bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS02.190: THE SIGNIFICANCE OF INTRAOPERATIVE PATHOLOGICAL OF RECURRENT NERVE NODE IN NECK-FIELD LYMPH NODE DISSECTION OF ESOPHAGEAL CANCER
Authors: Xu Jinxin , Zheng Bin 
Published: September 2018

Abstract

Background
The aim of this study is to explore whether the metastasis of the recurrent laryngeal nerve node can guide neck-field lymph node dissection of esophageal squamous cell carcinoma.

Methods
collected data from 58 patients who had undergone intraoperative pathological frozen of bilateral recurrent nerve node and three-field lymph node dissection in Fujian medical university union hospital, to explore the relationship between recurrent laryngeal nerve node metastasis and cervical lymph nodes metastasis.

Results
In the positive right laryngeal node group, 31.58% of the patients had metastasis in the cervical lymph nodes, and patients with negative laryngeal node, 10.26% of the patients had metastasis (P0.05). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value were 70.00%, 70.83%, 70.69%, 33.33% and 91.89%. In the positive left laryngeal node group, 55.56% of the patients had metastasis, and patients with negative laryngeal node, 10.20%of the patients had metastasisP0.05. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value were 50.00%, 91.67%, 84.48%, 55.56% and 89.80%. In the positive laryngeal node group(one of the laryngeal node were positive), 33.33% of the patients had metastasis, In the negative group, 5.88% of the patients had metastasisP0.05.The sensitivity, specificity, accuracy, positive predictive value, negative predictive value were 80.00%, 66.67%, 68.97%, 33.33% and 94.12%. In the group of bilateral laryngeal node metastasis, 66.67% of the patients had metastasis. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of the preoperative neck ultrasound combined with PET/CT were 20.00%, 83.33%, 72.41%, 20.00%, 83.33%. Table 1 The statistics about the intraoperative pathological frozen of bilateral recurrent nerve node and the preoperative neck ultrasound combined with PET/CT

Conclusion
If intraoperative pathological frozen prompted positive, we can decide whether three-field lymph node dissection should be performed combined with preoperative examination, tumor location and degree of tumor infiltration to get appropriately stage and achieve the purpose of radical.Intraoperative pathological frozen state of recurrent nerve node metastasis is an indicator for the selection of neck-field dissection in thoracic esophageal carcinoma.

Disclosure
All authors have declared no conflicts of interest.
PS02.192: TWO CASES OF PRIMARY MALIGNANT MELANOMA OF ESOPHAGUS TREATED WITH SUBTOTAL ESOPHAGECTOMY
Authors: Hirohata Ryosuke , Emi Manabu , Hamai Yoichi , Ibuki Yuta , Okada Morihito 
Published: September 2018

Abstract

Background
Malignant melanoma of the primary esophagus is rare, in general it has high malignancy and poor prognosis. We report two cases of early-stage primary malignant melanoma of esophagus (PMME) underwent subtotal esophagectomy.

Methods
Case presentation

Results
[Case 1]A 66-year-old man was pointed out a black legion on the lower esophagus by upper gastrointestinal endoscope for screening purposes. The lesion was diagnosed as malignant melanoma by biopsy. In addition, another black lesion was also found in the pharynx, but there was no malignant cell. Other examinations did not reveal any findings of lymph node metastasis and distant metastasis. We diagnosed PMME (T1aN0M0 Stage 0) and performed surgical resection. Pathologically it was pT1a (LPM), pN0. There is no recurrence, and it is under observation. [Case 2] A 51-year-old woman was conducted upper gastrointestinal endoscopy for the purpose of scarring epigastric pain, and a black lesion was pointed out in lower esophagus. Surgical resection was performed with diagnosis of PMME (T1bN0M0 Stage I). The pathological stage was pT1a (MM), pN0.

