Journal of Gastrointestinal Surgery

Our medical research library holds 9 studies published in Journal of Gastrointestinal Surgery (2009–2022). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 7 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it.

About the journal

• Publisher: Elsevier B.V
• Published: 1997 to the present, Netherlands
• Language: English
• ISSN: 1091-255X (print), 1873-4626 (electronic)
• Its record in the NLM Catalog

2020s

• Survival Outcomes for Malignant Peritoneal Mesothelioma at Academic Versus Community Hospitals. V.M. Welten, A.C. Fields, R.A. Malizia, et al. 2022;26(1):161-170. PubMed · Publisher

  Abstract

  Background: Malignant peritoneal mesothelioma is a rare disease with poor outcomes. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is the cornerstone of therapy. We aim to compare outcomes of malignant peritoneal mesothelioma treated at academic versus community hospitals.

  Methods: This was a retrospective cohort study using the National Cancer Database to identify patients with malignant peritoneal mesothelioma from 2004 to 2016. Patients were divided according to treating facility type: academic or community. Outcomes were assessed using log-rank tests, Cox proportional-hazard modeling, and Kaplan-Meier survival statistics.

  Results: In total, 2682 patients with malignant peritoneal mesothelioma were identified. A total of 1272 (47.4%) were treated at an academic facility and 1410 (52.6%) were treated at a community facility. Five hundred forty-six (42.9%) of patients at academic facilities underwent debulking or radical surgery compared to 286 (20.2%) at community facilities. Three hundred sixty-six (28.8%) of patients at academic facilities received chemotherapy on the same day as surgery compared to 147 (10.4%) of patients at community facilities. Unadjusted 5-year survival was 29.7% (95% CI 26.7-32.7) for academic centers compared to 18.3% (95% CI 16.0-20.7) for community centers. In multivariable analysis, community facility was an independent predictor of increased risk of death (HR: 1.19, 95% CI 1.08-1.32, p = 0.001).

  Conclusions: We demonstrate better survival outcomes for malignant peritoneal mesothelioma treated at academic compared to community facilities. Patients at academic centers underwent surgery and received chemotherapy on the same day as surgery more frequently than those at community centers, suggesting that malignant peritoneal mesothelioma patients may be better served at experienced academic centers.

  © 2021. The Society for Surgery of the Alimentary Tract.

• The Role of Hyperthermic Intraperitoneal Chemotherapy for Non-colorectal Peritoneal Surface Malignancies. M.C. Morris, J.M. Cloyd, J. Hays, et al. 2021;25(1):303-318. Review PubMed · Publisher

  Abstract

  Background: Peritoneal carcinomatosis, from a variety of gastrointestinal and gynecological malignancies, has been historically challenging to treat and there remains a wide range of biologic aggressiveness in these patients. Malignancies commonly associated with PC include those of colorectal, appendiceal, gastric, ovarian, sarcoma, small intestinal, and primary peritoneal origin among others. Advances in our understanding of this unique disease process have led to significant interest in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) as an emerging treatment option. The goal of CRS-HIPEC is to remove all visible macroscopic disease while preserving organ function, and then treat microscopic disease through perfusion of the peritoneal cavity with heated chemotherapy.

  Purpose: Although recent reviews have focused on the management of peritoneal carcinomatosis secondary to colorectal cancer given the publication of several recent randomized controlled trials, the purpose of the current review is to summarize the evidence on CRS-HIPEC for non-colorectal peritoneal surface malignancies, including appendiceal neoplasms, malignant peritoneal mesothelioma, gastric cancer, and ovarian cancer.

  Results: While retrospective studies have clarified the importance of prognostic factors such as the peritoneal carcinomatosis index, completeness of cytoreduction, histopathological characteristics, and lymph node positivity, the lack of convincing level 1 evidence for the use of CRS-HIPEC has led to it remaining a highly controversial topic.

  Conclusion: The decision to utilize CRS-HIPEC should involve a multidisciplinary team approach and evaluation of prognostic factors to balance the short-term morbidity of the operation with maximum long-term benefits. Large, multi-institutional groups and ongoing trials hold promise for clarifying the role of CRS-HIPEC in peritoneal surface malignancies.

