Diagnosis and Treatment of Upper and Lower Gastrointestinal Malignancies: Current Advances and Future Prospects

A special issue of Diseases (ISSN 2079-9721).

Deadline for manuscript submissions: closed (1 March 2024) | Viewed by 3263

Special Issue Editor

Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
Interests: prostate cancer; kidney cancer; bladder cancer; disparities; tumor metabolism; clinical trials
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cancers of the upper and lower gastrointestinal tract constitute a high global burden, with gastric and esophageal cancers representing the fifth and sixth most common cancers worldwide, respectively. Cancers of the esophagus, stomach, and small bowel comprise a heterogeneous group of malignancies distinguished by differences in histopathologic classification, risk factors and etiologies, and incidence and epidemiologic patterns, and, more recently, with comprehensive molecular profiling and molecular classification, leading to precision-based systemic therapy options in select scenarios. Despite improvements in screening, diagnosis, and radiation, surgical, and systemic therapies, global survival rates remain unsatisfactory, and the disease remains incurable in advanced stages.

Cancers of the lower gastrointestinal tract share a similar high public burden. Although inclusive of rarer tumor types such as appendiceal cancer, colorectal cancer constitutes a substantial public health burden, representing the second most common cause of cancer death globally. In colorectal cancer, significant gains have been made in both the management of non-metastatic and metastatic disease spanning from novel neoadjuvant approaches, newer postoperative surveillance strategies inclusive of minimal residual disease assessments, implementation of liquid biopsies and ctDNA, and developments in systemic therapies that are both biomarker-driven and unselected.

The focus of this Special Issue is to highlight global research efforts to improve outcomes in patients with upper and lower gastrointestinal cancers. We recognize that dramatic improvements in the management of these malignancies in recent decades have resulted from a multidisciplinary evaluation and treatment of patients. As such, we invite colleagues from across all disciplines, epidemiology, basic and translational science, genetics, nutrition, surgery, surgical oncology, hematology and oncology, radiation oncology, radiology, interventional radiology, gastroenterology, interventional gastroenterology, palliative care, and pathology, to highlight recent advancements in their respective fields that have contributed to the global care of patients with upper and lower gastrointestinal cancers.

Dr. Jun Gong
Guest Editor

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Keywords

  • gastric cancer
  • esophageal cancer
  • small bowel cancer
  • gastrointestinal cancer
  • colon cancer
  • rectal cancer
  • colorectal cancer
  • appendiceal cancer
  • screening
  • diagnosis
  • surgery
  • endoscopic
  • systemic therapy
  • radiation therapy

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Published Papers (2 papers)

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Research

13 pages, 4899 KiB  
Article
Exploratory Evaluation of Pre-Treatment Inflammation Profiles in Patients with Colorectal Cancer
by Catalin Vladut Ionut Feier, Calin Muntean, Sorana D. Bolboacă and Sorin Olariu
Diseases 2024, 12(3), 61; https://doi.org/10.3390/diseases12030061 - 20 Mar 2024
Cited by 1 | Viewed by 1375
Abstract
In light of the elevated incidence and consequential prognostic implications associated with colorectal cancer, a comprehensive investigation into the impact exerted by inflammatory status on patient management becomes imperative. A retrospective study spanning 7 years was conducted, involving the retrospective collection of data [...] Read more.
In light of the elevated incidence and consequential prognostic implications associated with colorectal cancer, a comprehensive investigation into the impact exerted by inflammatory status on patient management becomes imperative. A retrospective study spanning 7 years was conducted, involving the retrospective collection of data on colorectal cancer patients undergoing surgical intervention. We evaluated six inflammation ratios derived from complete peripheral blood counts. A thorough analysis of these markers’ prognostic capacity was conducted, revealing that patients who died postoperatively displayed significantly higher preoperative Aggregate Index of Systemic Inflammation—AISI (p = 0.014) and Systemic Inflammation Response Index—SII (p = 0.0197) levels compared to those with successful discharge. Noteworthy variations in neutrophil-to-lymphocyte ratio (p = 0.0103), platelet-to-lymphocyte ratio (p = 0.0041), AISI (p < 0.001), and SII (p = 0.0045) were observed in patients necessitating postoperative Intensive Care Unit (ICU) monitoring. Furthermore, patients with complications, such as an intestinal fistula, exhibited significantly elevated AISI (p = 0.0489). Inflammatory biomarkers stand out as valuable prognostic tools for colorectal cancer patients, offering potential assistance in predicting their prognosis. Full article
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14 pages, 1318 KiB  
Article
Three-Year Analysis of the Rectal Cancer Care Trajectory after the COVID-19 Pandemic
by Vlad Braicu, Lazar Fulger, Aditya Nelluri, Ram Kiran Maganti, Uday Shree Akkala Shetty, Gabriel Verdes, Dan Brebu, Catalin Dumitru, Ana-Olivia Toma, Ovidiu Rosca and Ciprian Duta
Diseases 2023, 11(4), 181; https://doi.org/10.3390/diseases11040181 - 11 Dec 2023
Viewed by 1564
Abstract
The global pandemic period from 2020 to 2022 caused important alterations in oncology care. This study aimed to describe the trends and variations in patient characteristics, comorbidities, and treatment approaches during this time in Romania. We conducted a retrospective database search to identify [...] Read more.
The global pandemic period from 2020 to 2022 caused important alterations in oncology care. This study aimed to describe the trends and variations in patient characteristics, comorbidities, and treatment approaches during this time in Romania. We conducted a retrospective database search to identify patients with rectal cancer who underwent surgical intervention between 2020 and 2022 and the year 2019, which served as a pre-pandemic period control. This study included 164 patients, with a yearly increase of approximately 10% in surgical interventions noted from 2020 (1709 interventions) to 2022 (2118 interventions), but an overall 34.4% decrease compared with the pre-pandemic period. Notable shifts were observed in the type of surgeries performed, with laparoscopic procedures doubling from 2020 (25%) to 2022 (47.5%), confirming the decrease in emergency presentations during the last year of the COVID-19 pandemic and a recovery to normality with planned, elective interventions. Elective interventions increased significantly in 2022 (79.7%) compared with the previous years (p = 0.043), with a concurrent rise in neoadjuvant therapy uptake in 2022 (35.6%). However, significant alterations in the TNM staging, from 12.5% stage IV cases in 2020 to 25.4% in 2022 (p = 0.039), indicated an increased diagnosis of advanced stages of rectal cancer as the years progressed. There was a significant difference in albumin levels over the years (p = 0.019) and in the American Society of Anesthesiology (ASA) scores (from 6.2% ASA stage IV in 2020 to 16.9% in 2022), denoting an increase in case complexity (p = 0.043). This study reveals a trend of increasing surgical interventions and the prevalence of more advanced stages of rectal cancer during the pandemic years. Despite the subtle fluctuations in various patient characteristics and treatment approaches, notable shifts were documented in the severity at diagnosis and surgery types, pointing toward more advanced disease presentations and changes in surgical strategies over the period studied. Nevertheless, the trends in ICU admission rates and mortality did not alter significantly during the pandemic period. Full article
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