bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS02.214: ANALYSIS OF PROGNOSTIC FACTORS IN RECURRENCE CASES AFTER SURGERY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Nishiyama Mitsuo , Takeda Shigeru , Kanekiyo Shinsuke , Kitahara Masahiro , Iida Michihisa , Tokumitsu Yukio , Tomochika Shinobu , Tokuhisa Yoshihiro , Suzuki Nobuaki , Yoshino Shigefumi , Hazama Shoichi , Ueno Tomio , Nagano Hiroaki 
Published: September 2018

Abstract

Background
Esophageal cancer is one of the most malignant gastrointestinal cancers and prognosis in recurrent cases remains extremely poor. However some studies show a relatively favorable prognosis among patients with solitary recurrence site who undergo locoregional therapy. It is important to clarify prognostic factors in postrecurrence cases.

Methods
This study included 156 patients who underwent curative resection for esophageal squamous cell carcinoma from January 2005 to December 2014. In this retrospective study we analysed relationship between clinicopathologic factors and prognosis after recurrence among these 156 patients.

Results
The average age was 65.2 years (± 8.2), 34 males, 11 females, The frequency of recurrence is pStage I: 2/36 cases (5.6%), pStage II: 7/48 cases (15%), pStage III: 21/43 cases (49%), pStage IVa: 8/11 cases (73%). Median survival time after recurrence was 377 (29 - 3266 days), and a 1 year/2 years/3 year survival rate after relapse was 50%/24%/11%. Patients with recurrent disease were offered treatment with chemotherapy + surgery (5 cases, 11%), chemotherapy + radiation (17 cases, 38%), chemotherapy (18 cases, 40%) and BSC (5 cases, 11%). MST was not reached in the chemotherapy + surgery group (741- 3266 days), 431 days (91–2324 days) in the chemotherapy + radiation group, 223 days (85–1079 days) in the chemotherapy group, and 52 days in the BSC group. There was a significant difference between each groups (P < 0.03). In univariate analysis, age (≤ 65/ > 65) single/multiple site recurrence, presence or absence of postoperative pneumonia, presence or absence of ARDS was selected as a prognostic factor after recurrence. In multivariate analysis, single/multiple site recurrence(HR 10.2, 95%CI 2.619–39.8, P = 0.0008), Postoperative pneumonia (HR 3.6, 95% CI 1.186 - 10.867, P = 0.024), postoperative ARDS (HR 5.6, 95% CI 1.209 - 26, 3, P = 0.0276) was selected.

Conclusion
Postoperative pulmonary complications might be related and aggressive local control for single site recurrence might improve the prognosis after recurrence of thoracic esophageal squamous cell carcinoma.

Disclosure
All authors have declared no conflicts of interest.
PS02.218: EFFECT OF SILENCING EGFR GENE ON RADIOSENSITIVITY OF SQUAMOUS CELL CARCINOMA AND ADENOCARCINOMA IN ESOPHAGEAL CARCINOMA
Authors: Li Jiancheng , Qiu Zidan 
Published: September 2018

Abstract

Background

Squamous cell carcinoma and adenocarcinoma in esophageal carcinoma have different radiosensitivity
We investigate the effect of silencing EGFR gene on radiosensitivity of Eca-109and OE-19To investigate the effect of silencing EGFR gene on radiosensitivity of Eca-109and OE-19.

Methods
SiRNA segments for EGFR gene were designed, synthesized and transfected into human Eca-109and OE-19 and authenticated by RT-PCR and Western blotting. Both the two cell lines were classified into three groups: control group, irradiation group and tranfected with EGFR-siRNA before irradiation group. Divided ECa-109, OE-19cellblank control group, only irradiation group and EGFR-siRNA1 irradiation group(irradiation 0,2,4,6,8Gy).The radiosensitivity of different groups was studied by clonogenic survival curves and SERD0ratio. Finally we analyzed cell-cycle distribution and cell-apoptosis detected by Flow cytometry.

