bluuebunny/crossref_metadata_2025_split huggingface dataset:
415. A WEBCAST FOR THE EDUCATION AND INFORMATION OF PATIENTS WITH BARRETT’S ESOPHAGUS AND BARRETT’S CANCER
Authors: Etzold Christian , Gockel Ines , Thieme René 
Published: September 2022

Abstract
To provide expert knowledge to patients becomes more and more important, especially during the Sars-CoV-2 pandemics, where self-helping groups could not meet and on-site information events could not take place. We discovered a need due to patients’ uninformedness about diagnostic procedures, treatment options and advice for disease prevention or special nutrition and medications after the diagnosis of Barrett’s esophagus and Barrett’s cancer.
A webpage was created, including a video streaming platform (https://webcast.barrett-initiative.de/). The events were performed live with the opportunity to ask questions via the chat function. Vimeo was used for the live streaming. Three to four lecturers were invited and one moderator organized the sequence of talks and questions. Additionally, the webpage is contains an encyclopedia, to explain disease related terms in a patient-orientated language. The invitation was done based on our nation-wide patient network based on genes for barrett’s (g4b) study https://www.barrett-konsortium.de/. Patients used a desktop computer (65%), mobile phones (28%), and tablets (7%) to join the video sessions.
The lecture series was started with a kick-off event in September 2021 to give a bright overview about reflux, Barrett’s esophagus und Barrett’s cancer. Four special topic events were conducted, dealing with tumor biology, cancer prevention, diagnostics needed for the correct staging and how the diagnostic will guide the therapy by explaining the expertise review board, discussing operability and prehabilitation. The series will be continued by the endoscopic and surgical treatment options. There were 1,100 views to the webpage. While during the kick-off 204 patients were online, approx. 71 to 171 patients saw the following events during the live sessions.
Based on the questions by our patients and the continuous participation at our livestream events, we discovered an urgent need to provide a platform to patients, where they can find disease specific information in a patients-oriented language. Therefore, all lectures were deposited to a media archive where they are available to patients. We implemented our webcast project as a growing platform to cover aspects from the disease development, to diagnosis, treatment, and follow-up care.
422. ROBOT-ASSISTED MINIMALLY INVASIVE THORACO-LAPAROSCOPIC ESOPHAGECTOMY VERSUS MINIMALLY INVASIVE ESOPHAGECTOMY FOR RESECTABLE ESOPHAGEAL ADENOCARCINOMA, A RANDOMIZED CONTROLLED TRIAL (ROBOT-2-TRIAL)
Authors: Tagkalos Evangelos , Berlth Felix , Uzun Eren , Hadzijusufovic Edin , Grimminger Peter P 
Published: September 2022

Abstract
For patients with esophageal adenocarcinoma or cancer of the gastroesophageal junction, radical esophagectomy with 2-field lymphadenectomy is the cornerstone of the multimodality treatment with curative intent. Both conventional minimally invasive esophagectomy (MIE) and robot assisted minimally invasive esophagectomy (RAMIE) were shown to be superior compared to open transthoracic esophagectomy considering postoperative complications. However, no randomized comparison exists between MIE and RAMIE in the Western World for patients with esophageal adenocarcinoma.
This is an investigator-initiated and investigator-driven multicenter randomized controlled parallel-group superiority trial. All adult patients (age ≥ 18 and ≤ 90 years) with histologically proven, surgically resectable (cT1-4a, N0–3, M0) esophageal adenocarcinoma of the intrathoracic esophagus or adenocarcinoma of the gastroesophageal junction and with European Clinical Oncology Group performance status 0, 1 or 2 will be assessed for eligibility and included after obtaining informed consent. Patients (n = 218) with resectable esophageal adenocarcinoma of the intrathoracic esophagus or adenocarcinoma of the gastroesophageal junction are randomized to either RAMIE (n = 109) or MIE (n = 109). T.
The primary outcome of this study is the total number of resected abdominal and mediastinal lymph nodes specified per lymph node station.
Short-term results and the primary endpoint (total number of resected abdominal and mediastinal lymph nodes per lymph node station) will be analyzed and published after discharge of the last randomized patient within this trial.
This is the first randomized controlled trial designed to compare RAMIE to MIE as surgical treatment for resectable esophageal adenocarcinoma or adenocarcinoma of the gastroesophageal junction in the Western World. The hypothesis of the proposed study is that RAMIE will result in a higher abdominal and mediastinal lymph node yield specified per station compared to conventional MIE.
423. POSTOPERATIVE SKELETAL MUSCLE MASS IN ESOPHAGEAL CANCER SURGERY PATIENTS AFTER NEOADJUVANT CHEMOTHERAPY
Authors: Daichi Utsunomiya 
Published: September 2022

