Gastrointestinal Cancer: Outcomes and Therapeutic Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 1293

Special Issue Editor


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Guest Editor
First Propaedeutic Department of Surgery, School of Medicine, Hippocration General Hospital, National and Kapodistrian University of Athens, 115 27 Athens, Greece
Interests: surgical oncology; clinical trials; meta-analysis; systematic review; surgical research
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Special Issue Information

Dear Colleagues,

In recent years, the therapeutic management and clinical outcomes of gastrointestinal cancers changed. This diverse group includes a very wide spectrum of neoplasms, such as esophageal, gastric, hepatic, biliary, pancreatic, small bowel and large bowel, as well as rectal cancers.

Neoadjuvant chemoradiotherapy, immunotherapy, and personalized medicine have demonstrated very promising results in terms of improving the oncological outcomes of patients suffering from these. On the other hand, new, upgraded technologies support open, laparoscopic, and robotic surgical operations, providing better perioperative results for patients who undergo surgical excisions of such neoplasms. Apart from this, precise preoperative diagnosis and clinical staging allow the best therapeutic strategy for every patient suffering from gastrointestinal cancer. Last but not least, patients' quality of life remains an essential goal for every therapeutic application related to digestive neoplasms necessitating dietary, psychological, and occupational interventions.

Therefore, the aim of the present Special Issue is to present the most recent findings to combine the therapeutic approaches for gastrointestinal malignancies, report accurate clinical outcomes, and propose clinical implications, as well as future research designs.

Dr. Maximos Frountzas
Guest Editor

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Keywords

  • surgical oncology
  • gastrointestinal cancer
  • esophageal
  • gastric
  • hepatic
  • biliary
  • pancreatic
  • colon
  • rectal
  • neoplasm

Published Papers (2 papers)

