bluuebunny/crossref_metadata_2025_split huggingface dataset:
330. RANDOMIZED PHASE II STUDY OF DOCETAXEL VERSUS PACLITAXEL IN PATIENTS WITH ESOPHAGEAL SCC REFRACTORY TO FLUOROPYRIMIDINE- AND PLATINUM-BASED CHEMOTHERAPY: OGSG1201
Authors: Matsuyama Jin , Yamamoto Sachiko , Kii Takayuki , Hara Hiroki , Kawabata Ryohei , Kawada Junji , Takeno Atsushi , Ueda Shugo , Kawakami Hisato , Okita Yoshihiro , Endo Shunji , Kimura Yutaka , Yanagihara Kazuhiro , Okuno Tatsuya , Kurokawa Yukinori , Shimokawa Toshio , Satoh Taroh 
Published: September 2022

Abstract
There is no standard chemotherapy for esophageal squamous cell carcinoma (ESCC) refractory to first-line fluoropyrimidine- and platinum-based chemotherapy. We therefore performed a randomized, selection-design phase II trial to compare docetaxel (DTX) and paclitaxel (PTX) in this setting.
Eligible patients were randomly assigned to receive either DTX (70 mg/m2 on day 1 of each 21-day cycle) or PTX (100 mg/m2 on days 1, 8, 15, 22, 29, and 36 of each 49-day cycle). The primary end point was overall survival (OS), and secondary end points included progression-free survival (PFS), time to treatment failure (TTF), response rate (RR), and safety. Seventy-eight eligible patients (N = 39 in each group) were included for efficacy analysis.
The median OS was significantly longer in the PTX group (8.8 vs. 7.3 months; hazard ratio [HR], 0.62; P = 0.047). A significant benefit of PTX over DTX was also apparent in the median PFS (4.4 vs. 2.1 months; HR, 0.49; P = 0.002) and median TTF (3.8 vs. 2.1 months; HR, 0.45; P &lt; 0.001). RR (25.6% vs. 7.7%, P = 0.065) were higher in the PTX group. Neutropenia (80% vs. 28%) and leukopenia (76% vs. 28%) of grade 3 as well as febrile neutropenia (46% vs. 0%, P &lt; 0.0001) occurred more frequently in the DTX group.
PTX showed a significantly better efficacy as well as a more manageable toxicity compared with DTX.
339. RESULTS OF LEFT COLON RECONSTRUCTION FOR ESOPHAGECTOMY IN A LOW VOLUME HOSPITAL IN JAPAN
Authors: Suenaga Takahiro , Nakanishi Yasutaka , Hata Hiroaki , Degawa Kanako , Moriyama Masaaki , Kanbe Hiroyuki , Miki Akimori , Yamaguchi Takashi 
Published: September 2022

Abstract
Our hospital is a low volume hospital that performs about 5–10 esophageal cancer surgeries per year in Japan. We aimed to evaluate the results of colon reconstruction in our hospital and the appropriateness of performing this procedure in a low volume hospital.
We retrospectively examined complications such as suture failure, conduit necrosis, and anastomotic stenosis in colon reconstruction cases performed at our hospital from 2012 to 2022.
Five cases were performed. In all cases, we have confirmed arterial supply of colon by dynamic CT before surgery, and have chosen to posterior mediastinal reconstruction using the left-sided colon. Esophageal-colon anastomosis was performed, with hand-sewn in 2 cases and triangulating stapling in 3 cases. Although a plastic surgeon was always waiting in case of poor blood supply of conduit, none of the cases needed microvascular anastomosis. Recurrent nerve palsy in 1 patient, ileus in 1 patient, and pneumonia in 2 patients were detected. The median operative time was 654 minutes, and the median blood loss was 260 mL.
We believe that our cautious preparations make it acceptable to perform esophageal cancer surgery with colon reconstruction even in low volume hospitals.
356. A CASE REPORT: A CASE OF HIATAL HERNIA WITH UPSIDE-DOWN STOMACH TREATED WITH LAPAROSCOPIC SURGERY
Authors: Uemura Takuji , Morishima Rento , Kanai Norifumi , Yoshida Satoru , Yonaiyama Shinnosuke , Maruyama Shota , Nakayama Yoshihito , Nishimura Ryuichi , Sato Tomoyuki , Aoki Kazunori , Mizuno Yutaka 
Published: September 2022

