bluuebunny/crossref_metadata_2025_split huggingface dataset:
381. PROGRESSIVE LOSS OF BONE DENSITY IN PATIENTS WITH ESOPHAGEAL CANCER
Authors: Cameron Miles E , Judge Sarah , Judge Andrew , Awad Ziad 
Published: August 2023

Abstract

Background
Changes in body composition are common in esophageal cancer (EC). A majority of patients, regardless of stage, display signs of cachexia, including weight loss, skeletal and cardiac muscle atrophy and fat wasting. Bone loss is also common in cancer, secondary to shared signaling pathways that contribute to lean body loss. In this study, we hypothesized that bone density decreases progressively in patients with EC and that the continued loss of bone associated with oncologic outcomes.

Methods
We performed a retrospective review of all patients that received esophagectomy between 2012 and 2020 at our facility. Body composition was measured using PET/CT scans, and patients were classified by muscle mass according to sex- and BMI-dependent cutoffs. Bone density was measured by determining the radiation attenuation of the lumbar (L1-L5) vertebral bodies. The change in bone density was normalized by time and compared to tumor pathologic variables. A p-value less than 0.05 was considered statistically significant.

Results
Bone density was significantly reduced in patients with cachexia relative to those with appropriate muscle mass (108 ± 37.2 HU v. 146 ± 55.0 HU, p = 0.003). Furthermore, bone density correlated with muscle mass (p &lt; 0.00001, R = 0.5055) and muscle quality/radiodensity (p = 0.0002, R = 0.4736). Mean rate of bone loss was −12.0 ± 27.9 HU/100d. Patients with regional lymph node metastases at surgery had more bone loss than those with N0 disease (−26.6 ± 30.8 HU/100d v. -2.71 ± 22.1 HU/100d, p = 0.03). Similarly, patients with positive lymphovascular invasion (−41.8 ± 32.6 HU/100d v. -3.53 ± 20.1 HU/100d, p = 0.005) and positive perineural invasion (−29.8 ± 32.4 HU/100d v. -3.12 ± 21.1 HU/100d, p = 0.01) progressively lost more bone.

Conclusion
Reduced bone mineral density is a key component of cachexia in patients with EC. We demonstrate herein that osteopenia in EC patients associates with several cachexia measures and that progressive loss of bone may predict early metastasis. Bone density may serve as a strong predictor of survival and stratification tool for clinical trials. These findings further highlight the need to study mechanisms that lead to bone wasting in tumor bearing hosts.
386. ROLE OF RECURRENT NERVE LYMPHADENECTOMY THROUGH MINIMALLY INVASIVE SURGERY IN THE TREATMENT OF OESOPHAGEAL CANCER
Authors: Chicote Cristina Martínez , Navarro Fernando Mingol , Pardo Luis Hurtado , Sánchez Marta Nieto , Audí David Abelló , Olmo Nuria García , Esteban Marcos Bruna , Urbaneja Francisco Javier Vaqué 
Published: August 2023

Abstract

Background
With the development of neoadjuvant therapy protocols and the advances in minimally invasive surgery, an increasing number of patients are undergoing surgery of oesophageal cancer. Lymphatic involvement is one of the most important independent prognostic factors. There is enough evidence to support that the greater the lymphadenectomy, the better survival rates.
Our aim is to present the results of our series, in which partial or total recurrent nerve lymphadenectomy was performed during oncological oesophagectomies.

Methods
Retrospective observational study that includes all patients that were operated on for oesophageal cancer from January 2019 to January 2023. All surgeries were performed by the same specialized team. Quantitative variables are described as mean and standard deviation, and qualitative variables as absolute number and percentage. The univariate methods used were Pearson’s X2 or Student’s t test for independent samples. We used logistic regression models to study prognostic factors influencing survival. The IBM SPSS Statistics 22 programme was chosen for data analysis.