Results
EGFR-siRNA can downregulate the EGFR expression obviously, while it can cause mild cell growth inhibition(4.9% and 4.5%). EGFR-siRNA can obviously down-regulate the espression of EGFR in two kinds of cell.The rate of cell proliferation in inhibition by transfection were less than 5% (4.9%, 4.5%). The radiosensitivity of two cell lines transfected with EGFR-siRNA were intensified, with lower SF values. Eca-109cell got a higher SERD0ratio(1.40 vs. 1.01). Flow cytometry suggested that the G2/M phase cells percentage and the apoptosis rate increased more evidently in Eca-109cell transfected with EGFR-siRNA and irradiation(P = 0.016 and P = 0.028), with S phase cells percentage decreased(P = 0.007).

Conclusion
Silencing EGFR could enhance the radiosensitivity of esophageal squamous cell carcinoma more effectively than esophageal adenocarcinoma.

Disclosure
All authors have declared no conflicts of interest.
PS02.227: A NEW POSTOPERATIVE PAIN MANAGEMENT LEADS TO ENHANCED RECOVERY AFTER ESOPHAGECTOMY: A PROPENSITY SCORE-MATCHED ANALYSIS
Authors: Nakano Yuta , Ohkura Yu , Ueno Masaki , Udagawa Harushi 
Published: September 2018

Abstract

Background
Opioid use is reportedly associated with delayed recovery after surgery because of gastrointestinal motility disorder and postoperative nausea and vomiting despite of acceptable efficacy for pain control.The aim of this study was to investigated the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhanced recovery after esophagectomy.

Methods
Of 93 and 57 consecutive patients who underwent esophagectomy for esophageal cancer before and after introduction of postoperative scheduled intravenous acetaminophen, propensity score-matched population was created and short-term clinical outcomes were compared.

Results
Significant defervescence was demonstrated in Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (P < 0.05), whereas no significant difference was observed in postoperative inflammatory parameters. The incidence of postoperative complications was similar between the groups. The number of PCA pushes and the frequency of use of other non-opioid analgesics was significantly reduced in the A-group (P < 0.05). Both daily and cumulative opioid use was significantly reduced in the A-group (P < 0.05). The time to first flatus and defecation significantly decreased in the A-group (P = 0.001 and P = 0.035, respectively). The day of first walking after surgery significantly decreased in the A-group (1.0 vs. 2.0 days, P < 0.001). The ICU stay (3.05 vs. 3.62 days, P = 0.003) and the hospital stay (21.6 vs.26.8 days, P = 0.074) tended to be decreased in the A-group.

Conclusion
Scheduled postoperative intravenous acetaminophen after esophagectomy may reduce the use of opioids and might be associated with enhanced GI motility and decreased incidence of PONV. Scheduled intravenous acetaminophen may be a feasible new pain management option in ERAS protocol after esophagectomy.

Disclosure
All authors have declared no conflicts of interest.
PS02.233: PRETREATMENT PROGNOSTIC FACTORS IN PATIENTS WITH RESECTABLE CSTAGE II-IV THORACIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Toyokawa Takahiro , Tamura Tatsuro , Sakurai Katsunobu , Kubo Naoshi , Tanaka Hiroaki , Yashiro Masakazu , Muguruma Kazuya , Hirakawa Kosei , Ohira Masaichi 
Published: September 2018

Abstract

Background

Background
Advanced esophageal cancer patients often develop tumor recurrence even after curative resection. Inexpensive and easily available prognostic factors are expected in daily clinical practice. The aim of this study was to identify the prognostic factors in patients with resectable cStage II-IV thoracic esophageal squamous cell carcinoma.

Methods

Patients and Methods
The study included 118 patients who underwent esophagectomy with curative intent for resectable cStage II-IV thoracic ESCC between January 2000 and December 2014. Time-dependent receiver operating characteristic curve analyses for 3-year overall survival (OS) as the endpoint were calculated, and the maximal Youden index was estimated to set the cut-off value for continuous variables. Survival rates were calculated by Kaplan-Meier method, and survival curves were compared using log-rank test. Univariate analysis and multivariate analysis for OS were conducted with Cox proportional hazards models.

