bluuebunny/crossref_metadata_2025_split huggingface dataset:
282. VALIDITY AND RELIABILITY OF CROWD-SOURCED AND EXPERT VIDEO ASSESSMENT IN MINIMALLY INVASIVE ESOPHAGECTOMY USING GLOBAL RATING SCALES
Authors: Ketel Mirte , Klarenbeek Bastiaan , Eddahchouri Yassin ,   MIE-GOALS Collaboration Group, Abma Inger , Rosman Camiel , van Workum Frans 
Published: September 2022

Abstract
Minimally Invasive Esophagectomy (MIE) is a complex and technically demanding procedure and implementation is associated with a substantial learning curve. Suboptimal surgical performance in complex minimally invasive procedures has convincingly been related to less favorable patient outcomes. Structured video-based assessment by other surgeons can objectively evaluate surgical performance, but requires a surgeon’s scarce time. This study investigated whether crowdsourcing, collective surgical performance evaluation by anonymous and untrained laypeople, could be a valid alternative for MIE.
Two video assessments types were conducted via the C-SATS platform with eight MIE operative videos. First, videos were cut into eight procedural phase-based video clips of maximum ten minutes. These 64 video clips were assessed with the validated Global Operative Assessment of Laparoscopic Skills (GOALS)‘s four domains (depth perception, bimanual dexterity, efficiency and tissue handling) using a 1-5 Likert scale. Each video clip was assessed by a pair of two MIE experts and &gt; 30 crowd workers, recruited via Amazon Mechanical Turk. Second, the same expert pairs assessed the corresponding complete video with the procedure-specific MIE competency assessment tool (MIE-CAT).
Experts assessed 128 clips and sixteen complete videos in 3.5 months. Crowd workers assessed 1984 clips in &lt; two days. Expert scores showed a wider range (expert GOALS score range 7.50-19.50 versus 12.84-15.63 for crowds). When comparing experts and crowd workers scores, a poor correlation was found on all domains and total GOALS scores (ICC ≤ 0.42). When correlating GOALS scores with MIE-CAT scores a strong, positive correlation between experts’ scores was found (r¬s = 0.76, p = 0.03) while between crowd’s GOALS and expert’s MIE-CAT scores a small correlation was found (r¬s = 0.23, p = 0.58) (Figure 1).
Despite rapid results from crowd workers, a poor agreement between crowd and experts’ GOALS scores was observed. MIE might be technically too difficult to assess for laypeople. Furthermore, GOALS might not be extensive enough to assess MIE performance in detail, while the procedure-specific MIE-CAT might be more comprehensive. However, the correlation between the experts’ MIE-CAT and GOALS scores indicates video clip assessments (instead of full length video assessments) could be helpful to shorten assessment time.
286. THORACOPHRENOLAPAROMY FOR SURGICAL TREATMENT OF GEJ CANCER
Authors: Garbarino Giovanni Maria , Eshuis Wietse J , Daams Freek , van Berge Henegouwen Mark I , Gisbertz Suzanne S 
Published: September 2022