Abstract
Upside-down stomach (UDS) is a rare type (&lt;5%) of hiatal hernia, often accompanied by organoaxial gastric volvulus. Although surgery is required for most patients, approach method is still controversial. It has been reported that open approach is a standard method in the case of UDS, but recently laparoscopic approach is reported to be useful for the patient without stomach ischemic sign. Here we report the case of UDS successfully treated by laparoscopic surgery.
Case presentation: A 57 year-old male patient with hiatal hernia for several years was referred to our institution because of frequent vomiting and UDS. He had no pain and vital signs were stable. Hematological investigations revealed neutrophil dominant elevation of white blood cell count, but CRP was normal in blood biochemistry. An enhanced computed tomography revealed a giant hiatal hernia (Type IV) and whole stomach migrated into posterior mediastinum with organoaxial gastric volvulus, but obviously ischemic signs were not detected. An esophagogastoroduodenoscopy (EGD) showed erosion of gastric mucosa, but no necrotic sign of stomach.
From these findings, surgery was thought to be necessary to improve the obstruction of stomach and prevent from necrosis of the incarcerated stomach. However, because of stable general conditions and no ischemic findings, we performed laparoscopic repair of hiatal hernia and Toupet fundopulication. Ischemic change of the stomach was not observed. After stomach withdrawal into the abdominal cavity from the mediastinum, hiatal defect was repaired and fundoplication was performed by Toupet method. After surgery, the symptom and stomach passage obstruction improved and the patient was discharged without no complications.
We successfully performed hiatal hernia repair and fundopulication with laparoscopic approach in the case of UDS. If there are no findings obviously indicating gastric ischemia and necrosis on an enhanced computed tomography and an EGD, laparoscopic hiatal hernia repair and fundoplication are considered as a useful method because of its less invasiveness and magnifying effect.
357. POSTOPERATIVE OUTCOMES OF SALVAGE ESOPHAGECTOMY AFTER DEFINITIVE CHEMORADIOTHERAPY AND PLANNED ESOPHAGECTOMY AFTER NEOADJUVANT CHEMORADIOTHERAPY
Authors: Pan Jie , Liu Zhichao , Li Chunguang , Yang Yang , Zhang Long , Jiang Chao , Liu Zhonghe , Yu Boyao , Li Zhigang 
Published: September 2022

Abstract
Salvage esophagectomy is indicated for esophageal cancer patients for recurrent/persistent disease after definitive CRT (dCRT). Salvage esophagectomy reportedly has higher postoperative complications and poor survival. This study aimed to compare the perioperative outcomes and survival of patients with dCRT followed by salvage esophagectomy (DCRE) and neoadjuvant chemoradiotherapy (nCRT) followed by planned esophagectomy (NCRE) in esophageal squamous cell carcinoma (ESCC).
Patients were identified from a prospectively maintained database at single institution from 2018 to 2021. All locally advanced ESCC patients receiving neoadjuvant/definitive chemoradiotherapy and following esophagectomy were reviewed. A total of 41 DCRE (24 persistent-disease, 17 recurrence) and 261 NCRE patients were included. Propensity score matching (PSM) was used to compensate for differences in some baseline characteristics.
No significant between-group differences were identified in in-hospital mortality, postoperative complications (Figure A), overall-survival and progression-free survival (all p &gt; 0.05) (Figure B-C). The median CRT-to-surgery interval was 47d in NCRE group, 43d and 440d in DCRE group of persistent-disease and recurrence, respectively. DCRE group was observed with more advanced ypT stage (63% vs 38%, p = 0.001), poorer differentiation (32% vs 15%, p = 0.005) and more lymphovascular invasion (29% vs 11%, p = 0.001) compared with NCRE. Similar results were obtained after PSM. Analyses comparing DCRE (due to persistent-disease), DCRE (due to recurrence) and NCRE groups showed no differences in postoperative complications, in-hospital mortality and survival.
Postoperative complications and prognosis were equivalent between DCRE and NCRE. DCRE has acceptable outcomes and is appropriate for selected patients.
363. THE MODALITY OF NEOADJUVANT VERSUS ADJUVANT CHEMORADIOTHERAPY FOR LOCALLY ADVANCED ESOPHAGEAL. CARCINOMA: A SINGLE CENTER, RANDOMIZED, CLINICAL TRIAL
Authors: Kun Liu 
Published: September 2022

