Total neoadjuvant therapy (TNT) has been proposed as an advancement over standard long-course chemoradiotherapy (LCCRT) for the treatment of locally advanced rectal cancer (LARC). It has been suggested that TNT enhances resectability, improves treatment compliance, increases the rate of pathological complete response, and reduces the risk of systemic recurrence. However, concerns have been raised that the prolonged interval to surgery associated with TNT, particularly in regimens such as the Rectal Cancer and Preoperative Induction Therapy Followed by Dedicated Operation (RAPIDO) protocol, may exacerbate fibrosis, leading to more technically challenging resections and poorer surgical outcomes.

Patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer, which may ultimately result in peritoneal metastases (PM). PM in patients with IBD is by nature difficult to treat due to the chronic inflammation and immunosuppression inherent in IBD. This minireview compiled existing evidence on management approaches to PM in patients with IBD, including surgical procedures, systemic treatment, and novel therapies. A literature review was conducted by searching PubMed and Scopus through June 2025 for studies addressing PM in IBD-associated colorectal or small bowel cancer. Literature specific to PM in IBD is sparse, comprising primarily two small retrospective cohort series comparing outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with and without IBD. These studies indicated that in high-volume centers with careful preoperative optimization perioperative morbidity and mortality rates for patients with IBD undergoing CRS/HIPEC were similar to those without IBD. However, median overall survival (approximately 19.6-24.0 months) and disease-free survival were consistently shorter and rates of early peritoneal recurrence were higher in patients with IBD. Although CRS/HIPEC can be performed safely in selected patients with IBD and PM, long-term oncologic outcomes appear inferior compared to populations without IBD, likely reflecting later-stage presentation, distinct tumor biology, and IBD-related factors.

The proliferative index of Ki-67 in pancreatic ductal adenocarcinoma (PDAC) exhibits strong correlations with tumor progression and prognosis, holding significant clinical implications. Yang employed contrast-enhanced ultrasound (CEUS) to indirectly evaluate neovascularization in pancreatic cancer lesions. Specific CEUS parameters demonstrated significant diagnostic value in assessing Ki-67 expression. The falling slope 50% achieved an area under the curve of 0.838. Meanwhile, the rise slope 10%-90% exhibited superior overall diagnostic accuracy (area under the curve = 0.863), showing a sensitivity of 0.92 and a moderate specificity of 0.759. These values demonstrate specificity in differentiating between low and high Ki-67 expression groups. This study effectively addresses the critical need for a non-invasive assessment of pancreatic cancer aggressiveness Ki-67 expression. These findings strongly support the translational potential of CEUS biomarkers for non-invasive Ki-67 assessment and treatment stratification in PDAC. While Yang demonstrated exhibited encouraging methodologies, its retrospective design, modest sample size, and single-center nature may impede generalizability, pending validation in multi-institutional cohorts. We recommend expanding the sample size to enhance representativeness and adopting prospective studies integrating multimodal imaging techniques, such as magnetic resonance imaging and positron emission tomography to improve diagnostic reliability. This study is the first to integrate insights from CEUS, magnetic resonance imaging, and positron emission tomography for Ki-67 expression assessment in PDAC. Building on this innovation, we focus this article on recent advances in the clinical diagnosis of pancreatic cancer, aiming to provide insights for advancing research in this field.

Liver metastases are very common in pancreatic neuroendocrine tumors (pNETs). When surgical resection is possible, it is typically associated with survival benefits in patients with pNET and liver metastases. Patient-derived organoids are a powerful preclinical platform that show great potential for predicting treatment response, and they have been increasingly applied in precision medicine and cancer research.

Pancreatic ductal adenocarcinoma (PDAC) is the most prevalent type of pancreatic neoplasm. It is a highly aggressive lethal malignancy related to its delayed in diagnosis and limited response to treatments. The incidence and mortality of pancreatic cancer have been increasing over the years. Tumor budding is a proven independent, adverse prognostic factor in PDAC. It is helpful for improvement of prognosis in PDAC in early and precise diagnostic modalities. Tumor budding should be conveyed in pathology reports and taken into account by future oncologic staging systems.

Gastric cancer (GC) remains one of the leading causes of cancer-related morbidity and mortality globally. Although significant progress has been made in treatment options, the survival rates for GC patients continue to be low. This is primarily attributed to the intricate and insufficiently understood mechanisms of disease progression, as well as the considerable challenges associated with tumor heterogeneity. The recent study by Tang provides a detailed single-cell RNA sequencing analysis of GC across different stages, revealing dynamic changes in the tumor microenvironment and key immune responses. We aim to offer a comprehensive interpretation of the study's findings and propose several innovative directions for future academic research in gastric cancer. These include exploring advanced multi-omics approaches, leveraging spatial transcriptomics, integrating artificial intelligence for clinical applications, and developing novel immunotherapy strategies. We further emphasize the importance of personalized medicine, early detection, and novel drug discovery techniques in improving GC treatment outcomes.