Conclusion
The 5 year survival rate of malignant melanoma of primary esophagus is poor with about 30 to 35%, and especially in cases with lymph node metastasis, the survival rate further decreases. The both cases were discovered accidentally by endoscopic examination, leading to early diagnosis and early treatment. Therefore, long survival is expected. There is also a report that melanosis is associated with melanoma, so case 1 requires careful follow-up observation.

Disclosure
All authors have declared no conflicts of interest.
PS02.194: THE GENERATION & VALIDATION OF FOUR NEW ESOPHAGEAL CANCER CELL LINES WITH MATCHED PATIENT-DERIVED TUMOR XENOGRAFTS
Authors: Read Matthew , Liu David , Guerra Glen , Duong Cuong , Krishnadath Kausilia , Clemons Nicholas , Phillips Wayne 
Published: September 2018

Abstract

Background
Research into esophageal cancer, in particular adenocarcinoma, has been hampered by a paucity of relevant pre-clinical models. To date, only 13 bona fide adenocarcinoma cell lines have been published, with only six being derived from patients with confirmed Barrett's esophagus. Having so few available cell lines makes it difficult to model the genetic diversity observed in esophageal adenocarcinoma. In addition, only one of these lines has been shown to be reproducibly metastatic in xenograft models. This is in distinct contrast to the disease in the human, which is almost universally metastatic when left untreated.

Methods
Using our previously published intramuscular xenografting technique1, patient derived tumour xenografts (PDTX) were generated from endoscopic biopsies of treatment naïve esophageal adenocarcinoma and SCC biopsies. Following successful engraftment, PDTX tissue was digested in order to generate small explant pieces. Explants were then plated with media and cultured for extended periods until a dominant clone was cultured. One cell line was directly obtained from the malignant ascites of a mouse that was harboring a PDTX that had metastasized. Established cell lines then underwent validation, which consisted of short tandem repeat (STR) analysis, targeted oncogene assessment using the Illumina TruSeq cancer panel, tumorigenic assay, immunohistochemical (IHC) analysis for both adenocarcinoma and SCC markers as well as FACS analysis for both epithelial and human markers.

Results
Matched PDTX and xenograft derived cell lines were generated from two separate SCCs in addition to two separate adenocarcinomas. From one of the adenocarcinoma lines, two separate cell lines were generated, with one clone demonstrating a reproducibly metastatic phenotype, while the other remained non-metastatic. STR analysis confirmed all of the PDTXs and cell lines were derived from their respective patients and IHC analysis confirmed that they expressed the appropriate epithelial markers.

Conclusion
We have successfully generated and validated four additional esophageal cancer cell lines (two adenocarcinoma and two SCC) with matched PDTXs. The combination of both models creates a powerful tool, given the ability of PDTXs to recapitulate the heterogeneity and stromal elements of the original tumour, and the versatility of cell lines for mechanistic studies. 1. Read, M., et al. Annals of surgical oncology 2015.

Disclosure
All authors have declared no conflicts of interest.
PS02.195: CIRCULATING TUMOUR DNA HAS UTILITY IN THE CLINICAL MANAGEMENT OF ESOPHAGEAL CANCER
Authors: Phillips Wayne , Yates Michael , Dawson Sarah-Jane , Duong Cuong , Clemons Nicholas 
Published: September 2018

Abstract

Background
Cell-free DNA, a consequence of normal cell death and apoptosis, is found in the blood of all individuals. In cancer patients, a proportion of circulating cell free DNA will be derived from tumour cells, and is termed circulating tumour DNA (ctDNA).We have developed a blood-based ‘liquid biopsy’ to detect ctDNA in plasma of esophageal cancer patients.

Methods
Tumour, buffy-coat (germline) and plasma samples were obtained from 28 esophageal cancer patients at the time of diagnosis. Serial blood samples were collected from 8 patients. Somatic DNA mutations in 9 genes (TP53, ARID1A, SMAD4, CDKN2A, SMARCA4, NRG1, APC, PIK3CA and KRAS) were evaluated in tumour biopsies and plasma using targeted sequencing. Tumour specific mutations were confirmed by droplet digital PCR, which was used to track patient-specific ctDNA in plasma from serially collected blood samples.

