Clinical Features and Etiology of Patients Having Advanced Stage Hepatocellular Carcinoma on Initial Presentation

Advanced-Stage Presentation of Gastric Cancer in India: Clinical, Endoscopic, and Socioeconomic Determinants

Background and Objectives Gastric cancer remains a major cause of cancer-related mortality in India because of advanced-stage presentation at diagnosis. Data on socioeconomic status, diagnostic delays, and endoscopic factors contributing to late stage disease remain limited. We aimed to characterize the clinicodemographic, endoscopic, and pathological profile of patients with newly diagnosed gastric cancer and identify factors associated with advanced-stage disease. Materials and Methods In this cross-sectional study, adults with newly diagnosed gastric adenocarcinoma presenting to a tertiary care center in South India between February 2023 and January 2024 were enrolled. Demographic, socioeconomic, clinical, endoscopic, pathological, and staging data were collected using a structured pro forma. Statistical Analysis Factors associated with advanced-stage disease were evaluated using univariate analysis and multivariable logistic regression. A two-sided p -value of < 0.05 was considered statistically significant. Results A total of 110 patients were recruited (mean age 53.7 ± 14 years; 70.9% male), of whom 74.5% belonged to the lower socioeconomic group. The median symptom duration prior to diagnosis was 3 months (interquartile range 2–4). Abdominal pain (46.4%) and vomiting (21.8%) were the most common presenting symptoms. A positive family history of gastric cancer in first-degree relatives was present in 12.7% of patients. Advanced-stage disease was observed in 81.8% of patients, with peritoneal metastasis being the most common metastatic site (32.7%). Post-endoscopy gastric cancer (PEGC) was identified in 6.4% of patients. On multivariable analysis, lower socioeconomic status was independently associated with advanced-stage disease, whereas PEGC was independently associated with early-stage disease. Conclusion Advanced-stage presentation remains common in gastric cancer. Lower socioeconomic status was independently associated with advanced-stage disease, while PEGC was associated with earlier-stage disease.

Chronic liver disease is associated with earlier-stage cholangiocarcinoma diagnosis and improved prognosis: Findings from the GLOBAL-BTC registry.

BACKGROUND AND AIMS Cholangiocarcinoma (CCA) is an aggressive cancer with rising incidence and mortality worldwide. Chronic liver disease (CLD) is a well-recognized risk factor, but its influence on tumor presentation and clinical outcomes remains unclear. We aimed to compare the clinical course of CCA in patients with and without CLD. METHODS We retrospectively analyzed 3,743 patients diagnosed with CCA between 2010 and 2024 across international centers. CLD was defined by documented primary sclerosing cholangitis, cirrhosis, viral hepatitis, or other chronic liver disorders; remaining patients were classified as non-CLD. Demographic, clinical, biochemical, treatment, and survival features were compared. RESULTS Among the CCA cohort, 993 patients had CLD. Compared with non-CLD patients (n=2,750), those with CLD were more frequently male (67% vs. 53%) and younger (median age 63 vs. 66 years). CLD-CCA patients more often presented with intrahepatic tumors (64% vs. 42%), better performance status (ECOG 0: 53% vs. 35%), lower CA19.9 levels (56 vs. 135 U/mL), and earlier-stage disease (localized: 57% vs. 43%; metastatic: 23% vs. 31%). In propensity score-matched analyses, patients with prior CLD were diagnosed at earlier CCA stages than non-CLD controls. Consequently, curative-intent tumor surgery was performed more frequently in CLD patients (60% vs. 48%), resulting into longer median overall survival (mOS 12.2 vs. 11.1 months; HR 0.88, 95%CI 0.80-0.98) and higher 5-year survival (OR 1.70, 95%CI 1.37-2.11), particularly in intrahepatic CCA (mOS: 14.2 vs. 11.1 months; HR 0.77, 95%CI 0.68-0.87; 5-year survival OR 2.19, 95%CI 1.60-3.01). Treatment responses across modalities were comparable between groups. CONCLUSION Pre-existing CLD is associated with earlier-stage CCA diagnosis and improved survival, supporting the implementation of structured surveillance strategies in high-risk CLD populations. IMPACT AND IMPLICATIONS This international multicenter study show that pre-existing CLD is associated with earlier-stage CCA diagnosis, likely due to closer clinical surveillance, greater eligibility for curative-intent surgery, and improved survival. Treatment responses were similar regardless of CLD status. These findings support established surveillance in high-risk groups and highlight the need to optimize strategies for selected moderate-to-high risk CLD populations, alongside prospective evaluation of their clinical utility, cost-effectiveness, and potential refinement through more accurate non-invasive biomarkers.

The correlation between clinical and pathological features of renal cancer patients with survival after surgical intervention

Findings highlight the importance of considering clinical and pathological features in the management and prognosis of RCC patients and highlight the importance of considering clinical and pathological features in the management and prognosis of patients diagnosed with malignant renal tumors.

[Analysis of clinical and pathological characteristics and prognostic factors in patients with pancreatic neuroendocrine neoplasms].

Hepatocellular Carcinoma at a Center of Clinical Excellence in Colombia: A Real-World Cohort Study of Clinical Characteristics, Treatment Trajectories, and Survival

Purpose Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide. In middle-income settings, fragmentation of care may delay diagnosis and limit access to timely treatment. This study aimed to describe the sociodemographic and clinical characteristics, treatment patterns, and overall survival of patients with HCC managed at a Center of Clinical Excellence (CCE). Patients and Methods We conducted a retrospective descriptive cohort study of adults (≥18 years) with HCC managed at a CCE between September 2022 and December 2025. Baseline variables included etiology, comorbidities, Child–Pugh class, Model for End-Stage Liver Disease (MELD) score, Barcelona Clinic Liver Cancer (BCLC) stage, and alpha-fetoprotein (AFP) levels. Treatment strategies and clinical course, including stage migration, liver transplantation, and death, were described. Overall survival was estimated using the Kaplan–Meier method. Results A total of 134 patients were included. Median age was 67.93 years (IQR 63.12–72.59) and 61.19% were men. The most common underlying etiology was metabolic dysfunction-associated steatotic liver disease (MASLD) (34.38%). Most patients were diagnosed at early BCLC stages 0/A (64.18%; n = 86). Ablation and transarterial chemoembolization were the most frequently used treatments, and liver transplantation was performed in 9.70% of patients. After a median follow-up of 21 months, median overall survival was not reached; estimated survival was 93.8% at 1 year and 80.0% at 3 years. Conclusion In this retrospective cohort managed at a CCE, MASLD was the most frequent underlying etiology, and patients were diagnosed at early stages BCLC stages 0/A. Treatment patterns were dominated by locoregional therapies, and median overall survival was not reached during the available follow-up period. These findings provide real-world data on HCC care in a middle-income setting and highlight the clinical relevance of describing treatment trajectories and survival within structured multidisciplinary care programs.

[Single-center analysis of surgery and prognosis in 927 patients with hepatocellular carcinoma at CNLC stages Ⅰa to Ⅲa].