bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS02.116: FEASIBILITY OF DOCETAXEL, CISPLATIN, AND 5-FLUOROURACIL (DCF) VERSUS RADIOTHERAPY WITH DCF (DCF-RT) AS PREOPERATIVE THERAPY FOR LOCALLY ADVANCED ESOPHAGEAL CANCER
Authors: Natsugoe Shoji , Sasaki Ken , Uchikado Yasuto , Okumura Hiroshi , Omoto Itaru , Osako Yusaku , Owaki Tetsuhiro 
Published: September 2018

Abstract

Background
In Japan, preoperative chemotherapy with cisplatin plus 5-fluorouracil (CF) followed by radical surgery has been accepted as the standard therapeutic approach for resectable esophageal squamous cell carcinoma (ESCC) result from a Japan Clinical Oncology Group randomized control trial. Whether preoperative chemoradiotherapy (CRT) followed by radical surgery is effective for Japanese ESCC patients has yet to be established. Some trials have reported usefulness of CF plus docetaxel therapy (DCF) for advanced or metastatic ESCC. Here, we have launched a randomized controlled trial to compare preoperative DCF versus DCF plus radiotherapy (DCF-RT) followed by surgery in locally advanced esophageal cancer.

Methods
Patients with clinical stage II/III (Japanese Classification of Esophageal Cancer, 11th Edition) are randomized to 2 groups. Patients in DCF group receive 2 courses of preoperative DCF (docetaxel, 60 mg/m2/day, day 1; cisplatin, 70 mg/m2/day, day 1; 5-FU, 700 mg/m2/day, days 1–5) repeated every 3 weeks. Patients in DCF-RT group receive preoperative chemoradiotherapy (40Gy/20fr) with 2 courses of DCF (docetaxel, 30 mg/m2/day, day 1, 15; cisplatin, 7 mg/m2/day and 5-FU, 350 mg/m2/day, days 1–5, days 8–12, days 15–19, days 22–26). The primary endpoint is overall survival and the secondary endpoints include adverse events, response rate and pathologic complete response rate.

Results
Twenty-seven patients were assigned to the DCF group and 26 patients to the DCF-RT group. Grade 3/4 leukopenia and febrile neutropenia occurred 37% and 19% in the DCF group, 35% and 12% in the DCF-RT group. The clinical response rates were 16.0% and 64.0% in the DCF and DCF-RT group. Twenty patients and 23 patients underwent surgery in the DCF and DCF-RT group, and the R0 resection rate was 80.0% and 91.3%. With regard to the surgical complications, the incidence of anastomotic leakage was significantly higher in the DCF-RT group compared with the DCF group. The histological effects of DCF-RT were significantly higher than those of DCF. Two-year survival rate was 46% in the DCF group and 70% in the DCF-RT group.

Conclusion
The DCF and DCF-RT were found to be feasible as neoadjuvant therapy, and DCF-RT demonstrated higher efficacy than DCF in clinical stage II/III esophageal cancer patients.

Disclosure
All authors have declared no conflicts of interest.
PS02.119: THE IMPACT OF RECEIVING ADJUVANT CHEMOTHERAPY ON SURVIVAL IN PATIENTS WITH LOCALLY ADVANCED ADENOCARCINOMA OF THE OESOPHAGUS
Authors: Madhavan Anantha , Phillips Alex , Wyatt Nicola , Boreham Charlotte , Navidi Maziar , Michael Griffin S 
Published: September 2018

Abstract

Background
Surgery remains the fundamental modality for achieving disease cure in patients with oesophageal adenocarcinoma In those with locally advanced disease, in the UK, is usually used in conjunction with perioperative chemotherapy as per the Magic trial. Not all patients manage to progress to the adjuvant component of the chemotherapy regimen, and its impact on outcome has not been determined. The aim of this review was to compare outcomes in those patients that received neoadjuvant treatment only with those that received neoadjuvant and adjuvant chemotherapy.

Methods
A retrospective review of patients who underwent treatment with curative intent for locally advanced oesophageal adenocarcinoma between 2006 to 2016 at a single institution was performed. Outcomes of patients who were staged T3 and above or had evidence of nodal disease and received perioperative chemotherapy were reviewed. Outcomes were stratified according to whether patients received only neoadjuvant chemotherapy or both neoadjuvant and adjuvant chemotherapy.

