This article highlights the role of meta-analysis as a statistical method for quantitatively summarizing existing research and reconciling conflicting findings. It discusses literature search methods for meta-analysis, the selection and interpretation of statistical models, and publication bias. Meta-analysis allows for the statistical consideration of homogeneity and heterogeneity among studies. Determining homogeneity and heterogeneity is crucial for selecting the appropriate meta-analysis model. Systematic reviews and meta-analyses provide a high level of evidence on treatment efficacy, especially when they include multicenter and multinational studies. In the case of well-researched disorders such as digestive cancer, meta-analysis can be useful in generalizing findings from existing papers, draw conclusions, and evaluate related medical technologies. Furthermore, these findings can be used to propose or enhance standards of care.

Even with the advances in chemotherapeutic procedures and agents, chemotherapy may cause certain side effects that impair patients’ quality of life. Cancer treatment can lead to various other side effects, such as xerostomia, mucositis, dental caries, opportunistic infections, hypogeusia, dysgeusia, hyposalivation, and medication-related osteonecrosis of the jaw. The oral cavity is a common site of discomfort and pain caused by chemotherapy. In this paper, I will discuss the dental considerations for patients undergoing chemotherapy and cover how to address dental problems and what to consider when consulting with dentists.

Endoscopic submucosal dissection (ESD) is a predominantly used technique for superficial esophageal cancer treatment. The primary advantages of esophageal ESD include its high en bloc resection rate and the precise pathological assessment it confers. This procedure enables local primary tumor resection while accurately assessing risk factors for lymph node metastasis, including tumor depth, vascular invasion, and invasion type. Esophageal ESD will play a crucial role in minimally invasive and effective esophageal cancer treatments. In this article we discuss esophageal ESD regarding its indications, treatment outcomes, techniques, potential complications, and follow-up guidelines to ensure its safe and effective application.

Post-colonoscopy colorectal cancer (PCCRC), classified as colorectal cancer (CRC) diagnosed following a negative colonoscopy and prior to the recommended follow-up; despite advancements in the quality of colonoscopy, remains a significant concern. PCCRC accounts for 1.8 to 9.0% of CRC cases globally and 6.2% CRC cases in Korea. The predominant reasons for the incidence of PCCRC include procedural factors such as missed lesions and incomplete resections, and newly developed lesions. Few strategies that can mitigate PCCRC include improving adenoma detection rates to at least 25 to 35%, ensuring withdrawal times of ≥ 8 minutes, adequate bowel preparation, and cecal intubation rates exceeding 90 to 95%. For preventing PCCRC, advanced imaging technologies and enhanced polypectomy techniques, such as en bloc resection for larger or potentially malignant polyps are critical. This review highlights the multifactorial nature of PCCRC and the significance of quality assurance in colonoscopy for reducing its prevalence.

Robotic gastrectomy is a promising alternative to laparoscopic surgery for gastric cancer. This review examines the indications and the short-term surgical and long-term oncologic results of robotic gastrectomy. The indications for robotic gastrectomy have evolved in parallel to those for laparoscopic gastrectomy, with D1+ lymphadenectomy performed for early gastric cancer and D2 lymphadenectomy reserved for advanced gastric cancer. Regarding short-term outcomes, robotic gastrectomy is associated with less intraoperative blood loss, and longer operation times, compared with laparoscopic gastrectomy. Mortality and overall complication rates are similar between the two approaches, although robotic gastrectomy has been associated with lower rates of severe complications requiring surgical intervention or intensive care unit admission as well as infectious complications, such as anastomotic leakage, pancreatic fistula, and intraabdominal abscess. Long-term oncologic outcomes, including overall and disease-free survival and recurrence rates, were comparable between robotic and laparoscopic surgeries.Despite the associated high cost, the potential of robotic gastrectomy is expected to be realized with the recent introduction of various robotic surgical systems, which should aid in resolving cost concerns through market competition. Furthermore, the development of new evaluation tools that can objectively assess ergonomic benefits and surgeon fatigue should demonstrate the practical value of robotic surgery in the treatment of gastric cancer.

Carbohydrate antigen 19-9 (CA 19-9) is a tumor marker initially identified from colorectal cancer cell lines and is currently widely used in the diagnosis and monitoring of pancreatic and biliary tract cancers. Although CA 19-9 is not routinely screened in general checkups, increasing its screening has led to the frequent detection of elevated CA 19-9 levels in asymptomatic individuals. Patients with elevated CA 19-9 levels often visit clinics for concerns about malignancy, making cancer exclusion essential to exclude cancers through detailed medical history taking, physical examination, and imaging studies. However, many cases of elevated CA 19-9 levels result from benign causes, such as pancreatobiliary diseases, hepatic diseases, pulmonary diseases, or gynecologic conditions. Thus, to avoid unnecessary tests, clinicians must understand the various causes and mechanisms of CA 19-9 elevation. Integrating the patient’s symptoms and medical and family history facilitates appropriate test selection and minimizes unnecessary procedures.

The global increase in the incidence of metabolic disorders is increasing the burden of nonalcoholic fatty liver disease (NAFLD) progression and NAFLD-related hepatocellular carcinoma (HCC) development; urgent measures are required to reduce this burden. The metabolic aspects of NAFLD led to the proposal to rename this condition as metabolic dysfunction-associated steatotic liver disease (MASLD). Diagnosis of MASLD, unlike that of NAFLD, requires the presence of at least one cardiometabolic risk factor (CMRF), creating a new focus on these factors, although the vast majority of patients with NAFLD meet the criteria for MASLD. In this article, we therefore review the current understanding of MASLD-related HCC, such as the epidemiology, risk factors with a particular focus on CMRFs, surveillance strategies, and risk stratification models.

Background/Aims: We investigated sex- and stage-specific associations of body mass index (BMI), fasting glucose, and high-density lipoprotein cholesterol (HDL-C) with gastric cancer. Methods: In total, 3,382 patients with gastric cancer and 19,609 healthy controls were enrolled. BMI was categorized into five groups. HDL-C was classified as low (< 40 and < 50 mg/ dl in males and females, respectively) and normal (≥ 40 and ≥ 50 mg/dl in males and females, respectively). Logistic regression analysis was performed to calculate odd ratios (ORs) and 95% confidence intervals (CIs). Results: After adjustment, low BMI (OR, 1.44; 95% CI, 1.13–1.84), low HDL levels (OR, 2.28;95% CI, 2.07–2.50), and high fasting glucose levels (OR, 2.94; 95% CI, 2.22–2.99) were associated with gastric cancer, whereas high BMI (OR, 0.61–0.81) was inversely associated with gastric cancer. In sex-specific analysis, BMI was inversely associated with gastric cancer only in males (trend: p < 0.001). Low serum HDL and high fasting glucose levels were strongly associated with gastric cancer in both males and females. The effect of high glucose content was more pronounced in females (OR, 4.02) than in males (OR, 2.58). BMI was inversely associated with both AGC (trend: p < 0.001) and EGC (trend: p = 0.001). Low serum HDL and high fasting glucose levels were strongly associated with gastric cancer in EGC and AGC. Conclusions The effect of BMI on gastric cancer varies by sex and stage, whereas low HDL levels are associated with gastric cancer regardless of these factors.