Abstract
Recently, the significant decrease in skeletal muscle mass after esophagectomy in patients who underwent neoadjuvant chemotherapy, which in turn has been reported to affect long-term survival. The results of JCOG1109 have been published, and while DCF has become the standard of care as neoadjuvant chemotherapy, its toxicity has also been pointed out. In this study, we analyzed the relationship between changes in body composition before and after neoadjuvant chemotherapy and postoperative complications after esophagectomy.
Among esophageal cancer patients who underwent esophagectomy after preoperative chemotherapy from September 2018 to May 2020, 74 patients were included, excluding patients with recurrence within 1 year after surgery and patients with gastrointestinal fistula. The relationship between body composition and postoperative complications, and changes in body weight and skeletal muscle mass were analyzed.
The male-to-female ratio was 60:14, and the median age was 65.0 years. When the subjects were divided into DCF and Others, there was a significant difference in skeletal muscle loss in the Others group. There was no significant difference in the incidence of postoperative complications by chemotherapy, nor an incidence of postoperative complications between the DCF and Others. There was no significant difference in weight loss between the DCF group and the Others group, but a significant decrease in skeletal muscle mass in the DCF group at one year. The decrease up to 4 months after surgery was particularly large.
In the present analysis, DCF therapy as preoperative treatment had no effect on the occurrence of postoperative complications, but was associated with a long-term decrease in skeletal muscle mass, suggesting that the toxicity of DCF therapy may have a long-term effect. Although the tumor suppression effect of preoperative treatment was proven, long-term nutritional and rehabilitative interventions were considered necessary to establish a truly favorable long-term prognosis for the patients.
429. DETECTION OF MOLECULAR RESIDUAL DISEASE (MRD) USING MATCHED TUMOR-MARGIN SEQUENCING IN EARLY STAGE ESOPHAGEAL SQUAMOUS CELL CARCINOMA
Authors: Lu Di , Tong Yu , Zhai Jianxue , Wang Zhizhi , Chen Zhiming , Wu Hua , Li Shaobin , Cai Kaican 
Published: September 2022

Abstract
Residual disease is one of the main sources of recurrence in post-surgical esophageal squamous cell carcinoma (ESCC). However, the prognostic value of histologically-defined surgical margin status is limited by its suboptimal accuracy in indicating patients’ outcomes. Here, we explored the potential of margin-molecular residual disease (MRD) based on next-generation sequencing (NGS) as a feasible and more reliable biomarker for identifying patients with a high risk of recurrence.
NGS data from 22 early stage ESCC patients with matched tumor and histologically negative resection margin, as well as normal epithelial tissue samples, were retrospectively reviewed. Comparisons of the respective mutational landscapes, as extracted by profiling using a 425-cancer-gene panel (GeneseeqPrime®), were performed. Associations of disease-free survival (DFS) with clinical features and margin-MRD were analyzed.
A total of the 11 (50%) patients with histologically negative margin had detectable somatic mutations as assessed by NGS. TP53 alterations were highly enriched in the tumor (ptumor-normal = 0.001) and the margin (pmargin-normal = 0.015) samples compared with the normal tissues, whereas NOTCH1 alterations were much more common in the normal samples (ptumor-normal = 0.001, pmargin-normal = 0.001). Tumor-specific mutations were detected in six (6/11, 55%) of the NGS-positive margins. Survival analysis showed that those having MRD-positive margins had an unfavorable DFS compared with those having MRD-negative margins (p = 0.08, HR (95%CI): 3.28 (0.81–13.4)).
In this study, the presence of mutations in a considerable proportion of histologically negative resection margins and a tendency for worse prognosis in patients carrying MRD-positive margins was demonstrated. Our findings suggest that margin-MRD may serve as a more accurate prognostic predictor for disease recurrence, and highlight the clinical relevance of using NGS to detect MRD for proper prognostic stratifications and precise treatment guidance.
436. DIFFERENCES IN MULTIDISCIPLINARY TEAM ASSESSMENT ON ESOPHAGEAL CANCER PATIENTS IN SWEDEN—A MULTICENTRE STUDY
Authors: Hannan Christine Jestin , Risso Solange León , Lindblad Mats , Szabo Eva , Edholm David , Bartholomä Wolf Claus , Åkesson Oscar , Lindberg Fredrik , Strandberg Sara , Linder Gustav , Hedberg Jakob 
Published: September 2022