Abstract
Nowadays, there is still a lack of consensus about the optimal surgical management of gastroesophageal junction (GEJ) tumor. The CARDIA-trial results, comparing transthoracic esophagectomy versus transhiatal extended gastrectomy for GEJ type II tumor, are still expected. Thoracophrenolaparotomy (TPL) allows to perform radical resections (higher rate of R0 and more extensive mediastinal lymphadenectomy) with both esophago-gastric or esophago-jejunal anastomoses. The aim of this study is to describe TPL for the treatment of GEJ and gastric cancer.
A retrospective analysis of all TPL performed for GEJ and gastric cancer with esophageal involvement at the Amsterdam UMC from January 2019 to October 2021 was conducted. The primary endpoint was the evaluation of R1 resections. The secondary endpoints were postoperative and pathological outcomes.
Forty-seven patients were included for the analysis. 18 patients underwent an esophago-cardia resection with gastric conduit reconstruction and 29 patients a total gastrectomy with distal esophagectomy. The main indications for TPL were cT3 (74.5%) and cN+ (55.3%) tumors. Postoperative pneumonia occurred in 4 (8.5%) patients and anastomotic leak in 2 (4.3%) patients. The mean hospital stay was 9.8 (±6.1) days. The mean tumor size was 42.3 (±32.8) mm and the mean proximal margin 31.0 (±20.7) mm. Two (4.3%)patients had a R1 resection of whom only one (2.1%) had a positive proximal margin. The mean number of retrieved lymph nodes was 31.6 (±9.9).
Thoracophrenolaparotomy for selected patients with GEJ and gastric cancer is associated with high R0 resection rate, low pneumonia and anastomotic leak incidence, together with a short hospital stay. TPL should still be considered a reliable surgical option, even in high-volume centers for minimally invasive upper gastrointestinal surgery.
291. A CASE OF LAPAROSCOPIC AND THORACOSCOPIC ENUCLEATION FOR GIANT CIRCUMFERENTIAL ESOPHAGEAL LEIOMYOMA
Authors: Sato Kazuhide , Masuda Takahiro , Tanishima Yuichiro , Fujisaki Muneharu , Uno Koei , Hara Keigo , Takahashi Keita , Yano Fumiaki , Eto Ken 
Published: September 2022

Abstract
Enucleation is surgically or endoscopically performed for submucosal tumors of the esophagus, especially for esophageal leiomyoma. Enucleation for large and circumferential tumors is technically challenging given a higher risk of mucosal injury and/or tumor rupture during procedure. We present a case of giant leiomyoma with a maximal diameter of 8 cm successfully enucleated by laparoscopic and thoracoscopic approaches.
A 24-year-old man was referred to our hospital with a mediastinal tumor suspected on chest X-ray. He suffered from heartburn for more than 10 years and recently dysphagia. Endoscopic examination revealed esophageal submucosal tumors located at 30 cm to 35 cm from the incisor, involving whole luminal circumference. Boring biopsies were endoscopically performed of which pathological diagnosis was esophageal leiomyoma. CT showed wall thickening in the lower esophagus with a maximal esophageal diameter of 8 cm.
Giant esophageal tumor enucleation with antireflux fundoplication was performed using both laparoscopy and thoracoscopy. The tumor expanded circumferential shape with the longitudinal extent of approximately 8 cm. After tumor enucleation, the esophageal mucosa was circumferentially exposed from the level of the azygos vein to the esophagogastric junction without the muscle layer. The esophageal mucosal injury occurred in 3 places, which were repaired by primary closure using absorbable threads. The operation time was 827 minutes and the loss of blood was 230 mL. The specimen was 160 g, and the final pathological diagnosis was leiomyoma. Postoperative course was not eventful.
We experienced a case of enucleation for a giant esophageal circumferential submucosal tumor. Enucleation may be considered a possible treatment strategy to avoid esophagectomy even for a giant circumferential tumor especially in young patients.
292. ROLE OF PREOPERATIVE NEOADJUVANT CHEMORADIOTHERAPY FOR LOCALLY ADVANCED BORDERLINE RESECTABLE THORACIC ESOPHAGEAL CANCER
Authors: Wakita Akiyuki , Motoyama Satoru , Sato Yusuke , Fujita Hiromu , Kemuriyama Kohei , Hayashi Kenjiro , Minamiya Yoshihiro 
Published: September 2022

