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Holowatyj AN, Overman MJ, Votanopoulos KI, Lowy AM, Wagner P, Washington MK, Eng C, Foo WC, Goldberg RM, Hosseini M, Idrees K, Johnson DB, Shergill A, Ward E, Zachos NC, Shelton D. Defining a 'cells to society' research framework for appendiceal tumours. Nat Rev Cancer 2025; 25:293-315. [PMID: 39979656 DOI: 10.1038/s41568-024-00788-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2024] [Indexed: 02/22/2025]
Abstract
Tumours of the appendix - a vestigial digestive organ attached to the colon - are rare. Although we estimate that around 3,000 new appendiceal cancer cases are diagnosed annually in the USA, the challenges of accurately diagnosing and identifying this tumour type suggest that this number may underestimate true population incidence. In the current absence of disease-specific screening and diagnostic imaging modalities, or well-established risk factors, the incidental discovery of appendix tumours is often prompted by acute presentations mimicking appendicitis or when the tumour has already spread into the abdominal cavity - wherein the potential misclassification of appendiceal tumours as malignancies of the colon and ovaries also increases. Notwithstanding these diagnostic difficulties, our understanding of appendix carcinogenesis has advanced in recent years. However, there persist considerable challenges to accelerating the pace of research discoveries towards the path to improved treatments and cures for patients with this group of orphan malignancies. The premise of this Expert Recommendation article is to discuss the current state of the field, to delineate unique challenges for the study of appendiceal tumours, and to propose key priority research areas that will deliver a more complete picture of appendix carcinogenesis and metastasis. The Appendix Cancer Pseudomyxoma Peritonei (ACPMP) Research Foundation Scientific Think Tank delivered a consensus of core research priorities for appendiceal tumours that are poised to be ground-breaking and transformative for scientific discovery and innovation. On the basis of these six research areas, here, we define the first 'cells to society' research framework for appendix tumours.
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Affiliation(s)
- Andreana N Holowatyj
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
- Vanderbilt University School of Medicine, Nashville, TN, USA.
| | - Michael J Overman
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Andrew M Lowy
- Department of Surgery, Division of Surgical Oncology, Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Patrick Wagner
- Division of Surgical Oncology, Allegheny Health Network Cancer Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Mary K Washington
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cathy Eng
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Wai Chin Foo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Mojgan Hosseini
- Department of Pathology, University of California, San Diego, San Diego, CA, USA
| | - Kamran Idrees
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Douglas B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Ardaman Shergill
- Department of Medicine, University of Chicago Medical Center, Chicago, IL, USA
| | - Erin Ward
- Section of Surgical Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Nicholas C Zachos
- Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
- Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Deborah Shelton
- Appendix Cancer Pseudomyxoma Peritonei (ACPMP) Research Foundation, Springfield, PA, USA
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Chandramouli M, Wagner PL. Overview: Challenges of Treating Peritoneal Surface Malignancies. Surg Oncol Clin N Am 2025; 34:133-144. [PMID: 40015795 DOI: 10.1016/j.soc.2024.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2025]
Abstract
Peritoneal surface malignancies (PSM) includes an expansive disease spectrum, ranging from low-grade appendiceal mucinous neoplasm to metastatic processes from invasive adenocarcinomas of the gastrointestinal tract. Management of PSM faces numerous challenges, from diagnosis to delivery of care, both from a treatment and navigational standpoint. This article outlines the various hurdles faced at different branch points and current management recommendations.
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Affiliation(s)
- Mathangi Chandramouli
- Allegheny Health Network Cancer Institute, Division of Surgical Oncology, 320 East North Avenue, Pittsburgh, PA 15212, USA
| | - Patrick L Wagner
- Allegheny Health Network Cancer Institute, Division of Surgical Oncology, 320 East North Avenue, Pittsburgh, PA 15212, USA.
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Pattalachinti VK, Haque E, Yousef M, Yousef A, Chowdhury S, Overman M, Parseghian CM, Morris VK, Kee B, Huey RW, Raghav K, Court CM, Shen JP. BRAF mutant appendiceal adenocarcinoma differs from colorectal cancer but responds to BRAF-targeted therapy. NPJ Precis Oncol 2025; 9:38. [PMID: 39910160 PMCID: PMC11799341 DOI: 10.1038/s41698-025-00821-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 01/21/2025] [Indexed: 02/07/2025] Open
Abstract
Appendiceal Adenocarcinoma (AA) is a rare gastrointestinal cancer with no FDA-approved targeted therapies. Here, we retrospectively compare BRAF-mutant AA and colorectal cancer (CRC). BRAF mutation is rare in AA (3%). Unlike CRC, BRAFV600E AA is not associated with poor prognosis, female sex, microsatellite instability, mucinous histology, or poor differentiation. In both cancers, BRAFV600E but not atypical BRAF mutations are mutually exclusive with other Ras-activating mutations. BRAFV600E + EGFR inhibition shows efficacy in BRAFV600E AA (disease control rate = 80%, median progression-free survival = 7.1 months).