Results
A total of 413 patients underwent transthoracic oesophagectomy and two field lymphadenectomy with perioperative chemotherapy. 276 (67%) received only neoadjuvant chemotherapy, with 137 (33%) receiving at least one cycle of adjuvant chemotherapy. Pathological staging was comparable between groups (P = 0.17). Overall estimated median survival was 30 months (neoadjuvant only) Versus 37 months (Both) P = 0.2. In patients that were found to be node positive median survival was 22 months (neoadjuvant) versus 28 months (both) P = 0.21. For node negative patients median survival was not reached in both groups.

Conclusion
These results indicate a trend towards improved survival with the addition of adjuvant chemotherapy. This may be of greater impact in those patients with nodal involvement. Further studies are required to fully evaluate the impact of adjuvant chemotherapy in patients surgically treated for oesophageal cancer.

Disclosure
All authors have declared no conflicts of interest.
PS02.120: NEOADJUVANT CHEMOTHERAPY VERSUS NEOADJUVANT CHEMORADIOTHERAPY FOR CANCER OF THE OESOPHAGUS OR GASTRO-OESOPHAGEAL JUNCTION: LONG-TERM RESULTS
Authors: Von Döbeln Gabriella , Klevebro Fredrik , Jacobsen Anne-Birgitte , Hilmer Nielsen Niels , Johnsen Gjermund , Hatlevoll Ingunn , Idar Glenjen Nils , Friesland Signe , Lundell Lars , Nilsson Magnus 
Published: September 2018

Abstract

Background
NeoRes I is a randomized phase II trial comparing neoadjuvant chemoradiotherapy with neoadjuvant chemotherapy in the treatment of resectable oesophageal cancer.

Methods
Patients with biopsy-proven adenocarcinoma or squamous cell carcinoma in the oesophagus or gastro-oesophageal junction (Siewert type I and II), T1N1 or T2–3N0–1 and M0-M1a (AJCC 6th edition) were randomized to receive three 3-weekly cycles of cisplatin 100 mg/m2 day 1 and fluorouracil 750 mg/m2/24 hours, days 1–5 with or without the addition of concurrent radiotherapy 40 Gy, 2 Gy/fraction, 5 days a week, followed by oesophageal resection with two-field lymphadenectomy. Primary endpoint was complete histopathological response rate. Survival and recurrence patterns were evaluated as secondary endpoints.

Results
Between 2008 and 2013, 181 patients were enrolled in 10 participating institutions in Sweden and Norway. Patients were well matched for pre-treatment characteristics T3: 64,1%, T2: 34,8%, T1: 1,1%. Adenocarcinoma: 72,4%, squamous cell carcinoma: 27,6%. Proximal/middle: 16,6%, distal: 65,2%, cardia (Siewert type II): 18,2%. < 60 years: 36,5%, 60–75 years: 63,5%. Treatment-related complications have previously been described with no significant differences between the treatment groups although postoperative complications were more severe in the chemoradiotherapy group. At the time of this analysis, median follow-up time for living patients was 63 months. Overall 5-year survival was better among those who achieved complete histopathological response (74,9%, 95% CI 54,2–87,2% versus 39,3%, 95% CI 30,6–47,8%, P = 0002). Despite the previously reported higher rate of tumour tissue response in those who received neoadjuvant chemoradiotherapy, this was not translated into better survival. Five-year progression-free survival was 38,6%, 95% CI 28,4–48,6% (chemoradiotherapy) versus 32,4%, 95% CI 22,9–42,4% (chemotherapy), P = 0,48. Five-year overall survival was 41,2%, 95% CI 30,9–51,3% (chemoradiotherapy) versus 38,9%, 95% CI 28,7- 49,0% (chemotherapy), P = 0,95. There were no differences in recurrence patterns between the two treatment-groups.

Conclusion
This is to our knowledge the largest completed randomized trial comparing neoadjuvant chemotherapy with neoadjuvant chemoradiotherapy followed be oesophageal resection in patients with cancer in the oesophagus or gastro-oesophageal junction. We found no overall or progression-free survival advantages by adding radiotherapy, despite better tumour tissue response.

Disclosure
All authors have declared no conflicts of interest.
PS02.128: SENSE OR NONSENSE OF A PALLIATIVE ESOPHAGECTOMY IN CASE OF UNEXPECTED OLIGOMETASTATIC DISEASE
Authors: Depypere Lieven , Moons Johnny , Lerut Toni , Coosemans Willy , Van Veer Hans , Nafteux Philippe 
Published: September 2018

Abstract

Background
Screening is an important tool in staging esophageal cancer as only patients without suspicion of metastases are considered for surgery-based treatment. Nevertheless unexpected metastatic disease is still found in some patients during surgery. In these cases should esophagectomy be aborted, or is there a place for palliative resection?

