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Open research questions in Gastric Cancer Management and Outcomes

153 unresolved questions extracted from the limitations and future-work sections of 458 Gastric Cancer Management and Outcomes papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Poor prognosis for locally advanced gastric/gastroesophageal junction adenocarcinoma. Limited success with prior neoadjuvant regimens. Need to balance efficacy and safety in the novel regimen.

    Low-dose interval radiotherapy combined with tirelizumab and SOX chemotherapy neoadjuvant therapy for locally advanced gastric/gastroesophageal junction adenocarcinoma: study protocol of a prospective, single-center, single-arm clinical trial · 2026 · DOI

  • Limited survival rates for locally advanced or metastatic gastric/gastroesophageal junction adenocarcinoma despite perioperative chemotherapy. Need for novel neoadjuvant regimens to improve therapeutic outcomes. Potential for immunotherapy combined with chemotherapy and radiotherapy to increase pathological complete response rates.

    Low-dose interval radiotherapy combined with tirelizumab and SOX chemotherapy neoadjuvant therapy for locally advanced gastric/gastroesophageal junction adenocarcinoma: study protocol of a prospective, single-center, single-arm clinical trial · 2026 · DOI

  • most landmark trials were not designed to isolate timing as an independent variable, - same-regimen comparisons may be influenced by differences in treatment completion, cumulative exposure, and patient selection, - real-world evidence remains similarly heterogeneous

    Gastric cancer and the TNT era: have we solved the timing question, or only redistributed the treatment? · 2026 · DOI

  • the next major phase III trial in gastric cancer should directly address the timing hypothesis, - comparing perioperative and postoperative delivery of the same effective systemic treatment under comparable planned cumulative treatment exposure, - incorporating molecular biological subtypes

    Gastric cancer and the TNT era: have we solved the timing question, or only redistributed the treatment? · 2026 · DOI

  • The study notes that the diagnosis of gastric carcinoma with coexisting exocrine and neuroendocrine components can be challenging due to its rarity and the need for specialized pathology expertise. The study also notes that the treatment of this type of cancer can be complex and requires a multidisciplinary approach. The study identifies the need for larger cohort studies to characterize the clinicopathological features and survival outcomes of gastric carcinoma with coexisting exocrine and neuroendocrine components.

    Gastric Carcinoma with Exocrine and Neuroendocrine Components: A 16-Year Cohort Analysis and International Comparison · 2026 · DOI

  • The study is retrospective, - The evidence is derived from a single center, - The study has a limited sample size for some analyses, - The diagnostic cut-off for high-grade NEC was a Ki-67 index >20% and/or a mitotic count >20 per 2 mm^2

    Gastric Carcinoma with Exocrine and Neuroendocrine Components: A 16-Year Cohort Analysis and International Comparison · 2026 · DOI

  • Substantial recurrence risk even after curative-intent resection. Poor prognosis of unresectable, recurrent, or metastatic disease. Limited rigorous gastric-cancer-specific in situ validation.

    Candidate Spatial Niches Associated with Gastric Cancer Metastasis and Treatment Resistance: Functional Classification, Evidence Boundaries, and a Translational Framework · 2026 · DOI

  • Rigorous gastric-cancer-specific in situ validation remains limited. No candidate niche has yet achieved full clinical validation. The level of evidence supporting the proposed categories varies substantially.

    Candidate Spatial Niches Associated with Gastric Cancer Metastasis and Treatment Resistance: Functional Classification, Evidence Boundaries, and a Translational Framework · 2026 · DOI

  • There is a lack of studies evaluating the clinical impact of local triamcinolone acetonide injection on post-ESD pharyngeal deformity. Previous studies have focused on preventing post-ESD esophageal stricture, but not pharyngeal deformity.

    Local triamcinolone acetonide injection for the prevention of pharyngeal deformity following endoscopic submucosal dissection of superficial pharyngeal neoplasms · 2026 · DOI

  • Persistent dysphagia after head and neck radiotherapy: a common and under-reported complication with significant effect on non-cancer-related mortal- ity. Therefore, although local TA injection was associated with a reduction in endoscopic pharyngeal defor- mity, whether this anatomical improvement translates into clinically meaningful benefits, such as improved swallow- ing function or reduced aspiration-related complications, remains uncertain. Future prospective multicenter studies with standardized indications and injection protocols are warranted to validate the present findings. Further prospective studies incorporat- ing standardized swallowing assessments and long-term clinical outcomes are warranted. Further studies evaluating long-term clinical outcomes are warranted to assess whether reduction of endoscopic deformity translates into meaningful patient benefits.

    Local triamcinolone acetonide injection for the prevention of pharyngeal deformity following endoscopic submucosal dissection of superficial pharyngeal neoplasms · 2026 · DOI

  • The risk of lymph node metastasis in patients with locally advanced gastric cancer. The challenge of achieving a pathological complete response in patients with locally advanced gastric cancer. The need to balance the benefits and risks of neoadjuvant therapy in patients with locally advanced gastric cancer.