Abstract
The results of the JCOG1109 trial indicate that the standard preoperative neoadjuvant therapy is Docetaxel-cisplatin-fluorouracil (DCF) combined chemotherapy. However, appropriate preoperative treatment for borderline resectable cases is still controversial. Preoperative CF-RT therapy with more substantial local control continues to be an option for tumors with a high risk of invading adjacent organs.
The study participants were 163 cT3 locally advanced thoracic esophageal cancer patients who underwent preoperative CF-RT therapy followed by radical esophagectomy. The patients were partitioned into 58 borderline resectable cases (cT3.5 group) and 105 resectable cases (cT3 group). We compared the clinicopathological features, surgical results, and survival between the two groups to verify the effectiveness of preoperative CF-RT therapy for cT3.5 cases.
SCC was the predominant cancer histological type. Significantly more upper and middle mediastinum cases and fewer lower mediastinum cases in the cT3.5 group (p &lt; 0.0001). There were no significant differences in postoperative complications; anastomotic leakage was 12.1%, and recurrent laryngeal nerve palsy was 32.8%. The pCR rate was significantly lower in the cT3.5 group (p = 0.0219). Nineteen patients (32.8%) in the cT3.5 group relapsed. Details of recurrence were locoregional in 7 patients, distant LN in 1 patient, and distant organ in 11 patients. There were no significant differences in neither 5-year OS nor 5-year DFS between the two groups (p = 0.6547, p = 0.8799; respectively).
Borderline resectable esophageal cancer (cT3.5) treated with preoperative CF-RT therapy showed a comparable survival rate even though the pCR rate was lower than that of resectable esophageal cancer (cT3). Preoperative CF-RT therapy may still be a promising treatment for locally advanced thoracic esophageal cancer with suspected invasion of adjacent organs.
307. INGENUITY OF ESOPHAGOGASTRIC ANASTOMOSIS IN OUR DEPARTMENT -RECONSTRUCTED GASTRIC TUBE STUMP CLOSURE USING ENDO GIA RADIAL RELOAD
Authors: Hirahara Noriyuki , Matsubara Takeshi , Hayashi Hikota , Yamamoto Tetsu , Hyakudomi Ryoji , Tajima Yoshitsugu 
Published: September 2022

Abstract
Anastomotic leakage is one of the three major complications after esophagectomy and can lead to surgery-related death. In our department, the standard surgical procedure is to elevate the gastric conduit via the posterior mediastinal pathway, and end-to-side anastomosis using a circular stapler for the residual esophagus and gastric conduit. In this study, we will report our reconstruction method and ingenuity, since Linear stapler was changed to Endo GIA Radial Reload and better outcomes were delivered.
The lesser curvature of the gastric conduit stump is the site where blood flow is most reduced. When the gastric conduit stump is closed with Linear stapler, the blood flow may be further reduced, because the stapler on the lesser curvature of the gastric conduit and the stapler on gastric conduit stump intersect. Closing the gastric conduit stump using Radial Reload avoids the stapler intersect at the lesser curvature and the gastric conduit stump. In addition, since a natural curve is formed at the gastric conduit stump, the pressure applied to the gastric tube stump by coughing can be dispersed.
Nine patients have undergone this reconstruction method, and no anastomotic leakage has been observed.
It is important to constantly evaluate one’s own surgical technique, and to continue developing the surgical technique for further safety by making improvements.
312. EFFICACY AND SAFETY OF NEOADJUVANT IMMUNOTHERAPY IN LOCALLY ADVANCED ESOPHAGEAL CANCER: A META-ANALYSIS OF CLINICAL TRIALS
Authors: Yang Xinyu , Sun Linyi , Tan Lijie 
Published: September 2022