Results

Results
The median follow-up period was 33 months (1–160 months). The 5-year OS rate for the entire study population was 52.2%. In univariate analysis, age (70 < ), sex, performance statue, American Society of Anesthesiologists Physical Status (ASA), serum squamous cell carcinoma antigen level (1.2 ng/ml < ), lymphocyte count (≤ 1172/μl), serum albumin level (≤ 3.7 g/dl), total cholesterol level (≤ 193 mg/dl), and C-reactive protein level (0.28 < mg/dl) were significantly associated with OS. In multivariate analysis, ASA (HR for ASA 2: 1.457, 95%CI 0.594–3.579; HR for ASA 3: 7.427, 95%CI 2.189–25.199; P = 0.001) and total cholesterol level (HR 0.506, 95% CI 0.261–0.983; P = 0.044) were independent prognostic factors for OS. The 5-year relapse free survival (RFS), cancer specific survival (CSS) and OS were 58.4%, 74.5% and 67.5% in high- total cholesterol group, and 38.7%, 51.3% and 39.1% in low- total cholesterol group, respectively (P = 0.031 in RFS, P = 0.004 in CSS, and P = 0.002 in OS).

Conclusion
Our findings showed that pretreatment total cholesterol level and ASA are independent prognostic factors of overall survival in patients with resectable cStage II-IV thoracic esophageal squamous cell carcinoma.

Disclosure
All authors have declared no conflicts of interest.
PS02.234: POSTOPERATIVE PNEUMONIA AFTER ESOPHAGEAL RESECTION: DO WE NEED PROPHYLCATIC ANTIBIOTICS FOR PREVENTION?
Authors: Maghsoudi Tina , Wilhelm Anke , Beumer Michael , Oldhafer Karl 
Published: September 2018

Abstract

Background
Postoperative pulmonary complications are a common course of serious morbidity after esophageal resection. In literature rates of pneumonia are quoted up to 38%. Recent studies showed that minimally invasive esophagectomy could reduce this to 9 to 15%, but is this the only approach to lower the incidence of postoperative pneumonia?

Methods
We analysed our data from esophagectomies performed in our department between 2014 to 2017. Only procedures with thoracotomy due to malignancies were included. All patients received a single shot dose of piperacillin/tazobactam repeated after 4 hours during operation. Bronchoscopy was performed intraoperatively with bronchial toilet. Patients at risk (COPD or viscous secretion) recieved antibiotics for further 7 days. If postoperatively elevation of CRP or leucocytes ocurred, thorax CT scan was performed. Only when pulmonary infiltrates were visible pneumonia was diagnosed.

Results
151 operations due to esophageal cancer were performed. Extended gastrectomies, minimal invasive esophagectomies with thoracoscopy and transhiatal resections were excluded. Only Ivor-Lewis resectios (108), McKeown resections (8) and colon interpositions (2) were analysed. The all over pneumonia rate was 13,6% (16 patients). The 30 day mortality was 2,5%. None of the patients died due to pneumonia.

Conclusion
To reduce postoperative pneumonia rates is an important aim in esophageal surgery. Latest data showed that minimally invasive surgery is adequate to achieve this. But not every patient is suitable for this procedure. From our single center experience we could show that also intraopereative bronchial toilet together with prophylactic antibiotic therapy could achieve good results.

Disclosure
All authors have declared no conflicts of interest.
PS02.236: THE IMPACT OF PREOPERATIVE SKELETAL MUSCLE MASS ON POSTOPERATIVE OUTCOMES AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER
Authors: Uemura Shion , Shichinohe Toshiaki , Ebihara Yuma , Kurashima Yo , Murakami Soichi , Hirano Satoshi 
Published: September 2018

Abstract

Background
It is said that preoperative muscle volume is likely associated with postoperative short- and long-term outcomes in several kinds of cancer by many reports. Esophagectomy for esophageal cancer (EC) is associated with high morbidity and EC has one of the worst prognoses in several kinds of cancer. We investigated the association of preoperative skeletal muscle mass with postoperative outcomes to improve them.

Methods
We analyzed 150 patients who underwent esophagectomy from February 2002 to March 2016. The cross-sectional area of the psoas muscle index (PMI) was measured at the third lumbar vertebral level using computed tomography. Clavien-Dindo classifications were used to analyze postoperative complications. Since skeletal muscle mass is significantly different according to gender, all analyses were completed by gender (male: 124, female: 26). The Mann-Whitney U test and the chi-square test were used to compare two groups for the analysis of postoperative complications. Multivariate analysis of postoperative complications was performed using a logistic regression model. Survival analyses were performed using a Cox proportional hazard model. Differences were considered to be significant if the P value was less than 0.05.

