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Cancers
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Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic...
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Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic Shapes the Field in the Years to Come

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 33886

Special Issue Editors

Dr. Anastasios Koulaouzidis

E-Mail Website
Guest Editor
Endoscopy Unit, The Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
Interests: capsule endoscopy; colonoscopy; deep enteroscopy; colorectal cancer
Dr. Wojciech Marlicz

E-Mail Website
Guest Editor
1. Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
2. Endoklinika sp. z o.o., Szczecin, Poland
Interests: microbiome; colonoscopy; probiotics; colorectal cancer; gastric cancer; stem cells
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Summary: Review of the current approaches for the diagnosis and management of gastrointestinal cancer patients with a view toward novel and innovative solutions for their diagnosis and treatment in the light of the current and future challenges in contemporary medical practice. 

Dear Colleagues, 

Gastrointestinal cancers (GICs) remain high on the list of the main causes of death worldwide; however, the recent emergence of new and on-going global healthcare threats, such as the COVID-19 pandemic, has led to a temporary reduction of elective endoscopic procedures and, consequently, to a temporary deferral in GIC diagnoses. Innovative ideas in prioritizing referrals and/or utilizing new or existing noncontact, aerosol-free diagnostic techniques and modalities, together with additional personal protective equipment, attempt to provide some resolution to this new reality. Furthermore, the associated impact in treatment and provided therapies call for the renewal of protocols and even the emergence of new drugs and drug delivery platforms for a more precise and flexible management. In this Special Issue, experts in this field will review the current approaches for the diagnosis and management of patients with the spectrum of GIC and suggest innovative solutions fit for the diagnosis and management of GIC in the light of the new challenges and abundance of innovations. 

Dr. Anastasios Koulaouzidis
Dr. Wojciech Marlicz
Guest Editors

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 short 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

  • innovation
  • capsule endoscopy
  • colonoscopy
  • colorectal cancer
  • gastric cancer
  • small bowel cancer
  • oesophageal cancer
  • monitoring
  • diagnosis
  • therapy

Published Papers (6 papers)

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Editorial

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4 pages, 200 KiB  
Editorial
A Flavor of the Future of GI Endoscopy—New Solutions Shape the Field of Modern Gastrointestinal Care
by Anastasios Koulaouzidis, Wojciech Marlicz and George Koulaouzidis
Cancers 2021, 13(12), 3007; https://doi.org/10.3390/cancers13123007 - 16 Jun 2021
Viewed by 1515
Abstract
Gastrointestinal (GI) cancers remain high on the list of the leading causes of death worldwide; however, the recent emergence of new and ongoing global healthcare threats, such as the COVID-19 pandemic, has led to a temporary reduction in elective endoscopic procedures [...] Full article
(This article belongs to the Special Issue Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic Shapes the Field in the Years to Come)

Research

Jump to: Editorial, Review

16 pages, 2189 KiB  
Article
Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries
by Junjie Huang, Anastasios Koulaouzidis, Wojciech Marlicz, Veeleah Lok, Cedric Chu, Chun Ho Ngai, Lin Zhang, Ping Chen, Shanjuan Wang, Jinqiu Yuan, Xiang-Qian Lao, Shelly L.A. Tse, Wanghong Xu, Zhi-Jie Zheng, Shao-Hua Xie and Martin C.S. Wong
Cancers 2021, 13(1), 141; https://doi.org/10.3390/cancers13010141 - 05 Jan 2021
Cited by 105 | Viewed by 10940
Abstract
This study aimed to examine the global burden, risk factors, and trends of esophageal cancer based on age, sex, and histological subtype. The data were retrieved from cancer registries database from 48 countries in the period 1980–2017. Temporal patterns of incidence and mortality [...] Read more.
This study aimed to examine the global burden, risk factors, and trends of esophageal cancer based on age, sex, and histological subtype. The data were retrieved from cancer registries database from 48 countries in the period 1980–2017. Temporal patterns of incidence and mortality were evaluated by average annual percent change (AAPC) using joinpoint regression. Associations with risk factors were examined by linear regression. The highest incidence of esophageal cancer was observed in Eastern Asia. The highest incidence of adenocarcinoma (AC) was found in the Netherlands, the United Kingdom, and Ireland. A higher AC/squamous cell carcinoma (SCC) incidence ratio was associated with a higher prevalence of obesity and elevated cholesterol. We observed an incidence increase (including AC and SCC) in some countries, with the Czech Republic (female: AAPC 4.66), Spain (female: 3.41), Norway (male: 3.10), Japan (female: 2.18), Thailand (male: 2.17), the Netherlands (male: 2.11; female: 1.88), and Canada (male: 1.51) showing the most significant increase. Countries with increasing mortality included Thailand (male: 5.24), Austria (female: 3.67), Latvia (male: 2.33), and Portugal (male: 1.12). Although the incidence of esophageal cancer showed an overall decreasing trend, an increasing trend was observed in some countries with high AC/SCC incidence ratios. More preventive measures are needed for these countries. Full article
(This article belongs to the Special Issue Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic Shapes the Field in the Years to Come)
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Graphical abstract