Abstract
There recently have been great achievements in immunotherapy for locally advanced esophageal cancer (LAEC), but the efficacy and safety of neoadjuvant immunotherapy for LAEC have not been clearly demonstrated. This meta-analysis of clinical trials, based on the data available so far, aims to demonstrate the efficacy and safety of neoadjuvant immunotherapy for LAEC, to provide further treatment options for LAEC in the future, and obtain better survival benefits.
Original articles or Unpublished updated data of clinical trials describing the safety and efficacy of neoadjuvant immunotherapy in LAEC were researched from PubMed, Embase and Cochrane Library, ASCO, and ESMO. before April 25, 2022. The efficacy outcomes were pathological complete response (pCR) and major pathological response (MPR). The safety outcomes were treatment-related adverse events (TRAEs), and surgical resection rate. The risk differences and 95% confidence interval (CI) were calculated. Heterogeneity was determined by the χ2 test and I2 test. Subgroup analysis was performed based on pathology, immune checkpoints inhibitors and treatment modes.
A total of 351 patients from 16 clinical trials were included. The risk differences of pCR and MPR in neoadjuvant immunotherapy were 0.31 (95% CI: 0.26–0.35) and 0.61 (0.52–0.70), respectively. The incidences of all-grade TRAEs, grade ≥ 3 TRAEs, and surgical resection rate were 0.37 (0–0.77), 0.32 (0.18, 0.46), and 0.86 (0.82, 0.89), respectively. The better pCR and MPR in immunotherapy was shown in the immunotherapy combined with radio-chemotherapy, compared with immunotherapy combined with chemotherapy (pCR: 0.41 [0.31–0.51] vs. 0.28 [0.23–0.33]; MPR: 0.89 [0.74–1.03] vs. 0.61 [0.55, 0.68]). There were similar outcomes in other subgroups.
Neoadjuvant immunotherapy is effective and safe for LAEC.
325. THE ASSOCIATED RISK BETWEEN SINGLE NUCLEOTIDE POLYMORPHISMS OF AP1S1 AND ESOPHAGEAL SQUAMOUS CELL CARCINOMA IN CHINESE POPULATION
Authors: Feng Su , Yong Fang , Jinjie Yu , Tian Jiang , Siyun Lin , Shaoyuan Zhang , Lu Lv , Tao Long , Huiwen Pan , Junqing Qi , Qiang Zhou , Weifeng Tang , Guowen Ding , Liming Wang , Lijie Tan , Jun Yin 
Published: September 2022

Abstract
The σ1A subunit of the adaptor protein 1 (AP1S1) participates in intracellular transport pathways, which is pivotal in carcinogenesis. It is therefore rational to presume that AP1S1 might also be involved in carcinogenesis. In this hospital-based case–control study, we investigated the genetic susceptibility to esophageal squamous cell carcinoma (ESCC) in relation to Single Nucleotide Polymorphisms (SNPs) of AP1S1 among Chinese population and made a preparation for the subsequent esophageal SNP risk model building.
A database containing a total of 1143 controls and 1043 ESCC patients were retrospectively studied. The AP1S1 SNPs were analyzed based on ligation detection reaction (LDR) method. Then the relationship between ESCC and SNPs of AP1S1 was determined with a significant crude P &lt; 0.05. Then the logistic regression analysis was used for the calculation for adjusted P in the demographic stratification comparison if a significant difference was observed in the previous step.
AP1S1 rs77387752 C &gt; T mutated homozygous TT was an independent risk factor for ESCC, while SNP rs4729666 C &gt; T and rs35208462 C &gt; T mutated heterozygote TC were associated with a lower risk for ESCC, especially in co-dominant model and allelic test for younger, male subjects who are not alcohol-drinkers nor cigarette smokers. These three AP1S1 SNP sites could be incorporated into subsequent SNPs risk models for ESCC in specific populations.
AP1S1 rs77387752, rs4729666 and rs35208462 polymorphisms are associated with susceptibility to ESCC in Chinese individuals. AP1S1 SNPs may exert an important role in esophageal carcinogenesis and could serve as potential diagnostic biomarkers. These SNP sites might be added into the building of risk model and then the early diagnosis of ESCC. Besides, further mechanical exploration is required.
Table. Logistic regression analyses of associations between AP1S1 SNPs rs77387752 C &gt; T, rs4729666 C &gt; T, rs35208462 C &gt; T and risk of ESCC.
336. IMPACT OF TIME TO SURGERY AFTER CHEMORADIOTHERAPY ON TUMOR REGRESSION AND SURVIVAL IN THE MULTICENTER RANDOMIZED CONTROLLED NEORES II TRIAL
Authors: Nilsson Klara , Klevebro Fredrik , Sunde Berit , Rouvelas Ioannis , Lindblad Mats , Szabo Eva , Halldestam Ingvar , Smedh Ulrika , Wallner Bengt , Johansson Jan , Borg David , Johnsen Gjermund , Aalin Eirik Kjus , Johannessen Hans-Olaf , von Döbeln Gabriella Alexandersson , Hjortland Geir Olav , Al-Haidari Ghazwan , Quaas Alexander , Wang Naining , Bartella Isabel , Bruns Christiane , Schröder Wolfgang , Nilsson Magnus 
Published: September 2022