Methods
Between 2002 and 2015, 681 patients with locally advanced potentially resectable esophageal cancer were scheduled for neoadjuvant therapy and subsequent esophagectomy. In 552 patients potentially curative esophagectomy was performed. In twelve patients, unexpected disease was discovered during surgery but esophagectomy was performed with synchronous resection of the metastases. Ten of them were oligometastatic (≤ 4 single organ metastases). In 117 patients esophagectomy was not performed with among them 50 patients because of disease progression. Fourteen of these patients were also single organ oligometastatic and ten of them received systemic treatment. 10 single organ oligometastatic patients that underwent esophageal resection (group1) were compared to 10 non-resected—but treated—counterparts (group2) and to 228 patients that underwent a potentially curative esophagectomy with persistent pathological lymph nodes (group3). Clinicopathological data were retrospectively reviewed and survival of the three groups was compared from date of pathological diagnosis.

Results
In the oligometastatic esophagectomy patients, 5 had lung metastases, 1 peritoneal, 2 adrenal, 1 pleural, and 1 pancreatic. In the oligometastatic non-resected patients, 2 had lung metastases, 5 liver and 3 brain metastases. Median overall survival was 21.4, 12.1 and 20.2 months in the respective groups. (group1 vs group2: P = 0.042; group2 vs group3: P = 0.002; group1 vs group3: P = 0.88).

Conclusion
Survival is prolonged in patients undergoing palliative esophagectomy in case of unexpected single organ oligometastatic disease during surgery and is comparable to survival of patients with persistent pathological lymph nodes. Palliative resection in unexpected oligometastatic disease seems to be justified.

Disclosure
All authors have declared no conflicts of interest.
PS02.131: PATTERN OF LYMPHATIC METASTASIS OF CERVICAL ESOPHAGEAL CANCER
Authors: Li Jiancheng , Shi Xiuling 
Published: September 2018

Abstract

Background
Cervical esophageal cancer were rarely surgeryed Analysis and discussion of lymph node metastasis of cervical esophageal cancer

Methods
From July 2008 to June 2017, 10 cases of successful esophagectomy of cervical esophageal cance in our hospital underwent radical resection. Surgical dissection range was the neck and the upper mediastinum. A total of 231 lymph nodes were dissected. The lymph nodes were summarized and grouped in different ways, and analyzed the law of lymph node metastasis.

Results
7 cases of esophageal cancer, lymph node metastasis occurred, and the rate of lymph node metastasis was 70% (7/10), of which 1 case was T1b stage. 17 lymph node metastases, the degree of lymph node metastasis was 7.36% (17/231), including 4 esophageal lymph nodes, 12 cervical lymph nodes and 1 upper right mediastinal lymph node.

Conclusion
Cervical esophageal cancer lymph node metastasis can spread occur early metastasis, and the metastasis site were mainly in neck..

Disclosure
All authors have declared no conflicts of interest.
PS02.134: COMPARISON OF PUSH PERCUTANEOUS ENDOSCOPIC GASTROSTOMY WITH OPEN GASTROSTOMY IN ADVANCED ESOPHAGEAL CANCER PATIENTS
Authors: Mahawongkajit Prasit 
Published: September 2018

Abstract

Background
In esophageal cancer treatment, nutrition by feeding tube has been demonstrated to improve patient tolerance of treatment, quality of life, and long term outcomes. The open gastrostomy and percutaneous endoscopic gastrostomy (PEG) push technique are procedures that avoid cancer cells seeding and also improve patient nutritional status. The aim of this study is to compare the results of the push PEG and open gastrostomy in patients with advanced esophageal cancer.

Methods
A retrospective study was analyzed in the advanced esophageal cancer patients who indicated and received feeding support between January 2016 and December 2017.

Results
28 patients in push PEG and 36 patients in open gastrostomy presented the following comparative data: mean operative duration time shorter in push PEG (11.9 min) than open gastrostomy (35.1 min), less blood loss in push PEG (0.8 mL) than open gastrostomy (5.6 mL), less pain score in push PEG (2.4) than open gastrostomy (5.9) and shorter hospitalization in push PEG (1.8 days) than open gastrostomy (2.6 days). Both groups showed no readmission or 30 day mortality. The adverse events of open gastrostomy demonstrated higher than push PEG group.

