crossing96/oncoscreening huggingface dataset:
Superselective transarterial chemoembolization (SSTACE) as second-line conversion therapy for locally advanced unresectable gastric or gastroesophageal junction adenocarcinoma: a preliminary retrospective cohort study.	BACKGROUND: In patients with locally advanced unresectable gastric or gastroesophageal junction adenocarcinoma, conversion therapy has shown suboptimal efficacy, typically resulting in stable disease (SD) or progressive disease (PD) leading to low surgical conversion rates and unfavorable prognosis. This study seeks to assess the efficacy and safety of superselective transarterial chemoembolization (SSTACE) in treating this specific patient cohort. METHODS: This retrospective cohort study analyzed patients diagnosed with locally advanced unresectable gastric cancer (GC) or gastroesophageal junction (GEJ) adenocarcinoma at the Affiliated Hospital of North Sichuan Medical College between January 2019 and March 2025. All of them underwent a single session of SSTACE, followed by an assessment of surgical resectability one month later. Patients considered resectable underwent gastrectomy with D2 lymphadenectomy, while those deemed unresectable continued with palliative chemotherapy regimens consistent with their pre-SSTACE systemic protocols. The primary endpoint was R0 resection rate, with secondary endpoints, including the postoperative complication rate, tumor regression rate post-chemoembolization, and pathological complete response (pCR) rate. RESULTS: This retrospective study analyzed 16 patients who underwent SSTACE. Tumor regression was observed in 12 patients, eight of whom met the criteria for partial response. In addition, 12 patients who exhibited regression subsequently achieved R0 resection. Pathological complete response (pCR) was observed in three patients. In terms of safety, all adverse events related to SSTACE in the cohort were manageable. The most common adverse events were nausea (43.8%, 7/16), vomiting (37.5%, 6/16), and abdominal pain (37.5%, 6/16). No instances of hepatic dysfunction were reported. In addition, none of the surgical patients experienced major postoperative complications. CONCLUSIONS: SSTACE could potentially offer a novel therapeutic approach for patients with locally advanced unresectable GC or GEJ cancer who have shown limited response to systemic chemotherapy/immunotherapy, characterized by SD or PD. This treatment may increase the likelihood of achieving surgical conversion and R0 resection rates while upholding a favorable safety profile.	esophagus
NCI 10211: a phase II, single-arm study of berzosertib in combination with irinotecan in patients with advanced TP53 mutant gastroesophageal cancer.	BACKGROUND: Mutations in TP53 are common in gastroesophageal cancer and portend a poor prognosis. Tumor cells with TP53 mutations increasingly rely on ataxia-telangiectasia and Rad3-related (ATR) protein to respond to and repair DNA damage induced by cytotoxic chemotherapy. We aimed to assess the efficacy of ATR inhibitor, berzosertib, with irinotecan in patients harboring TP53-mutated, metastatic gastroesophageal cancer. METHODS: NCI 10211 is a phase II trial that enrolled patients with TP53-mutated, unresectable or metastatic gastroesophageal adenocarcinoma to receive berzosertib with irinotecan on day 1, 15 in 28-day cycles. Initially, patients who had progressed on at least 1 prior line of therapy were enrolled which was later amended to at least 2 prior lines of therapy. The primary outcome was objective response rate (ORR), and secondary outcomes included progression-free survival (PFS) and overall survival (OS). Nine patients underwent biopsy for correlative studies, which included assay evaluation of γH2AX, NBS1, and KAP1 p-Ser 824 expression. RESULTS: Of the 17 patients enrolled, 16 were evaluable for the primary endpoint of ORR. The ORR was 0%, disease control rate (DCR) of 56.2%, median PFS (mPFS) of 4.01 months, and median OS (mOS) of 6.21 months. The study did not meet its primary endpoint. The most common treatment-related adverse events were nausea (52.9%), anemia (41.2%), diarrhea (41.2%), and lymphopenia (41.2%) without any unexpected adverse events. CONCLUSION: This novel combination of ATR inhibitor berzosertib with irinotecan did not lead to objective responses in patients with TP53-mutated, advanced gastroesophageal adenocarcinoma. The combination regimen was well tolerated without unexpected adverse events. This trial was registered with ClinicalTrials.gov (NCT03641313).	esophagus
