Currently, cancer-related competing endogenous RNA (ceRNA) networks are attracting significant interest. As long noncoding RNA ZEB1-AS1 has been reported to function as an oncogene due to sponging microRNAs (miRNAs) in several cancers, we hypothesized that it could interact with specific miRNAs to form regulatory networks and facilitate the growth of gastric cancer (GC). MiRNAs interacting with ZEB1-AS1 were screened for and selected by bioinformatics analysis. Overexpression or repression of ZEB1-AS1 was performed to determine whether it could regulate selected miRNAs. Quantitative real-time polymerase chain reactions (qPCR) validated the expression profiles of ZEB1-AS1 and miR-149-3p in GC cell lines and tissue. Statistical analysis determined the clinical significance of ZEB1-AS1 in relation to miR-149-3p. Cell counting, wound healing and transwell assays were performed to assess cell proliferation, migration and invasion. A luciferase reporter assay was utilized to confirm the putative miR-149-3p-binding sites in ZEB1-AS1. Briefly, bioinformatics analysis inferred that ZEB1-AS1 interacts with miR-204, miR-610, and miR-149. Gain- or loss-of function assays suggested that ZEB1-AS1 negatively regulates miR-149-3p, miR-204-5p and miR-610 in GC cells. Validated by qPCR, ZEB1-AS1 was up-regulated and miR-149-3p down-regulated in GC cells and tissue. Data analyses indicated that ZEB1-AS1 and miR-149-3p are associated with the independent diagnosis and prognosis of GC. Functional assays support the theory that miR-149-3p hinders GC proliferation, migration and invasion, whereas its overexpression abrogates the corresponding effects induced by ZEB1-AS1. Lastly, dissection of the molecular mechanisms involved indicated that ZEB1-AS1 can regulate GC partly via a ZEB1-AS1/miR-149-3p axis. ZEB1-AS1 can interact with specific miRNAs, forming a miRNA-mediated ceRNA network and promoting GC progress, partly through a ZEB1-AS1/miR-149-3p axis.

Background: Apoptosis is a type of cell death, which can produce abundant mediators to modify the tumor microenvironment. However, relationships between apoptosis, immunosuppression, and immunotherapy resistance of gastric cancer (GC) remain unclear.Methods: Gene expression data and matching clinical information were extracted from TCGA-STAD, GSE84437, GSE34942, GSE15459, GSE57303, ACRG/GSE62254, GSE29272, GSE26253, and IMvigor210 datasets. A consensus clustering analysis based on six apoptosis-related genes (ARGs) was performed to determine the molecular subtypes, and then an apoptosisScore was constructed based on differentially expressed and prognostic genes between molecular subtypes. Estimate R package was utilized to calculate the tumor microenvironment condition. Kaplan-Meier analysis and ROC curves were performed to further confirm the apoptosisScore efficacy.Results: Based on six ARGs, two molecular subgroups with significantly distinct survival and immune cell infiltration were identified. Then, an apoptosisScore was built to quantify the apoptosis index of each GC patient. Next, we investigated the correlations between the clinical characteristics and apoptosisScore using logistic regression. Multivariate Cox analysis shows that low apoptosisScore was an independent predictor of poor overall survival in TCGA and ACRG datasets, and was associated with the higher pathological stage. Meanwhile, low apoptosisScore was associated with higher immune cell, higher ESTIMATEScore, higher immuneScore, higher stromalScore, higher immune checkpoint, and lower tumorpurity, which was consistent with the “immunity tidal model theory”. Importantly, low apoptosisScore was sensitive to immunotherapy. In addition, GSEA indicated that several gene ontology and Kyoto Encyclopedia of Genes and Genomes items associated with apoptosis, several immune-related pathways, and JAK–STAT signal pathway were considerably enriched in the low apoptosisScore phenotype pathway.Conclusion: Our findings propose that low apoptosisScore is a prognostic biomarker, correlated with immune infiltrates, and sensitivity to immunotherapy in GC.