Conclusion
Both push PEG and open gastrostomy were the safe options for advanced esophageal cancer patients indicating for enteral nutrition and to avoid cancer cell seeding. The push PEG demonstrated the effective minimally invasive procedure, was safe and with fewer complications.

Disclosure
All authors have declared no conflicts of interest.
PS02.153: HER2 PATHWAY CONTROL SENSITIVITY TO CISPLATIN IN ESOPHAGEAL ADENOCARCINOMA CELL LINES
Authors: Dakpo Eugenia , Derouet Mathieu , Yeung Jonathan , Darling Gail 
Published: September 2018

Abstract

Background
Adenocarcinoma of the esophagus is increasing in frequency and is the 6th most common cause of cancer death in North America. Cisplatin has been the backbone of neoadjuvant therapy but despite improved 5-year survival with neoadjuvant chemoradiation, many tumor cells survive chemotherapy leading to distant metastases. This study investigated the molecular changes in tumors when they become cisplatin resistant by focussing on the HER family of proteins.

Methods
We created 2 cisplatin resistant cell lines and a matching control by exposing the adenocarcinoma cell lines SK-GT-4 and FLO-1 to repeated cycles of cisplatin. Resistance to cisplatin was assessed at the end of the treatment. The expression levels of the HER family members was assessed. Cell proliferation, resistance to cisplatin and siRNA transfection were used to assess the role of HER family members in cisplatin resistance in EAC.

Results
The cisplatin resistant cell line displayed a lower rate of proliferation than the matching control (1.5 fold difference after 72h, P < 0.05). When the level of HER family members in the cisplatin resistant and control cell lines were measured, we observed a downregulation of HER2 in both cisplatin resistant cell lines (FLO-1: 78.31 mean expression (control) vs 17.43 mean expression (cisplatin resistant), P < 0.05), whereas the EGFR level were unchanged (FLO-1: 154.76 mean expression (control) vs 137.64 mean expression (cisplatin resistant), P > 0.05). In order to confirm this observation, we downregulated HER2 by siRNA and by a HER2 specific inhibitor in control cells. Resistance to cisplatin was similar to the cisplatin resistant cell lines (3.33μM cisplatin for 72h, death rate: 72.1% control vs 23.6% HER2 siRNA, P < 0.05). Similar results were observed in two other EAC cell lines (OE33 And JHESO-AD1).

Conclusion
Our results suggest that there is a correlation between HER2 level/activity and cisplatin resistance in EAC cells. It appears that as EAC cells acquire cisplatin resistance, they block the HER2 pathway.

Disclosure
All authors have declared no conflicts of interest.
PS02.158: DISTRIBUTION OF LYMPH NODE METASTASES IN ESOPHAGEAL CARCINOMA [TIGER STUDY]: A MULTINATIONAL OBSERVATIONAL STUDY
Authors: Hagens Eliza , Van Berge Henegouwen Mark I , Gisbertz Suzanne 
Published: September 2018

Abstract

Background
Lymph node status is an important prognostic parameter in esophageal carcinoma and an independent predictor of survival. Distribution of metastatic lymph nodes may vary with tumor location within the proximal or distal esophagus, tumor histology, tumor invasion depth and neoadjuvant therapy. Surgical strategy depends on the distribution pattern of nodal metastases but consensus on the extent of lymphadenectomy differs worldwide. Especially for adenocarcinoma the distribution of lymph node metastases has not yet been described in large series. Aim of the present study is to evaluate the distribution of lymph node metastases in esophageal carcinoma specimens following transthoracic esophagectomy with a 2-or 3-field lymphadenectomy.

Methods
The TIGER-study is an international observational cohort study with 58 participating centers. All patients with a resectable esophageal or gastro-esophageal junction carcinoma in whom a transthoracic esophagectomy with a 2- or 3-field lymphadenectomy is performed in participating centers will be included. All lymph node stations will be excised and separately individually analyzed by pathological examination. The aim is to include 5000 patients. The primary endpoint is the distribution of lymph node metastases in esophageal and esophago-gastric junction carcinoma specimens following transthoracic esophagectomy with at least 2-field lymphadenectomy in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and (disease free) survival.

Results
We aim to start inclusion on 1/03/2018 and will present the first results during the congress.

Conclusion
The TIGER study will provide a roadmap of the location of lymph node metastases in relation to tumor histology, tumor location, invasion depth, number of lymph nodes and lymph node metastases, pre-operative diagnostics, neo-adjuvant therapy and survival. Patient-tailored treatment can be developed on the basis of these results, such as the optimal radiation field and extent of lymphadenectomy based on the primary tumor characteristics.