Abstract
Neoadjuvant chemoradiotherapy (nCRT) plus surgery is recommended as standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). However, studies have shown that surgery combined with adjuvant chemoradiotherapy (aCRT) can also provide survival benefits. The optimal modality of surgery combined chemoradiotherapy for esophageal cancer have not been determined yet.
From March 2018 to January 2021, 203 patients with resectable middle and lower thoracic ESCC, were enrolled in this prospective study. Patients were randomized into two groups: nCRT plus minimally invasive esophagectomy (MIE), MIE plus aCRT. In nCRT group, the patients were treated with paclitaxel plus carboplatin for two cycles, with a total concurrent radiation dose of 40.0Gy. In aCRT group, the patients with pN (+) were treated with paclitaxel plus carboplatin for four cycles, with a total sequential radiation dose of 54.0Gy, The primary end points were 3-year OS and DFS on the analysis of an intention-to-treat basis.
74 patients received surgery in the nCRT group，99 patients received surgery in aCRT group. Among 74 patients in nCRT group, 62 patients (83.8%) underwent MIE, compared with 88 of 99 (88.9%) in aCRT group (P = 0.65). With median follow-up of 28.4 months for all the enrolled patients, no significant differences were found in the 3-year OS (77.2% vs 75.8% P = 0.82) and DFS (60.9% vs 60.6% P = 0.86) among nCRT and aCRT groups. Postoperative complications did not differ significantly between groups, except for arrhythmia, which occurred more frequently in nCRT group (31.1%) than in aCRT group (14.1%) (P = 0.07).
Initial results of the trial showed that the treatment modality of nCRT followed by MIE has similar safety and survival benefit to that of MIE combined aCRT for locally advanced ESCC.
367. RANDOMISED CONTROLLED TRIAL (FEASIBILITY STUDY) OF PROPHYLACTIC PYLORIC BALLOON DILATATION DURING IVOR LEWIS ESOPHAGECTOMY TO PREVENT DELAYED GASTRIC EMPTYING
Authors: Abdelrahman Mohamed , Neilens Helen , Yates Victoria , Lord Amber , Ariyarathenam Arun , Berrisford Richard , Humphreys Lee , Sanders Grant , Wheatley Tim , Chan David 
Published: September 2022

Abstract
Early delayed gastric emptying (DGE) occurs in up to 37% of patients following esophagectomy. This can contribute to increased anastomotic leak and respiratory infection rates. Although the treatment of DGE in the form of pyloric balloon dilatation (PBD) post-operatively is well established, there is no consensus on the optimal approach in the prevention of DGE.
The aim is to carry out a randomised control trial to determine the efficacy of prophylactic PBD in the prevention of DGE following esophagectomy. This presentation details the protocol, recruitment strategy and potential timeline for a feasibility study addressing this. We detail the rationale, objectives, design, and methods of this study. Patients will be recruited over a three to six-month period (starting in January 2022) and randomised to either a control group (no intervention) or a treatment group (prophylactic PBD).
The Chief Investigator has obtained approval from the UK Health Research Authority (HRA) and Research Ethics Committee (REC) on 01/12/21 (IRAS project ID: 287659).
As a feasibility study, the objectives will be to ascertain the following: Number of patients approached; Number of patients who agreed to be randomised; Number of patients successfully randomised; Number of patients who dropped out; Successful measurement of outcome measures (delayed gastric emptying, pneumonia, anastomotic leak).
Prophylactic pyloric balloon dilatation is potentially a safe and effective procedure which can significantly improve outcomes in patients after an esophagectomy. This protocol describes details for the feasibility study to be carried out which will allow important learning points for the main randomised controlled trial.
374. THE ROLE OF EARLY MOBILIZATION AFTER ESOPHAGEAL CANCER SURGERY
Authors: Schuring Nannet , Geelen SJG , van Berge Henegouwen MI , Steenhuizen SCM , van der Schaaf M , van der Leeden M , Gisbertz SS 
Published: September 2022

Abstract
A key component of the Enhanced Recovery After Surgery pathway for esophagectomy is early mobilization. Evidence on a specific protocol of early and structured mobilization is scarce, which explains variation in clinical practice. This study aims to describe and evaluate the early mobilization practice after esophagectomy for cancer in a tertiary referral center in the Netherlands.
This retrospective cohort study included data from a prospectively maintained database of patients who underwent an esophagectomy between 01-01-2015 and 01-01-2020. Early mobilization entailed increase in activity with the first target of ambulating 100 meters. Primary outcomes were the number of postoperative days (PODs) until achieving this target and the reasons for not achieving this target. Secondary outcomes were the relationship between preoperative factors (e.g. Sex, BMI, ASA-score) and achieving the target on POD1, and the relationship between achieving the target on POD1 and postoperative outcomes (e.g. readmissions, postoperative complications).
In total 384 patients were included. The median POD of achieving the target was 2 (IQR 1-3), with 173 (45.1%) patients achieving this on POD1. Main reasons for not achieving the target on POD1 was due to hemodynamic instability (22.7%). Male sex was associated with achieving the target on POD1 (OR = 2.08, p = 0.007); achieving the target on POD1 was not associated with postoperative outcomes.
Ambulation up to 100 m on POD1 is achievable in patients after esophagectomy, with men having higher odds for achieving this target. No relationship between early mobilization and postoperative outcomes was found, however it may have effect on other parameters, such as improved long-term recovery, this should be investigated further in a larger patient cohort. ERAS pathways focusing on esophagectomy care are encouraged to incorporate 100 m ambulation on POD1 in their guideline as first postoperative target.
383. A LONGITUDINAL STUDY OF ENDOSCOPIC NASO-LEAKAGE NEGATIVE PRESSURE DRAINAGE FOR ANASTOMOTIC LEAK AFTER ESOPHAGECTOMY
Authors: Liu Xin-Yang , He Meng-jiang , Tan Li-Jie , Zhou Ping-Hong , Lin Miao 
Published: September 2022

