bluuebunny/crossref_metadata_2025_split huggingface dataset:
418. STRATEGIES FOR OLIGOMETASTATIC AFTER CURATIVE RESECTION OF ESOPHAGEAL CANCER
Authors: Tajima Kohei , Kanamori Kohei , Yatabe Kentaro , Yamamoto Miho , Kazuno Akihito , Syoji Yoshiaki , Koyanagi Kazuo 
Published: September 2022

Abstract
The recurrence rates in patients with esophageal cancer who are treated by curative esophagectomy is reported to be 29-43%. Recently, the concept of oligometastasis recurrence (OLR) has gained attention.
To clarify the relationship between treatment strategy and prognosis of patients with OLR after esophagectomy. We included 124 patients with recurrence among 446 patients who underwent esophagectomy for esophageal cancer.
OLR was defined as five or fewer recurrences in a single organ or five or fewer recurrences in a single lymph node. Patients were divided into two groups: OLR and non-OLR group. Recurrence within 6 months after surgery was defined as early recurrence. The relationship between early recurrence and prognosis was examined. We focused on liver and lung metastases and examined treatment methods and prognosis.
Of the recurrence patients, 40 (32%) were in the OLR group and 84 (78%) were in the non- OLR group. The overall survival was 49 months in the OLR group and 17 months in the non-OLR group (p &lt; 0.001). Survival after recurrence was 26 months in the OLR group and 6 months in the non-OLR group (p &lt; 0.001). In comparison of the early relapse and non-early relapse groups, both OS and survival after recurrence tended to be worse in the early relapse group (p = 0.05). The prognosis was better in the lymph node recurrence group and worse in the liver recurrence group (p = 0.05).
Oligometastasis is related to prognosis in patients with recurrence after esophagectomy, and patients with early recurrence or liver recurrence may have a poor prognosis.
428. CHARACTERIZATION OF CD82/KAI1 IN ESOPHAGEAL ADENOCARCINOMA
Authors: Ludwig Alexandra , Limberger Beate , Nowotny Robert , Gockel Ines , Thieme René 
Published: September 2022

Abstract
The incidence of esophageal adencocarcinoma (EAC) has increased in last decades. Regardless to improved perioperative chemotherapies and surgical approaches, the prognosis for EAC in advanced stages is poor. CD82 is a tumor suppressor gene, and its downregulation correlates with invasive growth, metastases formation and advanced clinical stages. CD82 might influence the Wnt/ß-catenin signaling pathway.
We used an in vitro Barrett’s esophagus cell culture model, represented by esophageal squamous cell epithelium (EPC1, EPC2), metaplasia (CP-A), dysplasia (CP-B) and esophageal adenocarcinoma (OE33, OE19, SKGT4, FLO1). Antisense LNA Oligonucleotides (GapmeRs, Qiagen) were used to achieve a transient knockdown of CD82 in OE33 and OE19 cells. mRNA and proteins were analyzed by q-RT-PCR and western blot analyses, respectively. A fluorescence antibody specific to CD82 was used for flow cytometry analysis. Proliferation assay, colony formation assay and boyden chamber assay were performed after CD82-knockdown to further analyze cell proliferation, cell growth and survival, colony forming and cell migration.
CD82 was expressed in all investigated cell lines by flow cytometry with a significant overexpression in OE19 and FLO1 cells. A stable downregulation of CD82 was achieved in OE33 and OE19 cells. Proliferation assays showed a significantly higher proliferation rate at 72 hours after CD82-knockdown in OE33 cells. A significantly higher mRNA expression of vimentin was observed after CD82-knockdown in OE33. Colony formation assay showed a significantly higher colony count after CD82-knockdown in both cell lines. Cell migration was increased after CD82-downregulated in OE33 and OE19 cells.
CD82 might influence the expression of mesenchymal marker proteins, cell migration abilities and the process of colony forming and thus enhance the metastatic potential of OE33 and OE19 cells. Low expression of CD82 could alter metastasis and cancer progression but further molecular characterizations are needed to elucidate the impact on carcinogenesis of EAC.
430. MICRONUTRIENT INSUFFICIENCY AFTER SURGERY FOR OESOPHAGOGASTRIC NEOPLASMS: A PROSPECTIVE INTERVENTION STUDY NAMED THE VITAMIN STUDY
Authors: Van der Velden Ariadne Lisa , Vermeer Thomas Adriaan , Boerma Evert-Jan Gijsbert , Belgers Eric Henricus Johannes , Stoot Jan Henri Marie Basile , Leers Mathie Peter Gertruda , Sosef Meindert Nico , Vijgen Guy Hubertus Elisabeth Joseph 
Published: September 2022

