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Dr Harsh Shah - Surgical Gastroenterologist and GI Robotic Surgeon, Ahmedabad
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Dr Harsh Shah - Surgical Gastroenterologist and GI Robotic Surgeon, Ahmedabad

Dr Harsh Shah

Belly Wall Hernias After Cancer Surgery: What Patients Should Know

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Belly Wall Hernias After Cancer Surgery: What Patients Should Know

You are here >> Home > Latest Updates > Hernias Updates > Belly Wall…

Risk Factors for Postoperative Incisional Hernia and Its Effects on Long-Term Outcomes After Gastrointestinal and Hepatopancreatobiliary DOI 10.117700031348251350991

After surgery for stomach, liver, pancreas, or bowel cancer, some patients may develop a bulge or weakness at the spot where the cut was made. This is called an incisional hernia. It happens when the muscle wall doesn’t heal properly, letting tissues push through.

A new study looked at 505 cancer patients who had surgery between 2018 and 2021. Around 1 in 6 of them developed an incisional hernia within two years.

People were more likely to get a hernia if they had a higher body weight, a wound infection after surgery, low levels of albumin (a protein in the blood), or more advanced cancer. These patients also had shorter survival after surgery.

This shows how important it is to keep the surgical wound clean and to eat well before and after surgery. Having a healthy weight and good nutrition may lower the risk. Doctors may also need to monitor high-risk patients more closely.

If you’re going into surgery for gastrointestinal or liver-related cancer, talk to your care team about how to reduce the chance of a hernia. It could improve recovery and long-term health.

Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology), performs robotic and laparoscopic repair of incisional and abdominal wall hernias after cancer surgery at Apollo Hospital, Bhat, Gandhinagar. Consultations: Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad.

DOI: 10.1177/00031348251350991

Better Surgery Option for Obesity and Acid Reflux

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Better Surgery Option for Obesity and Acid Reflux

You are here >> Home > Latest Updates > GERD Updates > Better Surgery…

Comparative efficacy of sleeve gastrectomy with fundoplication versus standard sleeve gastrectomy in obesity and gastroesophageal reflux disease DOI 10.1111dom.70094

Many people with obesity also suffer from acid reflux, also known as GERD. This condition causes stomach acid to move up into the food pipe, leading to heartburn and discomfort. A new study compared two types of weight-loss surgery to see which works better for people with both obesity and GERD.

The study looked at 80 people who had either a regular sleeve gastrectomy (LSG) or a modified version that includes a wrap-around technique called fundoplication (LSGFD). Both surgeries helped people lose weight. Both reduced waist size and improved health within a year.

But the group that had LSGFD felt much better from their GERD symptoms. Their acid reflux improved more, and the damage to the food pipe (esophagitis) healed more often in this group. This means they had less heartburn, better digestion, and fewer GERD-related problems.

Importantly, this surgery did not increase risk. It gave all the benefits of weight loss while helping with GERD at the same time.

For people with obesity and reflux problems, LSGFD may be the better choice.

DOI: 10.1111/dom.70094

Does Adding Immunotherapy to Chemotherapy Improve Outcomes in Stomach Cancer?

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Does Adding Immunotherapy to Chemotherapy Improve Outcomes in Stomach Cancer?

You are here >> Home > Latest Updates > Stomach Cancer Updates > Does Adding…

Pembrolizumab Plus Chemotherapy Versus Chemotherapy as Perioperative Therapy in Locally Advanced Gastric and Gastroesophageal Junction Cancer DOI- 10.1200JCO-25-00486

For people with advanced but operable stomach or gastroesophageal junction (GEJ) cancer, treatment usually involves chemotherapy and surgery. This new study tested whether adding an immunotherapy drug, pembrolizumab, to chemotherapy could help patients live longer and stay cancer-free.

In the KEYNOTE-585 trial, over 1,000 patients were given either:

⦿ Chemotherapy with pembrolizumab (before and after surgery), or

⦿ Chemotherapy with a placebo

Patients were followed for about five years. The group that got pembrolizumab had:

⦿ A median survival of 72 months, compared to 56 months in the placebo group

⦿ Slightly better event-free survival, meaning they went longer without cancer coming back or getting worse

⦿ Similar rates of serious side effects (65% vs. 63%)

⦿ No difference in quality of life, according to patient surveys

These results suggest that adding pembrolizumab to standard treatment may help some patients live longer, without affecting their daily well-being.

If you’re facing surgery for advanced stomach or GEJ cancer, ask your care team whether immunotherapy is part of the treatment plan and whether it might be right for you.

