Publications by authors named "Joseph Zhao"

Gastric cancer (GC) is a major cause of global cancer mortality with high levels of heterogeneity. To explore geospatial interactions in tumor ecosystems, we integrated 2,138 spatial transcriptomic regions-of-interest (ROIs) with 152,423 single-cell expression profiles across 226 GC samples from 121 patients. We observed pervasive expression-based intratumor heterogeneity, recapitulating tumor progression through spatially localized and functionally ordered subgroups associated with specific immune microenvironments, checkpoint profiles, and genetic drivers such as SOX9.

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  • Ascites is a common issue in patients with advanced gastrointestinal cancers that have spread to the peritoneum, impacting survival negatively; this study is the first to look specifically at ascites, peritoneal metastases (PM), and survival in metastatic colorectal cancer (mCRC) and metastatic gastric cancer (mGC).
  • A retrospective analysis of clinical trial data showed that mCRC patients with ascites had significantly shorter progression-free and overall survival compared to those without PM, while gastric cancer patients with ascites also had poorer survival outcomes and higher disease severity scores.
  • The findings suggest that ascites can indicate worse prognoses for certain cancer patients, highlighting the need for more focused research and tailored treatments for these individuals.
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  • The study investigates the genetic and environmental factors that lead to peritoneal metastasis (PM) in gastric cancer (GC), which typically has a poor prognosis.
  • Researchers conducted a detailed analysis of samples from 326 patients, looking at various genetic and expression changes in tumors and their surroundings.
  • Findings revealed specific genetic mutations and tumor microenvironment characteristics that enhance the risk of PM, along with potential therapeutic targets to improve treatment strategies for patients with GC.
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Gastroesophageal cancers (GECs) represent a significant clinical challenge. For early resectable GEC, the integration of immune checkpoint inhibitors into the perioperative chemotherapy and chemoradiation treatment paradigms are being explored and showing promising results. Frontline management of metastatic GEC is exploring the role of targeted therapies beyond PD-1 inhibitors, including anti-human epidermal growth factor receptor 2 agents, Claudin 18.

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Introduction: Periodontitis as a comorbidity in systemic lupus erythematosus (SLE) is still not well recognized in the dental and rheumatology communities. A meta-analysis and network meta-analysis were thus performed to compare the (i) prevalence of periodontitis in SLE patients compared to those with rheumatoid arthritis (RA) and (ii) odds of developing periodontitis in controls, RA, and SLE.

Methods: Pooled prevalence of and odds ratio (OR) for periodontitis were compared using meta-analysis and network meta-analysis (NMA).

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  • The study aimed to assess the effects of lymph node dissection (LND) on patients who underwent surgery for intrahepatic cholangiocarcinoma (ICC) through a systematic review and meta-analysis.
  • Researchers analyzed various studies that compared outcomes for patients with LND versus those without, focusing on those using advanced statistical methods to minimize bias.
  • Results showed no significant differences in overall survival or complications between the two groups, except for patients with clinically node-negative ICC, who had better overall survival with LND and a potential trend towards improved disease-free survival.
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Sarcoidosis is a multisystem granulomatous disorder of unknown etiology, manifesting with bilateral hilar adenopathy, pulmonary reticular opacities, skin, joint or eye lesions. Heerfordt-Waldenström Syndrome - a constellation of facial palsy, fever, uveitis and parotitis - is a rare presentation of this disorder. A 47-year-old Chinese woman presented with unintentional weight loss, lethargy with mediastinal and hilar lymphadenopathy.

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CDK4/6-inhibitors have demonstrated similar efficacy and are considered an effective first-line endocrine treatment of patients with hormone-receptor positive (HR+)/human-epidermal-growth-factor-receptor-2 negative (HER2-) metastatic breast cancer (MBC) in the endpoint of progression-free survival (PFS). Amongst these, palbociclib was first to achieve regulatory approval, followed subsequently by ribociclib and abemaciclib. However, recent updates of overall survival (OS) showed inconsistencies in the OS benefit for palbociclib compared with the other two CDK4/6-inhibitors.

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Purpose: Durable progression-free survivors (dPFSors) over 2 years have been reported among patients with melanoma or non-small-cell lung cancer (NSCLC) who received PD-(L)1 therapy. However, risk of progression still exists and the optimal imaging surveillance interval is unknown.

Methods: Individual patient data for progression-free survival (PFS) were extracted from PD-1 blockade clinical trials with a follow-up of at least 5 years.

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  • This study aimed to compare outcomes of robotic limited liver resections (RLLR) and laparoscopic limited liver resections (LLLR) for tumors in the posterosuperior liver segments, noting that previous research had not thoroughly examined the differences in performance and safety between the two approaches.
  • An analysis of data from 3510 patients showed that RLLR had significant advantages over LLLR, including a lower rate of open conversions, reduced blood loss, and shorter operative times, even in patients with cirrhosis.
  • Despite the improved perioperative outcomes for RLLR, postoperative metrics like readmission, morbidity, and mortality rates were similar between both surgical techniques.
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The diverse cell types of an organ have a highly structured organization to enable their efficient and correct function. To fully appreciate gene functions in a given cell type, one needs to understand how much, when and where the gene is expressed. Classic bulk RNA sequencing and popular single cell sequencing destroy cell structural organization and fail to provide spatial information.