Abstract
Oesophageal and gastric cancer are among the top ten cancers worldwide. Both diseases have major impact on the nutritional status and quality of life (QoL). Preoperative malnutrition is reported in 42–80%. However, studies investigating postoperative nutritional status are scarce and postoperative identification and treatment of micronutritional deficiencies are currently lacking in (inter-)national guidelines. The aim of this study is to identify and target micronutrient deficiencies after surgery for oesophageal or gastric neoplasms.
This is a single centre prospective intervention trial with inclusion of 248 patients who underwent oesophagectomy (n = 124) or (sub)total gastrectomy (n = 124). Patients will receive a tailormade multivitamin supplement which differs per group and additionally a calcium supplement. Baseline measurements consist of blood withdrawal, faecal elastase-1 analysis, QoL and dietary behaviour. After 6, 12 and 24 months from baseline, measurements are repeated, and a supplement questionnaire is added. The primary objective is micronutrient deficiency (yes/no). Secondary objectives include occurrence and symptoms of pancreas insufficiency (n, %), time between surgery and start of supplementation (mean in months) and QoL at all time points.
Inclusion started in December 2021 and is still recruiting. Currently, preliminary results of 40 included patients are available, whereby 24 patients underwent oesophagectomy and 16 patients underwent gastrectomy (table 1). In this population, 87.5% developed at least one micronutrient deficiency, equally seen per subgroup. The most profound deficiencies found are vitamin D (55.0%), ferritin (40.0%), Iron (32.5%), zinc (22.5%). Other deficiencies found are folic acid (12.5%), calcium (7.5%), vitamin B6 (5.0%) and vitamin B12 (2.5%). Decreased faecal elastase-1 (&lt; 200 mg/kg) was found in 15% of the total population.
Literature regarding the incidence of micronutrient deficiencies and supplementation after oesophageal and gastric surgery is scarce. If micronutrient deficiencies are significantly present in this population and daily supplementation can prevent and resolve these deficiencies, routine monitoring and supplementation of micronutrient deficiencies can be implemented in the standard postoperative care of oesophageal and gastric surgery.
434. A SINGLE INSTITUTIONAL SURGICAL RESULT OF ESOPHAGEAL RECONSTRUCTION WITH SUPERCHARGED JEJUNAL INTERPOSITION FOR PATIENTS WHO LOST BOTH ESOPHAGUS AND STOMACH
Authors: Su Ying-chieh , Fong Yao , Chen Chao-kun 
Published: September 2022

Abstract
Esophagectomy and gastrectomy are life saving surgeries for severe corrosive injury patients with detergent ingestion. Esophageal reconstruction to restore ingesting ability was performed with colon conduit traditionally. But the sustainability of colon conduit was doubtful. Jejunal graft with supercharged technique is a promising procedure that promise a conduit of smaller diameter and better resistant of lumen distention.
The medical records of patient in Chimei Medical Center (CMC) between 2010 to April 2022 were reviewed with keyword of supercharged jejunal graft. The data including patient characteristics, hospital stays, operative technique, and post operative outcomes were collected.
Eight patients, 5 female and 3 male, aged 22 to 60 years (median: 45), underwent esophageal reconstruction with supercharged jejunal interposition due to loss of both esophagus and stomach. Seven patients lost esophagus and stomach for detergent ingestion and the rest one has both esophageal and gastric cancer. The following time is between 1 month to 11.5 years (median: 4.4 years). There is no flap loss, no surgical mortality, and all 8 patients still survive to date. All patient could intake solid food.
Supercharged jejunal interposition can be safely performed for patient who can’t have gastric tube interposition after esophagectomy. It has good resistance for distention and is an idea substitute of esophagus for young patients who needs a conduit that last lifelong.
437. SURGEON’S BEHAVIOR STEERING PATIENTS TO PARTICIPATE IN A CLUSTER RANDOMIZED TRIAL ON ACTIVE SURVEILLANCE FOR ESOPHAGEAL CANCER
Authors: Van Der Zijden Charlène J , de Veer M , Hermus M , van der Wilk BJ , Wijnhoven BPL , Stiggelbout AM , Dekker JWT , Coene PPLO , van Busschbach JJ , van Lanschot JJB , Lagarde SM , Kranenburg LW 
Published: September 2022