Results
Somatic mutations in at least one of the targeted genes were detected in 19/28 (68%) tumour biopsies. The same mutations were detected in ctDNA from plasma in 9/19 (48%) patients. Additional mutations that were not detected in the tumour biopsies were detected in plasma DNA from 2 patients, highlighting the issues of intra-tumoural heterogeneity and sampling bias of tumour biopsies. ctDNA was more frequently detected in patients with advanced disease where it represented a greater proportion of the total cell-free plasma DNA than in patients with localised disease. In patients with serial samples, levels of ctDNA correlated with response to treatment, and rises in ctDNA could be detected prior to clinical evidence of relapse.

Conclusion
Detection of ctDNA using targeted sequencing and digital PCR is feasible in the majority of esophageal cancer patients, particularly those with advanced disease. Dynamic changes in ctDNA levels reflect response to treatment and disease relapse as determined by conventional clinical imaging. We conclude that ctDNA levels can provide supplemental evidence regarding disease staging, as well as prognostic and predictive information that can inform therapeutic pathway decisions in esophageal cancer patients.

Disclosure
All authors have declared no conflicts of interest.
PS02.196: STUDY OF BODY COMPOSITION CHANGE AFTER ESOPHAGECTOMY
Authors: Ogata Takashi , Osakabe Hiroaki , Nagasawa Shinsuke , Nakazono Masato , Hara Kentaro , Kumazu Yuta , Hayashi Tsutomu , Yamada Takanobu , Yoshikawa Takaki 
Published: September 2018

Abstract

Background
Esophageal cancer surgery with lymphadenectomy is known as a cause of weight loss during perioperative period, but the change of body composition is unclear.

Methods
The aim of study is to clarify the influence of body composition change after esophagectomy. 144 patients(51 cases without NAC and 93 cases with NAC: 98 cases with less than G2 perioperative complications and 46 cases with G2 or more perioperative complications: 36 cases with recurrence and 108 cases without recurrence were included) of esophageal cancer who underwent esophagectomy with lymphadenectomy from August 2011 to December 2016 and evaluated body composition examination before operation and after operation(1, 3, 6 month) were included in this study. We compared the change of body composition between with or without preoperative chemotherapy, postoperative complication, and recurrence.

Results
The weight loss rate at discharging hospital, 1,3,6 month after discharge for without NAC group/with NAC group was 3.3/3.8%, 7.8/6.8%, 10.1/9.2%, 11.1/9.1% (NS), and the lean body mass reduction rate was 4.1/4.5%, 7.1/6.6%, 6.5/6.7% (N.S.), 6.6/4.3% (P < 0.05). The weight loss rate for with less than G2 perioperative complication group/with G2 or more perioperative complication group was 2.9/4.9%(P < 0.01), 6.1/8.7%(P < 0.01), 8.4/12.1%(P < 0.01), 8.4/11.2%(P < 0.05), and the lean body mass reduction rate was 3.7/5.9%(P < 0.05), 5.9/9.0%(P < 0.01), 5.6/9.6%(P < 0.01), 4.4/5.5%(N.S.). And there was no significant differences of weight loss rate and lean body mass reduction rate at discharging hospital, 1,3,6 month after discharge between with recurrence group and without recurrence group.

Conclusion
Due to postoperative complications after esophagectomy, the rate of weight loss increased from hospital discharge to 6 months after discharge. Particularly, lean body mass was reduced within 3 months. So, we may have a strategy such as continuing enteral nutrition even after discharge for complicated cases.