    Cadonilimab alone as neoadjuvant immunotherapy followed by radical resection for dMMR/MSI-H gastric adenocarcinoma: a case report · 2026 · DOI

  • the study is based on a single case report - the patient's age and comorbidities may have influenced the treatment outcome - the lack of universally accepted endoscopic cCR criteria for gastric cancer

    Cadonilimab alone as neoadjuvant immunotherapy followed by radical resection for dMMR/MSI-H gastric adenocarcinoma: a case report · 2026 · DOI

  • The incidence of disease progression in this subgroup and the factors that might predict it remain insufficiently studied, and no data are available for the Russian population.

    Multicenter retrospective cohort study of patients with locally advanced gastric and esophagogastric junction cancer, who achieved pathological complete response: incidence, patterns and predictors of disease progression (report 3) · 2026 · DOI

  • The obtained data emphasize the need for further investigation of a selective approach to lymphadenectomy in this area.

    On the advisability of splenic hilar lymphadenectomy in gastric cancer · 2026 · DOI

  • While robotic gastrectomy (RG) offers ergonomic advantages, its impact on the technically demanding suprapancreatic area in obese patients remains unclear.

    Impact of the articulating robotic system on suprapancreatic lymphadenectomy in obese patients with gastric cancer: A comparative study with conventional laparoscopy · 2026 · DOI

  • Although approximately 13-22% of CLDN-positive mGCs are also CPS-positive, optimal treatment for mGC patients expressing both CLDN and PD-L1 remains undetermined due to the absence of direct comparative studies between zolbetuximab and ICIs.

    Treatment Selection for Patients with HER2-Negative Metastatic Gastric Cancer Expressing Claudin 18.2 and PD-L1 · 2025 · DOI

  • Yet studies on the impact of the gastric microbiome (GM) on the response to neoadjuvant chemotherapy (NACT) are still scarce.

    The relationship between gastric microbiome features and responses to neoadjuvant chemotherapy in gastric cancer · 2024 · DOI

  • Future research should explore the potential incorporation of LVI status into existing TNM staging systems and novel therapeutic strategies.

    Prognostic Implication of Lymphovascular Invasion in Early Gastric Cancer Meeting Endoscopic Submucosal Dissection Criteria: Insights from Radical Surgery Outcomes · 2024 · DOI

  • BACKGROUND: The effect of neoadjuvant immunotherapy on minimally invasive gastrectomy (MIG) in older patients with gastric cancer remains controversial.

    Safety and efficacy of minimally invasive gastrectomy for older patients with gastric cancer after neoadjuvant chemotherapy and immunotherapy: a propensity score-matched analysis · 2024 · DOI

  • Cumulative toxicities of platinum-based chemotherapy. Limited efficacy of platinum-based chemotherapy in stroma-rich metastatic environments. Need for new treatment options.

    Platinum-free triplet therapy with nab-paclitaxel, S-1, and tislelizumab as first-line treatment for advanced gastric/gastroesophageal junction adenocarcinoma: a phase ii single-arm trial · 2026 · DOI

  • The study is retrospective. The sample size is limited to 90 patients. The study was conducted in a single community-based European hospital.

    Endoscopic Submucosal Dissection for Colorectal Lesions in a Community-based European Hospital: Experience and Learning Curve · 2026 · DOI

  • The role of ESD in colorectal neoplasia is less established in Western regions. There is a need for studies on the learning curve and outcomes of ESD in community-based hospitals.

    Endoscopic Submucosal Dissection for Colorectal Lesions in a Community-based European Hospital: Experience and Learning Curve · 2026 · DOI

  • The study identifies a gap in the prediction of 5-year all-cause mortality specifically for patients with diffuse gastric cancer. Previous studies have not explored machine learning applications in this specific context.

    Machine learning-based prediction of 5-year survival in diffuse-type gastric cancer patients from Harbin · 2026 · DOI

  • The treatment of metastatic disease is now primarily dictated by molecular biomarkers. There is a need for consensus statements on evolving topics in GI cancer management. The conference addresses the gap in GI cancer management by developing consensus statements on key topics.

    Eastern Canadian Gastrointestinal Cancer Consensus Conference 2025 · 2026 · DOI

  • Maintaining treatment continuity is a substantial challenge in routine clinical practice. The study highlights the importance of completing the full perioperative chemotherapy sequence. The study emphasizes the need to refine therapeutic approaches and improve patient outcomes.

    Completion of perioperative chemotherapy and tumor regression grade as independent predictors of one-year survival after total gastrectomy for gastric cancer: a retrospective cohort study · 2026 · DOI

Most-cited papers in Gastric Cancer Management and Outcomes

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153 open questions have been extracted from the limitations and future-work passages of 458 Gastric Cancer Management and Outcomes papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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