bluuebunny/crossref_metadata_2025_split huggingface dataset:
289. RISK FACTOR OF RELAPSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA WHO ACHIEVE PATHOLOGIC COMPLETE RESPONSE TO NEOADJUVANT CHEMORADIOTHERAPY
Authors: Zhong Jian , Fang Shuogui , Yuan Jianye , Chen Rui , Xie Xiuying , Lin Ting , Liu Mengzhong , Liu Qianwen , Fu Jianhua 
Published: August 2023

Abstract

Background
Controversy still exists as to the risk factors of recurrence in patients with esophageal squamous cell carcinoma (ESCC) who achieve pathologic complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) plus esophagectomy. This study aimed to investigate the patterns and risk factors for recurrence in ESCC patients with pCR after nCRT in a single center.

Method
Between January 2008 and December 2018 a total of 96 ESCC cases with pCR were enrolled in this study. Sterilized lymph nodes (SLN) were defined as those lymph nodes without residual tumor but with the presence of treatment response to nCRT. Recurrence patterns were investigated and then prognostic factors for recurrence-free survival (RFS) were analyzed with univariate and multivariate analyses.

Results
The median follow-up time was 51.5 months. Recurrence occurred in 15 cases (15.6%) with a 9.9 months median time to recurrence and a 15.6 months median survival after recurrence. The most majority of recurrent diseases developed within the first 2 years after surgery. Distant recurrences were detected in 14 cases (14.6%), in which the most common recurrence sites were supraclavicular lymph nodes and lung, followed by para-aortic lymph nodes. The mean RFS in the whole cohort was 116.6 months. Positive SLN was identified as the independently prognostic factor for worse RFS in the multivariate analysis (HR: 5.93, 95%CI: 2.09–16.86, P = 0.001).

Conclusion
Relapse is not rare in ESCC cases with pCR after nCRT. Distant recurrences, the predominant pattern of relapse, mostly occur with the first 2 years after esophagectomy. pCR patients with positive SLN have a higher risk for postoperative recurrence.
299. OPTIMAL NUMBER OF NEOADJUVANT IMMUNOTHERAPY AND CHEMOTHERAPY CYCLES IN ADVANCED ESOPHAGEAL CANCER TREATMENT
Authors: Rusidanmu Aizemaiti , Zhou Kun , Ye Peng 
Published: August 2023

Abstract

Background
Neoadjuvant immunotherapy combined with chemotherapy (nICT) has shown potential benefits for patients with esophageal squamous cell cancer (ESCC) in clinical trials. However, the ideal number of nICT cycles for maximizing treatment outcomes in ESCC remains undetermined. This study aims to compare the short-term outcomes between two and three courses of nICT to establish the optimal approach for treating ESCC.

Methods
We conducted a retrospective analysis of clinical data from 118 patients with resectable locally advanced ESCC treated with nICT. Patients were divided into two groups: those who received 2 cycles of nICT (group A, n = 70) and those who received 3 cycles of nICT (group B, n = 48). The primary outcome was pathological complete response (pCR; ypT0 N0). Additionally, perioperative parameters and postoperative complications were examined.

Results
Overall, 28 patients (23.7%) achieved pCR. Group B, treated with 3 cycles of nICT, demonstrated a significantly higher pCR rate compared to group A (33.3% vs. 17.1%, P = 0.042). Postoperative complication rates were similar between the two groups (58.6% vs 54.2%, P = 0.635), and no significant difference was observed in anastomotic leakage rates (11.4% vs 6.3%, P = 0.522). Moreover, operation time (306.27 ± 87.05 vs. 306.13 ± 74.18 min, P = 0.996) and postoperative hospital stay (16.09 ± 10.55 vs. 15.04 ± 5.99 days, P = 0.537) did not significantly differ between the groups.

Conclusion
Three cycles of nICT led to better pathological responses compared to two cycles without increasing the incidence of postoperative complications. These findings can guide clinicians in counseling patients and inform the design of future prospective trials in ESCC treatment.
314. CLINICAL OUTCOME OF ICI COMBINATION THERAPY AS 1ST LINE TREATMENT FOR ESOPHAGEAL CANCER
Authors: Hara Shuichiro , Makino Tomoki , Momose Kota , Yamashita Kotaro , Tanaka Koji , Eguchi Hidetoshi , Doki Yuichiro 
Published: August 2023

Abstract

Background
The 1st line regimens including Immunocheckpoint Inhibitor (ICI) have lately been approved for unresectable advanced or recurrent esophageal squamous cell carcinoma (ESCC). However, evidence of these regimens in clinical practice remains limited.

