Endoscopic applications related to EGC, found within the Clarivate (Philadelphia, PA, USA) Web of Science Core Collection (WoSCC) database, were collected from 2012 to 2022. The collaboration network, co-citation, co-occurrence, cluster, and burst detection analyses were substantially carried out using CiteSpace (version 61.R3) and VOSviewer (version 16.18).
A comprehensive collection, totaling one thousand three hundred thirty-three publications, was used in the study. Consistent with annual patterns, the count of publications and the average citations per document per year each increased throughout the years. In the 52 nations and regions analyzed, Japan demonstrated the greatest output in publications, citations, and H-index, closely followed by South Korea and China. The National Cancer Center, an institution encompassing both Japan and the Republic of Korea, topped the rankings of all other institutions based on the total number of publications, the influence of citations, and the average number of citations received per publication. Lee Yong Chan's output as an author was the most substantial, while Ichiro Oda's publications achieved the most notable citation impact. Gotoda Takuji's cited authors held not only the highest citation impact but also the strongest centrality. Amongst publications, specifically journals,
The most prolific author, by measure of publications, was
This entity's citation impact and H-index were unparalleled in their magnitude. In the compilation of publications and referenced materials, a paper by Smyth E C et al. demonstrated significant citation impact, superseded only by the subsequent paper by Gotoda T et al. Using co-occurrence analysis and cluster analysis, we organized 1652 author keywords into 26 clusters, which were then segmented into six distinct groups. Artificial intelligence (AI) took the title of largest cluster, and endoscopic submucosal dissection, the title of newest.
Endoscopic applications' contribution to EGC research has incrementally strengthened throughout the last ten years. The Republic of Korea and Japan have made the most significant contributions in this field, nevertheless, Chinese research, developing from a low base, has witnessed impressive acceleration. Unfortunately, a paucity of cooperation amongst countries, institutions, and authors is frequently observed, and this deficiency should be rectified in the future. The most prominent research within this field centers around endoscopic submucosal dissection, while the leading-edge topic is undoubtedly the application of artificial intelligence. Future investigations into the application of artificial intelligence in endoscopy should delve into its ramifications for the clinical diagnosis and treatment of EGC.
Within the past ten years, there has been a gradual rise in endoscopic research focused on EGC applications. While Japan and South Korea have made the most significant contributions, research in this field within China is experiencing remarkable growth, despite a comparatively modest initial foundation. Although cooperation between countries, institutions, and the authors is essential, a lack of it remains a prevalent problem, and this lack should be addressed in subsequent projects. The primary focus of research, which comprises the largest cluster of studies, is endoscopic submucosal dissection, while AI occupies the newest and most advanced frontier. Future investigations into the application of artificial intelligence in endoscopic procedures should scrutinize its potential impact on the clinical diagnosis and treatment of esophageal cancer.
Immunotherapy, specifically programmed cell death-1 (PD-1) inhibitors, combined with chemotherapy, demonstrates a clear superiority to chemotherapy alone in the neoadjuvant treatment of previously untreated, unresectable advanced, or metastatic esophageal adenocarcinoma (EAC)/gastric/gastroesophageal junction adenocarcinoma (GEA). Yet, the conclusions drawn from the latest studies have shown a divergence of perspectives. To evaluate the combined efficacy and safety of PD-1 inhibitors and chemotherapy in neoadjuvant settings, this article employs a meta-analysis.
We systematically reviewed the literature and clinical randomized controlled trials (RCTs) by February 2022. This involved searches of databases such as Embase, Cochrane, PubMed, and ClinicalTrials.gov using Medical Subject Headings (MeSH) and keywords like esophageal adenocarcinoma or immunotherapy. Websites, the digital highways of the internet, provide pathways for connecting with others and accessing a wide range of information and services. Two authors independently selected studies, extracted data, and assessed risk of bias and quality of evidence, all within the framework of standardized Cochrane Methods procedures. To evaluate the efficacy, the primary outcomes of one-year overall survival (OS) and one-year progression-free survival (PFS) were assessed. A 95% confidence interval (CI) was determined for the combined odds ratio (OR) and hazard ratio (HR). The secondary outcomes of disease objective response rate (DORR) and adverse event incidence were calculated using odds ratios (OR).
