Christodoulidis G, Bartzi D, Tsagkidou K, Koumarelas KE, Zacharoulis D. Status quo of hypercoagulation as a prognostic indicator following neoadjuvant immunochemotherapy in locally advanced gastric cancer. World J Gastrointest Oncol 2025; 17(9): 106868 [DOI: 10.4251/wjgo.v17.i9.106868]
Corresponding Author of This Article
Grigorios Christodoulidis, MD, PhD, Department of General Surgery, University Hospital of Larissa, Mezourlo, Larissa 41110, Thessalia, Greece. gregsurg@yahoo.gr
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Grigorios Christodoulidis, Department of General Surgery, University Hospital of Larissa, Larissa 41110, Thessalia, Greece
Dimitra Bartzi, Department of Oncology, The 251 Airforce General Hospital, Athens 11525, Greece
Kyriaki Tsagkidou, Department of Gastroenterology, University Hospital of Larisa, Larisa 41100, Thessalia, Greece
Konstantinos Eleftherios Koumarelas, Department of General and Orthopaedic Surgery, Luzerner Kantonsspital Wolhusen, Luzern 6110, Switzerland
Dimitrios Zacharoulis, Department of General Surgery, University of Thessaly, Larisa 41110, Thessalia, Greece
Co-first authors: Grigorios Christodoulidis and Dimitra Bartzi.
Author contributions: Christodoulidis G and Bartzi D contributed equally to this manuscript as co-first authors; Christodoulidis G, Bartzi D, Tsagkidou K, Koumarelas KE, and Zacharoulis D contributed to the discussion and design of the manuscript, and the writing, editing the manuscript, and review of literature; Christodoulidis G designed the overall concept and outline of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Grigorios Christodoulidis, MD, PhD, Department of General Surgery, University Hospital of Larissa, Mezourlo, Larissa 41110, Thessalia, Greece. gregsurg@yahoo.gr
Received: March 10, 2025 Revised: April 1, 2025 Accepted: July 28, 2025 Published online: September 15, 2025 Processing time: 189 Days and 19 Hours
Abstract
Gastric cancer remains a major cause of cancer-related mortality worldwide, with immunotherapy emerging as a promising treatment strategy. Neoadjuvant immune checkpoint therapy has shown potential in enhancing antitumor responses and improving surgical outcomes. However, its effects on systemic coagulation and thrombotic risk remain poorly understood. This study aims to investigate the relationship between neoadjuvant immune checkpoint therapy and coagulation dynamics in patients with gastric cancer, exploring potential mechanisms that may contribute to a hypercoagulable state. By assessing coagulation markers, thrombotic events, and inflammatory responses, this research seeks to provide insights into the interplay between immune modulation and hemostatic alterations. A better understanding of these interactions may help optimize patient management and guide thromboprophylaxis strategies in this clinical setting.
Core Tip: The core message of the review emphasizes that hypercoagulation, observed after neoadjuvant immunochemotherapy in patients with locally advanced gastric cancer, serves as a significant independent prognostic indicator. Elevated coagulation markers such as D-dimer and fibrinogen are associated with poorer overall and disease-free survival rates. The article suggests that monitoring these coagulation parameters can enhance patient management by identifying high-risk individuals and tailoring postoperative care accordingly.