Methodological approach to optimize a step-by-step deterministic linkage of SNDS data with a clinical database (FREGAT) of gastric/gastroesophageal junction adenocarcinoma in France: Pitfalls and learnings.	PURPOSE: Survival rates in the European population with gastric and gastroesophageal junction (G/GEJ) adenocarcinoma remain low. Epidemiologic research is warranted to understand the population size, unmet need, and current treatment patterns of G/GEJ adenocarcinoma. The objective of this research was to develop an algorithm to link patients across the FRench EsoGAstric Tumours (FREGAT) and Système National des Données de Santé (SNDS) databases to develop a real-world dataset for G/GEJ adenocarcinoma. METHODS: A step-by-step, indirect, deterministic record linkage algorithm was developed to match patient records from the FREGAT and SNDS databases. Corresponding variables in each data source were matched at an individual level. Each step in the linkage process used a given scoring criterion; the linkage process proceeded until a unique pair of patient records had equal observations across the databases, at which time patient data were considered linked. Due to the large number of potential matches, the linkage process was performed in two parts: first, matching on the stratified population using individual corresponding variables, and second, by linking without any stratification. Descriptive and inferential statistics were used to assess validity of the linkage process. This study was approved by the National Expertise Committee (Ethical and Scientific Committee for Research, Studies and Evaluations in the Field of Health; 5758940) and the French Personal Data Protection Agency (CNIL; 92 1441/DR 2022 088). RESULTS: Of 1617 patients included in the FREGAT database, 1385 (85.7%) were successfully linked to the SNDS database. A majority of the linked patients (1159 [83.7%] of 1385) were matched in the first part of the linkage process. CONCLUSION: We established an algorithm that enabled linkage of the FREGAT and SNDS databases that may be applied to capture additional data related to G/GEJ adenocarcinoma in France.	esophagus
Development and validation of an interpretable Random Forest model for predicting recurrence after endoscopic submucosal dissection in superficial oesophageal squamous cell carcinoma.	BACKGROUND: Currently, endoscopic submucosal dissection (ESD) has become the preferred treatment for superficial oesophageal squamous cell carcinoma (SESCC). However, due to the residual background mucosa, some patients are still at risk of postoperative recurrence. This study aimed to develop and validate an explainable machine learning model to predict recurrence risk in SESCC patients undergoing ESD. METHODS: We enrolled SESCC patients treated with ESD between 1 January 2016 and 31 December 2023. Patients from 2016 to 2021 were allocated to the training set, further split into a 7:3 ratio for model training and internal validation. Patients from 2022 to 2023 constituted the temporal validation set. Seven machine learning algorithms - logistic regression, extreme gradient boosting, light gradient boosting machine, random forest (RF), gradient boosting decision tree, Gaussian Naïve Bayes and Multilayer Perceptron - were employed to construct risk models. Shapley Additive exPlanations (SHAP) method was applied to interpret the optimal model's feature importance. RESULTS: Eight predictors were identified for model construction: platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, low-density lipoprotein level, biological age, mid-oesophageal location, multiple tumour lesions, poor differentiation and infiltration depth (muscularis mucosa or superficial submucosa). Among the seven models, the RF algorithm demonstrated superior performance, achieving an area under the receiver operating characteristic curve of 0.892 in internal validation and 0.761 in temporal validation. An online prediction platform (https://zzhapp.shinyapps.io/shiny/) was developed for clinical application. CONCLUSION: This study successfully developed and validated an explainable RF-based machine learning model to accurately predict recurrence risk in SESCC patients after ESD.	esophagus