Abstract
Shared decision making (SDM) is used to involve patients in the decision-making process. Researchers have shown that clinicians, often unintendedly, use steering behavior which may persuade patients to choose for a specific treatment. Well-balanced information provision towards patients can be challenging when participation in a randomized trial is discussed. This study investigates if and how surgeons use steering behavior when patients are eligible to participate in a stepped-wedge cluster randomized trial.
Patients with locally advanced esophageal cancer, planned to undergo neoadjuvant chemoradiotherapy (nCRT) followed by standard surgery, were included prior to their first surgical consultation. During this consultation, the surgeon discussed the possibility to participate in a trial on active surveillance after nCRT as experimental treatment. Standard care (i.e. surgical resection) was offered to patients who refused participation. Randomization occurred on the institutional level and therefore both surgeons and patients were aware of allocated treatment in the experimental arm before making a decision. Consultations were audiotaped and transcribed verbatim. Data were analyzed using thematic content analysis.
Twenty consultations were recorded between June and December 2020. Surgeons used various techniques to steer patients towards a specific treatment, mostly towards participation. An imbalanced presentation of pros and cons of treatment options probably influenced patients’ preferences: positive framing of active surveillance was used to steer patients towards opting for active surveillance, negative framing of active surveillance was used to make surgical resection more attractive. Besides using steering language, also the timing at which the alternative treatment option was discussed resulted in more focus on either of the treatment options.
Various types of steering behavior were identified, including an imbalanced presentation of pros and cons, steering language and the timing at which different treatment options were discussed. Awareness of steering behavior in clinicians is the first step in improving objective information provision and thus shared decision making.
447. IMPACT OF PERIOPERATIVE MANAGEMENT BASED ON ERAS IN THORACIC ESOPHAGEAL CANCER SURGERY
Authors: Muroya Takahiro , Yokoyama Hiroshi , Yoshida Eri , Abe Atsumi , Hakamada Kenichi 
Published: September 2022

Abstract
Esophagectomy for esophageal cancer is one of the most invasive surgeries, thus it has high morbidity and mortality rates. A multidisciplinary perioperative management is required for improvement in surgical outcomes. Early recovery after surgery (ERAS) is now standard in the care of patients and has been associated with reduced complication rates and hospital stays. The aim of this study was to evaluate the impact of perioperative management based on ERAS for thoracic esophageal cancer patients.
A total 357 patients performed esophagectomy between January 2009 and August 2020 were enrolled. Patients were classified into non-ERAS (NE) group (n = 174) and ERAS (E) group (n = 183). Operative outcomes were compared between two groups. Postoperative complications were graded according to Clavien-Dindo classification. The complication defined as above Grade 3. Nutritional Status was evaluated with Controlling nutritional status (CONUT). Changes in body weight (BW) and area of psoas muscle mass at 3 months after surgery were evaluated.
Operative factors such as operative time and blood loss were not significant different between the NE and E groups. In E group, Postoperative any complications (p = 0.023), respiratory complications (p = 0.043) were significantly less than in NE group. CONUT score was lower on postoperative 1 month (p = 0.025) and 3 months (p = 0.044) in E group. Reduction rate of BW and psoas muscle mass index (PMI) on postoperative 3 months in E group was lower than in NE group (BW: 5.6 ± 6.4% vs 7.8 ± 5.2% (p = 0.045), PMI: 6.7 ± 14.9% vs 12.3 ± 13.3% (p = 0.021)).
ERAS could be effective for maintenance of a better nutritional status and prevention of the postoperative respiratory complication and loss of the BW and PMI.
459. MULTIDISCIPLINARY TREATMENT STRATEGY FOR ADVANCED CERVICAL ESOPHAGEAL CANCER AIMED AT PRESERVING THE LARYNX
Authors: Tanabe Shunsuke , Noma Kazuhiro , Hashimoto Masashi , Maeda Naoaki , Shirakawa Yasuhiro , Fujiwara Toshiyoshi 
Published: September 2022