Methods
A total of 67 unresectable advanced or recurrent ESCC patients who received FP (5-FU + CDDP) + Pembrolizumab/Nivolumab (FP + ICI group; n = 43) or Ipilimumab+Nivolumab (ICI + ICI group; n = 24) as the 1st line treatment from December 2017 to March 2023 at our hospital were evaluated.

Results
Patient characteristics(FP + ICI: ICI + ICI) were as follows; age = 69:74 year-old, male/female = 36/7:22/2, recurrent/unresectable = 17(40%)/26(60%):13(54%)/11(46%), number of administered courses = 4 [1–35]: 2 [1–17], follow up period = 9: 6 months. Best response rate was CR/PR/SD/PD = 6/22/9/6:4/9/6/5 cases, while response/disease control rates were 65:54% and 86:79%, respectively. Regarding survival analysis, median OS = 23 months:did not reach, and 1-year OS = 83.7:87.5%, median PFS = 8:5 months, 1-year PFS = 48.8:49.3%, and DOR (duration of response) = 4[2–38]:5[5–9] months. The most common treatment-related adverse events (CTCAE Grade 3 or higher) were neutropenia in 18 cases, followed by anorexia in 7 cases (FP + ICI group), and adrenal hypofunction in 2 cases and pruritus in 2 cases (ICI + ICI group).

Conclusion
Both 1st line regimens for unresectable advanced or recurrent esophageal squamous cell carcinoma seemed to be feasible and promising in clinical use.
338. USING NEURO-LINGUISTIC PROGRAMMING TO IMPROVE THE QUALITY OF LIFE OF ESOPHAGEAL CANCER PATIENTS REQUIRING NEOADJUVANT THERAPY
Authors: Zheng Bin 
Published: August 2023

Abstract

Background
Esophageal cancer has a higher incidence and mortality rate than most malignancies. At present, radical esophagectomy remains the treatment of choice for esophageal cancer. However, a significant proportion of patients are in the middle or advanced stages when diagnosed and requiring preoperative treatment before surgical resection and lengthy postoperative adjuvant therapy after surgery. In this process, a considerable number of patients usually have a negative attitude towards treatment and psychological sub-health states or even disease states, leading to be unable to cooperate with treatment and unwell prognosis. Therefore, the main purpose of this study is to evaluate the application of mind–body language program (NLP) to evaluate the psychological state of patients during treatment, and intervene in time, so as to improve the quality of life and prognosis of patients.

Methods
This was a single-center, prospective, randomized controlled trial (allocation rate = 1:1). It is proposed to enroll 40 potentially operable esophageal cancer patients requiring neoadjuvant therapy and divided into two groups: NLP and control. Inclusion criteria included different age groups, different neoadjuvant treatments, elective surgery, etc., and signed informed consent. Data from different groups of participants (pre-neoadjuvant therapy, preoperative, 1 week postoperative, and 1 month after discharge) were collected and recorded using the Quality of Life Scale (QCR-15) and the Fear-Anxiety Assessment Scale.
The primary endpoint of this study was to compare the difference in survival status between different experimental groups with or without NLP for psychological intervention.

Discussion
This trial will provide a basis for the significance of psychotherapy in the management of esophageal cancer and help to improve the guidance on non-physical and chemotherapy treatment in esophageal cancer guidelines.
Key words: Neuro-linguistic programming: Esophageal cancer: Preoperative treatment: Quality of Life.
342. VIDEO-ASSISTED THORACOSCOPIC ENUCLEATION OF BENIGN SCHWANNOMA MISDIAGNOSED AS MALIGNANT LESION ON F-18 FDG PET/CT IN ESOPHAGEAL SUBMUCOSAL TUMOR
Authors: Lee Sung Kwang 
Published: August 2023

Abstract

Background
Esophageal SMT is a rare disease, and most of them are benign. Esophageal schwannoma accounts for about 2% among esophageal SMT.
Recently, F-18 FDG PET/CT has been widely used to confirm malignancy or to identify other metastatic lesions in cancer patients. However, even benign tumors often show an elevated SUV, and in the case of schwannomas, various values of SUV have been reported, which seems to limit differentiation from other malignant peripheral nerve sheath tumors.