Abstract
There are differences in esophageal cancer care across different counties in Sweden. According to national guidelines, all patients should be offered equal care which should be administrated by regional multidisciplinary cancer conferences (MCCs). The aim of the study was to investigate differences between the six regional MCCs in Sweden regarding clinical stageing and recommended treatment.
Ten consecutive cases per participating center, 60 cases in total, were planned for inclusion. After anonymization the radiological investigations were presented, along with the original case-specific medical history, anew at the six regional MCCs. Estimation of clinical TNM and treatment allocation (curative, palliative or best supportive care) were compared between MCCs as well as with the original assessment. Interim analysis was performed in April 2022 when ten cases had been presented at five of the six regional MCCs.
All available cases were assessed at five MCCs in addition to the previous original assessment (60 assessments). The mean age for the first ten cases was 74.8 years (SD ± 9.8 years). Eight out of ten cases were men. In estimations of T- and N-stage the MCCs agreed in only one out of ten cases. In half of the cases more than three different estimations of N-stage were made. For clinical M-stage there was exact agreement in three cases. In determination of recommended treatment, all five MCCs were in agreement on half of the cases.
Preliminary data show striking differences, both in assessment of TNM as well as treatment recommendation at different MCCs. One patient, recommended curative treatment by one MCC could be allocated to palliative care by another. Inclusion is ongoing and further analysis of these differences are warranted to achieve more equal care for esophageal cancer patients in Sweden.
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438. THE NEED FOR INFORMATION AND SUPPORT IN DECISION-MAKING IN PATIENTS WITH ESOPHAGEAL CANCER WHO PREFER STANDARD SURGERY OR ACTIVE SURVEILLANCE
Authors: Van Der Zijden Charlène J , Hermus M , van der Wilk BJ , Chang R , Dekker JWT , Coene PPLO , Nieuwenhuijzen GAP , Rosman C , Heisterkamp J , Hartgrink HH , Wijnhoven BPL , van Lanschot JJB , van Busschbach JJ , Lagarde SM , Kranenburg LW 
Published: September 2022

Abstract
Shared decision making (SDM) is the cornerstone of patient-centered care and is associated with improved treatment outcomes. Making a well-informed decision can be challenging. Patients have to weigh possible outcomes and take into account a certain level of uncertainty. This study investigated patients’ information and supportive needs during the decision-making process to prefer active surveillance or standard surgery after neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer.
Patients who underwent nCRT for carcinoma of the esophagus or esophagogastric junction and refused participation in a randomized trial on active surveillance versus standard surgery were included. Patients were interviewed about their need for information and support and received questionnaires on information- and decision-making preferences and health literacy 3 months after completion of nCRT or before surgery. Interviews were audiotaped and transcribed verbatim. Data were analyzed according to the principles of grounded theory.
Forty patients were included of which 20 preferred surgery and 20 preferred active surveillance. Overall, patients’ information needs were met. Patients highly value support received from their loved ones and appreciate emphatic doctors who actively involved them in the decision-making process while paying attention to their individual needs and values. Information resources as the internet and conversations with others were largely used to confirm the treatment decision. Patients prefer to receive information from doctors first and they predominantly rely on this information to make a treatment decision.
The importance of shared decision making and the role of doctors in this process is underlined by patients’ wish to be guided in decision-making. The role of healthcare professionals is essential at the initial phase of the decision-making process. After patients seem to have made a treatment decision, the influence of extern resources (including doctors) is limited.
440. MULTIDISCIPLINARY TREATMENT CONFERENCE IMPROVES SURVIVAL IN ESOPHAGEAL CANCER
Authors: Linder Gustav , Lindblad Mats , Edholm David 
Published: September 2022