Significance of the use of a laryngotracheal flap to reconstruct defects and manage pharyngoesophageal stenosis after the resection of hypopharyngeal carcinoma with cervical oesophagus involvement: a retrospective study.	BACKGROUND: The main objective of this study was to investigate cervical oesophageal reconstruction by a laryngotracheal flap (LTF) and the management of postoperative pharyngoesophageal stenosis (PES) after the resection of hypopharyngeal carcinoma with cervical oesophageal involvement. METHODS: The retrospective cohort study of fourteen patients with hypopharyngeal carcinoma exhibiting cervical oesophageal involvement were included in the study from January 2012 to January 2021. Postoperative radiochemotherapy was utilised, and follow-up occurred for 3-5 years. The Kaplan-Meier method was used for survival analysis. RESULTS: All of the patients demonstrated healing without events, except for one patient who experienced a pharyngocutaneous fistula, which also healed after approximately 2 weeks of dressing changes. With a follow-up of 3-5 years, the median duration of follow-up was 49 months (range = 36-60 months). Eight patients died during follow-up. Moreover, three patients had metastases in the neck, 1 patient had metastases in the lung, and 1 patient discontinued further treatment because of thoracic oesophageal carcinoma with hepatic metastasis. The 5-year overall survival was 42.9%. Among the 14 included patients, two patients developed pharyngoesophageal stenosis, and the remaining patients recovered well. Two patients with pharyngoesophageal stenosis causing feeding difficulties received nasogastric tube nasal feeding and urinary catheter dilation after the scar tissue was removed via coblator plasma surgery at the stenosis and were fed via nasogastric tube for 1-3 months. CONCLUSION: As an effective repair method, laryngotracheal flaps have broad application prospects in the repair of the cervical oesophagus after the resection of hypopharyngeal carcinoma with cervical oesophageal involvement. Coblator plasma surgery and catheter dilation may effectively address the problem of eating difficulties in patients with postoperative pharyngoesophageal stenosis.	esophagus
Improvement in Coronary Dose Distribution Using Dynamic Swing Arc in Volumetric-modulated Arc Therapy During Esophageal Cancer Radiotherapy.	BACKGROUND/AIM: The dose to the left anterior descending coronary artery (LAD) is associated with mortality in patients with esophageal cancer (EC) who underwent radiotherapy. The aim of this study was to compare the dose distributions to the LAD region achieved through volumetric-modulated arc therapy (VMAT) planning using a dynamic swing arc in OXRAY (DSA-VMAT) and conventional coplanar (Conv-VMAT) planning. PATIENTS AND METHODS: Ten patients with EC who had undergone radiotherapy (60 Gy in 30 fractions) at our Institution were selected for inclusion in the study. Two virtual plans (DSA-VMAT and Conv-VMAT) were created to compare the dose distributions of the LAD region, heart, lungs, and planning target volume (PTV). All plans were analyzed using paired t-tests. RESULTS: The mean values±standard deviation for 15 Gy to the LAD region (V15) were 10.48±13.04% for DSA-VMAT and 30.28±23.56% for Conv-VMAT. Compared with Conv-VMAT, DSA-VMAT significantly improved V15 of the LAD region (p=0.01). In addition, DSA-VMAT significantly reduced the mean heart dose (8.64±5.37 vs. 11.23±7.37 Gy), heart V40 (17.55±4.76% vs. 20.44±6.06%), lung V20 (14.87±5.93% vs. 17.81±7.70%), and lung V5 (57.27±8.24% vs. 61.15±9.97%) compared to Conv-VMAT (all p≤0.01). In contrast, there were no significant differences between the two groups in PTV dose coverage [D95 (p=0.61), D50 (p=0.62)], or conformity index (p=0.91). CONCLUSION: Compared with Conv-VMAT, DSA-VMAT improved the dose distribution of the LAD region without impairing the PTV dose coverage. Thus, DSA-VMAT may reduce radiation-induced heart disease in patients with EC without loss of efficacy.	esophagus
Development and validation of a nomogram for predicting long-term survival in pN + esophageal squamous cell carcinoma treated using radical resection without neoadjuvant therapy.	BACKGROUND: The pN + status represents a crucial risk factor for esophageal squamous cell carcinoma (ESCC) patients without neoadjuvant therapy after radical resection. The necessity for adjuvant therapy post-surgery remains debatable. Our goal was to develop a personalized nomogram for predicting overall survival (OS) in pN + ESCC patients. MATERIALS AND METHODS: This study included 705 ESCC patients spanning from 1997 to 2016. All patients were staged according to the AJCC 8th edition TNM staging system and underwent radical resection without neoadjuvant therapy. The nomogram was constructed through univariate, multivariate, and LASSO Cox regression analyses. Its performance was evaluated and compared with the TNM staging system. RESULTS: The training and external validation cohorts included 451 and 254 patients, respectively. Independent prognostic factors included age, history of drinking, thoracic duct ligation, pT stage, pN stage, length of ICU stay, and postoperative adjuvant chemotherapy. The AUC values of nomogram at 2- and 5-year intervals in the training cohort were 0.732 and 0.716, respectively, and 0.697 and 0.705 in the external validation cohort, respectively, both superior to the TNM staging system. The nomogram's effectiveness and stability were validated internally and externally, with significant OS differences observed among the various risk groups defined by the nomogram. CONCLUSIONS: This study developed a prognostic nomogram for pN + ESCC patients who have not undergone neoadjuvant therapy and have undergone radical resection, providing superior predictive accuracy compared to the TNM staging system and easy to use in routine practice.	esophagus