Abstract
Time to surgery after termination of neoadjuvant chemoradiotherapy for esophageal cancer has traditionally been 4–6 weeks. Observational studies have suggested that delay of surgery for up to three months may lead to improved tumor regression and better outcomes. NeoRes II is the first randomized trial to address this in esophageal cancer. No difference in surgical morbidity or mortality between early and delayed surgery was reported in a previous publication from the trial.
A multicenter clinical trial with randomized 1:1 allocation of standard time to surgery of 4–6 weeks, or delay of surgery to 10–12 weeks, after termination of chemoradiotherapy. The primary endpoint was complete histological tumor regression in patients with adenocarcinoma. Secondary endpoints included tumor regression grade, tumor free resection margins and overall survival in all patients, and stratified by histological subtype.
In total 249 patients were randomized, 204 with adenocarcinoma and 45 with squamous cell carcinoma. There was no significant difference in histological complete response between adenocarcinoma patients allocated to standard time to surgery (20.6%) compared to delayed (25.6%) surgery (P = 0.18). Tumor free resection margin was achieved in 97.4% after standard time to surgery and 97.1% after delayed surgery (P = 1.0). The median follow-up time for survival was 51 months. Delayed time to surgery was associated with a 35% higher overall mortality, hazard ratio 1.35 (95% CI:0.94–1.95), (P = 0.11).
No significant difference in complete histological tumor regression or tumor free resection margins comparing standard and delayed time to surgery after chemoradiotherapy was observed. There was a non-significant trend towards inferior overall survival after delayed surgery, suggesting caution in delaying surgery for more than 6 weeks after neoadjuvant chemoradiotherapy.
343. THE RISK FACTORS OF HIATAL HERNIA IN ESOPHAGEAL CANCER PATIENTS WHO RECEIVED GASTRIC INTERPOSITION THROUGH POSTERIOR MEDIASTINAL ROUTE
Authors: Leow Osbert Qi Yao , Yeow Yun Jen , Yeow Kee Min , Gao Xing , Chao Yin Kai 
Published: September 2022

Abstract
Hiatal hernia (HH) after esophagectomy is becoming more relevant due to improvement in survival. The aims of this study were to define the incidence, risk factors of HH in patients who underwent esophagectomy and reconstructed with gastric tube via posterior mediastinal route.
We performed a monocentric retrospective study on 510 patients with esophageal cancer who underwent esophagectomy and reconstructed with the gastric substitute via posterior mediastinal route from 2007 to 2019. All postoperative computer tomography images were re-reviewed by two radiologists independently. The incidence of HH was estimated using Kalbfleisch and Prentice method and risk factors of HH were studied using the Fine and Gray competitive risk regression model by treating death as a competing event.
A total of 27 developed HH with the two-year cumulative incidence of 5.3%. The median time to diagnosis was 297 days. HH were symptomatic in 14 patients (52%) in whom five required emergent repair. Among the 22 patients who were treated non-operatively, progression of HH was found in 9. In the multivariable analysis, the risk factors for HH were: laparoscopic gastric tube harvest (HR = 5.756[1.07 ~ 31.2], p = 0.042) and the use of preoperative therapy (HR = 2.714[1.03 ~ 7.14], p = 0.043) were identified as independent factors associated with increased risk of HH.
HH represents a relevant surgical complication after esophagectomy and reconstructed with the gastric substitute via posterior mediastinal route. Especially in those who received preoperative therapy and using laparoscopic approach.
347. DEFINITIVE CHEMORADIOTHERAPY WITH DOCETAXEL, CISPLATIN, AND 5-FLUOROURACIL (DCF-RT) FOR ADVANCED CERVICAL ESOPHAGEAL CANCER
Authors: Okamoto Hiroshi , Taniyama Yusuke , Sato Chiaki , Ozawa Yohei , Ishida Hirotaka , Koseki Ken , Yamauchi Takuro , Kato Nobuhumi , Kamei Tokashi 
Published: September 2022