15 pages, 2606 KiB  
Article
Robotic-Assisted Colonoscopy Platform with a Magnetically-Actuated Soft-Tethered Capsule
by Mauro Verra, Andrea Firrincieli, Marcello Chiurazzi, Andrea Mariani, Giacomo Lo Secco, Edoardo Forcignanò, Anastasios Koulaouzidis, Arianna Menciassi, Paolo Dario, Gastone Ciuti and Alberto Arezzo
Cancers 2020, 12(9), 2485; https://doi.org/10.3390/cancers12092485 - 02 Sep 2020
Cited by 33 | Viewed by 5238
Abstract
Background and Aims: Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide. Despite offering a prime paradigm for screening, CRC screening is often hampered by invasiveness. Endoo is a potentially painless colonoscopy method with an active locomotion tethered capsule [...] Read more.
Background and Aims: Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide. Despite offering a prime paradigm for screening, CRC screening is often hampered by invasiveness. Endoo is a potentially painless colonoscopy method with an active locomotion tethered capsule offering diagnostic and therapeutic capabilities. Materials and Methods: The Endoo system comprises a soft-tethered capsule, which embeds a permanent magnet controlled by an external robot equipped with a second permanent magnet. Capsule navigation is achieved via closed-loop interaction between the two magnets. Ex-vivo tests were conducted by endoscopy experts and trainees to evaluate the basic key features, usability, and compliance in comparison with conventional colonoscopy (CC) in feasibility and pilot studies. Results: Endoo showed a 100% success rate in operating channel and target approach tests. Progression of the capsule was feasible and repeatable. The magnetic link was lost an average of 1.28 times per complete procedure but was restored in 100% of cases. The peak value of interaction forces was higher in the CC group than the Endoo group (4.12N vs. 1.17N). The cumulative interaction forces over time were higher in the CC group than the Endoo group between the splenic flexure and mid-transverse colon (16.53Ns vs. 1.67Ns, p < 0.001), as well as between the hepatic flexure and cecum (28.77Ns vs. 2.47Ns, p = 0.005). The polyp detection rates were comparable between groups (9.1 ± 0.9% vs. 8.7 ± 0.9%, CC and Endoo respectively, per procedure). Robotic colonoscopies were completed in 67% of the procedures performed with Endoo (53% experts and 100% trainees). Conclusions: Endoo allows smoother navigation than CC and possesses comparable features. Although further research is needed, magnetic capsule colonoscopy demonstrated promising results compared to CC. Full article
(This article belongs to the Special Issue Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic Shapes the Field in the Years to Come)
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Review