Case
A 56-year-old female patient was incidentally found with extrinsic compressing mass at 22 cm from the incisor. An endoscopic ultrasonography and chest CT showed a 3.4 cm sized homogenous well-defined mass in upper esophagus, leiomyoma or gastrointestinal stromal tumor was suspected. SUV was elevated on PET-CT was performed to identify malignancy and metastatic lesions. When confirmed as malignant, additional surgery was planned, and enucleation was performed for primary diagnosis and treatment.
The esophageal bulging was confirmed. After dividing the esophageal muscle, and underwent enucleation. In immunohistochemical staining, S-100 protein showed positive findings, which could be diagnosed as schwannoma.

Conclusion
Due to the characteristics of esophageal SMT, FDG uptake may be observed on PET-CT, but if there is no evidence of metastasis, it is likely to proceed with treatment according to the benign disease. Then, if immunohistochemistry examination is diagnosed as malignancy, it would be desirable to apply additional stage surgery.
348. IDENTIFYING NOVEL MOLECULAR SUBTYPES OF ESOPHAGEAL ADENOCARCINOMA USING LASER CAPTURE MICRODISSECTED RNA-SEQ SAMPLES
Authors: Wilson Gavin , Cotton James , Allison Frances , Bach Yvonne , Allen Jonathan , Darling Gail , Elimova Elena , Kalimuthu Sangeetha , Yeung Jonathan 
Published: August 2023

Abstract

Background
Treatment options for esophageal adenocarcinoma (EAC) are limited by a lack of disease stratification methods. In other cancers, gene expression profiling has been successfully used to identify prognostically-relevant and treatment-susceptible molecular subtypes. Previous efforts to subtype EAC have been hindered by low biopsy and resection tumour cellularity. We hypothesize that laser-capture microdissection (LCM) tumour cell enrichment will permit the classification EAC tumours into multiple molecular subtypes that will be important for future therapeutic strategies.

Methods
Treatment naïve patient samples (N = 52) were collected from primary biopsies (N = 37), resections (N = 10) and metastatic biopsies (N = 5). Samples were laser-capture microdissected to enrich tumour cells followed by total RNA-seq. Gene expression was quantified using salmon and non-negative matrix factorization with 10 components was used to identify gene expression programs. The components identified were validated on a publicly available normal tissue cohort (N = 13 esophagus, gastric, intestinal, Barrett’s samples) and the TCGA EAC cohort (N = 80). We applied NMF with 4 components to the normal tissue (K = cohort) to identify normal tissue gene signatures to validate our RNA-seq data.

Results
We verified that our RNA-seq samples were depleted for normal tissue using the four NMF signatures from normal tissue cohort and, as expected, our samples were depleted for gene expression from the gastric and esophagus tissues compared to TCGA. Next, we explored the gene expression programs from our tumour samples and identified seven tumour-intrinsic components and three tumour microenvironmental components. The top 50 genes from each tumour intrinsic components were used with consensus cluster plus to identify K = 6 subtypes (Figure 1). Interestingly, two of these subtypes would be difficult to separate from normal tissue contamination without the use of LCM.

Conclusion
We have successfully used LCM to deplete normal tissue gene expression from our esophageal adenocarcinoma cohort and identified six molecular subtypes. We are currently evaluating the treatment and clinical implications of these subtypes and aiming to accumulate an additional (N = 50) EAC RNA-seq samples.
370. TRANSMEDIASTINAL ESOPHAGECTOMY IS USEFUL FOR ESOPHAGOGASTRIC JUNCTION CANCER
Authors: Miwa Yoshiyuki , Yagi Koichi , Atsumi Shinichiro , Okamoto Asami , Oya Syuichiro , Urabe Masayuki , Sakamoto Kei , Okumura Yasuhiro , Yajima Sho , Sachiyo Nomura , Yasuyuki Seto 
Published: August 2023

Abstract

Background
The extent of surgical resection and lymph node dissection in esophagogastric junction cancer depends on the localization of the tumor center and the length of esophageal invasion. We developed Robot assisted-transmediastinal esophagectomy (TME) and have been applied for thoracic esophageal cancer. Since 2018, we also applied TME for esophagogastric junction (EGJ) cancer with esophageal involvement according to our determined indications, and examined its safety and usefulness.

Methods
Our indication of esophagetomy for EGJ cancer is, i) squamous cell carcinoma, ii) differentiated adenocarcinoma with≧3 cm esophageal involvement, iii) poorly differentiated with≧2 cm. Since 2018, we applied TME for all of these cases.
Our operation procedure is following; upper thoracic paraesophageal LNs and recurrent nerve LNs are dissected by left-side cervical mediastinoscopic approach. Lower mediastinal LN is dissected by laparoscopic approach. Subcarinal LNs and main bronchus LNs are dissected by transhiatal robotic approach. When robot is not used, these LNs are dissected mediastionscopically. Reconstruction is done by gastric tube through posterior mediastinal route.