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Affiliation(s)
- Vinay K Pattalachinti
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- The Joe R. and Teresa Lozano Long School of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - Emaan Haque
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mahmoud Yousef
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Abdelrahman Yousef
- Internal Medicine Department, University of New Mexico Hospital, Albuquerque, NM, USA
| | - Saikat Chowdhury
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Overman
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christine M Parseghian
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Van K Morris
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bryan Kee
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ryan W Huey
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kanwal Raghav
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Colin M Court
- Department of Surgical Oncology and Endocrine Surgery, Mays Cancer Center, University of Texas Health San Antonio, San Antonio, TX, USA
| | - John Paul Shen
- Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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4
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Pullen RL. Caring for a patient with appendiceal cancer. Nursing 2025; 55:16-25. [PMID: 39849329 DOI: 10.1097/nsg.0000000000000134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2025]
Abstract
ABSTRACT Appendiceal cancer (AC) is a rare malignancy, occurring in 1 to 2 individuals per million annually in the US. It is often diagnosed incidentally during appendectomies or imaging for unrelated conditions. This article explores the risk factors, clinical presentation, diagnostic methods, pathology, staging, and treatment options for AC, highlighting disparities in access to care across different demographics. This article also emphasizes the importance of early detection and tailored management strategies to enhance nurses' understanding and improve outcomes for patients with this uncommon but significant disease.
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Affiliation(s)
- Richard L Pullen
- Richard Pullen is a professor and the RN to BSN program director at Texas Tech University Health Sciences Center School of Nursing. Dr. Pullen is also a member of the Nursing2025 editorial board
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5
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Liu C, Tang L, Yang W, Gu Y, Xu W, Liang Z, Jiang J. cGAS/STING pathway and gastrointestinal cancer: Mechanisms and diagnostic and therapeutic targets (Review). Oncol Rep 2025; 53:15. [PMID: 39611480 PMCID: PMC11632663 DOI: 10.3892/or.2024.8848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Accepted: 10/23/2024] [Indexed: 11/30/2024] Open
Abstract
The health of individuals is seriously threatened by intestinal cancer, which includes pancreatic, colorectal, esophageal, gastric and gallbladder cancer. Most gastrointestinal cancers do not have typical and specific early symptoms, and lack specific and effective diagnostic markers and treatment methods. It is critical to understand the etiology of gastrointestinal cancer and develop more efficient methods of diagnosis and treatment. The cyclic GMP‑AMP synthase (cGAS)/stimulator of interferon genes (STING) pathway serves a crucial role in the occurrence, progression and treatment of gastrointestinal cancer. The present review focuses on the latest progress regarding the role and mechanism of the cGAS/STING pathway in gastrointestinal cancer, and discusses treatment approaches and related applications based on the cGAS/STING signaling pathway. In order to improve the knowledge of the connection between the cGAS/STING pathway and gastrointestinal cancer, aid the diagnosis and treatment of gastrointestinal cancer, and lessen the burden on patients and society, the present review also discusses future research directions and existing challenges regarding cGAS/STING in the study of gastrointestinal cancer.
