{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T01:16:21Z","timestamp":1774574181369,"version":"3.50.1"},"reference-count":76,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"P. Carl Petersens Fond","award":["22010"],"award-info":[{"award-number":["22010"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Granulocyte-colony stimulating factor (G-CSF) prophylaxis is widely used in gastrointestinal (GI) cancers. The use of G-CSF in GI cancers has not previously been investigated systematically in a meta-analysis. Thus, we systematically reviewed the literature to describe the G-CSF use and potential influence on long-term oncological outcomes in GI cancers. Method: The literature search of this systematic review and meta-analysis was conducted in PubMed, Embase, Cochrane Library and Web of Science. The PRISMA-P guidelines were followed. Studies that reported data on patients with GI cancers undergoing oncological treatment with G-CSF prophylaxis were included. Outcomes of interest were overall survival (OS), progression-free survival (PFS) and adverse events (AE), specifically neutropenia grade III\/IV. A time-to-event random-effects meta-analysis was conducted. Risk of bias was assessed using the Newcastle\u2013Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Controlled Trials (RoB) tool. Findings: In total, 2452 articles were screened for eligibility. Ultimately, 13 studies were included with a total patient number of 2673. The included studies indicated a positive association between OS and G-CSF prophylaxis (HR 0.72, 95% CI: 0.56\u20130.91, I2: 54%, low quality evidence). No significant relation between G-CSF use and PFS was found in the pooled analyses (HR 0.74, 95% CI: 0.51\u20131.08, I2: 73%, moderate quality evidence). However, a positive effect of G-CSF use was found in the retrospective cohorts reporting data on PFS (HR 0.50, 95% CI: 0.32\u20130.77, I2: 0%). A marked drop in neutropenia grade III\/IV rates was observed in patients treated with G-CSF (risk ratio (RR) 0.46, 95% CI: 0.28\u20130.77, I2: 72%, high quality evidence). Interpretation: G-CSF prophylaxis provides a reduction in neutropenia grade III\/IV in patients with GI cancers (high level of certainty) and a favorable OS (low certainty), while PFS is unaffected (moderate certainty). Studies on PFS and G-CSF use are nonetheless limited.<\/jats:p>","DOI":"10.3390\/cancers17081313","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T03:39:16Z","timestamp":1744601956000},"page":"1313","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Oncological Outcomes of Granulocyte Colony-Stimulating Factor (G-CSF) Treatment in Gastrointestinal Cancers: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7127-8795","authenticated-orcid":false,"given":"Oliver Wedel","family":"Fischer","sequence":"first","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, 4600 K\u00f8ge, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6133-0543","authenticated-orcid":false,"given":"Tobias Freyberg","family":"Justesen","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, 4600 K\u00f8ge, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7708-3471","authenticated-orcid":false,"given":"Dilara Seyma","family":"G\u00f6genur","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, 4600 K\u00f8ge, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0652-123X","authenticated-orcid":false,"given":"Michael Tvilling","family":"Madsen","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, 4600 K\u00f8ge, Denmark"},{"name":"Department of Surgery, Slagelse Sygehus, 4200 Slagelse, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7270-5005","authenticated-orcid":false,"given":"Michael Bau","family":"Mortensen","sequence":"additional","affiliation":[{"name":"Odense PIPAC Center, Odense University Hospital, 5000 Odense, Denmark"},{"name":"Odense Pancreas Center (OPAC), Odense University Hospital, 5000 Odense, Denmark"},{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark"},{"name":"Department of Surgery, Odense University Hospital, 5000 Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"G\u00f6genur","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, 4600 K\u00f8ge, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4291-2174","authenticated-orcid":false,"given":"Adile","family":"Orhan","sequence":"additional","affiliation":[{"name":"Center for Surgical Science, Department of Surgery, Zealand University Hospital, 4600 K\u00f8ge, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s40259-017-0214-9","article-title":"Impact of Guidance on the Prescription Patterns of G-CSFs for the Prevention of Febrile Neutropenia Following Anticancer Chemotherapy: A Population-Based Utilization Study in the Lazio Region","volume":"31","author":"Trotta","year":"2017","journal-title":"BioDrugs"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cooper, K.L., Madan, J., Whyte, S., Stevenson, M.D., and Akehurst, R.L. 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