Results
59 patients were operated during this period through minimally invasive approach, including recurrent nerve lymphadenectomy. Anatomopathological results showed 6 (10.2%) patients with recurrent lymph node involvement, 2 (3.4%) with right-sided positive nodes, 3 (5.1%) with left-sided ones and 1 (1.7%) with bilateral invasion. Analysis by subgroups showed that 20% of tumours larger than T2 had recurrent nerve lymph node metastasis.
There were 18 (30.5%) recurrent nerve injuries, all of which were transient except for 3 (5.1%) that required scheduled surgery.
A statistically significant relationship was found between the number of affected nodes and disease-free survival time (p-value = 0.045).

Conclusions
Mediastinal and recurrent nerve lymphadenectomy in oesophageal cancer increases the number of total positive lymph nodes obtained after surgery, allowing for a better adequacy of adjuvant treatment and corelating positively with disease-free survival time. Complications derived from these procedures are similar in number to standard lymphadenectomy and most of them can be managed by conservative treatment.
404. A SYSTEMATIC REVIEW AND META-ANALYSIS ON THE ROLE OF RADIOMICS IN ESOPHAGEAL CANCER: DIAGNOSIS, TREATMENT RESPONSE AND SURVIVAL PREDICTION
Authors: Menon Nainika , Guidozzi Nadia , Chidambaram Swathikan , Markar Sheraz Rehan 
Published: August 2023

Abstract

Background
The use of artificial intelligence, in the form of radiomics, enables more detailed interpretation of radiological images in less time, when compared to the human eye. Some challenges in managing esophageal cancer, particularly those reliant of human factors, can be addressed by incorporating radiomics into image interpretation, thereby supporting diagnosis, treatment planning and predicting treatment response and survival. This systematic review and meta-analysis aims to summarize the evidence in this expanding field.

Methods
The systematic review was carried out using Pubmed, MEDLINE and Ovid EMBASE databases—articles describing the use of radiomics in 18F-FDG PET/CT scans and CT scans in the esophageal cancer management were included. A meta-analysis was also performed.

Results
50 studies were included, most of which were single center cohort studies. For the assessment of treatment response using 18F-FDG PET/CT scans, 7 studies (443 patients) were included in the meta-analysis. The pooled sensitivity and specificity were 86.5% (81.1–90.6) and 87.1% (78.0–92.8). For the assessment of treatment response using CT scans, 5 studies (625 patients) were included in the meta-analysis, with a pooled sensitivity and specificity of 86.7% (81.4–90.7) and 76.1% (69.9–81.4). The remaining 38 studies discussed the benefits of radiomics in diagnosis, radiotherapy planning and survival prediction, often in less time and best when used in conjunction with radiologists.

Conclusion
This review explores the many possibilities of radiomics in esophageal cancer management. The sensitivities of 18F-FDG PET/CT scans and CT scans are comparable but 18F-FDG PET/CT scans have improved specificity for AI-based prediction of treatment response. Integrated clinical and radiomic models were the best at facilitating diagnosis and survival prediction, particularly when combined with radiologists. More multi-center studies are required to compare and externally validate models to build an evidence base.
406. A SYSTEMATIC REVIEW AND META-ANALYSIS ON THE USE OF ARTIFICIAL INTELLIGENCE IN THE ENDOSCOPIC DIAGNOSIS OF ESOPHAGEAL CANCER
Authors: Guidozzi Nadia , Menon Nainika , Chidambaram Swathikan , Markar Sheraz Rehan 
Published: August 2023

Abstract

Introduction
Endoscopy plays a key role in the surveillance of patients with Barrett’s esophagus and the diagnosis of esophageal cancer. The subtleties of endoscopic interpretation are subject to clinical expertise, diagnostic skill, and thus human error. Therefore, artificial intelligence (AI) is increasingly being incorporated into endoscopy in order to improve diagnostic accuracy and early detection. This systematic review and meta-analysis consolidates the evidence on the use of AI in the endoscopic diagnosis of esophageal cancer.

