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Cancers
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Clinical Studies in Gastrointestinal Malignancies
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Clinical Studies in Gastrointestinal Malignancies

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Clinical Research of Cancer".

Deadline for manuscript submissions: 1 December 2025 | Viewed by 4075

Special Issue Editor

Prof. Dr. Ulrich Ronellenfitsch

E-Mail Website
Guest Editor
Department of Visceral, Vascular and Endocrine Surgery, University Medical Center Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
Interests: upper gastrointestinal cancer; multimodal treatment; gastrectomy; esophagectomy; sarcoma; quality of care; meta-analysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gastrointestinal malignancies pose a major health burden worldwide. They have a relevant mortality and sustained effects on the health and well-being of patients. Treatment is usually multimodal, comprising surgery, radiotherapy, cytotoxic therapy, and targeted therapy and immunotherapy. Tumor stage, molecular tumor characteristics (tumor phenotype), and patient characteristics (host phenotype) are heterogenous and can change over time, which requires treatments to be increasingly personalized. Moreover, not only do "traditional" outcomes such as tumor response and survival need to be assessed, but also more directly patient-relevant outcomes too, such as functional status, quality of life, and satisfaction with treatment, which can be comprehensively summarized as patient-reported outcome measures and patient-reported experience measures. These issues make the evaluation of treatments for gastrointestinal malignancies challenging. In order to create valid evidence with clinical implications, studies require both innovative designs and rigorous methodology.

For this Special Issue of Cancers, I invite you to submit up-to-date original research, including meta-analyses reporting on the treatment of gastrointestinal malignancies as well as methodological contributions addressing the design and conduct of studies in the field.

Prof. Dr. Ulrich Ronellenfitsch
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • gastrointestinal cancers
  • clinical studies
  • multimodal treatment
  • study design
  • outcomes

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Published Papers (4 papers)

