Oxidative stress and chronic inflammation are tightly interconnected biological processes that play central roles in colorectal cancer (CRC) initiation, progression, and resistance to therapy. Understanding their reciprocal interactions may identify novel biomarkers and therapeutic targets with translational relevance. Methods: This systematic review with qualitative synthesis was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive literature search of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar was performed from January 2005 to June 2025. Eligible studies investigated mechanistic links between oxidative stress and inflammation in colorectal cancer, assessed oxidative or inflammatory biomarkers, or explored redox- and inflammation-targeted therapeutic strategies. Study selection and data extraction were performed systematically. Due to heterogeneity in study designs and outcomes, a qualitative synthesis was undertaken without meta-analysis. Results: Twenty-six studies met the inclusion criteria. Evidence consistently demonstrated that redox-sensitive pathways—including NF-κB, NRF2, and IL-6/JAK/STAT3—drive colorectal carcinogenesis by promoting genomic instability, immune evasion, angiogenesis, and therapy resistance. Biomarkers such as 8-hydroxy-2′-deoxyguanosine, malondialdehyde, F₂-isoprostanes, C-reactive protein, interleukin-6, and tumor necrosis factor-α were frequently associated with tumor stage, prognosis, and treatment response. Therapeutic strategies targeting oxidative stress and inflammation showed promising preclinical and early translational results, particularly in combination with chemotherapy or immunotherapy. Conclusion: Oxidative stress and inflammation constitute a synergistic axis that critically influences colorectal cancer biology. Although several biomarkers and redox-targeted interventions demonstrate translational potential, robust clinical validation is still required before routine implementation. Integrative strategies guided by biomarker profiling may represent a future direction for personalized CRC management. Most therapeutic approaches discussed are supported by preclinical and early translational evidence, and their clinical applicability remains to be validated.

Background/Objective: Gastrointestinal tract cancers may have been severely affected by the COVID-19 pandemic. The limitations of digestive endoscopy, the fear effect, and restrictions on hospital admissions during the pandemic may have delayed the presentation of patients to hospitals and surgical procedures and may have impacted overall survival. Methods: We conducted an observational, cross-sectional study of esophageal, gastric, small bowel, and colorectal cancer patients admitted to our hospital between 1 January 2018 and 31 December 2021. We analyzed the hospitalization rates, pathological type, the onset by complications, staging, and surgery during the pandemic compared to a pre-pandemic period (January 2018–December 2019). Results: During 2018–2021, 1613 patients with malignant gut tumors were admitted to our hospital (112 esophageal and eso-cardial tumors, 419 gastric tumors, 34 small bowel tumors, and 1058 colorectal tumors). Admission was reduced by 30.3% for esophageal and eso-cardial malignant tumors, 27.6% for gastric tumors, and 17.3% for malignant colorectal tumors. For esophageal and eso-cardial tumors, a higher frequency of stenosing tumors and palliative gastrostomies was noted. More stage III gastric cancers and a lower rate of vascular invasion were recorded during the pandemic. No differences regarding small bowel tumors were noted. In colorectal tumors, slightly more stage II cancers and more stenosing tumors were recorded, but occlusive, bleeding, and perforated tumors were similar; also, surgical rates were similar, with a two-fold higher perioperative mortality. The overall survival of gastric and colorectal carcinoma was higher during the pandemic (but with no statistical significance), although a clear explanation has not emerged. Conclusions: The impact of the COVID-19 pandemic on gut cancer included a significantly lower rate of newly diagnosed admissions, more stage II colorectal and stage III gastric carcinomas, a two-fold higher perioperative mortality for colorectal carcinoma, and a trend for a surprisingly higher overall survival for gastric and colorectal tumors (but without statistical significance). Future research is necessary for assessing long-term impact.

(1) Background: Acute variceal bleeding (AVB) represents an important cause of upper gastrointestinal bleeding (UGIB). Several prognostic scores may be useful for assessing mortality and rebleeding risk, with the Glasgow-Blatchford score (GBS) and Rockall score being the most commonly used for non-variceal bleeding. Scores assessing liver failure (MELD and Child) do not reflect bleeding severity. The neutrophil-to-lymphocyte ratio (NLR) increases in UGIB and can predict survival and rebleeding. (2) Methods: We analyzed the predictive role of NLR, GBS, Rockall, AIMS65, Child, and MELD for mortality (48 h, 5-day, in-hospital, and 6-week) and rebleeding in AVB patients admitted to our hospital from 2017 to 2021. ROC analysis was performed, and a multivariate analysis with logistic regression was used to construct a simplified model. (3) Results: A total of 415 patients were admitted. NLR exhibited fair accuracy for 48-h mortality (AUC 0.718, 95% CI 0.597–0.839, p < 0.0001), with limited predictive value for medium-term mortality. The NLR accuracy was better than that of the GBS and Rockall score, similar to that of the AIMS65 and Child scores, but inferior to that of MELD. The value for all scores in predicting rebleeding was poor, with the highest AUC for the NLR. (4) Conclusions: The NLR exhibited reasonable accuracy in predicting short-term mortality in AVB. Our model (including NLR, age, creatinine, bilirubin, albumin, INR, platelet count, HCC, and etiology) demonstrated 80.72% accuracy in predicting 6-week mortality.