Abstract
Postoperative anastomotic leak is a threatening complication after esophagectomy. Recently, endoscopic naso-leakage negative pressure drainage has become a promising choice when satisfactory drainage could not be attained using chest drainage or other conservative therapies. This study aims to evaluate the efficacy of endoscopic naso-leakage negative pressure drainage for anastomotic leak by longitudinal analyses, so as to focus on the intra-individual changes associated with the drainage in the disease course and to minimize the between-subjects variations.
We conducted a retrospective longitudinal study based on patients who were diagnosed with anastomotic leak after esophagectomy and treated with endoscopic naso-leakage negative pressure drainage in Zhongshan Hospital Fudan University, from 2018 to 2021. We hypothesize that maximum temperature (Tmax), maximum heart rate (HRmax), White blood cell count (WBC), and C reactive protein (CRP) had a two-piece linear spline growth curve with a notch at the time of drainage. Linear mixed-effects regressions were used to test the hypothesis of whether endoscopic naso-leakage negative pressure drainage changed the pattern of development of these clinical parameters with time.
Thirty patients were included, among which 83.3% were male, with a median age of 77 years. The median postoperative time to drainage was 16.5 days (range 6–66). Observations for Tmax, HRmax, WBC and CRP were 1366, 1372, 394, and 296, respectively. After adjusting for age, sex and body mass index, Tmax, HRmax, WBC and CRP showed similar pattern. There was no significant change over time before naso-leakage negative pressure drainage, while the four parameters all decreased significantly over time after naso-leakage negative pressure drainage. There was no overlap of the confidence intervals of slopes before and after drainage. (Table).
The slope over time of Tmax, HRmax, WBC and CRP changed significantly after naso-leakage negative pressure drainage. Naso-leakage negative pressure drainage brought gradual decrease of these inflammatory parameters and could serve as a promising management for postoperative anastomotic leak after esophagectomy.
391. MINIMALLY INVASIVE ESOPHAGECTOMY IN PRONE POSITION. INITIAL EXPERIENCE OF NATIONAL CANCER INSTITUTE MEXICO
Authors: Takahashi Alberto Mitsuo Leon , Basave Horacio Noe Lopez , Silva Leonardo Saul Lino , Barragan José Abraham Fabela , Hernandez Rosa Angelica Salcedo , Gomez Angel Herrera , Morales Carolina Castillo 
Published: September 2022

Abstract
Transthoracic approach in esophageal cancer increases oncologic outcomes but open surgery associates with poor respiratory outcomes. Minimally invasive thoracoscopic (MIT) has been selected for minimizing postoperative complications and faster recovery. It is thought that long term outcomes are equivalent to open surgery. Prone position (PP) is becoming more world important because it reduces respiratory complications and blood loss. It provides a clean surgical field and allows more lymph node harvests due to the better exposure.
Observing the benefits of PP to perform esophagectomy in cancer patients, we obtained pre-certification in Japan and started in 2017. This is a retrospective study in patients with esophageal cancer operated from January 2017 to December 2021 in the National Cancer Institute. We used AJCC 8th to clinical stage; early stage was operated and locally advanced stage did neoadjuvant treatment and surgery. Our surgical results show complications and mortality on postoperative day 60 (Clavien-Dindo and ECCG classification) and short oncological results in PP-MIT esophagectomy.
There were 25 PP-MITesophagectomies, median age was 57 y.o. and 84% were men. The general characteristics are indicated in image 1. The main clinical stages were locally advanced in 96% (CS III and IVA), all received neoadjuvant therapy (80% QT/RT) with a partial response of 76%. The major complications (Clavien &gt;3) were 12% and one patient died of arrhythmia on the 10th day. Complications were classified by using the ECCG classification, are shown in image 1. The pathological results are in image 1. The mean survival was 32.1 (24.8–39.5) months and cancer specific survival was 76%.
Esophagectomy has a high risk of complications and mortality and is one of the most complex surgeries in the digestive tract.
In our cancer institute, we separated surgical groups to place experts in each area. Our initial experience of PP-MIT esophagectomy was a good oncological control with low complications, despite advanced cancer with poor prognosis requiring multimodal treatment.
394. ENDOSCOPIC VACUUM THERAPY FOR PATIENTS WITH ANASTOMOTIC LEAKAGE AFTER ESOPHAGO-GASTRIC SURGERY
Authors: Pattynama Lisanne , Pouw Roos , van Berge Henegouwen Mark , Daams Freek , Gisbertz Suzanne , Bergman Jacques , Eshuis Wietse 
Published: September 2022