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Research

14 pages, 2953 KB  
Article
The Impact of Neoadjuvant Chemotherapy on Survival Outcomes in Gastric Signet-Ring Cell Carcinoma: An International Multicenter Study
by Yujuan Jiang, Peng Wang and Yantao Tian
Cancers 2025, 17(15), 2419; https://doi.org/10.3390/cancers17152419 - 22 Jul 2025
Viewed by 497
Abstract
Background: Gastric signet-ring cell carcinoma (GSRCC) is associated with a poor prognosis, and the effectiveness of neoadjuvant chemotherapy (NAC) in improving survival outcomes remains inconclusive. This study aimed to evaluate the impact of NAC on survival in patients with GSRCC. Methods: [...] Read more.
Background: Gastric signet-ring cell carcinoma (GSRCC) is associated with a poor prognosis, and the effectiveness of neoadjuvant chemotherapy (NAC) in improving survival outcomes remains inconclusive. This study aimed to evaluate the impact of NAC on survival in patients with GSRCC. Methods: This retrospective cohort study included GSRCC patients from two databases: the National Cancer Center (n = 1289) and SEER (n = 1773), all of whom underwent radical surgery between January 2011 and January 2018. The primary endpoint was overall survival (OS) after surgery. Kaplan–Meier survival curves were generated, and multivariate Cox regression analyses were performed to adjust for confounding factors. Additionally, subgroup analyses were conducted to assess the potential survival benefits of NAC in specific patient subsets. Results: NAC use was limited, with 24.6% (436/1773) of patients in the SEER cohort and 22.6% (292/1289) of patients in the NCC cohort receiving NAC. The median follow-up duration was 30 months (range: 8–131 months; IQR: 24–70 months). In the SEER cohort, the 3-year and 5-year survival rates were 47.4% and 41.3%, respectively, whereas in the NCC cohort, they were 82.4% and 73.9%. Multivariate analysis identified race, tumor size, cTNM stage, pT stage, and pN stage as independent predictors of survival in the SEER cohort (all p < 0.05). In the NCC cohort, age, tumor size, and cTNM stage were significant predictors (p < 0.05). NAC did not demonstrate a significant OS benefit in either cohort (SEER: p = 0.653; NCC: p = 0.139). Subgroup analyses focusing on mid/distal tumor locations and cTNM stages II/III indicated a significant trend towards improved survival with NAC (all p < 0.001). Conclusions: NAC showed limited efficacy in unselected GSRCC patients. However, its selective application in patients with mid/distal tumors or locally advanced tumors (cTNM II/III) may offer potential survival benefits. Further studies are needed to explore tailored NAC strategies as a means to improve outcomes in this highly aggressive cancer. Full article
(This article belongs to the Special Issue Clinical Studies in Gastrointestinal Malignancies)
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11 pages, 983 KB  
Article
Machine Learning Insight: Unveiling Overlooked Risk Factors for Postoperative Complications in Gastric Cancer
by Sejin Lee, Hyo-Jung Oh, Hosuon Yoo and Chan-Young Kim
Cancers 2025, 17(7), 1225; https://doi.org/10.3390/cancers17071225 - 4 Apr 2025
Viewed by 747
Abstract
Background: Since postoperative complications after gastrectomy for gastric cancer are associated with poor clinical outcomes, it is important to predict and prepare for the occurrence of complications preoperatively. Conventional models for predicting complications have limitations, prompting interest in machine learning algorithms. Machine learning [...] Read more.
Background: Since postoperative complications after gastrectomy for gastric cancer are associated with poor clinical outcomes, it is important to predict and prepare for the occurrence of complications preoperatively. Conventional models for predicting complications have limitations, prompting interest in machine learning algorithms. Machine learning models have a superior ability to identify complex interactions among variables and nonlinear relationships, potentially revealing new risk factors. This study aimed to explore previously overlooked risk factors for postoperative complications and compare machine learning models with linear regression. Materials and Methods: We retrospectively reviewed data from 865 patients who underwent gastrectomy for gastric cancer from 2018 to 2022. A total of 85 variables, including demographics, clinical features, laboratory values, intraoperative parameters, and pathologic results, were used to conduct the machine learning model. The dataset was partitioned into 80% for training and 20% for validation. To identify the most accurate prediction model, missing data handling, variable selection, and hyperparameter tuning were performed. Results: Machine learning models performed notably well when using the backward elimination method and a moderate missing data strategy, achieving the highest area under the curve values (0.744). A total of 15 variables associated with postoperative complications were identified using a machine learning algorithm. Operation time was the most impactful variable, followed closely by pre-operative levels of albumin and mean corpuscular hemoglobin. Machine learning models, especially Random Forest and XGBoost, outperformed linear regression. Conclusions: Machine learning, coupled with advanced variable selection techniques, showed promise in enhancing risk prediction of postoperative complications for gastric cancer surgery. Full article
(This article belongs to the Special Issue Clinical Studies in Gastrointestinal Malignancies)
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14 pages, 1646 KB  
Article
Patients with Colorectal Cancer and BRAFV600E-Mutation in Argentina: A Real-World Study—The EMOGI-CRC01 Study