Methods
The systematic review was carried out using Pubmed, MEDLINE and Ovid EMBASE databases as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies which described the role of AI in supporting endoscopic video or image diagnosis of esophageal cancer were included. A meta-analysis was also performed.

Results
45 studies formed the qualitative and quantitative review. 14 studies with 1590 patients in total assessed the use of AI in endoscopic diagnosis of esophageal squamous cell carcinoma (ESCC)- the pooled sensitivity and specificity were 91.2% (84.3–95.2%) and 80% (64.3–89.9%). A further, 9 studies consisting of 478 patients overall explored the capabilities of AI in supporting the endoscopic diagnosis of esophageal adenocarcinoma (EAC), with a pooled sensitivity and specificity of 93.1% (86.8–96.4%) and 86.9% (81.7–90.7%). AI was often superior to endoscopists when diagnosing ESCC and improved the overall accuracy of both novice and expert endoscopists.

Conclusion
AI technology, as an adjunct to endoscopy has proven to be beneficial in early, accurate detection of esophageal malignancy. Multiple studies have shown superior diagnostic capabilities when comparing AI technology to endoscopists alone. Despite promising results, the application in real-time endoscopy is limited, and further multicenter trials are required to accurately assess its use in routine practice.
410. IMPACT ON BODY WEIGHT OF REMNANT STOMACH PRESERVING ESOPHAGECTOMY FOR THE PATIENTS WITH PAST MEDICAL HISTORY OF GASTRECTOMY
Authors: Momose Kota , Yamashita Kotaro , Saito Takuro , Tanaka Koji , Yamamoto Kazuyoshi , Makino Tomoki , Takahashi Tsuyoshi , Kurokawa Yukinori , Nakajima Kiyokazu , Eguchi Hidetoshi , Doki Yuichiro 
Published: August 2023

Abstract

Background
Esophagectomy has a great impact on patients’ nutritional status. Particularly for the patients with past medical history of gastrectomy, there is a concern that surgical procedure of esophagectomy accommpanying remnant gastrectomy may potentially deteriorate nutritional status more than standard esophagectomy, resulting in excessive body weight loss. In order to reduce such negative impact, we perform remnant stomach preserving esophagectomy. The purpose of this study is to assess the impact on body weight of this procedure.

Methods
The patients with past medical history of gastrectomy who underwent remnant stomach preserving esophagectomy in our institute from 2015 to 2022 were enrolled in this study. All the measured body weights were collected from the electronic medical record retrospectively and all data point were plotted as BMI over time to see any transitional trend. The day of esophagectomy was defined as day0. The enrolled patients were divided into two groups according to the median initial BMI; lower BMI group and higher BMI group. The BMI transitional trends were detected in each group.

Results
Totally 37 patients were eligible in this study. Median age was 72 (57–88), the number of female was 1 (36 male), cStage1/2/3/4 of esophageal cancer were 9/9/13/5, median time period from gastrectomy was 21.0 years (0–54.5), and median initial BMI was 20.7 (15.1–27.7). All BMI data points from every patient according to the higher/lower initial BMI groups were shown in the figure. The decreasing trend in BMI until about 3 months after the esophagectomy was seen in the higher BMI group whilst relatively plateau trend in such period was seen in the lower BMI group.

Conclusion
Efficacy of the remnant stomach preserving esophagectomy in terms of reducing body weight loss could be more apparent in lower BMI patients than higher BMI patients. When you see an esophageal cancer patient with past medical history of gastrectomy, the remnant stomach preserving procedure should be considered particularly when the BMI is low.
424. EXPRESSION OF KCNB1 AND ITS RELATION TO TUMOR PROGRESSION IN ESOPHAGEAL CANCER
Authors: Ota Atsuki , Shiozaki Atsushi , Nishibeppu Keiji , Kiuchi Jun , Ohashi Takuma , Shimizu Hiroki , Arita Tomohiro , Yamamoto Yusuke , Konishi Hirotaka , Morimura Ryo , Kuriu Yoshiaki , Ikoma Hisashi , Kubota Takeshi , Fujiwara Hitoshi , Otsuji Eigo 
Published: August 2023