Nanoliposomal Irinotecan in Combination With 5-Fluorouracil and Leucovorin for Advanced Head and Neck and Esophageal Squamous Cell Carcinoma After Prior Platinum-Based Chemotherapy or Chemoradiotherapy: A Multicenter Phase II Trial.	PURPOSE: To evaluate the efficacy and safety of nanoliposomal irinotecan (nal-IRI) plus 5-fluorouracil (5-FU) and leucovorin (LV) in patients with platinum-refractory or intolerant head and neck squamous cell carcinoma (HNSCC) and esophageal squamous cell carcinoma (ESCC). METHODS: In this multicenter, phase 2 study (NCT03712397), patients with advanced HNSCC (n = 43) or ESCC (n = 16) who had failed or were intolerant to platinum-based chemotherapy received biweekly nal-IRI 80 mg/m(2) (equivalent to 70 mg/m(2) of irinotecan base), LV 400 mg/m(2), and 5-FU 2400 mg/m(2) until progression or unacceptable toxicity. The primary endpoint was the objective response rate (ORR). RESULTS: In the intent-to-treat analysis, the ORR and disease control rate were 8.5% and 59.3% for the entire group. In the HNSCC subgroup, ORR and disease control rate were 11.6% and 65.1%, with a median progression-free survival (PFS) of 2.7 months and an overall survival (OS) of 8.1 months. By contrast, no objective responses were observed in ESCC (ORR 0%, disease control rate 43.8%, median OS 4.2 months). The most common grade 3/4 toxicities were lymphopenia (50.8%), neutropenia (42.4%), leukopenia (33.9%), anemia (28.8%), and anorexia (8.5%). CONCLUSIONS: Nal-IRI/5-FU/LV demonstrates modest activity with acceptable safety profiles in patients with platinum-refractory or intolerable advanced HNSCC. The exploratory findings warrant confirmation in larger, randomized studies. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03712397.	esophagus
Serum IgG titer findings for Fusobacterium nucleatum associated with clinical outcome following surgery in patients with esophageal squamous cell carcinoma.	Fusobacterium nucleatum (Fn) is known as an etiological factor related to periodontitis. However, recent reports have shown that it also functions as an oncogenic pathogen and is associated with progression of various cancers as well as poor prognosis of esophageal squamous cell carcinoma (ESCC) patients. The present study was conducted to examine the correlations of serum IgG antibody titer level against Fn (IgG-Fn) with clinicopathological characteristics, oral conditions, and survival outcomes in 305 patients who underwent an esophagectomy procedure for ESCC. The results revealed that 40.7% of the patients tested positive for IgG-Fn, and those in the positive group had significantly lower rates of overall survival (OS) and cancer-specific survival (CSS) as compared to patients who tested negative (OS; p = 0.01, CSS; p = 0.02). Multivariate analysis showed IgG-Fn positivity as an independent predictor of CSS (hazard ratio, 1.96; 95% CI, 1.32-2.90; p < 0.001). Moreover, among patients who were diagnosed with stage II-IV and underwent neoadjuvant therapy (NAT), those in the IgG-Fn-positive group showed higher pathological progression and greater incidence of inadequate response to NAT as compared to the IgG-Fn-negative group (odds ratio 0.48, 95% CI 0.24-0.92; p = 0.04). The present findings indicate that IgG-Fn can serve as a marker indicating poor tumor response to NAT in advanced ESCC cases.	esophagus
The right side of the anastomosis is the leakage-prone site following McKeown esophagectomy with cervical circular-stapled anastomoses.	This retrospective study of 116 patients undergoing McKeown esophagectomy with cervical circular-stapled anastomosis identified an overall anastomotic leakage (AL) rate of 28.4 % (33/116). Leak sites were localized via CT esophagography and endoscopy and classified using a clock-face system. Analysis of leakage sites in these patients revealed a strong right-sided predominance, accounting for 84.9 % (28/33), with posterior, left, and anterior wall leaks accounting for 3.0 % (1/33), 9.1 % (3/33), and 3.0 % (1/33), respectively. We propose a novel biomechanical hypothesis analyzing the gastric conduit from a mechanical standpoint to explain the distinctive distribution and higher incidence of right-sided leakage.	esophagus