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26 pages, 2496 KiB  
Review
Training Simulators for Gastrointestinal Endoscopy: Current and Future Perspectives
by Martina Finocchiaro, Pablo Cortegoso Valdivia, Albert Hernansanz, Nicola Marino, Denise Amram, Alicia Casals, Arianna Menciassi, Wojciech Marlicz, Gastone Ciuti and Anastasios Koulaouzidis
Cancers 2021, 13(6), 1427; https://doi.org/10.3390/cancers13061427 - 20 Mar 2021
Cited by 23 | Viewed by 6256
Abstract
Gastrointestinal (GI) endoscopy is the gold standard in the detection and treatment of early and advanced GI cancers. However, conventional endoscopic techniques are technically demanding and require visual-spatial skills and significant hands-on experience. GI endoscopy simulators represent a valid solution to allow doctors [...] Read more.
Gastrointestinal (GI) endoscopy is the gold standard in the detection and treatment of early and advanced GI cancers. However, conventional endoscopic techniques are technically demanding and require visual-spatial skills and significant hands-on experience. GI endoscopy simulators represent a valid solution to allow doctors to practice in a pre-clinical scenario. From the first endoscopy mannequin, developed in 1969, several simulation platforms have been developed, ranging from purely mechanical systems to more complex mechatronic devices and animal-based models. Considering the recent advancement of technologies (e.g., artificial intelligence, augmented reality, robotics), simulation platforms can now reach high levels of realism, representing a valid and smart alternative to standard trainee/mentor learning programs. This is particularly true nowadays, when the current demographic trend and the most recent pandemic demand, more than ever, the ability to cope with many patients. This review offers a broad view of the technology available for GI endoscopy training, including platforms currently in the market and the relevant advancements in this research and application field. Additionally, new training needs and new emerging technologies are discussed to understand where medical education is heading. Full article
(This article belongs to the Special Issue Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic Shapes the Field in the Years to Come)
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17 pages, 4658 KiB  
Review
Colon Capsule Endoscopy vs. CT Colonography Following Incomplete Colonoscopy: A Systematic Review with Meta-Analysis
by Ulrik Deding, Lasse Kaalby, Henrik Bøggild, Eva Plantener, Mie Kruse Wollesen, Morten Kobaek-Larsen, Siri Juul Hansen and Gunnar Baatrup
Cancers 2020, 12(11), 3367; https://doi.org/10.3390/cancers12113367 - 13 Nov 2020
Cited by 19 | Viewed by 2724
Abstract
Following incomplete colonoscopy (IC) patients often undergo computed tomography colonography (CTC), but colon capsule endoscopy (CCE) may be an alternative. We compared the completion rate, sensitivity and diagnostic yield for polyp detection from CCE and CTC following IC. A systematic literature search resulted [...] Read more.
Following incomplete colonoscopy (IC) patients often undergo computed tomography colonography (CTC), but colon capsule endoscopy (CCE) may be an alternative. We compared the completion rate, sensitivity and diagnostic yield for polyp detection from CCE and CTC following IC. A systematic literature search resulted in twenty-six studies. Extracted data included inter alia, complete/incomplete investigations and polyp findings. Pooled estimates of completion rates of CCE and CTC and complete colonic view rates (CCE reaching the most proximal point of IC) of CCE were calculated. Per patient diagnostic yields of CCE and CTC were calculated stratified by polyp sizes. CCE completion rate and complete colonic view rate were 76% (CI 95% 68–84%) and 90% (CI 95% 83–95%). CTC completion rate was 98% (CI 95% 96–100%). Diagnostic yields of CTC and CCE were 10% (CI 95% 7–15%) and 37% (CI 95% 30–43%) for any size, 13% (CI 95% 9–18%) and 21% (CI 95% 12–32%) for >5-mm and 4% (CI 95% 2–7%) and 9% (CI 95% 3–17%) for >9-mm polyps. No study performed a reference standard follow-up after CCE/CTC in individuals without findings, rendering sensitivity calculations unfeasible. The increased diagnostic yield of CCE could outweigh its slightly lower complete colonic view rate compared to the superior CTC completion rate. Hence, CCE following IC appears feasible for an introduction to clinical practice. Therefore, randomized studies investigating CCE and/or CTC following incomplete colonoscopy with a golden standard reference for the entire population enabling estimates for sensitivity and specificity are needed. Full article
(This article belongs to the Special Issue Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic Shapes the Field in the Years to Come)
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19 pages, 1477 KiB  
Review
Frontiers of Robotic Gastroscopy: A Comprehensive Review of Robotic Gastroscopes and Technologies
by Wojciech Marlicz, Xuyang Ren, Alexander Robertson, Karolina Skonieczna-Żydecka, Igor Łoniewski, Paolo Dario, Shuxin Wang, John N Plevris, Anastasios Koulaouzidis and Gastone Ciuti
Cancers 2020, 12(10), 2775; https://doi.org/10.3390/cancers12102775 - 28 Sep 2020
Cited by 38 | Viewed by 5869
Abstract
Upper gastrointestinal (UGI) tract pathology is common worldwide. With recent advancements in robotics, innovative diagnostic and treatment devices have been developed and several translational attempts made. This review paper aims to provide a highly pictorial critical review of robotic gastroscopes, so that clinicians [...] Read more.
Upper gastrointestinal (UGI) tract pathology is common worldwide. With recent advancements in robotics, innovative diagnostic and treatment devices have been developed and several translational attempts made. This review paper aims to provide a highly pictorial critical review of robotic gastroscopes, so that clinicians and researchers can obtain a swift and comprehensive overview of key technologies and challenges. Therefore, the paper presents robotic gastroscopes, either commercial or at a progressed technology readiness level. Among them, we show tethered and wireless gastroscopes, as well as devices aimed for UGI surgery. The technological features of these instruments, as well as their clinical adoption and performance, are described and compared. Although the existing endoscopic devices have thus far provided substantial improvements in the effectiveness of diagnosis and treatment, there are certain aspects that represent unwavering predicaments of the current gastroenterology practice. A detailed list includes difficulties and risks, such as transmission of communicable diseases (e.g., COVID-19) due to the doctor–patient proximity, unchanged learning curves, variable detection rates, procedure-related adverse events, endoscopists’ and nurses’ burnouts, limited human and/or material resources, and patients’ preferences to choose non-invasive options that further interfere with the successful implementation and adoption of routine screening. The combination of robotics and artificial intelligence, as well as remote telehealth endoscopy services, are also discussed, as viable solutions to improve existing platforms for diagnosis and treatment are emerging. Full article
(This article belongs to the Special Issue Modern Gastrointestinal Cancers Detection, and Treatment: How the Recent Pandemic Shapes the Field in the Years to Come)
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