Disclosure
All authors have declared no conflicts of interest.
PS02.197: UPREGULATION OF IMP3 HAS A NEGATIVE PROGNOSTIC IMPACT IN EARLY INVASIVE ESOPHAGEAL ADENOCARCINOMA
Authors: Plum Patrick , Ulase Dita , Chon Seung-Hun , Berlth Felix , Zander Thomas , Alakus Hakan , Bollschweiler Elfriede , Hölscher Arnulf , Bruns Christiane , Quaas Alexander , Löser Heike 
Published: September 2018

Abstract

Background
Despite improvements in perioperative treatments, the overall survival of patients with esophageal adenocarcinoma (EAC) remains low. In early invasive tumors (pT1) there is striking risk discrepancy for tumors with vascular invasion (L1/V1). As this tumor stage is potentially locally resectable, there is an urgent need for reliable pretherapeutical evaluation. High expression of IMP3 correlates with worse prognosis in colon and gastric cancer. In a small series of 30 patients with EAC, IMP3 is significantly associated with lymphovascular invasion. In our large cohort of EAC, we analyzed the immunohistochemical expression of IMP3 in correlation to clinical data.

Methods
371 patients who underwent esophagectomy due to EAC at the Department of General, Visceral and Cancer Surgery, University of Cologne between 1999 and 2012 were included. Tissue Microarrays (TMA) were retrospectively established from the formalin-fixed, paraffin embedded material of the resected specimens and immunohistochemically stained using the primary antibody specific for IMP3. The IMP3 staining intensity was scored manually according to a 3-tier-scoring system (negative, weak and strong).

Results
TMAs from 371 patients were interpretable for further analysis. 109 patients (29.3%) had superficial EAC (pT1a/pT1b) while 262 (70.7%) showed locally advanced tumors (pT2 or pT3). 67 (26.7%) patients with advanced tumors and all pT1 EAC patients did not receive neoadjuvant therapy (chemotherapy or chemo-radiotherapy) prior to surgery. 259 of the 371 EAC revealed positive immunostaining for IMP3 including 167 strongly and 92 weakly positive. For patients without neoadjuvant therapy, there was a significant trend for higher IMP3 expression in early invasive tumors (pT1a/pT1b) showing significantly higher rates of IMP3 positive tumors compared to locally advanced pT3-tumors without neoadjuvant therapy (P = 0.0015). There was no difference of IMP3 expression according to neoadjuvant therapy in patients with pretreated EAC. There is a statistically significant association between IMP3 protein expression and shortened survival in early invasive pT1-esophageal carcinomas (P = 0.045).

Conclusion
IMP3 is a feasible marker in early invasive EAC (pT1a and pT1b) and is significantly associated with worse outcome. IMP3 indicates lymph node metastases, advanced infiltration depth and higher tumor grade. Thus IMP3 might be useful for therapeutic decisions in early invasive EAC.

Disclosure
All authors have declared no conflicts of interest.
PS02.198: RELATIONSHIP BETWEEN SUPPLEMENTAL TUBE-FEEDING NUTRITION AFTER HOSPITAL DISCHARGE AND LOSS OF SKELETAL MUSCLE AFTER ESOPHAGECTOMY IN ESOPHAGEAL CANCER PATIENTS
Authors: Niihara Masahiro , Tsubosa Yasuhiro 
Published: September 2018

Abstract

Background
Malnutrition is common after esophagectomy in esophageal cancer, and loss of skeletal muscle has been reported as a risk factor for survival. However, the impact of nutritional intervention on postoperative changes in skeletal muscle has been poorly reported.

Methods
Patients and methods: We have reported prospective feasibility study (FAST-ERAS Trial) will provide preliminary information on the routine use of 90-day supplemental tube-feeding nutrition (STN). Between February 2015 and September 2016, 24 patients following esophagectomy were enrolled in this study. For the first 90 days after hospital discharge, the participant would administer intermittent jejunostomy (trans-gastric) tube-feeding of total 250 ml enteric nutrient (ENEVO TM) a day using catheter tip by patient himself/herself in addition of oral intakes. The completion was defined as administering 70% or more of planned nutrient. We investigated the correlation between the completion of nutritional intervention, and the decrement in the skeletal muscle in cross-sectional area (CSA) at the third lumbar vertebra before and 6 months after surgery.