Disclosure
All authors have declared no conflicts of interest.
PS02.170: EFFICACY OF PERIOPERATIVE IMMUNONUTRITION OF ESOPHAGECTOMY FOR ESOPHAGEAL CANCER
Authors: Kanekiyo Shinsuke , Takeda Shigeru , Iida Michihisa , Nishiyama Mitsuo , Kitahara Masahiro , Tokumitsu Yukio , Tomochika Shinobu , Suzuki Nobuaki , Yoshino Shigefumi , Hazama Shoichi , Nagano Hiroaki 
Published: September 2018

Abstract

Background
Malnutrition is frequent in esophageal cancer patients and aggravated by operation, increasing postoperative complications and mortality. Although a preoperative immunonutrition pharmaceutics diet significantly reduced the incidence of postoperative infectious complications, the effect of perioperative immunonutrition of esophagectomy for esophageal cancer still remains unclear.

Methods
This study design was a prospective randomized study. 40 patients with thoracic esophageal carcinoma who underwent esophagectomy were divided into two groups. Continiously 7 days before and after surgery, they enrolled and received either immunomodulating enteral nutrition (IMPACT® Group: IG) or standard enteral nutrition (Ensure® Group: EG). The nutrition statement, postoperative ICU stay, postoperative hospital stay, morbidity and mortality were investigated prospectively.

Results
There was no difference of patient demographics between two groups. Retinol-binding protein as rapid turnover protein was significantly higher on postoperative day (POD) -1, POD 7 and POD 14 in the IG than in the EG (P = 0.009, P = 0.004 and P = 0.024, respectively). The incidence of postoperative infectious complications and changes to therapeutic antibiotics was significantly lower in the IG than in the EG (P = 0.048 and P = 0.012, respectively). No difference was observed in postoperative ICU stay and postoperative hospital stay between two groups. The 5-year PFS in the IG and EG groups were 75% and 64% (P = 0.188), respectively, and OS were 68% and 55% (P = 0.187), respectively.

Conclusion
This study showed that immunonutrition would be effective to improve the early nutritional status and reduce postoperative infectious complications.

Disclosure
All authors have declared no conflicts of interest.
PS02.171: STUDY OF LONG TERM FOLLOW-UP OF EXERCISE LEVELS FOLLOWING PARTICIPATION IN A PREHABILITATION PROGRAMME IN OESOPHAGO-GASTRIC (OG) CANCER SURGERY
Authors: Doganay Emre , Mckinnon Tom , Osborn Hayley , Winter-Blyth Venetia , Moorthy Krishna 
Published: September 2018

Abstract

Background
Sedentary behaviour is emerging as an important field of scientific enquiry for cancer survivorship research. The aim of this study is to evaluate the impact of PREPARE, a multi-modal pre-operative optimization programme, and the impact this has on sustained activity following completion of cancer treatment.

Methods
66 patients were approached in clinic or sent letters to consent for the study. Median follow up time was 14 months. Patients either consented to telephone questionnaire or exercise testing or both. Telephone questionnaire included the validated Godin-Shephard Leisure-Time physical activity questionnaire in oncology, and exercise testing included the validated Chester-Step test, to obtain an accurate METS score. Scores were calculated at baseline (P1), 6–8 weeks postoperative (P4) and at follow up.

Results
66 patients were included in the study. Of these, 13 (19%) patients were excluded due to disease progression, death or declined to participate. The remaining 43 (65%) who were included in the study either consented for telephone questionnaire (74%) or exercise testing (60%) or both. Median follow up time was 14 months since surgery. Majority of the patients remained active at follow up; 23 (77%) were active, 5 (16%) were moderately active and, 4 (12%) were insufficiently active/sedentary. Overall, the median weekly METS scores were 5.8 (equivalent moderate intensity activity). On exercise testing, there was an improvement in median METS scores. At P1, baseline median METS were 5.0, at P4 5.0 and at 14 months 6.5. There was an overall increase in median self-efficacy scores. At P1, baseline scores were 8.3, at P4 8.5 and at 14 months 9.

Conclusion
There is emerging evidence to support the benefits of physical activity in cancer survivors and the impact this has on overall survival, quality of life and symptomatology. Starting prehabilitation at the time of diagnosis leads to improved confidence and sustained activity levels in the post-treatment period.

Disclosure
All authors have declared no conflicts of interest.