Purpose: This study aims to evaluate the effectiveness and safety of prophylactic hyperthermic intraperitoneal chemotherapy (P-HIPEC) in patients with locally advanced gastric cancer (AGC) after laparoscopic radical gastrectomy. Additionally, it explores how the frequency and timing of P-HIPEC influence treatment outcomes.Methods: A retrospective analysis was conducted on 227 patients with locally AGC who underwent laparoscopic surgery at Maoming People’s Hospital from January 2016 to December 2022. Patients were stratified into the HIPEC group (n=101) and the non-HIPEC group (n=126), based on whether they received postoperative P-HIPEC. Propensity score matching (PSM) was used to adjust for baseline characteristics, facilitating a comparative analysis of survival outcomes, postoperative complications and recurrence patterns. Cox regression analysis was performed to identify prognostic factors. Furthermore, the impact of varying P-HIPEC frequencies and initiation timings was evaluated.Results: No significant differences in overall survival (OS) or postoperative complication rates were observed between the two groups in the original and PSM cohorts. But the disease-free survival (DFS) of the HIPEC group was significantly higher than that of the non-HIPEC group (HR 0.569; 95% CI 0.362–0.894; p = 0.013) in the PSM cohort, with 1-year, 3-year, and 5-year DFS rates showing notable improvement (77.9% vs. 69.7%, 60.1% vs. 43.0%, and 46.2% vs. 25.5%). The incidence of isolated peritoneal metastasis (PM) was significantly lower in the HIPEC group (5.3% vs. 17.3%, p = 0.039). Multivariate Cox regression analysis identified P-HIPEC as an independent protective factor for DFS. Further analysis indicated that neither the number of P-HIPEC sessions had a significant impact on OS (p = 0.388) or DFS (p = 0.735), nor did the timing of P-HIPEC initiation affect OS (p = 0.620) or DFS (p = 0.488). Likewise, different P-HIPEC frequencies or initiation timings had no significant impact on postoperative complication rates or recurrence patterns.Conclusion: P-HIPEC effectively reduces the risk of postoperative PM and improves DFS in patients with locally AGC without increasing postoperative complications. However, it does not significantly impact OS. Additionally, variations in the frequency and timing of P-HIPEC initiation do not significantly affect survival outcomes, postoperative complications, or recurrence patterns.

After publication of the original article [1], the authors have notified us of 5 errors which are highlighted below. The authors apologize for any inconvenience.

Purpose: This study aims to develop and validate an explainable machine learning model for predicting postoperative survival in patients with locally advanced gastric cancer (LAGC), optimizing predictive accuracy while ensuring clinical applicability to facilitate personalized prognostication for patients. Methods: The study utilized data from 8616 LAGC patients who underwent gastrectomy (2004–2015) in the Surveillance, Epidemiology, and End Results (SEER) database for model development and validation, with external validation performed using 235 postoperative LAGC cases (2016–2022) from Maoming People's Hospital (Maoming, China). Five predictive models—Cox proportional hazards model (CoxPH), random survival forest (RSF), extreme gradient boosting (XGBoost), gradient boosting machine (GBM), and DeepSurv—were developed using the training set. Model performance was evaluated using the concordance index (C‐index), area under the receiver operating characteristic curve (AUROC), and Brier score. Additionally, 1‐, 3‐, and 5‐year receiver operating characteristic curves (ROC), calibration curves, and decision curve analysis (DCA) were employed for further assessment. The optimal model was interpreted using explainability tools such as SurvSHAP and SurvLIME. Finally, an interactive prediction tool was created to provide personalized survival evaluation for LAGC patients. Results: RSF exhibited the highest predictive performance, with a C‐index of 0.732 (95% CI: 0.720–0.745) in the validation set and 0.723 (95% CI: 0.696–0.755) in the external validation set. The 1‐, 3‐, and 5‐year AUROCs were 0.771, 0.803, and 0.809 in the validation set, and 0.802, 0.711, and 0.721 in the external validation set. Explainability analysis identified lymph node ratio (LNR), AJCC stage, and age as the most influential prognostic factors. An interactive prediction tool was developed to provide individualized prognosis visualization. Conclusion: This study developed an RSF‐based model to predict postoperative survival in LAGC patients, emphasizing the prognostic significance of LNR, AJCC stage, and age. The interactive prediction tool enhances clinical utility, facilitating personalized treatment decision‐making for physicians.

Purpose: Neoadjuvant chemoradiotherapy (nCRT) constitutes an integral component of the standard therapeutic strategy for locally advanced rectal cancer (LARC) but carries cumulative toxicity, cost, and occasional non-response. Intraoperative radiotherapy (IORT) delivers a single high dosage directly to the tumor bed and may overcome these limitations. We compared short-term efficacy and safety of low-kilovoltage(kV) x-ray IORT with long-course nCRT. Methods: LARC patients treated at Maoming People's Hospital (2022–2024) were retrospectively reviewed. The nCRT cohort received 45–50 Gy radiotherapy plus capecitabine before surgery; the IORT cohort underwent INTRABEAM low-kV x-ray IORT (12.5–20 Gy) during surgery. Disease-free survival (DFS), overall survival (OS), postoperative complications, and recurrence were analyzed. Survival was estimated by Kaplan–Meier curves. Results: A total of 67 patients were included (46 in nCRT, 21 in IORT). Kaplan–Meier analysis showed no significant difference in DFS or OS between the IORT and nCRT groups (DFS P = 0.669; OS P = 0.864). 3-year DFS (53.7% vs. 52.8%, P = 0.669) and OS (89.0% vs. 78.4%, P = 0.864) did not differ between IORT and nCRT. Early postoperative bowel obstruction and urinary retention were more frequent after IORT, although neither difference was significant; long-term complications and recurrence patterns remained comparable between the groups. Conclusion: Single-fraction low-kV IORT provides short-term survival equivalent to standard nCRT with acceptable perioperative safety. It is a viable option for LARC patients unable or unwilling to undergo prolonged nCRT, although vigilance for early gastrointestinal and urinary complications is warranted.