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Affiliation(s)
- Chang Liu
- Aoyang Institute of Cancer, Affiliated Aoyang Hospital of Jiangsu University, Suzhou, Jiangsu 215600, P.R. China
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Li Tang
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Wenhui Yang
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Yuning Gu
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Wenrong Xu
- Aoyang Institute of Cancer, Affiliated Aoyang Hospital of Jiangsu University, Suzhou, Jiangsu 215600, P.R. China
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Zhaofeng Liang
- Aoyang Institute of Cancer, Affiliated Aoyang Hospital of Jiangsu University, Suzhou, Jiangsu 215600, P.R. China
- Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China
| | - Jiajia Jiang
- Aoyang Institute of Cancer, Affiliated Aoyang Hospital of Jiangsu University, Suzhou, Jiangsu 215600, P.R. China
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Salam A, Ali A, Nishan U, Khan N, Ibrahim MA, Iqbal Z, Muhammad N, Fayyaz A, Muhammad F, Mateen A, Wu Z, Afridi S. Investigation of Programmed Death Ligand-1 as a New Prognostic Biomarker in Pancreatic Cancer Patients. ACS Pharmacol Transl Sci 2024; 7:3585-3591. [PMID: 39539267 PMCID: PMC11555514 DOI: 10.1021/acsptsci.4c00490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Revised: 09/18/2024] [Accepted: 09/25/2024] [Indexed: 11/16/2024]
Abstract
Pancreatic cancer is one of the most lethal and fast-growing cancers with a poor prognosis. Herein, we report the expression of programmed death ligand 1 (PD-L1) as a new prognostic biomarker in pancreatic cancer progression analysis at the clinical level. Immunohistochemistry was performed on 86 clinically proven cases of pancreatic cancer tissue microarrays (TMAs) using anti-PD-L1 antibodies. Histoscore was done, and a variety of cutoffs were identified for analyses of the results. The chi-square test and Kaplan-Meier method were used to find the association between pancreatic cancer and various clinicopathological variables and the overall survival of the patients. PD-L1 expression was associated with histological grade and recurrence of the disease for epithelial and stromal staining at 10 histoscores. In addition, PD-L1 expression was strongly associated with lymph node involvement at the stromal 20 histoscore. The tumor stage of pancreatic cancer had an association with PD-L1 expression with epithelial and stromal 20 histoscores for all comparisons. At a stromal 20 histoscore, overall survival in high-low expression of PD-L1 was 7-19 months, and at a nuclear/cytoplasmic 10 histoscore, it was 9-28 months (p = 0.0001), respectively. Overall, PD-L1 overexpression in subcellular compartments was associated with disease aggression phenotypes and poor patient survival. Overexpression of PD-L1 was directly linked to pancreatic cancer progression and a poor survival rate. Therefore, PD-L1 may be used as a prognostic biomarker in the diagnosis, treatment, and management of pancreatic cancer patients.
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Affiliation(s)
- Abdul Salam
- Department
of Histopathology, Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar 25000, Khyber Pukhtunkhwa, Pakistan
| | - Asif Ali
- Department
of Histopathology, Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar 25000, Khyber Pukhtunkhwa, Pakistan
| | - Umar Nishan
- Department
of Chemistry, Kohat University of Science
and Technology, Kohat 26000, Khyber Pukhtunkhwa, Pakistan
| | - Noaman Khan
- Department
of Chemistry, Kohat University of Science
and Technology, Kohat 26000, Khyber Pukhtunkhwa, Pakistan
| | - Mohamed A. Ibrahim
- Department
of Pharmaceutics, College of Pharmacy, King
Saud University, Riyadh 11451, Saudi Arabia
| | - Zafar Iqbal
- Department
of Surgery, College of Medicine, King Saud
University, P.O. Box 7805, Riyadh 11472, Saudi Arabia
| | - Nawshad Muhammad
- Department
of Dental Materials, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar 25000, Khyber Pukhtunkhwa, Pakistan
| | - Anum Fayyaz
- Pathology
Department, Rehman Medical College, Peshawar 25000, Khyber Pukhtunkhwa, Pakistan
| | - Fawad Muhammad
- Department
of Microbiology & Molecular Biology, Peshawar Medical College, Warsak Road, Peshawar 25000, Khyber Pukhtunkhwa, Pakistan
| | - Abdul Mateen
- Department
of Pharmacy, University of Swabi, Swabi 23562, Khyber Pukhtunkhwa, Pakistan
| | - Zhiyuan Wu
- Department
of Pediatric Intensive Care Unit, Guangzhou Institute of Pediatrics,
Guangzhou Women and Children’s Medical Center, Joint Center
for Infection and Immunity, Guangzhou Medical
University, Guangzhou 510623, China
| | - Saifullah Afridi
- Department
of Chemistry, Kohat University of Science
and Technology, Kohat 26000, Khyber Pukhtunkhwa, Pakistan
- Department
of Pediatric Intensive Care Unit, Guangzhou Institute of Pediatrics,
Guangzhou Women and Children’s Medical Center, Joint Center
for Infection and Immunity, Guangzhou Medical
University, Guangzhou 510623, China
- Department
of Allied Health Sciences, Faculty of Life Sciences, Sarhad University of Science & Information Technology (SUIT), Mardan Campus, Mardan 23200, Khyber
Pukhtunkhwa, Pakistan
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Li X, Dong J, Li B, Aimei O, Sun Y, Wu X, Liu W, Li R, Li Z, Yang Y. Prediction of Neoadjuvant Chemoradiotherapy Sensitivity in Patients With Esophageal Squamous Cell Carcinoma Using CT-Based Radiomics Combined With Clinical Features. Dose Response 2024; 22:15593258241301525. [PMID: 39588071 PMCID: PMC11587189 DOI: 10.1177/15593258241301525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 09/21/2024] [Accepted: 10/03/2024] [Indexed: 11/27/2024] Open
Abstract