Abstract

Background
KCNB1 is a member of voltage-gated potassium channels, which mediate transmembrane potassium transport. Previous studies have elucidated the roles of and the mechanisms by which KCNB1 is activated in various cancer type. However, the role of KCNB1 in esophageal cancer remains poorly understood. In the present study, we analyzed the relationship between KCNB1 expression and tumor progression in esophageal cancer.

Methods
Knockdown (KD) experiments were performed on human esophageal cancer cell lines using KCNB1 small interfering RNA. 129 primary tissue samples from esophageal cancer patients were examined immunohistochemistry (IHC), and its relationship with clinicopathological factors and prognosis were examined.

Results
KCNB1-KD suppressed the proliferation, migration and invasion of cells and enhanced apoptosis. Cell cycle analysis showed that KCNB1-KD suppressed the progression of G2/M phase. Survival analysis showed significantly poorer 5-year relapse-free survival (RFS) in the KCNB1 high expression group by IHC (high vs low; 28.5% vs 58.1%, p = 0.0016). The multivariate analysis identified the high expression of KCNB1 as an independent prognostic factor for 5-year RFS in esophageal cancer patients (p = 0.0197).

Conclusion
The present study may contribute to the identification of KCNB1 as a mediator in tumor progression, with it eventually being a promising prognostic biomarker or a novel therapeutic target of esophageal cancer.
466. ESOPHAGECTOMY AFTER NEOADJUVANT CHEMORADIATION THERAPY: DOES THE TIMING OF SURGERY INFLUENCE THE OUTCOME?
Authors: Giorgi Lorenzo , Pansa Andrea , Marano Salvatore , Perano Vittoria , Alfieri Rita , Basato Silvia , Castoro Carlo 
Published: August 2023

Abstract

Background
Multimodality treatment, either neoadjuvant chemoradiotherapy (nCRT) or perioperative chemotherapy (e.g., FLOT), and surgery, represents the standard of care for locally advanced, resectable cancer of the esophagus and esophago-gastric junction. The recommended interval between the ending of nCRT and surgery is between 6 and 8 weeks. A prolonged time to surgery (TTS) is associated with an increase in pathologic complete response (pCR) and survival in different malignancies, with a possible increase in surgical difficulty and postoperative complications.
Materials and methods: A retrospective analysis was conducted on 154 patients with cT2-4aN0-(+), cT1bN+, M0 squamous cell (SCC) and adenocarcinoma (AC) cancer of the esophagus and esophagogastric junction (Siewert type 1) treated with nCRT and surgery between August 2017 and January 2022. Three groups were identified: patients operated within 10 (n = 37), between 10 and 12 (n = 48) and beyond 12 weeks (n = 69). Minimum follow-up period was six months.

Results
Demographic and clinical characteristics were comparable. Mean length of stay was 13.1, 15.6 and 16.5 days (p = 0.06) respectively. Incidence of postoperative complications and their severity were not different between groups. No postoperative deaths were observed. No difference in pCR was found. When analyzed by histology, a slight increase was evident in patients with SCC (33.3%, 43.5%, 39.4%; vs ADC 16%, 16%, 16.7%), though not statistically significant. Similar results were obtained for tumor regression grade, with an increase in major responses for SCC over time (Mandard 1–2: SCC 50%, 61%, 62%; ADC 60%, 64%, 58%). No difference in overall survival was observed.