2010s

• Primary Sarcomatoid Malignant Mesothelioma of the Pancreas. Y. Zhao, Z. Li, C. Wang. 2019;23(7):1518-1520. PubMed · Publisher · Free full text

• Tumor Symbiosis: Gastrointestinal Stromal Tumor as a Host for Primary Peritoneal Mesothelioma. J. de la Torre, S. Banerjee, J. Baumgartner, et al. 2019;23(4):879-881. PubMed · Publisher · Free full text

• Extragastrointestinal Stromal Tumor Presenting as Omental Cyst. A. Monabati, M. Safavi, F. Solhjoo. 2016;20(6):1275-7. Case report PubMed · Publisher

  Abstract

  Introduction: Extragastrointestinal stromal tumors (EGIST) are rarer counterparts of gastrointestinal stromal tumors (GIST) in omentum, mesentery, and retroperitoneum.

  Case Report: Hereby, authors present a 47-year-old man with abdominal mass whose abdominal CT scan revealed a large septated cystic mass measuring 16 cm in largest diameter. The mass was aspirated and resected by laparotomy. Pathologic examination exhibited a mesenchymal spindle cell neoplasm which was immunohistochemically reactive for CD117 and SMA. Thus, the diagnosis of extragastrointestinal stromal tumor was made.

  Discussion: A cystic EGIST in omentum falls in the differential diagnoses of omental cystic lesions which include omental cyst, mesenteric teratoma, cystic mesothelioma, cystic spindle cell tumors, pseudomyxoma peritonei, pancreatic pseudocyst, and complicated ascites. Therefore, proper diagnosis of cystic GIST is of great importance in respect to different behavior, management, and complications in comparison to its mimickers and GI counterparts.

• Predictive factors analysis for malignant peritoneal mesothelioma. S. Jin, S. Cao, J. Cao, et al. 2015;19(2):319-26. PubMed · Publisher

  Abstract

  Background: Malignant peritoneal mesothelioma (MPM) is an uncommon disease with a dismal prognosis and unclear natural history. The present study aims to assess potential prognostic factors and management of MPM.

  Methods: Clinical records of 39 patients with MPM between December 2003 and April 2014 were retrospectively reviewed. Overall survival was identified with Kaplan-Meier curves and Cox regression analysis.

  Results: Mean age of 39 patients was 55.0 years; asbestos exposure was recorded in two patients. Main presentations were abdominal distension, abdominal pain, and weight loss. Thrombocytosis, low serum albumin level, and anemia were principal laboratory abnormalities. Ascites, peritoneal cavity mass, and peritoneum thickening were the main signs on CT scans. Cytoreductive surgery (CRS) plus adjuvant therapies were performed in 22 patients, single chemotherapy in 13, and best supportive care in 4. Median survival time was 10.0 months after pathological diagnosis, with a 6-, 12-, 18-, and 24-month survival rate of 84.4, 31.6, 18.5, and 15.8 %, respectively. Significant prognostic factors were age, performance status (PS), abdominal pain, serum albumin level, thrombocytosis, and treatment strategy on univariate analysis, while only age, abdominal pain, and treatment strategy hold statistical significance on multivariate analysis.

  Conclusions: Age ≤65 years, abdominal pain, and CRS plus adjuvant therapy are independent positive prognostic factors of MPM.

• An analysis of the utility of handheld PET probes for the intraoperative localization of malignant tissue. S.J. González, L. González, J. Wong, et al. 2011;15(2):358-66. PubMed · Publisher · Free full text

  Abstract

  Introduction: The intraoperative localization of suspicious lesions detected by positron emission tomography (PET) scan remains a challenge. To solve this, two novel probes have been created to accurately detect the (18)F-FDG radiotracer intraoperatively.

  Methods: Nude rats were inoculated with mesothelioma. When PET scans detected 10-mm tumors, animals were dissected and the PET probes analyzed the intraoperative radiotracer uptake of these lesions as tumor to background ratio (TBR).