Background: Brain metastases (BM) from gastric cancer (GC) are rare but associated with poor prognosis, significantly impacting patient survival and quality of life. The objective of this systematic review and meta-analysis is to consolidate existing research on BM from GC, evaluate the incidence and clinical outcomes, and explore the effectiveness of treatment options. Methods: A systematic search was conducted across the Medline, Web of Science, and Scopus databases, following PRISMA guidelines. Eighteen high-quality studies, as per the Newcastle–Ottawa Quality Assessment Scale, were included, encompassing 70,237 GC patients, of whom 621 developed BM. Data on progression-free survival (PFS), overall survival (OS), neurological symptoms, and HER2 status were analyzed using a random-effects model. Results: The incidence of BM in GC patients was found to be 2.29% (95% CI: 1.06–3.53%), with the range extending from 0.47% to 7.79% across studies. HER2-positive status was significantly associated with a higher likelihood of developing BM, with an odds ratio of 43.24 (95% CI: 2.05–913.39; p = 0.02), although this finding was based on limited data. The surgical resection of BM was linked to significantly improved survival outcomes, with a mean difference in OS of 12.39 months (95% CI: 2.03–22.75; p = 0.02) compared to non-surgical approaches. Conclusions: The surgical resection of brain metastases in GC patients significantly enhances overall survival, while HER2-positive patients may show a higher risk for developing BM. These findings underscore the importance of tailored therapeutic approaches for GC patients with BM.

Background/Objectives: The COVID-19 pandemic profoundly disrupted gastric cancer care, reducing access to screening, delaying diagnosis, and altering therapeutic pathways worldwide. Beyond clinical challenges, it exposed structural weaknesses in healthcare systems but also accelerated innovation. Methods: We conducted a narrative review supported by a structured literature search (PubMed/MEDLINE, Scopus, Web of Science; 1 January 2014–30 November 2025), with a narrative synthesis of observational studies, registry analyses, and meta-analyses addressing COVID-19–related changes in gastric cancer epidemiology, diagnosis, treatment, vaccination, and telemedicine. A PRISMA-style flow diagram was used to illustrate study selection. Results: Elective endoscopy volumes fell by up to 80%, leading to diagnostic backlogs and increased proportions of advanced-stage gastric cancer. Surgical postponements, modified chemotherapy and radiotherapy schedules, and reduced molecular/genetic testing further compromised outcomes. Conversely, vaccination, telemedicine, capsule endoscopy, and adaptive triage frameworks enabled partial recovery of services. Geographical variations were observed in the recovery of gastric cancer care services, with regions that had established screening infrastructure generally resuming activity more rapidly, whereas others experienced ongoing delays and diagnostic backlogs. Conclusions: This review integrates epidemiological, diagnostic, and therapeutic evidence to demonstrate how COVID-19 redefined gastric cancer care. By highlighting regional disparities and outlining a conceptual model for oncologic resilience, it provides an innovative framework for future crisis preparedness. The lessons of the pandemic—digital health integration, flexible treatment protocols, and international collaboration—represent a foundation for more robust, equitable gastric cancer management in the post-pandemic era.

Background/Objectives: Type 2 diabetes mellitus (T2DM) and atherogenic dyslipidemia have been implicated in colorectal cancer (CRC) development, but their prognostic relevance after cancer diagnosis remains unclear. This study aimed to evaluate the association between T2DM, lipid-derived atherogenic indices, and survival outcomes in patients with CRC. Methods: We conducted a retrospective cohort study including 240 CRC patients, of whom 60 had coexisting T2DM. Overall survival (OS) and disease-free survival (DFS) were analyzed using the Kaplan–Meier (KM) method and log-rank tests. In the absence of recurrence-specific data, DFS was defined as time to death or last follow-up. Lipid-related indices, including the atherogenic index of plasma (AIP), atherogenic coefficient (AC), remnant cholesterol (RC), non-high-density lipoprotein cholesterol (non-HDL-C), triglyceride–glucose (TyG) index, and triglyceride-to-HDL cholesterol ratio (TG/HDL-C), were evaluated by tertiles in KM analyses. Multivariable Cox proportional hazards models were constructed to assess the independent prognostic value of AIP, AC, and RC (entered separately as a continuous variable standardized to 1 standard deviation), adjusted for age, sex, adjuvant chemotherapy, radiotherapy, and T2DM status. Sensitivity analyses were performed in stage III–IV patients. Results: During follow-up, 28 deaths occurred. OS did not differ significantly between CRC patients and those with CRC coexisting with T2DM (log-rank p-values = 0.220). DFS analyses showed no significant differences across tertiles of any lipid-related index (all log-rank p-values > 0.05), with overlapping survival curves and no consistent dose–response patterns. In adjusted Cox models, AIP (hazard ratio [HR] per 1 SD = 0.71, 95% CI 0.48–1.06), AC (HR = 0.72, 95% CI 0.44–1.20), and RC (HR = 0.66, 95% CI 0.39–1.12) were not independently associated with DFS. Results were consistent in advanced-stage disease (stage III–IV). Conclusions: In this cohort of patients with CRC, neither T2DM nor lipid-derived indices reflecting atherogenic dyslipidemia and insulin resistance were independently associated with OS or DFS. These findings help refine the clinical interpretation of lipid-derived biomarkers in CRC, suggesting limited prognostic utility beyond established oncologic factors.