Conclusions
Esophagectomy performed more than 10 weeks after the end of chemoradiation therapy was not associated with an increase in postoperative morbidity. We observed, though, a trend towards longer hospital stays. The rate of major pathological response seems to increase over time after completion of chemoradiation therapy, but only for squamous histotype. Larger studies are required to corroborate these findings.
479. TRANSTHORACIC VERSUS TRANSABDOMINAL SURGICAL APPROACH FOR SIEWERT TYPE II ESOPHAGOGASTRIC JUNCTIONAL ADENOCARCINOMAS—A PROPENSITY SCORE-MATCHED ANALYSIS
Authors: Wong Claudia , Chan Desmond , Wong Ian , Law Betty , Chan Fion , Law Simon 
Published: August 2023

Abstract

Background
Esophagogastric junctional(EGJ) adenocarcinoma is a complex type of cancer that varies in etiology and disease pattern depending on the tumor level. There is increasing evidence on the need for different surgical approaches for different Siewert types. The optimal surgical approach for Siewert type II cancer remains controversial. This study aims to compare the oncological and surgical safety of transthoracic and transabdominal approaches for type II cancers.

Methods
The study included patients who underwent resection for Siewert type II adenocarcinomas from 2003–2020 in a single tertiary center using transthoracic (TT) and transabdominal (TA) approaches with macroscopic tumor clearance. The TT approach referred to Lewis-Tanner esophagogastrectomy, while the TA approach included total gastrectomy and proximal gastrectomy. Data from a prospectively-managed database were analyzed to compare postoperative morbidity and mortality rates, lymph node harvest, completeness of resection and overall survival between the two groups. Propensity score matching (PSM) was used in further analyses.

Results
Excluding R2 resections, there were 54 patients in the TT and 45 (proximal gastrectomy:23) in the TA groups. cT stages were comparable. In TT group, median tumor length was 6 cm (vs. 3 cm,p = 0.000), 18.5% with esophageal extension of &gt;4 cm above EGJ;75.9% had nodal metastases (vs. 47.7%, p = 0.004);20.4% underwent neoadjuvant therapy (vs. 6.8%, p = 0.057).
Anastomotic leak and cardiopulmonary complication rates, R0 resection rates, nodal yield and positive lymph node ratios were comparable. Proximal margin was involved in 15.9% for TA (vs. 5.6%, p = 0.092). Overall median survival times were similar (TT vs. TA: 42vs.65 months, p = 0.557).
PSM yielded 33 patients per group. Only one in TT group had &gt;4 cm esophageal involvement. Cardiac complication rate in TT group was 23.6%(vs. 3.5%, p = 0.024).

Conclusion
After correcting for selection bias, positive lymph node ratio, resection margin and overall survival did not differ for the TT and TA approaches. Resection by the TT approach is associated with more cardiac complications. For Siewert type II tumors with limited thoracic esophageal extension, the TA approach is safe and should be sufficient.
489. COLON DIVERTICULUM IN THE CERVICAL REGION FOLLOWING COLON INTERPOSITION FOR CORROSIVE INJURY: A CASE REPORT
Authors: Maurice Karim , Elfiky Mohamed , Hawary Ramy , Elshayeb Amr , Elkholy Shaimaa 
Published: August 2023

Abstract

Background
Colon interposition is one of the traditional procedures for esophageal reconstruction following corrosive injury. While the colonic conduit has the potential to restore swallowing function in patients, yet the long term complications are not well documented. we, herby, present a case of colon diverticulum in the neck 17 years after bypass surgery.

Methods
a 22 years old female patient presented with a one year history of gradually progressive grade I dysphagia following a colon bypass surgery performed for esophageal reconstruction for corrosive stricture at the age of 5 years old. Clinical assessment revealed the presence of a swelling on the left side of her neck which increased in size upon swallowing. The patient reported that applying pressure on the swelling was associated with sensation of passage of the food bolus.
Endoscopic and Radiological assessment confirmed the presence of a neck diverticulum at the site of the anastomosis.