Results
Between January 2018 and March 2023, 36 patients was performed TME for EGJ cancer. In these, robot was used in 24 patients. Median operation time and amount of blood loss were 429 minutes and 170 mL. Pathological metastasis of thoracic paratracheal LNs; right recurrent nerve LNs, left recurrent nerve LNs and tracheobronchial LNs was detected in 2(5.5%), 1(2.7%) and 1(2.7%) patients, respectively. Anastomotic leakage was occurred in 2(5.5%) patients, but recovered conservatively. Recurrent laryngeal nerve (RLN) palsy severe more than Clavien-Dindo (CD) grade III was not occurred. Postoperative complications≧C-D IIIb was occurred in 1(2.7%) patient.

Conclusion
TME for EGJ cancer seems to be safe, especially can avoid intra-mediastinal anastomosis and severe complication associated with leakage. It might be more widely accepted when RLN palsy could be reduced. Recuurent nerve LNs dissection is main cause of RLN palsy, and not recommended in the algorism of LN dissection for EGJ cancer because the frequency of metastasis is low, so TME without recurrent nerve LNs dissection could be the option for EGJ cancer.
418. A TALE OF SIXTEEN ESOPHAGEAL DUPLICATION CYSTS AND ITS MANAGEMENT STRATEGIES
Authors: Jethani Manish M , Mistry Rajesh 
Published: August 2023

Abstract

Background
Esophageal duplication cysts are rare entities with a spectrum of clinical presentation. Adults are usually asymptomatic. Surgical management is preferred. We present our experience of management of 16 esophageal duplication cysts.

Methods
A retrospective cohort analysis of all esophageal duplication cyst patients was performed at our centre from January 2012 to December 2022. Variables collected include patient demographics, operative techniques, morbidity and mortality. Study data was collected using electronic medical records at our centre and follow-up data was taken physically or telephonically. A total of 16 patients of esophageal duplication cyst were identified, out of which 81.25% (13) underwent surgical excision, 6.25% (1) underwent endoscopic aspiration and 12.5% (2) were conserved with expectant management due to co-morbidities.

Results
Out of 16 patients, 50% (8) were in the lower esophagus, 37.5% (6) were in mid third esophagus and 12.5% (2) were in upper esophagus. The patient population was composed of 75% (12) males and 25% (4) females, and mean age was 47.5 years (27–76). 81.25% (13) patients were symptomatic; common symptoms included chest pain/discomfort, breathlessness, and coughing. The mean size of cyst was 6.4 cm (range: 3-10 cm). 81.25% (13) patients underwent surgery out of which 62.5% (10) underwent VATS/Robotic and 18.75% (3) underwent thoracotomy. The mean hospital stay was 4 days (range: 2–10 days). Two (15.4%) patients developed Clavein-Dindo grade III complication, for which pigtail insertion was done. The most common histopathology found was ciliated columnar epithelium in 61.5% (8) patients.

Conclusion
Esophageal duplication cysts remain rare in adults and are frequently located in the distal esophagus. Various surgical techniques may successfully be employed in the treatment of this pathology. Minimally invasive procedures have a shorter hospital stay.
427. CAN WE OPTIMIZE THE RECOMMENDATIONS FOR FOLLOW-UP OF BARRETT’S ESOPHAGUS THROUGH CRITICAL ANALYSIS OF RISK FACTORS IN A SPECIFIC POPULATION?
Authors: Szachnowicz Sergio , Gallon Eduardo , Duarte Andre Fonseca , Lopes Letícia Nobre , Cirlinas Alexandra Messa , Marques Sergio Barbosa , Moura Eduardo H G , Sallum Rubens A A , Cecconello Ivan 
Published: August 2023

Abstract

Introduction
Barrett’s esophagus (BE) affects approximately 3 million people in Brazil with its incidence has been increasing in recent years. In this pathology, the genetically unstable metaplastic epithelium leads to risks of progression to dysplasia and esophageal adenocarcinoma (EAC). In a scenario where most EACs arise in the presence of BE, it is necessary to study the epidemiological risk factors associated with this evolution to implement optimized surveillance recommendations.

Objective
Evaluate the epidemiological risk factors involved in the development of dysplasia and adenocarcinoma from BE in a specific population and propose an appropriate suggestion on how to carry out the follow-up according to these factors.

