer mortality in Shandong Province, China: a large population based study
IF 7.6 Q1 ONCOLOGY Pub Date : 2025-04-01 DOI: 10.1016/j.jncc.2024.08.002
Zhentao Fu , Fan Jiang , Zilong Lu , Jie Chu , Xiaohui Xu , Bingying Zhang , Xiaolei Guo , Aiqiang Xu , Jixiang Ma

Objective

To analyze the trend of major malignant tumor mortality in Shandong Province, eastern China from 1970 to 2021, and to provide the scientific basis for malignant tumor prevention and control.

Methods

Cancer mortality data were sourced from three nationwide cause-of-death surveys and the Shandong Death Registration System. Trends in overall mortality and major causes of death were elucidated through indicators such as mortality rates and age-adjusted death rates, by comparing findings from the three comprehensive mortality surveys and the Shandong Death Registration System. The difference decomposing method was employed to estimate the contributions of non-demographic and demographic factors to the observed changes in cancer mortality.

Results

From 1970 to 2021, the crude mortality rate of malignant tumors witnessed an overall increase in Shandong Province. The age-standardized mortality rate initially rose before subsequently declining. The proportion of cancer deaths among all causes of death increased initially and then stabilized at a high level of approximately 25 %. Both non-demographic and demographic factors played a role in the rise of the crude cancer mortality rate, with the proportion attributed to demographic factors gradually surpassing that of non-demographic factors. Despite the continuous increase in the crude mortality rate, the adjusted mortality rate exhibited a downward trend since 1990. Significant changes were observed in the ranking of the mortality rates of major cancers. For example, the mortality rate of lung cancer exhibited a continuous upward trajectory, ascending from the fifth to the first place and marking a 7.69-fold increase from 1970 to 2021. Conversely, digestive system tumors, including gastric cancer, esophageal cancer, and liver cancer, displayed varying degrees of decline, particularly in the standardized rates, which demonstrated a notable downward trend since 1990. The crude mortality rate of colorectal cancer and breast cancer showed an obvious upward trend, but the standardized rate did not rise significantly. For cervical cancer, both the crude and adjusted mortality rates displayed a pattern of initially decreasing and then increasing.

Conclusions

Malignant tumors remain a significant threat to the residents of Shandong Province. The changing trends in various malignant tumors are inconsistent, underscoring the need for tailored intervention strategies to effectively control different types of malignant tumors.
{"title":"Changes in cancer mortality in Shandong Province, China: a large population based study","authors":"Zhentao Fu ,&nbsp;Fan Jiang ,&nbsp;Zilong Lu ,&nbsp;Jie Chu ,&nbsp;Xiaohui Xu ,&nbsp;Bingying Zhang ,&nbsp;Xiaolei Guo ,&nbsp;Aiqiang Xu ,&nbsp;Jixiang Ma","doi":"10.1016/j.jncc.2024.08.002","DOIUrl":"10.1016/j.jncc.2024.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the trend of major malignant tumor mortality in Shandong Province, eastern China from 1970 to 2021, and to provide the scientific basis for malignant tumor prevention and control.</div></div><div><h3>Methods</h3><div>Cancer mortality data were sourced from three nationwide cause-of-death surveys and the Shandong Death Registration System. Trends in overall mortality and major causes of death were elucidated through indicators such as mortality rates and age-adjusted death rates, by comparing findings from the three comprehensive mortality surveys and the Shandong Death Registration System. The difference decomposing method was employed to estimate the contributions of non-demographic and demographic factors to the observed changes in cancer mortality.</div></div><div><h3>Results</h3><div>From 1970 to 2021, the crude mortality rate of malignant tumors witnessed an overall increase in Shandong Province. The age-standardized mortality rate initially rose before subsequently declining. The proportion of cancer deaths among all causes of death increased initially and then stabilized at a high level of approximately 25 %. Both non-demographic and demographic factors played a role in the rise of the crude cancer mortality rate, with the proportion attributed to demographic factors gradually surpassing that of non-demographic factors. Despite the continuous increase in the crude mortality rate, the adjusted mortality rate exhibited a downward trend since 1990. Significant changes were observed in the ranking of the mortality rates of major cancers. For example, the mortality rate of lung cancer exhibited a continuous upward trajectory, ascending from the fifth to the first place and marking a 7.69-fold increase from 1970 to 2021. Conversely, digestive system tumors, including gastric cancer, esophageal cancer, and liver cancer, displayed varying degrees of decline, particularly in the standardized rates, which demonstrated a notable downward trend since 1990. The crude mortality rate of colorectal cancer and breast cancer showed an obvious upward trend, but the standardized rate did not rise significantly. For cervical cancer, both the crude and adjusted mortality rates displayed a pattern of initially decreasing and then increasing.</div></div><div><h3>Conclusions</h3><div>Malignant tumors remain a significant threat to the residents of Shandong Province. The changing trends in various malignant tumors are inconsistent, underscoring the need for tailored intervention strategies to effectively control different types of malignant tumors.</div></div>","PeriodicalId":73987,"journal":{"name":"Journal of the National Cancer Center","volume":"5 2","pages":"Pages 132-139"},"PeriodicalIF":7.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143816219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of the National Cancer Center
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