DOI: 10.1200/JCO-25-00486

How Gene Changes Affect Treatment Results in Gallbladder and Bile Duct Cancer

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How Gene Changes Affect Treatment Results in Gallbladder and Bile Duct Cancer

You are here >> Home > Latest Updates > Gallbladder Cancer Updates > How Gene…

Genomic pathway alterations and their prognostic impact in biliary tract cancer Insights from a multinational cohort treated with cisplatin DOI- 10.1016j.ejca.2025.116035

Biliary tract cancers are rare and aggressive. Even with strong treatments like chemotherapy and immunotherapy, results can vary widely. This new study looked at the genes inside the tumors to find out which patients may do better with treatment.

Researchers studied 735 people with advanced bile duct cancer. Everyone received a mix of chemotherapy (cisplatin and gemcitabine) and immunotherapy (durvalumab). Around 200 patients also had their tumor DNA tested to find changes in key pathways—sets of genes that control how cancer grows.

They found:

⦿ People with changes in a group of genes called HRD/BRCAness lived longer and had more time before the cancer got worse.
⦿ Changes in the TGF-beta pathway were also linked to slower cancer growth.
⦿ Patients with high tumor mutational burden (TMB)—meaning many genetic changes in the tumor—had better outcomes overall.

These results show that DNA testing might help doctors know who is likely to benefit most from chemo-immunotherapy.

Right now, this kind of gene testing isn’t done for every patient with bile duct cancer. But studies like this suggest it could help guide treatment and improve survival.

DOI: 10.1016/j.ejca.2025.116035

How Esophageal Cancer Can Return After Treatment: Insights From the ESOPEC Trial

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How Esophageal Cancer Can Return After Treatment: Insights From the ESOPEC Trial

You are here >> Home > Latest Updates > Esophagus Cancer Updates > How Esophageal…

Recurrence Patterns of Esophageal Adenocarcinoma in the Phase III ESOPEC Trial Comparing Perioperative Chemotherapy With Preoperative DOI- 10.1200JCO-25-00948

Esophageal adenocarcinoma is a type of cancer that affects the food pipe. Two major treatment plans are often used before surgery: one uses only chemotherapy (called FLOT), and the other uses chemotherapy with radiation (called CROSS). This study compared both options to see which worked better at preventing cancer from coming back.

Researchers followed 438 patients from the ESOPEC trial. Most had surgery after their treatment. After almost 5 years, they looked at how many patients stayed cancer-free.

Here’s what they found:

⦿ FLOT (chemo only) patients had better results overall. About 55% stayed cancer-free for 3 years, compared to 39% in the CROSS group.
⦿ The number of local recurrences (cancer coming back in the same area) was about the same in both groups.
⦿ But FLOT reduced the risk of the cancer spreading to other parts of the body, which made the biggest difference.

This shows that for many patients with this type of cancer, chemotherapy alone may do a better job of preventing the cancer from spreading, leading to better survival.

If you or someone you love is facing esophageal cancer, ask your doctor about FLOT and CROSS and which treatment might be right for your case.

DOI: 10.1200/JCO-25-00948

Which Chemotherapy Works Better for Advanced Pancreatic Cancer?

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Which Chemotherapy Works Better for Advanced Pancreatic Cancer?

You are here >> Home > Latest Updates > Pancreas Cancer Updates > Which Chemotherapy…

Modified Fluorouracil, Leucovorin, Irinotecan, and Oxaliplatin or S-1, Irinotecan, and Oxaliplatin Versus Nab-Paclitaxel + Gemcitabine DOI- 10.1200JCO.24.00936

People with advanced or returning pancreatic cancer usually need strong chemotherapy to control the disease. Doctors often choose between a few different combinations of drugs. This study tested three of them to see which one helps people live longer.

The trial involved over 500 patients across 45 hospitals in Japan. It compared:

⦿ mFOLFIRINOX, a common but intense chemotherapy mix

⦿ S-IROX, a newer combination using an oral drug called S-1

⦿ Nab-paclitaxel plus gemcitabine, another standard treatment

The goal was to find which option gave the best overall survival.

Results showed:

⦿ Patients on nab-paclitaxel plus gemcitabine lived the longest—17.1 months on average.

⦿ Patients on mFOLFIRINOX and S-IROX lived about 14 months.

⦿ Side effects like severe appetite loss were more common with the other two treatments.

Because the two newer options did not outperform nab-paclitaxel plus gemcitabine—and caused more side effects—the trial was stopped early.

This study confirms that nab-paclitaxel plus gemcitabine remains the best first-line treatment for many people with advanced pancreatic cancer. If you or a loved one are facing treatment choices, this option may offer the best chance for both longer survival and fewer side effects.

DOI: 10.1200/JCO.24.00936

Dr Harsh Shah - Surgical Gastroenterologist and GI Robotic Surgeon, Ahmedabad

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