Abstract
The advantages of multidisciplinary treatment conferences (MDT) are advocated in staging and treatment of esophageal cancer. Improved timeliness to surgery, adherence to guidelines, increased probability of complete clinical staging and allocation to curative treatment have all been attributed to the introduction of MDTs but there are few studies published in support of MDTs positive effect on outcomes.
The aim is to investigate the association between MDT and survival in esophageal cancer.
All patients diagnosed with esophageal cancer in the Swedish Registry for Esophageal and Gastric Cancer between 2006-2018 were included in this retrospective cohort study. Patients were grouped according to whether or not they had been discussed at an MDT as part of their staging process. The cohort was followed until death, emigration, or end of follow-up. Factors possibly affecting group allocation was explored with multivariable logistic regression and the impact of MDT on survival was studied with Cox-regression and the Kaplan–Meier method.

Of 6607 patients diagnosed with esophageal cancer, 1338 (20%) were not discussed at an MDT. Median survival was 10.7 months with MDT and 4.4 months without MDT.
Age above 80, OR 0.29 (0.18-0.47 95%CI), Charlson Comorbidity Index&gt;2, OR 0.79 (0.66-0.96) and clinical stage IVb, OR 0.66 (0.44-0-97) all decreased the probability of being presented at an MDT, whereas squamous cancer, OR 1.45 (1.18-1.77) and later year of diagnosis OR 1.33 (1.30-1.37 per year) increased the probability of an MDT.
Adjusted for the well-established prognostic factors above, the MDT was still an independent predictor of survival, HR 0.63 (0.58-0.69 95%CI).
The role of the MDT in the staging and treatment of patients with esophageal cancer is, in the present study, clearly associated with improved survival. Older, more comorbid patients with advanced disease are at a disadvantage since they are not consistently discussed in a multidisciplinary setting. Whether the survival benefit is due to the MDT alone or lack of ambition in what appears to be non-curable cases is yet to be determined.
441. ESOPHAGEAL CANCER MANAGEMENT IN A SWISS REFERRAL CENTER; A 20-YEAR EXPERIENCE
Authors: Gaspar-Figueiredo Sérgio , Mantziari Styliani , Teixeira-Farinha Hugo , Demartines Nicolas , Schäfer Markus 
Published: September 2022

Abstract
In the past decades, management of esophageal cancer (EC) has significantly changed with the widespread use of oncological treatments, as well as minimally invasive surgery and enhanced recovery protocols. Concurrently, the histological type, comorbidity status and life expectency of the ‘typical’ EC patient have also evolved. The aim of this study was to assess the evolution in epidemiology, management and outcomes of EC patients treated in a Swiss tertiary referral center the last 20 years.
Baseline demographics, clinico-pathological data, treatment details and postoperative outcomes were retrieved from our institutional prospective database for all consecutive patients operated for esophageal cancer with curative intent. Emergency surgery and endoscopic treatment of early EC were excluded, hence 332 patients (265 male, 67 female) were included in the final analysis. Patients were divided in 3 groups: ‘historical group’: 2000–2007, n = 73; ‘transition group’: 2008–2014, n = 108; ‘modern group’: 2015–2020, n = 151. Comparison was performed with the x2 test for discrete and the ANOVA tests for continuous variables, with the Bonferroni method to determine significance in pairwise comparisons (p &lt; 0.05).
The annual caseload doubled (10 to 25 cases/y). Alcohol consumption (57.5% to 28.5%, p &lt; 0.001), active smoking (64.4% to 38.4%, p = 0.001) and COPD (41.1% to 35.1%, p = 0.05) decreased. Squamous cell carcinoma (58.9% historic, 34.4% modern group) was replaced by adenocarcinoma as the most prevalent type (35.6% vs 64.2%, p = 0.001). Detection of locally advanced disease increased from 58.8% to 75.8% (p = 0.022), along with the use of neoadjuvant treatment (34.2% historic, 83.4% modern group, p &lt; 0.001). Major postoperative morbidity was documented in 34.2% of patients (historic group) versus 58.3% (modern group, p = 0.002), but mortality remained stable. No differences were observed in long-term survival.
Centralization significantly increased the annual caseload. Improved preoperative workup enabled more accurate detection of locally advanced disease and subsequently appropriate multimodal treatment that is currently used in most patients. The ‘typical’ EC patient has shifted from the squamous cell to the adenocarcinoma type, but males are still more concerned. Postoperative complications are nowadays more rigorously detected and managed, keeping mortality rates low. Long-term survival remained unchanged over time.
448. THE PRIMARY TUMOR BURDEN SCORE: A NOVEL CLINICOPATHOLOGICAL STAGING TOOL FOR PATIENTS WITH ESOPHAGEAL CARCINOMA RECEIVING NEOADJUVANT CHEMORADIOTHERAPY PLUS SURGERY
Authors: Huang Xu , Tang Han , Tan Lijie , Hou Yingyong 
Published: September 2022