Abstract
In the treatment of advanced cervical esophageal cancer, the availability of laryngeal preservation has a great effect on quality of life. Factors affecting laryngeal preservation include tracheal invasion of the tumor, extension to the pharyngeal side, and duplication of head and neck cancer. In our institute, we provide multimodal treatment aiming at preserving the larynx as much as possible. We report on preoperative treatment and surgical outcome for patients with advanced cervical esophageal cancer.
Of the 713 cases of esophageal cancer surgery from 2014 to March 2021, 29 cases of advanced cervical esophageal cancer were examined for preoperative treatment and surgical outcome. In our institution, non-T4 cases are first introduced with Docetaxel + Cisplatin +5-FU (DCF) chemotherapy. For cT4 cases and cases who DCF therapy did not respond, we added radiation therapy to DCF for local control. For resectable cases, we performed esophagectomy actively.
The primary diagnosis was StageII:III:IV = 6:19:4 (UICC 8th). Preoperative treatment was performed in 28 cases, 26 cases with neoadjuvant chemotherapy (NAC), and 2 cases with chemoradiotherapy (CRT). NAC regimen was DCF in all cases. The therapeutic effect of NAC was evaluated PR in 15 of 26 cases and SD in 11. Laryngeal preservation was possible in 11 of 15 NAC-PR cases (73.3%) and 7 of 11 NAC-SD cases (63.6%), and the laryngeal preservation rate was higher in the NAC responder group. Recurrence was observed in 15 cases. 10 cases were in the laryngeal preservation group, but only 2 cases had local recurrence.
This study suggests that the response of NAC may increase the laryngeal preservation rate. Laryngectomy does not necessarily contribute to the control of local recurrence. But patients with positive margins have a poor prognosis. And it is important to make an appropriate decision as to whether radiation therapy or surgery should be performed for patients who do not respond to chemotherapy.
460. SARCOPENIA AFTER NEOADJUVANT CHEMOTHERAPY IS ASSOCIATED WITH DEVELOPMENT OF MODERATE TO SEVERE POST-OPERATIVE COMPLICATIONS IN ESOPHAGOGASTRIC ADENOCARCINOMA PATIENTS
Authors: Convill James , Chmelo Jakub , Prasad Pooja , Brown Joshua , Petrides George , Phillips Alexander 
Published: September 2022

Abstract
Sarcopenia is defined as a loss of skeletal muscle mass and function. Preoperative sarcopenia amongst patients with esophageal cancer has been linked to various postoperative complications and to the degree of severity of these complications. The majority of this evidence comes from populations with squamous cell carcinoma or where neoadjuvant chemoradiotherapy was used. Whether sarcopenia pre- or post-neoadjuvant chemotherapy (NAC) for esophagogastric adenocarcinoma (EGA) is associated with postoperative complications is not fully understood.
Patients diagnosed with EGA between January 2017 and December 2020 and undergoing NAC followed by esophagectomy from a single high-volume center had their pre- and post-NAC CT scans assessed for radiological sarcopenia. Skeletal muscle index (SMI) was calculated from muscle area measured on CT scans at the level of third lumbar vertebra. Previously published SMI cut off values for radiologically defined sarcopenia were used (52.4cm2 for men and 38.5cm2 for women). Post-operative complications were prospectively evaluated and classified using the Clavien-Dindo (CD) classification system. Patients were grouped as either CD 0-I (no-mild complications) or CD II-V (moderate–severe complications).
There were 144 patients included in the analysis. 62 patients had FLOT NAC and 82 patients had ECX NAC. Pre-NAC sarcopenia was not associated with the development of moderate–severe postoperative complications (p = 0.075). However, sarcopenia assessed on restaging scan post-NAC was found to be associated with moderate–severe postoperative complications (p = 0.044).
EGA patients with sarcopenia post-NAC are more likely to develop moderate–severe post-operative complications than those without sarcopenia. Strategies to treat sarcopenia and prevent its further development are desperately needed in order to reduce post-operative complications.
462. IMPACT OF THE RATIO OF THE VISCERAL FAT AREA TO PSOAS MUSCLE AREA ON SURVIVAL FOR SURGICALLY RESECTED ESOPHAGEAL CANCER
Authors: Sakai Makoto , Sohda Makoto , Uchida Shintaro , Yamaguchi Arisa , Watanabe Takayoshi , Saito Hideyuki , Nakazawa Nobuhiro , Kuriyama Kengo , Sano Akihiko , Ogawa Hiroomi , Yokobori Takehiko , Shirabe Ken , Saeki Hiroshi 
Published: September 2022

