Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment—Volume II

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

Deadline for manuscript submissions: 25 July 2024 | Viewed by 5365

Special Issue Editor

Regional Hospital Treviso, DISCOG, University of Padua, 31100 Treviso, Italy
Interests: colorectal diseases; colorectal cancer; gastrointestinal diseases; anorectal disorders; functional defecation disorders; anal fistula; hemorrhoidal disease; inflammatory bowel diseases
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Special Issue Information

Dear Colleagues,

Gastrointestinal (GI) malignancies are a diverse group of cancers with significant incidence and prevalence around the world. The articles published in Part I of the Special Issue “Gastrointestinal Malignancies: Screening, Diagnosis, and Treatment” increased our knowledge about the multidisciplinary and often complex management of these diseases, demonstrated the importance of appropriate diagnostic paths for this patient group and highlighted the role of medical and surgical treatments (https://www.mdpi.com/journal/jcm/special_issues/Gastrointestinal_Malignancies_Screening_Diagnosis_Treatment).

For the upcoming Part II, we invite more researchers to share their knowledge about this vitally significant topic.

Dr. Ugo Grossi
Guest Editor

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Keywords

  • gastrointestinal malignancies
  • cancer outcomes
  • cancer survivorship
  • value in cancer care
  • equitable care

Published Papers (4 papers)