Background: For patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC), the current standard treatment is neoadjuvant chemoradiotherapy (nCRT) plus radical surgery. Objective: This study aimed to establish a predictive model, based on computed tomography (CT) radiomics features and clinical parameters, to predict sensitivity to nCRT in patients with ESCC pre-treatment. The goal was to provide risk stratification and decision-making recommendations for clinical treatments and offer more valuable information for developing personalized therapies. Methods: This retrospective study involved 102 patients diagnosed with ESCC through biopsy who underwent nCRT. To select radiomics features, we used the least absolute shrinkage and selection operator (LASSO) algorithm. A combined model was constructed, integrating the selected clinically relevant parameters with the Rad-Score. To assess the performance of this combined model, we utilized calibration curves and receiver operating characteristic (ROC) curves. Results: Nine optimal radiomics features were selected using the LASSO algorithm. The support vector machine (SVM) classifier was identified as having the best predictive performance. The area under the curve (AUC) of the SVM training group was 0.937 (95% CI: 0.856-1.000), and of the validation group was 0.831 (95% CI: 0.679-0.983). Smoking and alcohol history, neutrophil to lymphocyte ratio, serum aspartate aminotransferase to alanine aminotransferase ratio, and carcinoembryonic antigen and fibrinogen levels were independent predictors of sensitivity to nCRT in patients with ESCC. The AUCs of the combined model for the training and validation groups were 0.870 (95% CI: 0.774-0.964) and 0.821 (95% CI: 0.669-0.972), respectively. The calibration curve showed that the nomogram's predictions were close to the actual clinical observations, indicating that the model exhibited good predictive performance. Conclusion: Our combined model based on Rad-Score and clinical characteristics showed high predictive performance for predicting sensitivity to nCRT in patients with ESCC. It may be useful for predicting treatment effects in clinical practice and demonstrates the significant potential of radiomics in predicting and optimizing treatment decisions.
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Affiliation(s)
- Xindi Li
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Tianjin Key Laboratory of Digestive Cancer, Tianjin, China
- Department of Oncology, Shandong University, Shandong Provincial Third Hospital, Jinan, China
| | - Jigang Dong
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin’s Clinical Research Center for Cancer, Tianjin Key Laboratory of Digestive Cancer, Tianjin, China
- Qingdao Jiaozhou Central Hospital, Qingdao, China
| | - Baosheng Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Ouyang Aimei
- Department of Radiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yahong Sun
- Department of Oncology, Shandong University, Shandong Provincial Third Hospital, Jinan, China
| | - Xia Wu
- Department of Oncology, Shandong University, Shandong Provincial Third Hospital, Jinan, China
| | - Wenjuan Liu
- Shandong Provincial Key Laboratory of Radiation Oncology, Cancer Research Center, Shandong Cancer Hospital and Institute, Jinan, China
| | - Ruobing Li
- Department of Radiology, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zhongyuan Li
- School of Medical Imaging, Shandong Second Medical University, Weifang, China
| | - Yu Yang
- Shandong Medical Imaging and Radiotherapy Engineering Center (SMIREC), Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
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Zhang D, Zheng B, Xu L, Wu Y, Shen C, Bao S, Tan Z, Sun C. A radiomics-boosted deep-learning for risk assessment of synchronous peritoneal metastasis in colorectal cancer. Insights Imaging 2024; 15:150. [PMID: 38886244 PMCID: PMC11183032 DOI: 10.1186/s13244-024-01733-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/09/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES Synchronous colorectal cancer peritoneal metastasis (CRPM) has a poor prognosis. This study aimed to create a radiomics-boosted deep learning model by PET/CT image for risk assessment of synchronous CRPM. METHODS A total of 220 colorectal cancer (CRC) cases were enrolled in this study. We mapped the feature maps (Radiomic feature maps (RFMs)) of radiomic features across CT and PET image patches by a 2D sliding kernel. Based on ResNet50, a radiomics-boosted deep learning model was trained using PET/CT image patches and RFMs. Besides that, we explored whether the peritumoral region contributes to the assessment of CRPM. In this study, the performance of each model was evaluated by the area under the curves (AUC). RESULTS The AUCs of the radiomics-boosted deep learning model in the training, internal, external, and all validation datasets were 0.926 (95% confidence interval (CI): 0.874-0.978), 0.897 (95% CI: 0.801-0.994), 0.885 (95% CI: 0.795-0.975), and 0.889 (95% CI: 0.823-0.954), respectively. This model exhibited consistency in the calibration curve, the Delong test and IDI identified it as the most predictive model. CONCLUSIONS The radiomics-boosted deep learning model showed superior estimated performance in preoperative prediction of synchronous CRPM from pre-treatment PET/CT, offering potential assistance in the development of more personalized treatment methods and follow-up plans. CRITICAL RELEVANCE STATEMENT The onset of synchronous colorectal CRPM is insidious, and using a radiomics-boosted deep learning model to assess the risk of CRPM before treatment can help make personalized clinical treatment decisions or choose more sensitive follow-up plans. KEY POINTS Prognosis for patients with CRPM is bleak, and early detection poses challenges. The synergy between radiomics and deep learning proves advantageous in evaluating CRPM. The radiomics-boosted deep-learning model proves valuable in tailoring treatment approaches for CRC patients.