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Research

12 pages, 1905 KiB  
Article
The Trends and Outcomes of Initial Palliative Chemotherapy in Patients with Pancreatic Cancer in Korea Based on National Health Insurance Service Data
by Dong Kee Jang, Young Ae Kim, Jang Won Lee, Hak-June Kim, Yoon Suk Lee, Jung Won Chun, Jong-Chan Lee, Sang Myung Woo and Jin-Hyeok Hwang
J. Clin. Med. 2024, 13(11), 3229; https://doi.org/10.3390/jcm13113229 - 30 May 2024
Viewed by 222
Abstract
Background/Objectives: The survival rate of patients with pancreatic cancer (PC) has improved gradually since the introduction of FOLFIRINOX (FFX) and gemcitabine + albumin-bound paclitaxel (GnP) regimens. However, the trends and outcomes of initial palliative chemotherapy before and after the advent of these [...] Read more.
Background/Objectives: The survival rate of patients with pancreatic cancer (PC) has improved gradually since the introduction of FOLFIRINOX (FFX) and gemcitabine + albumin-bound paclitaxel (GnP) regimens. However, the trends and outcomes of initial palliative chemotherapy before and after the advent of these regimens and their contribution to survival rates are not well understood. This study aimed to investigate this in patients with PC in Korea using claims data from the National Health Insurance Service (NHIS). Methods: Patients diagnosed with PC who underwent initial palliative chemotherapy between 2007 and 2019 were identified from the NHIS database. Patient demographics, comorbidities, chemotherapy regimens, and survival rates were analyzed using follow-up data up to 2020. Results: In total, 14,760 patients (mean age, 63.78 ± 10.18 years; men, 59.19%) were enrolled. As initial palliative chemotherapy, 3823 patients (25.90%) received gemcitabine alone; 2779 (18.83%) received gemcitabine + erlotinib; 1948 (13.20%) received FFX; and 1767 (11.97%) received GnP. The median survival values were 15.00 months for FFX; 11.04 months for GnP; 8.40 months for gemcitabine alone; and 8.51 months for gemcitabine + erlotinib. The adjusted hazard ratio (aHR) for GnP vs. FFX was 1.291 (95% CI, 1.206–1.383) in the multivariate Cox regression analysis of mortality. Radiation therapy (aHR, 0.667; 95% CI, 0.612–0.728) and second-line chemotherapy (aHR, 0.639; 95% CI, 0.597–0.684) were significantly associated with improved survival. Conclusions: Our study found that first-line chemotherapy with FFX was associated with significantly longer survival than the other regimens, although caution is needed in interpreting the results. Full article
(This article belongs to the Special Issue Gastrointestinal Cancer: Outcomes and Therapeutic Management)
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13 pages, 246 KiB  
Article
Evaluation of Stages, Treatment Protocols, and Outcomes of Colorectal Cancer among West Bank Patients
by Ibrahim O. Sawaid, Abraham O. Samson and Rowa Al-Ramahi
J. Clin. Med. 2024, 13(8), 2284; https://doi.org/10.3390/jcm13082284 - 15 Apr 2024
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Abstract
Background: Colorectal cancer (CRC) is the second most widespread cancer among Palestinian patients. As cancer care improves in hospitals across the West Bank, services like palliative care, targeted therapy, bone marrow transplantation, and individualized therapy are still limited. This study aimed to assess [...] Read more.
Background: Colorectal cancer (CRC) is the second most widespread cancer among Palestinian patients. As cancer care improves in hospitals across the West Bank, services like palliative care, targeted therapy, bone marrow transplantation, and individualized therapy are still limited. This study aimed to assess the CRC stages, treatment protocols, and survival rates of patients in the West Bank. Methodology: This retrospective study collected data from the medical records of Al-Najah University Hospital (NUH), which specializes in the care of cancer patients. Patients with confirmed CRC (stages I–IV) undergoing surgical or medical treatment were included in the study. Data collection was standardized by using a data collection form to gather information from the medical records included in the study. All statistical analyses were performed using SPSS (version v27), and survival was assessed using a regression analysis of the number of days from the time of diagnosis to the most recent visit against the type of treatment (e.g., surgery, chemotherapy, radiotherapy). Results: A sample of 252 patients with CRC from NUH was collected, including 143 males and 109 females aged between 27 and 86 years, with the average age being 60.6 ± 11.4 years. The sample included 183 patients (72.6%) diagnosed with colon cancer only, 29 patients (11.5%) diagnosed with rectal cancer only, and 40 patients (15.9%) diagnosed with both. Diagnosis took place at CRC stage I for 3 patients (1.2%), stage II for 33 patients (13.1%), stage III for 57 patients (22.6%), and stage IV for 159 patients (63.1%). Surgery was the most prevailing mode of treatment for 230 patients (91.3%), while 227 patients (90.1%) received chemotherapy treatment, and 38 patients (15.1%) received radiotherapy. Of the 252 patients, 40 patients (15.8%) received FOLFOX (i.e., folinic acid, fluorouracil, oxaliplatin), and 25 patients (9.9%) received FOLFIRI (i.e., folinic acid, fluorouracil, irinotecan), while the 187 remaining patients (74.2%) were treated with capecitabine, oxaliplatin, bevacizumab, cetuximab, regorafenib, cisplatin, etoposide, gemcitabine, or a combination thereof. The sample was categorized into six outcomes: (1) death, (2) cure, (3) disease progression, (4) disease recurrence, (5) under-treatment, and (6) unknown. Mortality was high, with 104 patients (41.3%) dying within a short time after diagnosis, and may have been attributable to delayed diagnosis. Surgical treatment had a positive impact on increasing the survival years, and it was significant (p = 0.033). Conclusions: A high percentage of patients were diagnosed in advanced CRC stages. The treatment modes were adopted from general international guidelines; however, the cure rates were low, and mortality was high. More studies need to be undertaken to investigate the actual application of chemotherapy protocols, and survival would benefit from the involvement of clinical pharmacists in the chemotherapy protocol selection, dosing, frequency, and follow-up. The present study advocates for greater public awareness of CRC and attests to the merits of screening by primary care professionals, which can help to avoid this serious illness and to promote a better prognosis. Full article
(This article belongs to the Special Issue Gastrointestinal Cancer: Outcomes and Therapeutic Management)
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