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Research

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19 pages, 1757 KiB  
Article
Risk for Esophageal Cancer Based on Lifestyle Factors–Smoking, Alcohol Consumption, and Body Mass Index: Insight from a South Korean Population Study in a Low-Incidence Area
by Mi Jung Kwon, Ho Suk Kang, Hyo Geun Choi, Joo-Hee Kim, Ji Hee Kim, Woo Jin Bang, Sung Kwang Hong, Nan Young Kim, Sangkyoon Hong and Hong Kyu Lee
J. Clin. Med. 2023, 12(22), 7086; https://doi.org/10.3390/jcm12227086 - 14 Nov 2023
Cited by 3 | Viewed by 967
Abstract
Esophageal cancer constitutes a global public health challenge. However, South Korean population-specific information on the association of lifestyle (smoking, alcohol consumption, and obesity status) with esophageal cancer risk is sparse. This nested case–control study analyzed the Korean national health screening cohort data (2002–2019) [...] Read more.
Esophageal cancer constitutes a global public health challenge. However, South Korean population-specific information on the association of lifestyle (smoking, alcohol consumption, and obesity status) with esophageal cancer risk is sparse. This nested case–control study analyzed the Korean national health screening cohort data (2002–2019) of 1114 patients with esophageal cancer and 4456 controls (1:4 propensity-score matched for sex, age, income, and residential region). Conditional and unconditional logistic regression analyses, after adjustment for multiple covariates, determined the effects of lifestyle factors on esophageal cancer risk. Smoking and alcohol consumption increased the esophageal cancer risk (adjusted odds ratio [95% confidence interval]: 1.37 [1.15–1.63] and 1.89 [1.60–2.23], respectively). Overweight (body mass index [BMI] ≥ 23 to <25 kg/m2), obese I (BMI ≥ 25 to <30 kg/m2), or obese II (BMI ≥ 30 kg/m2) categories had reduced odds of esophageal cancer (0.76 [0.62–0.92], 0.59 [0.48–0.72], and 0.47 [0.26–0.85], respectively). In the subgroup analyses, the association of incident esophageal cancer with smoking and alcohol consumption persisted, particularly in men or those aged ≥55 years, whereas higher BMI scores remained consistently associated with a reduced esophageal cancer likelihood across all age groups, in both sexes, and alcohol users or current smokers. Underweight current smokers exhibited a higher propensity for esophageal cancer. In conclusion, smoking and alcohol drinking may potentially increase the risk, whereas weight maintenance, with BMI ≥ 23 kg/m2, may potentially decrease the risk, for esophageal cancer in the South Korean population. Lifestyle modification in the specific subgroups may be a potential strategy for preventing esophageal cancer. Full article
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10 pages, 7268 KiB  
Article
Local Recurrence after Endoscopic Submucosal Dissection of Early Gastric Cancer
by Dae-Gon Ryu, Su-Jin Kim, Cheol-Woong Choi, Su-Bum Park, Hyeong-Seok Nam, Si-Hak Lee and Sun-Hwi Hwang
J. Clin. Med. 2023, 12(5), 2018; https://doi.org/10.3390/jcm12052018 - 03 Mar 2023
Cited by 3 | Viewed by 1422
Abstract
Endoscopic submucosal dissection (ESD) is considered the treatment of choice for early gastric cancer (EGC) with a negligible risk of lymph node metastasis. Locally recurrent lesions on artificial ulcer scars are difficult to manage. Predicting the risk of local recurrence after ESD is [...] Read more.
Endoscopic submucosal dissection (ESD) is considered the treatment of choice for early gastric cancer (EGC) with a negligible risk of lymph node metastasis. Locally recurrent lesions on artificial ulcer scars are difficult to manage. Predicting the risk of local recurrence after ESD is important to manage and prevent the event. We aimed to elucidate the risk factors associated with local recurrence after ESD of EGC. Between November 2008 and February 2016, consecutive patients (n = 641; mean age, 69.3 ± 9.5 years; men, 77.2%) with EGC who underwent ESD at a single tertiary referral hospital were retrospectively analyzed to evaluate the incidence and factors associated with local recurrence. Local recurrence was defined as the development of neoplastic lesions at or adjacent to the site of the post-ESD scar. En bloc and complete resection rates were 97.8% and 93.6%, respectively. The local recurrence rate after ESD was 3.1%. The mean follow-up period after ESD was 50.7 ± 32.5 months. One case of gastric cancer-related death (0.15%) was noted, wherein the patient had refused additive surgical resection after ESD for EGC with lymphatic and deep submucosal invasion. Lesion size ≥15 mm, incomplete histologic resection, undifferentiated adenocarcinoma, scar, and the absence of erythema of the surface were associated with a higher risk of local recurrence. Predicting local recurrence during regular endoscopic surveillance after ESD is important, especially in patients with a larger lesion size (≥15 mm), incomplete histologic resection, surface changes of scars, and no erythema of the surface. Full article
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10 pages, 1696 KiB  
Article
Combining HAIC and Sorafenib as a Salvage Treatment for Patients with Treatment-Failed or Advanced Hepatocellular Carcinoma: A Single-Center Experience
by Chia-Bang Chen, Chun-Min Chen, Ruo-Han Tzeng, Chen-Te Chou, Pei-Yuan Su, You-Chuen Hsu and Cheng-Da Yang
J. Clin. Med. 2023, 12(5), 1887; https://doi.org/10.3390/jcm12051887 - 27 Feb 2023
Cited by 2 | Viewed by 1310
Abstract
Background: Hepatic arterial infusion chemotherapy (HAIC) has been proven to be an effective treatment for advanced HCC. In this study, we present our single-center experience of implementing combined sorafenib and HAIC treatment for these patients and compare the treatment benefit with that of [...] Read more.
Background: Hepatic arterial infusion chemotherapy (HAIC) has been proven to be an effective treatment for advanced HCC. In this study, we present our single-center experience of implementing combined sorafenib and HAIC treatment for these patients and compare the treatment benefit with that of sorafenib alone. Methods: This was a retrospective single-center study. Our study included 71 patients who started taking sorafenib between 2019 and 2020 at Changhua Christian Hospital in order to treat advanced HCC or as a salvage treatment after the failure of a previous treatment for HCC. Of these patients, 40 received combined HAIC and sorafenib treatment. The efficacy of sorafenib alone or in combination with HAIC was measured in regard to overall survival and progression-free survival. Multivariate regression analysis was performed to identify factors associated with overall survival and progression-free survival. Results: HAIC combined with sorafenib treatment and sorafenib alone resulted in different outcomes. The combination treatment resulted in a better image response and objective response rate. Moreover, among the patients aged under 65 years old and male patients, the combination therapy resulted in a better progression-free survival than sorafenib alone. A tumor size ≥ 3 cm, AFP > 400, and ascites were associated with a poor progression-free survival among young patients. However, the overall survival of these two groups showed no significant difference. Conclusions: Combined HAIC and sorafenib treatment showed a treatment effect equivalent to that of sorafenib alone as a salvage treatment modality used to treat patients with advanced HCC or with experience of a previously failed treatment. Full article
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11 pages, 815 KiB  
Case Report
Bile Duct Lithiasis Mimicking a Perihilar Cholangiocarcinoma—An Endless Dilemma: A Case Report
by Marco Piccino, Ilda Hoxhaj, Ugo Grossi, Maurizio Romano, Marco Brizzolari, Michele Scopelliti, Michele Finotti and Giacomo Zanus
J. Clin. Med. 2023, 12(15), 5104; https://doi.org/10.3390/jcm12155104 - 03 Aug 2023
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Abstract
Hilar bile duct strictures are mostly caused by malignant lesions. The morphological appearance of perihilar cholangiocarcinomas in various imaging modalities have other malignant and even benign mimics, which pose challenges to an accurate diagnosis and treatment and drive to futile surgery. Herein, we [...] Read more.
Hilar bile duct strictures are mostly caused by malignant lesions. The morphological appearance of perihilar cholangiocarcinomas in various imaging modalities have other malignant and even benign mimics, which pose challenges to an accurate diagnosis and treatment and drive to futile surgery. Herein, we present the case of a 50-year-old woman admitted with jaundice and abdominal pain, elevated bilirubin level, liver function tests and carbohydrate antigen 19-9 level. Magnetic resonance cholangio-pancreatography (MR-CP) and the computed tomography with contrast enhancement revealed a suspected extrahepatic cholangiocarcinoma of the common bile duct. Further spontaneous resolution of the scenario, confirmed by diagnostic assessment, changed the clinical hypothesis in favor of a non-oncological disease. Indeed, the multidisciplinary evaluation supported a diagnosis of transient cholangitis secondary to non-evident intrahepatic lithiasis rather than cholangiocarcinoma. After a 26-month follow-up, the patient was asymptomatic with normal tumor markers and laboratory data. Consecutive MR-CPs showed no suspicion of malignancy. This case report underlines the need for an accurate preoperative assessment in patients with suspected cholangiocarcinoma. Full article
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