Results
The ratio of patients who completed the intervention: 20/24 (83.3%). The CSA of the skeletal muscle before surgery were 58.2 ± 11.6 cm2 in the patients who completed the nutritional intervention (complete group), 64.6 ± 22.9 cm2 in the patients who did not complete (non-complete group), respectively. The decrement in CSA were -0.63 ± 5.09 cm2 in complete group, 3.77 ± 3.33 cm2 in non-complete group (P = 0.017).

Conclusion
s: The supplemental tube-feeding nutrition not only during hospitalization but also during the first 90 days after discharge at home was significantly associated with maintaining and improving skeletal muscle after esophagectomy.

Disclosure
All authors have declared no conflicts of interest.
PS02.203: CHARACTERISTICS AND RISK FACTORS OF LYMPH NODE METASTASIS IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA PATIENTS WITH PREOPERATIVE COMPUTED TOMOGRAPHY-NEGATIVE LYMPH NODES
Authors: Dai Wei , Zhang Yuanqiang , Li Xueming , Peng Lin , Han Yongtao 
Published: September 2018

Abstract

Background
Characteristics and risk factors of lymph node metastasis (LNM) in esophageal squamous cell carcinoma (ESCC) patients with preoperative computed tomography (CT)-negative lymph nodes are not well elucidated. This study aimed to identify the characteristics and risk factors of LNM in ESCC patients with preoperative CT-negative lymph nodes.

Methods
We conducted a retrospective analysis of consecutive ESCC patients who had preoperative CT-negative lymph nodes and received esophagectomies between August 2013 and July 2016. Lymph node with a short-axis diameter ≦10 mm on preoperative CT image was considered as CT-negative lymph node. Eligible patients included those: aged 18∼80, without neoadjuvant therapy, without other malignant tumor history, without distant metastasis, without multiple esophageal lesions, tumor locating in the thoracic esophagus, receiving McKeown esophagectomy, undergoing R0 resection, having number of lymph nodes resection≧15, pathological staging as T1a-4aN0–3. Univariate and multivariate logistic regression analyses were used to identify risk factors of LNM.

Results
Among 243 ESCC patients identified, 137 had LNM (56.4%). The median number of lymph nodes dissected and LNM were 24 (range 15–79) and 2 (range 1–14), respectively. The rates of LNM of the upper, middle and lower thoracic ESCC were 50.0%, 59.3% and 55.1%, respectively. The rates of LNM with the maximal short-axis diameter of lymph node on preoperative CT of ≦5 mm, 6 mm, 7 mm, 8 mm, 9 mm and 10 mm were 57.4%, 42.9%, 47.4%, 31.8%, 73.9% and 70.8%, respectively (P = 0.034). Univariate analysis showed that age (P = 0.041), maximal short-axis diameter of lymph node on CT (P = 0.034), cervical lymph node dissection (P = 0.031), lymphovascular invasion (P < 0.001) and perineural invasion (P = 0.017) were associated with LNM. Multivariate analysis revealed that cervical lymph node dissection (P = 0.018), lymphovascular invasion (P = 0.007) and perineural invasion (P = 0.025) were independent risk factors of LNM.

Conclusion
Our study showed that the rates of LNM were also high in ESCC patients with preoperative CT-negative lymph nodes. Standard lymph node dissection is necessary for these patients. Cervical lymph node dissection, lymphovascular invasion and perineural invasion are independent risk factors of LNM in ESCC patients with preoperative CT-negative lymph nodes.