Abstract
Anastomotic leakage (AL) is one of the most serious complications of upper gastro-intestinal (UGI) surgery. Recently endoscopic vacuum therapy (EVT), using an endoscopically placed sponge, was introduced as treatment of AL. The aim of this study was to describe the initial experiences with EVT in a tertiary referral center, in the treatment of AL after esophago-gastric surgery.
For this retrospective cohort study, all patients treated with EVT for AL in the UGI tract at a tertiary referral center, between January 2018 and October 2021, were included. In this period, patients with AL, based on CT-scan or endoscopic findings, were primarily treated with EVT. Cases were identified from the endoscopy reporting system, with a search including all available terms for EVT, and from the prospective UGI surgery database. Data on patient characteristics, EVT and outcomes were analyzed. The primary endpoint was success rate of EVT alone, defined as closure of the defect assessed by endoscopy or CT-scan.
A total of 38 patients were included (Table 1). Successful treatment with EVT was achieved in 28 patients (74%, 95%CI[57,87]). In 10 patients EVT failed: one deceased during treatment (due to radiation pneumonitis) and 9 underwent additional surgery: two due to an EVT-related complication (a trachea-esophageal fistula and iatrogenic expansion of the defect during overtube placement) and 7 because defect closure was not achieved. EVT-associated complications occurred in two patients, as described above.
Median hospital stay was 42 days. Median duration of EVT was 27 days, with median 6 EVT-related endoscopies and 5 days between sponge-exchanges.
EVT is a paradigm shifting treatment, potentially preventing surgical re-intervention in patients with AL after UGI surgery, with a success rate of 74%. More experience with the technique and indications for use will likely improve success rates in the future.
404. SURVEILLANCE STRATEGY AFTER CURATIVE RESECTION FOR OESOPHAGEAL SQUAMOUS CELL CANCER USING THE HAZARD FUNCTION
Authors: Kanematsu Kyohei , Sakurai Toru , Kubo Yuto , Utsunomiya Daichi , Kubo Kentaro , Kurita Daisuke , Ishiyama Koshiro , Oguma Junya , Daiko Hiroyuki 
Published: September 2022

Abstract
The optimal surveillance period and frequency after curative resection for oesophageal squamous cell carcinoma (OSCC) remain unclear, and current guidelines are mainly based on traditional Kaplan–Meier analyses of cumulative incidence rather than risk analysis. The aim of this study was to determine a suitable follow-up surveillance program following oesophagectomy for OSCC using the hazard function.
A total of 1187 patients who underwent curative resection for OSCC between 2000 and 2014 were retrospectively analyzed. The changes in the estimated hazard rates (HRs) of recurrence over time were analyzed according to tumour-node-metastasis stage.
Four hundred seventy-eight (40.2%) patients experienced recurrence during the follow-up period (median, 116.5 months). The risk of recurrence peaked at 9.2 months after treatment (HR = 0.0219) and then decreased to half the peak value at 24 months post-surgery. The HRs for Stage I and II patients were low (&lt;0.007) post-treatment. The HR for Stage III patients peaked at 9.9 months (HR = 0.031) and the hazard curve declined to a plateau at 30 months. Furthermore, the HR peaked at 10.8 months (HR = 0.052) in Stage IV patients and then gradually declined from 50 months.
According to tumour-node-metastasis stage, changes in the HRs of postoperative recurrence in OSCC varied significantly. Intensive surveillance should be undertaken for 3 years in Stage III patients and for 4 years in Stage IV patients, followed by annual screening. For Stage I OSCC patients, a reduction in the surveillance intensity could be taken into consideration.