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Diagnosis and Treatment of Upper and Lower Gastrointestinal Malignancies: Current...
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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 5187

Special Issue Editor

Dr. Jun Gong

E-Mail Website
Guest 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

Manuscript Submission Information

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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. Diseases is an international peer-reviewed open access monthly 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 1800 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

  • 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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Related Special Issue

Published Papers (3 papers)

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Research

10 pages, 571 KiB  
Article
Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: Insights from the Western Australian Context
by Oliver Oey, Chak Pan Lin, Muhammad Adnan Khattak, Thomas Ferguson, Mary Theophilus, Siaw Sze Tiong, Sayed Ali and Yasir Khan
Diseases 2024, 12(10), 257; https://doi.org/10.3390/diseases12100257 - 17 Oct 2024
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Abstract
Background: Recent studies have associated total neoadjuvant therapy (TNT) with better treatment adherence, decreased toxicity, improved complete clinical response and anal sphincter preservation rates in patients with locally advanced rectal cancer (LARC). However, real-world experience with TNT in the management of LARC remains [...] Read more.
Background: Recent studies have associated total neoadjuvant therapy (TNT) with better treatment adherence, decreased toxicity, improved complete clinical response and anal sphincter preservation rates in patients with locally advanced rectal cancer (LARC). However, real-world experience with TNT in the management of LARC remains limited. Aim: This study aimed to evaluate the efficacy and safety outcomes of TNT for LARC in Western Australia. Methods: Patients with LARC (cT2-4 and/or cN1-2) who underwent induction chemotherapy followed by neoadjuvant chemoradiotherapy or neoadjuvant chemoradiotherapy followed by consolidation chemotherapy, followed by surgery were recruited from two hospitals in Western Australia. Efficacy outcomes assessed included clinical response (complete, partial, no response), and pathologic complete response (pCR) rate, R0 resection rate, and R1 resection rate were evaluated. Those patients who achieved clinical complete response following TNT were given the option of active surveillance. The safety and tolerability of TNT were assessed. Results: 32 patients with LARC were treated with TNT. In total, 17 patients (53%) received chemoradiotherapy followed by consolidation chemotherapy and 15 patients (47%) received induction chemotherapy followed by chemoradiotherapy. Nine (28%) of the patients with LARC treated with TNT had a complete clinical response, twenty-one (66%) patients had a partial clinical response, and two (6%) patients had no response to TNT. Of the 32 patients, 27 (84%) underwent surgery. There was a 100% R0 resection rate. The pCR rate was 15%. pCR, clinical response, and the R0 resection rate were similar between the two TNT regimens. TNT was well tolerated, with the majority of patients (88%) completing the chemotherapy course with grade 1 and 2 adverse effects. Conclusions: In conclusion, TNT emerges as a promising approach for the management of LARC. However, further research is warranted to refine the optimal TNT protocols, determine its long-term outcomes, and identify patient populations who would benefit the most from this innovative therapeutic strategy. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Upper and Lower Gastrointestinal Malignancies: Current Advances and Future Prospects)
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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 2 | Viewed by 1995
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
(This article belongs to the Special Issue Diagnosis and Treatment of Upper and Lower Gastrointestinal Malignancies: Current Advances and Future Prospects)
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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
Cited by 1 | Viewed by 1912
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
(This article belongs to the Special Issue Diagnosis and Treatment of Upper and Lower Gastrointestinal Malignancies: Current Advances and Future Prospects)
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