Abstract
Recently, the selection rate of definitive chemoradiotherapy (CRT) as a treatment option for cervical esophageal squamous cell carcinoma (ESCC) has increased to preserve the larynx. However, many things about the regimen, irradiation field, or which is better treatment have not been determined. We have started definitive chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF-RT) for advanced cervical esophageal squamous cell carcinoma.
We evaluated 20 advanced cervical ESCC patients (clinical stage II–IV, including T4b and/or M1 lymph node) in our department who received DCF-RT as the first-line treatment between December 2010 and August 2021.
16 males and 4 females. The pretreatment clinical stage included one stage II, five stage III, six stage IVa, and eight stage IVb cases (including 10 with T4b and 8 with M1 lymph node. Grade 3 or more adverse events included leucopenia (95%), neutropenia (90%), febrile neutropenia (55%). We attained CR in 17 patients (85%), SD in 2 patients, and PD in 1 patient. Of 17 patients with CR, 8 experienced recurrence and 9 continued exhibiting CR. Two patients who underwent salvage surgery. While the 2−/3-year overall survival rate was 60.2%/46.4%, the 2−/3-year recurrent-free survival rate was 51.4%/45.7%, respectively.
DCF-RT for advanced cervical ESCC could be completed by the careful administration, and although a strong blood toxicity might occur, a favorable prognosis can be obtained with larynx preservation. Further observations are warranted to establish the long-term prognosis, late complications of radiotherapy, and the significance of salvage surgery.
372. ASSESSMENT OF TUMOR REGRESSION GRADE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER CHEMORADIOTHERAPY: COMPARISON OF 3 COMMONLY USED SCORING SYSTEMS
Authors: Huang Shih-han , Chao Yin-Kai , Wen Yu-Wen 
Published: September 2022

Abstract
Tumor regression grade (TRG) is a measure of histopathological response of cancer to neoadjuvant chemoradiotherapy (nCRT) and is associated with outcomes. Several TRG system are used in esophageal cancer: Becker (0%,1 ~ 10%,10 ~ 50%, &gt;50% vital residual tumor cell [VRTC]), Chirieac (0%,1 ~ 50%, &gt;50% VRTC) and Japan TRG (0%,1 ~ 33%,33 ~ 66%, &gt;66% VRTC). Although these methods are generally accepted, currently there is no common standard.
We compared the application of three systems for assessment of TRG. Hematoxylin and eosin–stained slides from 482 resection specimens of esophageal squamous cell carcinoma following nCRT were independently reviewed by three pathologists.
Interobserver agreement was analyzed by kappa statistics. The prognostic strength of each TRG system was assessed using the concordance index.
Interobserver agreement for the Chirieac system showed the best kappa value (0.93) followed by the Becker (0.90) and JTRG (0.87) system. All three models predicted survival (P &lt; 0.0001) independent of yp-stage in multivariate analysis. Concordance indices of the Chirieac, Becker and JTRG were: 0.627, 0.627 and 0.633, respectively (higher number = better prediction). When comparing with Chirieac system, the JTRG system more accurately predicted survival (p = 0.03) while the Becker system did not (p = 0.12).
Chirieac system is most reproducible for the evaluation of esophageal cancer response to nCRT. However, the JTRG system seemed to be more accurate in predicting survival.