Real-World Clinical and Translational Research in Gastrointestinal Cancers

Gastrointestinal (GI) cancers represent a significant global health burden with complex biological behaviors and heterogeneous clinical outcomes. Although randomized controlled trials (RCTs) remain the gold standard for evidence generation, they often exclude important patient subgroups and may not reflect real-world clinical practice. This is particularly problematic for rare GI malignancies such as cholangiocarcinoma, ampullary tumors, appendiceal mucinous neoplasms, and pancreatic neuroendocrine tumors, where large phase III trials are scarce or unfeasible. Consequently, treatment decisions for these conditions often rely on lower-level evidence or expert opinion. Real-world studies using clinical databases, registries, and institutional cohorts offer valuable complementary insights by capturing broader patient populations, longer follow-up periods, and practice patterns across diverse healthcare settings. Furthermore, integrating novel technologies such as organoid models, artificial intelligence algorithms, radiomics, and metabolomics with clinical data can enhance our understanding of disease mechanisms and treatment responses, potentially bridging the gap between bench research and bedside application.

This Research Topic aims to assemble high-quality real-world clinical and translational studies that address critical knowledge gaps in the management of gastrointestinal cancers. We seek to provide clinically relevant insights that may not be captured in conventional RCTs, particularly for rare digestive tumors with limited high-level evidence. By highlighting innovative methodological approaches and integrating cutting-edge technologies with clinical observations, we aim to accelerate the translation of research findings into practical clinical applications and inform evidence-based decision-making in GI oncology. Ultimately, we hope this collection will contribute to improving outcomes for patients with common and rare digestive tract malignancies through practice-based evidence.

We welcome original research articles, systematic reviews, meta-analyses, and perspective papers addressing the following themes:
• Retrospective or prospective real-world studies of treatment outcomes, prognostic factors, or diagnostic approaches in common GI cancers (gastric, colorectal, hepatobiliary, and pancreatic)
• Clinical studies focusing on rare digestive tract malignancies with limited high-level evidence
• Translational research integrating clinical data with advanced technologies (organoids, artificial intelligence, radiomics, metabolomics)
• Real-world validation or implementation studies of novel biomarkers, imaging modalities, or treatment strategies
• Comparative effectiveness research using large clinical databases, registries, or multi-institutional cohorts
• Studies addressing disparities in care, access to treatments, or outcomes across different healthcare settings


Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal.

Keywords: Real-World Evidence, Gastrointestinal Cancers, Translational Research, Rare Digestive Tumors, Precision Oncology

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.