Results
In male patients, PMI value was significantly higher in CD≦ II groups than CD≧ III groups. It was also a independent factor for predicting postoperative complications (odds ratio: 0.995, 95% confidence interval: 0.991–0.999, P = 0.02). On the other hand, there was not a significant difference between PMI and overall survival. In female patients, PMI was not associated with postoperative complications and survival. Only pulmonary function (vital capacity percentage) was associated with postoperative complications and survival.

Conclusion
Preoperative muscle mass was associated with postoperative complications in male patients with EC. In male patients, PMI can be a useful tool to predict postoperative outcomes and select patients who require preoperative nutritional intervention and rehabilitation.

Disclosure
All authors have declared no conflicts of interest.
PS02.240: COMBINED GERMAN CLINICAL CANCER REGISTRIES: FIRST EXPERIENCE WITH ANALYSES ON DEMOGRAPHY AND TREATMENT OF CANCERS OF THE ESOPHAGUS AND STOMACH
Authors: Thomaschewski Michael , Hummel Richard , Kopeleva Olga , Barlag Hagen , Keck Tobias , Wellner Ulrich 
Published: September 2018

Abstract

Background
One critical aspect for improvement of health care delivery to the population is a continuous monitoring of results. In this context, an increasing number of clinical cancer registries has been implemented in Germany since 2013. Main aspects of these registries include quality control, assessment of clinical outcome, support of epidemiological registries and potential implementation into clinical follow up. The ADT (Cooperation of German Cancer Centres e.V.) aims to merge data from local cancer registries into one nation-wide registry. In this context, we were able to analyse for the first time data of > 100.000 patients with malignant diseases of the stomach and esophagus.

Methods
Data from all local cancer registries in Germany were requested in the context of the National German Cancer Conference 2018 hosted by the German Cancer Society (DKG). After preparation of data, analysis included demographic and treatment aspects, and esophageal/gastric/GOJ cancers were analysed separately.

Results
From 2000–2016, 101.559 patients with cancers of the esophagus and stomach have been reported, representing approximately one quarter of the expected cancer cases in this time frame in Germany. Data quality and completeness improved over time. Incidences of esophageal and GOJ cancers increased, whereas incidence of gastric cancer decreased. Median age differed between entities with highest respectively lowest age in gastric/esophageal cancer. Further, median age increased in all three tumor types in the study period. Treatment pattern changed over time with a distinct increase of the use of neoadjuvant therapy in all cancer types. Percentage of curative intended surgery increased over time, reaching roughly 60% in gastric cancer, about 50% in GOJ and esophageal adenocarcinoma, and slightly less then 25% in esophageal squamous cell carcinoma. Finally, analysis of tumor stage dependent treatment confirmed higher rates of curative intended surgical treatment in early tumor stages, and an increased use of neoadjuvant treatment or chemo/radiotherapy approaches in higher tumor stages.

Conclusion
Combined Clinical Cancer Registries provide the unique opportunity to assess clinical relevant data of a large population based cohort of patients for purposes such as quality control and outcome measurement. Further, subgroup analyses can provide valid information on clinically relevant questions such as outcome/quality of different treatments.

Disclosure
All authors have declared no conflicts of interest.
PS02.242: SIGNET-RING CELL PERCENTAGE MAY INFLUENCE PATHOLOGICAL RESPONSE TO CHEMOTHERAPY IN ESOPHAGO-GASTRIC JUNCTION SIGNET RING CELL CARCINOMA
Authors: Zanoni Andrea , Giacopuzzi Simone , Weindelmayer Jacopo , Veltri Alessandro , Fumagalli Romario Uberto , Parise Paolo , Rosati Riccardo , De Manzoni Giovanni 
Published: September 2018

Abstract

Background
Like in gastric cancer, the incidence of signet-ring cell carcinoma (SRCC) is rising also in esophago-gastric junction (EGJ) adenocarcinoma Siewert type I and II. SRCC is much more studied in gastric cancer and WHO classification divides poorly cohesive gastric cancer in two subtypes, depending on the percentage of signet-ring cells: real SRCC (percentage of signet-ring cell more than 50%) and poorly cohesive non-SRCC (less than 50%). Real SRCC seems to have higher chemosensitivity and better prognosis than poorly cohesive non-SRCC. Recently, a new classification for SRCC has been proposed, which subdivides SRCC based on different cut-off percentages of signet ring cells (less than or equal to 90% vs more than 90%). Aim of this study was to compare pathological response in patients with EGJ SRCC treated with neoadjuvant chemotherapy.