Methodology
A retrospective cross-sectional study was conducted in a tertiary center with patients with BE followed in this center. Patients with BE who presented adenocarcinoma and/or dysplasia were compared to those who did not, considering the variables gender, age, smoking, BMI, ethnicity, and extent of Barrett’s. Logistic regression was performed to measure the odds ratio (OR) between risk factors for the outcome of adenocarcinoma and the outcome of dysplasia. Finally, the presence of proven epidemiological risk factors in this population was correlated with the time of development of EAC from BE.

Results
There was a statistically significant difference between smoking, race, gender, extent of Barrett’s, and age among patients that presented adenocarcinoma and not. Smokers and ex-smokers had a 4.309 times higher risk of developing adenocarcinoma, and the extent of Barrett’s increased this risk by 1.193 times per centimeter. Among the group that presented dysplasia compared to the group that did not, smoking, the extent of Barrett’s, and age were statistically significant, with the extent of Barrett’s increasing the risk of developing dysplasia by 1.128 times per centimeter and age increased the risk of this outcome by 1.023 per year. Patients without risk factors did not develop EAC in less than 12 months, even if they had dysplasia before.

Conclusion
The study confirmed a higher risk of developing dysplasia and adenocarcinoma in specific epidemiological groups, which can redirect follow-up in patients with BE in a more cost-effective manner.
439. ACUTE GASTRIC VOLVULUS—LATE OCCURRENCE AFTER HIATAL HERNIA REPAIR WITH MESH
Authors: Brandalise Andre , Lorenzetti Claudia , Coelho-Neto João 
Published: August 2023

Abstract
Video presentation of acute gastric volvulus in one patient with previous history of a giant recurrent hiatal hernia, corrected with synthetic absorbable mesh one year prior to the event.
The video contains the first surgery, follow-up studies, the intra operative findings (mesh status) and resolution. It raises the question whether, in extremely large hiatal hernias, specially recurred ones, adjuvant techniques should be associated.
https://www.dropbox.com/s/tkj2vt35cd3pn91/Acute%20Gastric%20Volvulus.mov?dl=0.
462. MAJOR PATHOLOGIC RESPONSE IN ESOPHAGEAL ADENOCARCINOMA: SHOULD WE ADOPT A NEW PARADIGM IN DEFINING RESPONSE TO TREATMENTS?
Authors: Sciuto Maria Elisa , Capovilla Giovanni , Scarton Alessia , Tagkalos Evangelos , Uzun Eren , Moletta Lucia , Hadzijusufovic Edin , Provenzano Luca , Salvador Renato , Pierobon Elisa Sefora , Zanchettin Gianpietro , Berlth Felix , Lang Hauke , Grimminger Peter P , Valmasoni Michele 
Published: August 2023

Abstract

Background
Incidence of adenocarcinoma (ADC) of the esophagus is arising in Western countries and it is still burdened by a significant mortality. A complete primary tumor regression after neoadjuvant treatment is associated with improved long-term survival, however this favorable response is rarely achieved. The primary endpoint of this study was to determine whether the survival benefit associated with a complete tumor regression could be achieved also with a major, albeit subtotal, tumor response.

Methods
We evaluated all consecutive patients who underwent esophagectomy for cancer at 2 high-volume centers. Inclusion criteria were histologically confirmed ADC involving the thoracic esophagus or Siewert I and II cancers, treated by neoadjuvant chemotherapy (CT) or chemoradiotherapy (CRT) and surgery. Pathological tumor response was quantified using the Mandard score. Kaplan-Maier plots were used to estimate overall survival (OS) according to the TRG.

Results
Overall, 424 patients were recruited in the study period, 236 received CT and 188 CRT. The median follow-up time was 55 months. TRG 1 and 2 showed comparable OS curves both in the CT group (p = 0.76) and in the CRT group (p = 0.82) (Figure 1). TRG 1–2 were associated with a significantly improved OS compared to TRG 3–5 after CT (p = 0.004) and CRT (p = 0.0003). The trend was confirmed in the whole cohort, with TRG 1 and 2 patients showing comparable 5-years OS proportions (70% vs. 65%, p = 0.52) and a significantly improved survival compared to TRG 3–5 (p &lt; 0.0001).

Conclusion
Tumor regression after neoadjuvant treatment is significantly associated with long term survival irrespective of the adopted regimen. The long-term survival was comparable between TRG 1 and TRG 2 patients after CT and CRT and in the overall population. This finding allowed us to define the criterion of major tumor response, which includes both TRG 1 and 2 patients, potentially creating a homogeneous and larger subgroup of subjects to be evaluated in future clinical trials.