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Rama NJG, Sousa I. Bridging the gap: The role of technological advances in shaping gastrointestinal oncological outcomes. World J Gastrointest Oncol 2025; 17:101752. [PMID: 40092923 PMCID: PMC11866242 DOI: 10.4251/wjgo.v17.i3.101752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Revised: 11/13/2024] [Accepted: 12/16/2024] [Indexed: 02/14/2025] Open
Abstract
Gastrointestinal (GI) cancers are highly prevalent and considered a major global health challenge. Their approach has undergone a remarkable transformation over the past years due to the development of new technologies that enabled better outcomes regarding their diagnosis and management. These include artificial intelligence, robotics, next-generation sequencing and personalized medicine. Nonetheless, the integration of these advances into everyday clinical practice remains complex and challenging as we are still trying to figure out if these innovations tangibly improve oncological outcomes or if the current state of art should remain as the gold standard for the treatment of these patients. Additionally, there are also some issues regarding ethical subjects, data privacy, finances and governance. Precision surgery concept has evolved considerably over the past decades, especially for oncological patients. It aims to customize medical treatments and to operate on those patients who most likely will benefit from a specific surgical procedure. In the future, to improve GI oncological outcomes, a delicate balance between technological advances adoption and evidence-based care should be chased. As we move forward, the question will be to harness the power of innovation while keeping up the highest standards of patient care.
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Affiliation(s)
- Nuno J G Rama
- Division of Colorectal Surgical, Leiria Hospital Centre, Leiria 2410-021, Portugal
| | - Inês Sousa
- Department of Surgical, Leiria Hospital Centre, Leiria 2410-021, Portugal
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Ma S, Xia W, Wu B, Sun C, Jiang Y, Liu H, Lowe S, Zhou Z, Xie P, Gao J, Feng L, Guo X, Qu G, Sun Y. Effect of aspirin on incidence, recurrence, and mortality in prostate cancer patients: integrating evidence from randomized controlled trials and real-world studies. Eur J Clin Pharmacol 2023; 79:1475-1503. [PMID: 37648741 DOI: 10.1007/s00228-023-03556-7] [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] [Received: 06/15/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE Aspirin has been suggested to reduce the risk of cancer. However, previous studies have been inconsistent regarding the relationship between aspirin use and the risk of occurrence of prostate cancer (PCa). The purpose of this study was to assess the effect of aspirin on clinical outcomes in patients with PCa in a meta-analysis and to explore the possible dose-response relationship. METHODS A systematic literature search was conducted in 10 electronic databases and 4 registries. The combined relative risks (RRs) were calculated using a random-effects model with 95% confidence interval (CIs) to assess the effect of aspirin on the risk of PCa. Relevant subgroup analyses and sensitivity analyses were performed. RESULTS The across studies results show that aspirin use associated with lower incidence of PCa (RR: 0.96, 95% CI: 0.95-0.98), and reduced mortality (RR: 0.88, 95% CI: 0.82-0.95). The results of the subgroup analysis indicated that both cohort and population studies in the Americas showed a reduction in PCa incidence and mortality with aspirin use. A linear correlation was observed between dosage/duration of aspirin use and its protective effect. Additionally, post-diagnosis aspirin use was associated with decreased risk of PCa mortality. CONCLUSIONS This meta-analysis revealed an independent correlation between the use of aspirin and reductions in both the incidence and mortality rates of PCa. However, randomized controlled trials did not find any association between aspirin use and PCa. Furthermore, the impact of aspirin on PCa occurrence was found to be dependent on both dosage and duration.
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Affiliation(s)
- Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Weihang Xia
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Birong Wu
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chenyu Sun
- Department of General Surgery, the Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei, 230032, Anhui, China
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA
| | - Yuemeng Jiang
- Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University North District, No. 100 Huaihai Avenue, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO, 64106, USA
| | - Zhen Zhou
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia
| | - Peng Xie
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Juan Gao
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Linya Feng
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238000, Anhui, China.
- Center for Evidence-Based Practice, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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