Methods
Study population comprised 11 patients with Siewert I and II EGJ SRCC treated with neoadjuvant chemotherapy and surgery. We analyzed differences in pathological response to therapy between ‘pure’-SRCC (more than 90% of SRC) and ‘non-pure’-SRCC (less than or equal to 90%). Tumor regression grade (TRG) was used to define response to treatment, with TRG 1–2 defining good response to treatment and TRG 3–5 poor or absent response to treatment.

Results
Among the 11 patients with EGJ SRCC, 6 had ‘pure’-SRCC histology and 5 ‘non-pure’-SRCC. Response to treatment in ‘pure’-SRCC patients was equally splint into good and poor responders: 3 had good response to treatment (TRG 1–2) and 3 poor or absent response (TRG 3–5). On the contrary most of ‘non-pure’-SRCC had poor or absent response: 4 out of 5 patients had TRG 3–5.

Conclusion
Although the case series was too small to perform statistical analyses, our results suggest that signet-ring cell percentage may influence the outcome of neoadjuvant therapy. Probably a larger case series would allow to better define cut-offs of percentage of signet-ring cell carcinoma of the EGJ. Moreover it would allow to inspect other factors related to response to treatment. This is only a preliminary investigation and further studies are needed to better understand the characteristics of these rising in incidence types of cancer.

Disclosure
All authors have declared no conflicts of interest.
PS02.245: GLUTATHIONE S-TRANSFERASE PI 1 (GSTP1) IS ONE OF VALUABLE PREDICTORS RELATED TO POOR PROGNOSIS AND RESISTANCE TO CHEMOTHERAPY IN ESOPHAGEAL CANCER
Authors: Ogino Shinpei , Konishi Hirotaka , Matsubara Daiki , Shoda Katsutoshi , Arita Tomohiro , Kosuga Toshiyuki , Shiozaki Atsushi , Okamoto Kazuma , Otsuji Eigo 
Published: September 2018

Abstract

Background
Esophageal squamous cell carcinoma (ESCC) is one of the most aggressive malignancies worldwide, however, there is no useful marker for diagnosis and treatment. Glutathione S-transferase Pi 1 (GSTP1) is a member of GST family, a phase-II metabolic enzyme, and has reported as a predictor of malignancy and sensitivity to anti-cancer drugs in some cancers. In this study, we investigated the association of GSTP1 expression with malignancy and resistance to chemotherapy in ESCC patients.

Methods
The ability of proliferation and sensitivity to anti-cancer drugs regarding GSTP1 expression were examined in ESCC cell lines, KYSE170 and TE13. Proliferation assay and apoptosis assay using fluorescent activated cell sorting (FACS) were performed. In addition, immunohistochemistry assays of tissue samples were performed in 75 ESCC patients without neoadjuvant chemotherapy and 71 patients with neoadjuvant chemotherapy.

Results
The proliferation of GSTP1 knockdown cells were significantly decreased compared to that of control cells in KYSE170 and TE13. Similarly, the frequency of early apoptosis in GSTP1 knockdown cells were higher than that of control cells. Survival rate of GSTP1 knockdown cells treated with cisplatin was lower than that of control cells in chemoresistance assays. Moreover, the frequency of early apoptosis in GSTP1 knockdown cells treated with cisplatin were markedly higher than that of control cells. In immunohistochemistry assay of ESCC patients without neoadjuvant chemotherapy, high GSTP1 expression was an independent predictor of a poor prognosis (P = 0.029). Regarding immunohistochemistry assay of tissue samples with neoadjuvant chemotherapy, GSTP1 expression significantly associated with downstaging of clinical stage (P = 0.042).

Conclusion
GSTP1 related to the prognosis and resistance to chemotherapy in ESCC patients. However, accurate assessment of resected specimen with chemotherapy was difficult because tumor cells sensitive to chemotherapy were already absent. Further analysis using samples without chemotherapy such as biopsy samples would be more appropriate for the assessment of the sensitivity to chemotherapy.

Disclosure
All authors have declared no conflicts of interest.