Abstract
The AJCC TNM staging system (8th edition) contains a ypTNM stage classification for patients with EC receiving neoadjuvant therapy prior to surgery. However, the ypTNM staging system may be unable to represent tumor changes occurring during the treatment. This study was to develop a prognostic model for esophageal carcinoma (EC) describing both the pretreatment pathological state of the tumor and its change after neoadjuvant chemoradiotherapy (nCRT) plus surgery.
187 patients with esophageal carcinoma treated with nCRT plus surgery were identified from two medical centers. The Primary Tumor Burden Score (PTBS) was calculated by multiplying the percentage of residual primary cancer cells and the pretreatment pathological T stage (prepT-stage). Univariate and multivariate Cox regression was used to determine the relationships between clinicopathological parameters and prognosis. The discriminatory power of the model was evaluated using the area under the curve (AUC) and goodness-of-fit Akaike information criterion (ΔAIC). The revised TNM stage was compared with the ypTNM stage using the AIC and the C-index.
The PTBS model (AUC:0.727) outperformed to the residual tumor ratio (AUC:0.588) and the pretreatment T stage (AUC:0.6) in OS prediction (P &lt; 0.05). High PTBS scores were associated with significantly worse outcomes: five-year OS of stage 1, 2, and 3 were 73.1%, 42.0%, and 11.4%, respectively, P &lt; 0.001. The PTBS model was more accurate in predicting patient prognosis than cT-stage or ypT-stage (ΔAIC: PTBS vs cT-stage and pT-stage, 30.38 vs −1.87 and 7.61). Multivariate analysis indicated that PTBS independently predicted OS and DFS, The PTBS-based revised TNM stage showed superior prognostic strength to the 8th AJCC ypTNM stage.
The PTBS model showed superior prognostic discriminatory ability than cT-stage or ypT-satge and may thus be useful for describing the influence of the primary tumor burden on survival in patients who had received neoadjuvant CRT before surgery. A revised TNM stage based on PTBS showed superior prognostic capability to the 8th AJCC ypTNM stage.
452. OUTCOME OF ESOPHAGEAL RESECTION IN PATIENTS WITH ESOPHAGEAL CANCER WITH HISTOPATHOLOGICALLY CONFIRMED DISTANT METASTASIS
Authors: Atanasova Elena 
Published: September 2022

Abstract
Patients suffering from esophageal cancer with metastatic disease are usually considered not eligible for resection. In selected patients, however, surgery including resection of distant metastasis, is performed.
This study aimed to study the frequency and outcomes after surgery for metastatic esophageal cancer.
A nationwide cohort study on all patients resected for esophageal cancer in Sweden, between 2006 and 2017, with histopathological verified metastatic disease (pM1). Complete follow-up regarding survival was acquired from the Cause of death registry. Overall survival was analyzed and presented with the Kaplan Meier method and multivariable Cox-regression with Hazard Ratios (HR) with 95% Confidence Intervals (CI).
Of 1572 patients who underwent esophageal resection 75 had pM1 disease. Of those, 70% (n = 53) had been preoperatively staged as cM0. Conversely, 3% of patients with pM0 disease were staged as clinical cM1 or cMX prior to surgery.
Advanced T or N-stage was more common in M1 patients compared to M0 patients. Additionally, neoadjuvant treatment was less common in M1 compared to M0 patients (40%vs52%) while adjuvant therapy was more common in M1 patients (38%vs14%).Five-year overall survival was significantly lower in M1 compared to M0 patients, 15%vs43% respectively (p &lt; 0.001, log-rank test). In numbers, 11 out of 75 patients were alive after five years.
There are long-term survivors among patients with confirmed metastatic esophageal cancer that underwent radical resection. Selection of patients with limited metastatic disease and response to neoadjuvant therapy may contribute to this effect.