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Affiliation(s)
- Ding Zhang
- Medical School of Nantong University, Nantong, JiangSu, China
- Department of Nuclear Medicine, Affiliated Hospital of Nantong University, Nantong, JiangSu, China
| | - BingShu Zheng
- Medical School of Nantong University, Nantong, JiangSu, China
| | - LiuWei Xu
- Medical School of Nantong University, Nantong, JiangSu, China
| | - YiCong Wu
- Medical School of Nantong University, Nantong, JiangSu, China
| | - Chen Shen
- Department of General Surgery, Affiliated Hospital of Nantong University, Nantong, JiangSu, China
| | - ShanLei Bao
- Department of Nuclear Medicine, Affiliated Hospital of Nantong University, Nantong, JiangSu, China
| | - ZhongHua Tan
- Department of Nuclear Medicine, Affiliated Hospital of Nantong University, Nantong, JiangSu, China.
| | - ChunFeng Sun
- Department of Nuclear Medicine, Affiliated Hospital of Nantong University, Nantong, JiangSu, China.
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Liu Q, Jiao J, Li C, Chen Y, Wang B, Shi J, Yu G. Analysis of causes and prognostic impact of tube occlusion during hyperthermic intraperitoneal chemotherapy for appendiceal pseudomyxoma peritonei. World J Surg Oncol 2024; 22:134. [PMID: 38769546 PMCID: PMC11107022 DOI: 10.1186/s12957-024-03412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Appendiceal pseudomyxoma peritonei (PMP), a rare tumor from mucinous appendiceal origins, is treated with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). However, tubing blockages during HIPEC treatment pose a common challenge, impeding the smooth progression of therapy. Few studies to date have explored the incidence and risk factors of tube occlusion during HIPEC in patients with appendiceal PMP, as well as its adverse impact on postoperative complications. METHODS From October 2017 to June 2023, a total of 80 patients with appendiceal PMP undergoing combined CRS and HIPEC were included in this study. Tubing blockage events were strictly defined, with patients experiencing blockages during HIPEC treatment allocated to the study group, while those with unobstructed perfusion were assigned to the control group. A comparative analysis was conducted between the two groups regarding post-HIPEC health assessments and occurrence of complications. Risk factors for luminal occlusion during closed HIPEC procedures were identified through univariate and multivariate analysis of data from 303 HIPEC treatments. RESULTS Tubing blockages occurred in 41 patients (51.3%). The study group experienced prolonged gastrointestinal decompression time (4.1 ± 3.0 vs. 2.5 ± 1.7 days, P = 0.003) and prolonged time to bowel movement (6.1 ± 2.3 vs. 5.1 ± 1.8 days, P = 0.022) compared to the control group. There was no significant difference in the incidence of complications between the two groups. The 1-year survival rate postoperatively was 97%, and the 3-year survival rate was 81%, with no association found between tubing blockage and poorer survival. Additionally, In 303 instances of HIPEC treatment among these 80 patients, tube occlusion occurred in 89 cases (89/303, 29.4%). Multivariable logistic regression analysis revealed age, diabetes, hypertension, and pathology as independent risk factors for tube occlusion. CONCLUSION Tubing blockages are a common occurrence during HIPEC treatment, leading to prolonged postoperative gastrointestinal functional recovery time. When patients are elderly and have concomitant hypertension and diabetes, along with a histological type of low-grade mucinous tumor, the risk of tube occlusion increases. However, this study did not find a significant correlation between tubing blockage and the incidence of postoperative complications or overall patient survival.
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Affiliation(s)
- Qi Liu
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
- Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jie Jiao
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, China
- Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Chengzhen Li
- Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yunxiang Chen
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Baoxuan Wang
- Shandong First Medical University, Jinan, China
- Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jingbo Shi
- Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Guanying Yu
- Department of Gastrointestinal Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, China.
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