Early esophageal neuroendocrine carcinoma (E-NEC) is a rare but aggressive malignancy with poorly understood endoscopic features. Despite advancements in multi-model endoscopy, including white light endoscopy, magnifying endoscopy narrow-band imaging (NBI), and endoscopic ultrasonography (EUS), the diagnostic characteristics of early E-NEC remain unclear. Comprehensive evaluation using these techniques can improve early detection and guide clinical management. This study aimed to investigate the endoscopic features of early E-NEC using multiple imaging modalities. We hypothesized that specific endoscopic patterns, such as irregular microvascular morphology or signs of submucosal invasion, could reliably distinguish early E-NEC from other esophageal lesions.

Gastrointestinal stromal tumors (GISTs) are generally characterized by driver mutations in or . However, the molecular landscape of wild-type GISTs remains complex, posing significant therapeutic challenges. Recent evidence has indicated alterations in as potential oncogenic drivers in patients with various cancers. However, the role of these drivers in GIST pathogenesis remains underexplored.

Colorectal cancer (CRC) is one of the most common cancers worldwide. The gold standard screening methods for early detection and monitoring are colonoscopy and stool-based tests. However, innovative and minimally invasive biomarkers need to be integrated into clinical practice.

Chemotherapy is an essential treatment for colorectal cancer (CRC) patients after surgery, but many patients do not benefit from chemotherapy because tumour heterogeneity results in varied responses.

Colorectal cancer (CRC) is a prevalent gastrointestinal malignancy with a typically unfavorable prognosis following the onset of liver metastases.

Pancreatic cancer tissues mainly consist of fibrotic and dense stroma, which limits their therapeutic efficacy. The stromal fibroblasts of pancreatic tumors frequently express the secreted protein acidic and rich in cysteine (SPARC).

Transcatheter arterial chemoembolization (TACE) combined with lenvatinib is an important modality for the treatment of unresectable hepatocellular carcinoma (HCC). To date, no prognostic analysis exists for clinical predictive models of TACE combined with lenvatinib in treating advanced unresectable HCC. A model was constructed through meta-analysis, and its validation was further enhanced by the collection of external clinical data, thereby providing guidance for clinical practice.

Colorectal cancer (CRC) is increasingly recognized as a multifactorial disease influenced by hereditary, environmental, and microbial factors. This article explores recent insights into the role of gut microbiota dysbiosis in CRC pathogenesis and progression. Key differences in microbial composition, characterized by enrichment of pro-carcinogenic species such as and and depletion of beneficial commensals like have been identified alongside changes in microbial metabolites such as short-chain fatty acids and secondary bile acids. We discuss immune system modulation by the microbiota, formation of bacterial biofilms, and the activation of host pathways such as the urea cycle during tumorigenesis. Special attention is given to therapeutic innovations, including microbiota-informed precision modelling, synthetic biology-based engineered probiotics, and evolving alternatives to fecal microbiota transplantation. These integrative strategies represent promising tools in the era of personalized oncology for CRC.

Early metastasis and recurrence are risk factors that negatively affect the prognosis of advanced hepatocellular carcinoma (HCC). Alpha fetoprotein (AFP) is currently the most prevalent serum biomarker for detecting HCC and predicting tumor recurrence. However, its sensitivity and specificity are not sufficient, especially in patients who are AFP negative.

Liver cancer poses a significant public health threat. The difference between disease patterns and national policies is crucial to elucidating factors influencing hepatocellular carcinoma (HCC) incidence.

Hepatocellular carcinoma (HCC) remains one of the commonest cancers worldwide with an overall poor prognosis and survival rates. The rising incidence of liver disease, in particular non-alcoholic fatty liver disease, will account for a continued increase in the rates of liver cancer. The recurrence of HCC has been reported across the different etiologies of liver disease. Unlike primary HCC, there is no agreed consensus or guidance as to the optimum management of recurrent HCC (RHCC). Furthermore, the management of RHCC may prove more challenging compared to primary liver cancer, given the smaller residual liver volume and functions in settings following surgery or transplantation. Various modalities exist for the treatment of primary HCC including resection, liver transplantation, loco-regional and systemic therapies. Nevertheless, the role of such modalities remains unclear in the management of RHCC. In this article, we aim to review the different approaches of the current standards for the management of RHCC. We will also shed some light on the future perspectives in this field.

Colorectal cancer (CRC) is the second leading cause of cancer-related death, largely due to limited treatment options in advanced stages. Genomic alterations in advanced CRC (aCRC) are complex and not fully characterized, with only 30% of patients benefiting from targeted therapies.

Colorectal cancer (CRC) is one of the most common causes of cancer mortality worldwide. The transcription factor Myc-associated zinc finger protein (MAZ) has been implicated in cancer progression. However, its precise function and mechanisms in CRC remain unclear.

The early diagnosis rate of pancreatic ductal adenocarcinoma (PDAC) is low and the prognosis is poor. It is important to develop an interpretable noninvasive early diagnostic model in clinical practice.

Gastric cancer is one of the most common malignant tumors of the digestive system globally, with a generally poor prognosis for patients with advanced disease. In recent years, immune checkpoint inhibitors have made significant advancements in gastric cancer treatment, with some HER-2 negative advanced gastric cancer patients benefiting from the combination of immunotherapy and chemotherapy. However, significant biological heterogeneity exists among patients, resulting in a lack of effective tools to predict the benefits of immunotherapy and survival outcomes. Therefore, there is an urgent need to develop a scientific and precise survival prediction model to provide robust support for personalized treatment decisions.