[Establishment of the SAFER low-risk, high-quality surgical system for esophageal cancer: an analysis of 131 cases].	Objective: To address postoperative complications of esophageal cancer, especially anastomotic leakage and the resulting fatal infections, we aimed to establish an optimized surgical system, secure approach for esophagectomy with retrosternal reconstruction (SAFER), centered on the retrosternal reconstruction route, with the goals of reducing surgical risk and enhancing surgical quality. Methods: The SAFER esophagectomy system was developed in collaboration with 9 medical centers in China. We retrospectively analyzed data from 131 consecutive esophageal cancer patients treated at the Cancer Hospital of the Chinese Academy of Medical Sciences and Nanjing Drum Tower Hospital between January and April 2025. All patients underwent thoracoscopic-laparoscopic-assisted three-incision esophagectomy or inflatable mediastinoscopic esophagectomy, with digestive tract reconstruction via the retrosternal route. Key components of the SAFER system included: (1) Standardized total mesoesophageal excision and lymphadenectomy with preservation of the azygos vein arch and right bronchial artery; (2) Gastric mobilization and abdominal lymphadenectomy; (3) Tubular stomach construction and retrosternal tunnel creation; (4) Cervical anastomosis; (5) Enhanced recovery after surgery (ERAS) protocols. Results: There were no perioperative deaths. The anastomotic leakage rate was 5.3% (7/131), significantly lower than the rates reported in most traditional literature (4.2%-22.2%). None of the leakage cases developed systemic infection or organ failure, with an average healing time of 17 days. Other complications included pneumonia (8.4%, 11/131), hoarseness (9.2%, 12/131), and atrial fibrillation (7.6%, 10/131). No chylothorax occurred. Median operative time was 268 minutes, with a median blood loss of 50 ml. The median number of lymph nodes dissected was 36 (19 thoracic + 17 abdominal). Physical status score at 1 week postoperatively was 0-1, and the average hospital stay was 7 days. Conclusions: The SAFER system, utilizing retrosternal reconstruction and other optimized procedures, maximally isolates the tubular stomach and anastomosis from the thoracic cavity, thereby preventing systemic infection caused by anastomotic leakage. Its standardized workflow significantly reduces surgical complexity, ensures oncological resection and standardized lymphadenectomy, and facilitates rapid recovery, providing a safe and high-quality solution for esophageal cancer surgery.	esophagus
Chyle leak following esophagectomy: 'a retrospective 10-year single-site experience of a tertiary center'.	Post-esophagectomy chyle leak following injury to the thoracic duct and/or its tributaries is a rare but well-recognized complication with a reported incidence of 0.4-21% and a mortality of 0-50%. The aim of this study was to describe our experience as a tertiary esophagogastric cancer center in managing this complication over a 10-year period. This was a retrospective study, using an electronic database, to analyze our incidence and management of chyle leak in all patients who underwent elective esophagectomy between April 2009 and December 2019 in a tertiary upper gastrointestinal cancer center. Non-normally distributed data were presented as a median and range/interquartile range with analysis being conducted using the Mann-Whitney U test. A P-value <0.05 was considered statistically significant. Between 2009 and 2019, a total of 550 patients underwent esophagectomy. Chyle leak was identified in 24 patients (4.4%); all 24 patients had neoadjuvant chemotherapy and underwent an open 2 stage Ivor Lewis esophagectomy with routine ligation of the thoracic duct at the time of operation. 83.3% (n = 20) of chyle leak patients were managed surgically with a median length of stay of 20 days (Range 11 to 148) and mortality of 5% (n = 1). 16.7% (n = 4) were managed conservatively with a median length of stay of 31 days (Range 14 to 51) and mortality of 0%. Our data are consistent with the evidence in the literature, which suggests that early surgical intervention in high volume leaks is safe and effective and low mortality rates with chyle leak can be achieved with surgical intervention. This is crucial in reducing the length of stay in hospital and morbidity. Conservative management is suitable in low volume chyle leak and cases clinically responding to medical management.	esophagus