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  • The study investigated factors that predict primary resistance to immune checkpoint inhibitors (ICIs) in patients with advanced non-small-cell lung cancer (NSCLC), defining resistance as disease progression within 6 months of treatment.
  • Out of 108 patients, over half (54.6%) exhibited primary resistance, with notable demographics including a majority being male, smokers, and predominantly Chinese with adenocarcinoma.
  • Key predictive factors for resistance included being female, having a neutrophil-to-lymphocyte ratio (NLR) of 3 or higher at 6 weeks, and receiving immunotherapy as a later treatment line (≥2 lines).
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Background: Bronchial thermoplasty (BT) has shown favorable safety and efficacy in several randomized controlled trials (RCTs), but has not been directly compared to biological therapies.

Methods: Electronic literature searches were performed on PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials, to retrieve RCTs of BT or FDA-approved biologicals against controls in patients with severe asthma. Six outcomes were analyzed: Asthma Control Questionnaire (ACQ), Asthma Quality of Life Questionnaire (AQLQ), the number of patients experiencing ≥1 asthma exacerbation, annualized exacerbation rate ratio (AERR), oral corticosteroid dose reduction (OCDR), and morning peak expiratory flow rate (amPEF).

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  • The study aimed to compare outcomes of robotic major hepatectomy (R-MH) versus laparoscopic major hepatectomy (L-MH), exploring whether R-MH offers any advantages.
  • An analysis of 4822 patient cases across 59 centers revealed that R-MH resulted in significantly less blood loss, fewer applications of the Pringle maneuver, and lower rates of conversion to open surgery.
  • Moreover, R-MH showed reduced postoperative morbidity and shorter hospital stays for patients with cirrhosis compared to L-MH, indicating its potential benefits.
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Introduction: Sorafenib was historically the standard of care for advanced hepatocellular carcinoma (aHCC) until it was superseded by the combination of atezolizumab and bevacizumab. Thereafter, several novel first-line combination therapies have demonstrated favorable outcomes. The efficacies of these treatments in relation to current and previous standards of care are unknown, necessitating an overarching evaluation.

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Introduction: Lung cancer in never-smokers is the major cancer cause of death globally. We compared the efficacy of low-dose computed tomography (LDCT) lung cancer screening among never-smokers versus ever-smokers using systematic review and meta-analysis.

Methods: LDCT lung cancer screening studies that simultaneously included both ever-smoker and never-smoker participants published by April 30, 2021, were searched through PubMed and Scopus.

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Introduction: Despite promising trials, catheter ablation is still regarded as an adjunct to antiarrhythmic drugs (AADs) in the treatment of paroxysmal atrial fibrillation (PAF). This study aimed to compare the effectiveness of various ablation therapies and AADs.

Method: Randomised controlled trials or propensity score-matched studies comparing atrial tachyarrhythmia recurrence among any combination of ablation modalities or AAD were retrieved.

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Importance: Immune checkpoint inhibitors (ICIs) have improved survival outcomes of patients with advanced esophageal squamous cell carcinoma in both first- and second-line settings. However, the benefit of ICIs in patients with low programmed death ligand 1 (PD-L1) expression remains unclear.

Objective: To derive survival data for patient subgroups with low PD-L1 expression from clinical trials comparing ICIs with chemotherapy in esophageal squamous cell carcinoma and to perform a pooled analysis.

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Purpose: Sarcopenia, an age-related loss of skeletal muscle mass and function, is frequent in patients with chronic obstructive pulmonary disease (COPD) and is linked to a poor prognosis. The diagnosis of sarcopenia requires specific equipment and is inconvenient to introduce into clinical practice. Ultrasound is an innovative method to assess muscle quantity.

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Background: Durvalumab consolidation is associated with improved survival following concurrent chemoradiotherapy (CCRT) in patients with stage III non-small cell lung cancer (NSCLC). Given the heterogeneity of stage III NSCLC patients, in this study we evaluated the efficacy and safety of durvalumab in the real-world setting.

Method: Unresectable stage III NSCLC patients were retrospectively studied: one cohort received CCRT, another had CCRT-durvalumab.

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Background: An updated systematic review and meta-analysis was conducted to compare radiofrequency ablation (RFA) versus repeat hepatectomy (RH) for patients with recurrent hepatocellular carcinoma (rHCC) after a previous liver resection.

Methods: PubMed, EMBASE, and Cochrane databases were searched from inception to October 2021 for randomized controlled trials and propensity-score matched studies. Individual participant survival data of disease-free survival (DFS) and overall survival (OS) were extracted and reconstructed followed by one-stage and two-stage meta-analysis.

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