  Results: The 17 suspicious lesions seen on PET scan were localized intraoperatively (by their high TBR) using the PET probes and found malignant on pathology. Interestingly, smaller tumors not visualized on PET scan were detected intraoperatively by their high TBR and found malignant on pathology. Furthermore, using a TBR threshold as low as 2.0, both gamma (sensitivity, 100%; specificity, 80%; positive predictive value (PPV), 96%; and negative predictive value (NPV), 100%) and beta (sensitivity, 100%; specificity, 60%; PPV, 93%; and NPV, 100%) probes reliably detected suspicious lesions on PET scan imaging. They also showed an excellent area under the curve of 0.9 and 0.97 (95% CI of 0.81-0.99 and 0.93-1.0) for gamma and beta probes, respectively, in the receiver operating characteristic analysis for detecting malignancy.

  Conclusion: This novel tool could be used synergistically with a PET scan imaging to maximize tissue selection intraoperatively.

• Primary omental mesothelioma: a rare but important differential diagnosis in previous asbestos exposure. A. Harb, E. King, H. Lloyd, et al. 2010;14(2):423-5. Case report PubMed · Publisher

  Abstract

  Primary omental mesothelioma is a malignant tumour of the mesothelial cells of the omentum, related to asbestos exposure. It is an extremely rare condition that presents both diagnostic and therapeutic challenges. We present a review of the related literature and report on a fatal case of primary omental mesothelioma in a 70 year old man, presenting with a painful abdominal mass. Radiological imaging was not diagnostic but useful in excluding other pathologies. Diagnosis relied on specific immunohistochemical analysis. The difficulty in diagnosis and management and the advanced stage of disease meant that prognosis was very poor. Our patient died within 3 weeks of diagnosis.

2000s

• Assessment of "gene-environment" interaction in cases of familial and sporadic pancreatic cancer. T.P. Yeo, R.H. Hruban, J. Brody, et al. 2009;13(8):1487-94. PubMed · Publisher

  Abstract

  Introduction: Pancreatic cancer (PC) is the fourth leading cause of cancer death in the United States. This study characterizes one of the largest national registries of familial PC (FPC) and sporadic PC (SPC), focusing on demographics, clinical factors, self-reported environmental and occupational lifetime exposures, and survival status.

  Background: Reported risk factors for PC include advancing age, a family history of PC, high-risk inherited syndromes, cigarette, cigar, and pipe smoking, exposure to occupational and environmental carcinogens, African-American race, high fat/high cholesterol diet, obesity, chronic pancreatitis, and diabetes mellitus.

  Patients And Methods: This retrospective cross-sectional, case-only analysis includes cases of FPC (n = 569) and SPC (n = 689) from the Johns Hopkins National Familial Pancreas Tumor Registry (NFPTR) enrolled between 1994 and 2005.

  Results: FPC smokers with environmental tobacco smoke (ETS) exposure were diagnosed at a significantly younger mean age (63.7 years) as compared to FPC non-smokers without ETS exposure (66.6 years; p = 0.05). Non-smoker ETS-exposed cases were diagnosed with PC at a significantly younger mean age (64.0 years) compared to non-smoker non-ETS-exposed cases (66.5 years) (p < 0.0004). The mean age at diagnosis for Ashkenazi Jewish SPC subjects was significantly younger (by 2.1 years) than Ashkenazi Jewish FPC cases (p = 0.05). In addition, Ashkenazi Jewish FPC subjects who smoked were diagnosed 5.9 years earlier than Ashkenazi Jewish FPC non-smokers (p = 0.05). The median length of survival for unresected FPC cases was significantly shorter (168 days) as compared to unresected SPC cases (200 days) (p = 0.04). Survival was improved in resected cases, 713 days for FPC cases and 727 days for SPC cases, but was not significantly different between the groups (p = 0.4). Mild to moderate multiplicative interaction was found between a family history of PC and exposure to asbestos, environmental radon, and environmental tobacco smoke (ETS), as evidenced by odds ratios >1.0.

  Conclusions: These are the first data to show that occupational and environmental exposures may act synergistically with inherited or acquired genetic polymorphisms, resulting in earlier occurrence of PC. Exposure to cigarette smoking and ETS exposure in non-smokers when younger than 21 years of age are associated with a younger mean age of diagnosis in FPC and SPC cases and Ashkenazi Jewish smokers, when compared to non-exposed cases. Risk prediction models which take into account environmental exposures as well as family history may more accurately predict the risk of PC. High-risk individuals will likely benefit from early identification of pre-malignant lesions and molecular profiling, as methods of early detection, prevention, and personalized therapy.

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