by Greta Catani, Stefano Kim, Federico Waisberg, Diego Enrico, Romina Luca, Federico Esteso, Luisina Bruno, Andrés Rodríguez, Marcos Bortz, Berenice Freile, Matías Chacón, Ana Isabel Oviedo Albor, Guillermo Méndez, Ezequiel Slutsky, María Cristina Baiud, Romina Llanos, Ayelen Solonyezny, Luis Basbus, Gerardo Arroyo, Julieta Grasselli, Rosario Pasquinelli, Luciana Bella Quero, María Victoria Faura, Ana Cecilia Adur, Mariano Dioca, Mercedes Tamburelli, Javier Castillo and Juan Manuel O’Connoradd Show full author list remove Hide full author list
Cancers 2025, 17(6), 1007; https://doi.org/10.3390/cancers17061007 - 17 Mar 2025
Viewed by 867
Abstract
Background/Objectives: The BRAF-mutation is a poor prognostic factor in colorectal cancer (CRC). There is a need for real-world data in low-middle-income countries regarding clinical characteristics, outcomes, and treatment strategies. This study aims to describe progression-free survival (PFS) and in the first- and [...] Read more.
Background/Objectives: The BRAF-mutation is a poor prognostic factor in colorectal cancer (CRC). There is a need for real-world data in low-middle-income countries regarding clinical characteristics, outcomes, and treatment strategies. This study aims to describe progression-free survival (PFS) and in the first- and second-line setting and sequences of treatment regimens. Methods: We retrospectively analyze patients from ten oncology centers in Argentina, diagnosed with BRAFV600E-mutated advanced CRC between January 2014 and July 2023. Results: A total of 161 patients with metastatic CRC and BRAFV600E-mutation. The median age was 58.5 (IQR 47–69), and 21.7% were MMR-deficient (dMMR). Of these patients, 93.8% received first-line treatment. With a median follow-up of 23 months (95% CI 16.5–33.4 months), the median PFS was 9 months (95% CI 7.4–10.5 months). The most common regimen in first line setting was doublet chemotherapy plus anti-VEGF for 49% of the patients. Twenty-six percent of the patients received BRAF inhibitors in the second-line setting, with a median PFS of 5.2 months (95% CI 4.9—NR); the overall response rate (ORR) was 10.5%. Conclusions: This study represents, to the best of our knowledge, the largest published real-world cohort of BRAFV600E-mutated CRC in Latin America. The heterogeneity of the treatments reflects the existence of barriers to access to high-cost drugs in our country. Cooperative efforts are needed to understand the particular characteristics of this subgroup of patients. Full article
(This article belongs to the Special Issue Clinical Studies in Gastrointestinal Malignancies)
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25 pages, 1960 KB  
Article
Evaluating Sorafenib (SORA-2) as Second-Line Treatment for Unresectable Hepatocellular Carcinoma: A European Retrospective Multicenter Study
by Christian Möhring, Moritz Berger, Farsaneh Sadeghlar, Xin Zhou, Taotao Zhou, Malte Benedikt Monin, Kateryna Shmanko, Sabrina Welland, Friedrich Sinner, Birgit Schwacha-Eipper, Ulrike Bauer, Christoph Roderburg, Angelo Pirozzi, Najib Ben Khaled, Peter Schrammen, Lorenz Balcar, Matthias Pinter, Thomas J. Ettrich, Anna Saborowski, Marie-Luise Berres, Enrico N. De Toni, Tom Lüdde, Lorenza Rimassa, Ursula Ehmer, Marino Venerito, Iuliana-Pompilia Radu, Ingo G. H. Schmidt-Wolf, Arndt Weinmann, Arndt Vogel, Matthias Schmid, Jörg C. Kalff, Christian P. Strassburg and Maria A. Gonzalez-Carmonaadd Show full author list remove Hide full author list
Cancers 2025, 17(6), 972; https://doi.org/10.3390/cancers17060972 - 13 Mar 2025
Viewed by 1726
Abstract
Background/Objectives: Systemic treatment for unresectable hepatocellular carcinoma (HCC) has rapidly advanced, with immune checkpoint inhibitors now the preferred first-line option. However, with multiple agents available and no established treatment sequence, selecting the most suitable second-line (2L) therapy remains challenging. While sorafenib is frequently [...] Read more.
Background/Objectives: Systemic treatment for unresectable hepatocellular carcinoma (HCC) has rapidly advanced, with immune checkpoint inhibitors now the preferred first-line option. However, with multiple agents available and no established treatment sequence, selecting the most suitable second-line (2L) therapy remains challenging. While sorafenib is frequently chosen for 2L treatment, comprehensive data supporting its use is limited. This study evaluates the effectiveness of sorafenib as 2L therapy and factors influencing outcomes following first-line treatment failure in advanced HCC patients. Methods: This is a retrospective, multicenter study, including 81 patients with unresectable HCC from 12 European centers who received sorafenib as 2L treatment. Median overall survival (mOS), median progression-free survival (mPFS), radiological response to treatment, and toxicity were evaluated. Univariable and multivariable analyses were performed to identify potential predictors of clinical benefit. Results: In this cohort, some patients were treated with 2L sorafenib mOS for 7.4 months (95% CI: 6.6–13.6) and other patients were treated with mPFS for 3.7 months (95% CI: 3.0–4.8). Multivariable analysis revealed the best median OS for patients with CP A and AFP levels < 400 ng/mL (15.5 months). Adverse events (AE) of grade ≥ 3 were reported in 59.4% of patients. Conclusions: In this real-world cohort of European patients with unresectable HCC, the outcome of sorafenib treatment in the 2L setting was comparable to that of the other established 2L treatment options in patients with preserved liver function and good performance status. This study contributes to the understanding of the role of sorafenib in the 2L setting and underscores the need for further research to identify predictive factors for response and survival in order to optimize treatment algorithms for advanced HCC. Full article
(This article belongs to the Special Issue Clinical Studies in Gastrointestinal Malignancies)
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