Disclosure
All authors have declared no conflicts of interest.
PS02.207: NEUTROPHIL-LYMPHOCYTE RATIO HOLDS NO PROGNOSTIC VALUE FOR OESOPHAGEAL AND JUNCTIONAL ADENOCARCINOMA IN PATIENTS TREATED WITH NEOADJUVANT CHEMOTHERAPY
Authors: Van Hootegem Sander , Smithers Mark , Gotley David , Brosda Sandra , Thomson Iain , Thomas Janine , Gartside Michael , Wijnhoven Bas P L , Barbour Andrew 
Published: September 2018

Abstract

Background
Several studies have been suggesting that neutrophil-lymphocyte ratio (NLR), as it reflects systemic inflammation, could help predict survival in oesophageal and junctional carcinomas. Therefore, we aimed to determine whether baseline NLR holds prognostic and predictive value in oesophageal and junctional adenocarcinomas (OAC) for patients treated with neoadjuvant chemotherapy (nCT) followed by surgery.

Methods
We studied the data of 144 included patients that received nCT, all identified from a prospectively maintained database. Pre-treatment haematology reports were used to calculate the baseline NLR, dividing absolute neutrophil count by absolute lymphocyte count. Multiple ways of grouping patients based on NLR were tried, including determining the optimal cut-off value based off a ROC-curve and the standard threshold for elevated NLR (> 5). NLR quartiles were used to display possible differences between groups in relation to overall survival (OS), disease-free survival (DFS) and pathological response according to Mandard score. Cox regression analysis was performed to determine independent prognostic factors for OS.

Results
The ROC-curve showed that NLR has no discriminating power for survival status (area under the curve = 0.460) and therefore no optimal cut-off value could be determined. Also, using the most frequently used threshold for elevated NLR (≥ 5) to group patients did not lead to a difference in OS (P = 0.112). Median OS times for NLR quartiles were 65 (Q1), 32 (Q2), 45 (Q3) and 46 months (Q4), with no significant difference (P = 0.926). DFS showed no difference between groups either, with median DFS times of 30 (Q1), 22 (Q2), 38 (Q3) and 23 months (Q4, P = 0.973). Pathological response according to Mandard score did not vary between NLR quartiles (P = 0.925). In addition, NLR was not associated with OS in univariate analysis (P = 0.518). Multivariate analysis showed that both pathological N- and M-stage, and number of involved nodes were independent prognostic indicators for OS.

Conclusion
The present study shows that, in contrast to other recently published papers, baseline NLR holds no prognostic or predictive value for OAC patients treated with nCT. This result strongly questions the validity of NLR as a prognostic indicator and its clinical usefulness.

Disclosure
All authors have declared no conflicts of interest.
PS02.210: EVALUATION OF PREDICTION SYSTEM IN TREATMENT EFFECT AND PROGNOSIS OF ESOPHAGEAL CANCER BASED ON RADIOEPIGENOMICS THEORY
Authors: Hoshino Isamu , Ishige Fumitaka , Iwatate Yosuke , Takiguchi Nobuhiro , Ikeda Atsushi , Soda Hiroaki , Tonooka Toru , Sato Nami , Nabeya Yoshihiro 
Published: September 2018

Abstract

Background
We tried integrated analysis of epigenomic information (Epigenomics) and image information (Radiomics) as Ragioepigenomics for esophageal cancer.

Methods
1, Expression analysis of miR, evaluation as prognostic predictor (Epigenomics), 2, Image information analysis (Radiomics): a, Normalization of contrast CT images, feature quantities by 3D gray level co-occurrence matrix extraction. b, Normalization of SUV of FDG-PET image. Extraction of feature quantity by 3D gray level co-occurrence matrix. c, Image analysis of features. 3, Integrated analysis of Epigenomics and Radiomics information: We analyzed the relationship between miR expression level and variables obtained from image analysis.

Results
As a result of Cox regression by the selection method using elastic net, three variables were selected from contrast CT, and the results of both were consistent. Furthermore, when the survival curve and the log rank test were performed by the Kaplan-Meier method for the cluster shade high value group and the low value group, a significant difference was observed in the 2 groups.

Conclusion
A multimodal approach so called Radioepigenomics, which is a system for analyzing molecular information from image analysis will be applied to future Precision Medicine.

Disclosure
All authors have declared no conflicts of interest.