Abstract
Sarcopenia (the loss of skeletal muscle volume and/or quality) and obesity have received increasing attention in many malignancies because they are associated with postoperative complications and poor surgical outcomes. The synergic effects of muscle mass reduction with excess body adiposity in surgically resected esophageal cancer (EC) patients remains controversial, especially in non-obese patients.
One hundred and six patients with EC who underwent surgery between 2006 and 2014 were included in this study. Reduction in muscle mass and excess body adiposity were defined as the ratio of the visceral fat area (VFA) to psoas muscle area (PMA) (V/P ratio) on the same axial computed tomography (CT) slice at the third lumbar vertebra (L3).
A high V/P ratio was associated with higher age (p = 0.03), higher body mass index (BMI) (p&lt;0.001), higher VFA (p&lt;0.001), and increased age-adjusted Charlson comorbidity index (ACCI) (p = 0.005). Multivariate analysis revealed a high V/P ratio to be an independent prognostic factor for poor overall survival (OS) in EC patients who underwent surgery (p = 0.003). The prognostic value of the V/P ratio was still significant in EC patients with a BMI &lt; 25.
A high V/P ratio was associated with poor survival in surgically resected EC patients, even in non-obese patients. The V/P ratio as a surrogate marker of relative muscle mass reduction and fat accumulation may have prognostic value in EC patients regardless of body composition differences.
471. OUTCOMES OF RETROSTERNAL RECONSTRUCTION ROUTE FOR ESOPHAGECTOMY IN ESOPHAGEAL CANCER PATIENTS IN OUR HOSPITAL
Authors: Kurata Kanako , Horioka Kohei , Akagawa Shin , Kobayashi Kiichiro , Nishihara Kazuyoshi , Nakano Toru 
Published: September 2022

Abstract
In cervical esophagogastric anastomosis after esophagectomy for esophageal cancer, the main reconstructive routes are retrosternal and posterior mediastinal. Since April 2019, the retrosternal route has been the standard procedure at our hospital. We report on the results of reconstruction by a retrosternal route at our hospital.
This study included 38 patients with esophageal cancer (squamous cell carcinoma) who underwent resection and reconstructed by the retrosternal route between April 2019 and March 2021. We evaluated the short-term postoperative outcomes of these patients.
All the reconstructed organs were the gastric tube. The anastomosis method was a Circular stapler: 33 cases and a Linear stapler: 5 cases. The median start of oral intake after surgery was 3 days, and the median postoperative length of stay was 16 days. Perioperative complications of Clavien-Dindo classification grade 3 or higher occurred in 4 cases: anastomotic leakage grade IIIa: 3 cases and grade IVa: 1 case. Complications within 1 month after the operation were anastomotic stenosis grade IIIa in 1 case, and within 6 months were anastomotic stenosis grade IIIa in 2 cases.
In our department, anastomotic leakage of a retrosternal route reconstruction was about 10%, which was similar to the domestic data (all reconstruction route). The stylization of surgical techniques and instruments used contributes to the reduction of postoperative complications, especially anastomotic leakage. In addition to establishing surgical techniques, careful perioperative management including rehabilitation and nutritional management is also important for preventing complications.
479. THE ROLE OF PET/CT IN PREDICTING THE PATHOLOGICAL RESPONSE TO NEOADJUVANT IMMUNOCHEMOTHERAPY FOR RESECTABLE ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Yang Weixiong , Wang Xiaoyan , Luo Hui , Zhang Shuishen , Gan Yi , Zeng Bo , Liu Zhenguo , Cheng Chao 
Published: September 2022

Abstract
Accurate assessment of residual disease of tumor and lymph nodes after neoadjuvant immunochemotherapy is crucial in the active surveillance for patients with ﻿pathological complete response (pCR) and the optimal extent of lymphadenectomy for patients with non-pCR. This post-hoc analysis aimed to evaluate the performance of 18F-FDG PET/CT to predict the pathological response to neoadjuvant immunochemotherapy for esophageal squamous cell carcinoma (ESCC).
Fifty-eight resectable ESCC patients who received neoadjuvant PD-1 blockade in combination with chemotherapy were enrolled in the final analysis. The scans of 18F-FDG-PET/CT were acquired at baseline (scan-1) and after immunochemotherapy but prior to surgery (scan-2). Maximum standardized uptake value (SUVmax), mean standard uptake value (SUVmean), tumor-to-blood pool SUVmax ratio (SUVTBR), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were evaluated for their association with the pathological response to immunochemotherapy.
The TLG and MTV at scan-1 was significantly lower in pCR than that in non-pCR group. At scan-2, the SUVmax, SUVmean, SUVTBR, TLG and MTV were significantly lower in pCR. Decrease in TLG and MTV between scan-2 and scan-1 were significantly higher in the pCR group. In the receiver operating characteristic curve analysis, SUVmax, SUVmean, SUVTBR, TLG and MTV in scan-2 showed excellent predictive value for the pCR of primary tumors. Furthermore, SUVmax at scan-2 were significantly higher in positive lymph nodes than that in negative ones, suggested a high negative predictive ability (98.6%) with a cut-off value at 1.4.
The parameters of 18F-FDG PET/CT have the excellent performance for predicting pCR after the combined neoadjuvant immunochemotherapy in resectable ESCC.