Results
Neck exploration was performed. The diverticulum was dissected from the surrounding tissues with particular care to preserve the colon mesentery. The esophago-colic anastomosis was identified. It was found that this anastomosis was performed in an end to side fashion. The diverticulum appeared to be the enlarged side of the colon which was enlarged causing compression on the esophagus (1). This part was resected using a stapler after intraoperative endoscopic assessment (2,3). A second layer of interrupted sutures was performed over the stapled part (4). The postoperative course was uneventful and was associated with improved dysphagia.

Conclusion
Symptomatic colon diverticulum in the neck is a rare long term complication following colon bypass and esophago-colic anastomosis. Particular care should be made when performing it in an end to side fashion. End to end esophago-colic anastomosis could potentially prevent such complication.
Cornelia de Lange Syndrome mutations in SMC1A cause cohesion defects in yeast
Authors: Chen Jingrong , Floyd Erin N , Dawson Dean S , Rankin Susannah 
Published: August 2023

Abstract
Cornelia de Lange Syndrome (CdLS) is a developmental disorder characterized by limb truncations, craniofacial abnormalities, and cognitive delays. CdLS is caused mainly by mutations in genes encoding subunits or regulators of the cohesin complex. Cohesin plays 2 distinct roles in chromosome dynamics as follows: it promotes looping, organization, and compaction of individual chromosomes, and it holds newly replicated sister chromatids together until cell division. CdLS-associated mutations result in altered gene expression likely by affecting chromosome architecture. Whether CdLS mutations cause phenotypes through impact on sister chromatid cohesion is less clear. Here, we show that CdLS-associated mutations introduced into the SMC1A gene of budding yeast had measurable impacts on sister chromatid cohesion, mitotic progression, and DNA damage sensitivity. These data suggest that sister chromatid cohesion-related defects may contribute to phenotypes seen in CdLS affected individuals.
Microbial and Metabolite Signatures of Stress Reactivity in Ulcerative Colitis Patients in Clinical Remission Predict Clinical Flare Risk
Authors: Jacobs Jonathan P , Sauk Jenny S , Ahdoot Aaron I , Liang Fengting , Katzka William , Ryu Hyo Jin , Khandadash Ariela , Lagishetty Venu , Labus Jennifer S , Naliboff Bruce D , Mayer Emeran A 
Published: August 2023

Abstract

Background
Stress reactivity (SR) is associated with increased risk of flares in ulcerative colitis (UC) patients. Because both preclinical and clinical data support that stress can influence gut microbiome composition and function, we investigated whether microbiome profiles of SR exist in UC.

Methods
Ninety-one UC subjects in clinical and biochemical remission were classified into high and low SR groups by questionnaires. Baseline and longitudinal characterization of the intestinal microbiome was performed by 16S rRNA gene sequencing and fecal and plasma global untargeted metabolomics. Microbe, fecal metabolite, and plasma metabolite abundances were analyzed separately to create random forest classifiers for high SR and biomarker-derived SR scores.

Results
High SR reactivity was characterized by altered abundance of fecal microbes, primarily in the Ruminococcaceae and Lachnospiraceae families; fecal metabolites including reduced levels of monoacylglycerols (endocannabinoid-related) and bile acids; and plasma metabolites including increased 4-ethyl phenyl sulfate, 1-arachidonoylglycerol (endocannabinoid), and sphingomyelin. Classifiers generated from baseline microbe, fecal metabolite, and plasma metabolite abundance distinguished high vs low SR with area under the receiver operating characteristic curve of 0.81, 0.83, and 0.91, respectively. Stress reactivity scores derived from these classifiers were significantly associated with flare risk during 6 to 24 months of follow-up, with odds ratios of 3.8, 4.1, and 4.9. Clinical flare and intestinal inflammation did not alter fecal microbial abundances but attenuated fecal and plasma metabolite differences between high and low SR.

Conclusions
High SR in UC is characterized by microbial signatures that predict clinical flare risk, suggesting that the microbiome may contribute to stress-induced UC flares.