This meta-analysis scrutinized four randomized controlled trials including a total of 3013 patients with gastrointestinal cancer, comparing the efficacy of immunotherapy plus chemotherapy to chemotherapy alone. For patients with advanced, unresectable, and metastatic EAC/GEA, combining immune checkpoint inhibitors with chemotherapy resulted in a notable decrease in the risk of progression-free survival (HR = 0.76 [95% CI 0.70-0.83]; p < 0.0001), overall survival (HR = 0.81 [95% CI 0.74-0.89]; p < 0.0001), and an increased disease-oriented response rate (RR = 1.31 [95% CI 1.19-1.44]; p < 0.00001) as compared to chemotherapy alone. Immunotherapy in conjunction with chemotherapy was linked to a greater frequency of adverse reactions, including elevated alanine aminotransferase (OR = 155 [95% CI 117-207]; p = 0.003) and palmar-plantar erythrodysesthesia (PPE) syndrome (OR = 130 [95% CI 105-163]; p = 0.002). learn more A significant association was found between nausea (OR = 124 [95% CI 107-144]; p = 0.0005) and decreased white blood cell count (OR = 140 [95% CI 113-173]; p = 0.0002), and other potential factors. Immune changes Happily, the manifestation of toxic effects remained confined to acceptable limits. Patients with a combined positive score (CPS) of 1 who received immunotherapy in addition to chemotherapy experienced a higher rate of overall survival compared to those who received chemotherapy alone (hazard ratio = 0.81, 95% confidence interval = 0.73 to 0.90, p = 0.00001).
Immunotherapy, when combined with chemotherapy, demonstrates a substantial benefit for patients with previously untreated, unresectable, advanced, or metastatic EAC/GEA, in contrast to chemotherapy alone. Adverse reactions are a potential concern when combining immunotherapy and chemotherapy, and further studies on therapeutic approaches for advanced, unresectable, or metastatic EAC/GEA cases, where no current treatment is available, are necessary.
On the website of the York Centre for Reviews and Dissemination, www.crd.york.ac.uk, the identifier CRD42022319434 is documented.
CRD42022319434, the identifier, is present on the website www.crd.york.ac.uk, managed by the York Centre for Reviews and Dissemination.
The execution of a 4L lymph node dissection (LND) procedure continues to provoke considerable debate and discussion among experts. Past studies have demonstrated the prevalence of station 4L metastasis, and the potential for improved survival when performing 4L lymph node dissection. Analyzing the histological aspects of 4L LND was critical in comprehending the clinicopathological features and survival outcomes of this study population.
From January 2008 to October 2020, this retrospective study involved 74 cases of squamous cell carcinoma (SCC) and 84 cases of lung adenocarcinoma (ADC). Pulmonary resection, coupled with station 4L LND, was performed on all patients, and subsequent staging revealed a T1-4N0-2M0 classification. Histological analysis was used to examine clinicopathological characteristics and survival rates. The study's evaluation criteria encompassed disease-free survival (DFS) and overall survival (OS).
The overall incidence of station 4L metastasis was 171% (27 out of 158 patients) in the entire cohort; this manifested as 81% in the squamous cell carcinoma (SCC) group and 250% in the adenocarcinoma (ADC) group. No statistically significant differences emerged when comparing the 5-year DFS rates, recorded at 67%.
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The 0812 rate and the 5-year OS rate stand at 686%.
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Discrepancies in the results were observed when the ADC and SCC groups were contrasted. Histological analysis (specifically, squamous cell carcinoma) was found to be a significant predictor in a multivariate logistic model.
An alternative, ADC or 0185; a 95% confidence interval calculation yields 0049-0706.
The factor =0013 independently predicted the presence of 4L metastasis. Analysis of survival, using a multivariate approach, indicated that the existence of 4L metastasis was an independent predictor of DFS (hazard ratio, 2.563; 95% confidence interval, 1.282-5.123).
In OS cases, the hazard ratio (HR) did not exhibit a significant change (HR, 1.597; 95% CI, 0.749-3.402).
=0225).
Station 4L metastasis is observed relatively often in individuals with left lung cancer. Patients with ADC have a heightened likelihood of experiencing metastasis at the 4L location, suggesting potential gains from undergoing 4L lymph node dissection.
Instances of station 4L metastasis are not exceptional in cases of left lung cancer. Acute care medicine Station 4L metastasis is frequently linked with ADC, leading to the possibility of greater effectiveness with 4L LND for these patients.
Immune suppressive cellular responses, especially in metastatic tumors, are strongly linked to cancer progression, metastasis, tumor immune evasion, and drug resistance. Within the tumor microenvironment (TME), myeloid cells significantly impact adaptive and innate immune responses, ultimately hindering tumor control. Subsequently, strategies to eradicate or modify the myeloid cellular constituents of the tumor microenvironment have a growing appeal for non-specifically boosting anti-tumoral immunity and enhancing the efficacy of existing immunotherapeutic regimens.