crossing96/oncoscreening huggingface dataset:
Small RNA: a large contributor to carcinogenesis?	INTRODUCTION: Homeostasis in normal tissue includes balancing cell proliferation and apoptosis (programmed cell death). Mutations in proto-oncogenes or tumor suppressor genes may lead to disruption of normal cellular function, uncontrolled cell proliferation, and subsequent carcinogenesis. DISCUSSION: Micro-RNAs (miRNAs) are short (19-24 nucleotide) noncoding RNA sequences that inhibit protein translation and can cause the degradation of subsequent messenger RNA, thus playing an important role in the regulation of gene expression. Aberrant expression of miRNAs has been shown to inhibit tumor suppressor genes or inappropriately activate oncogenes initiating the cancer process. Unique miRNA expression profiles have been found in different cancer types at different stages, suggesting a possible diagnostic application. This review summarizes the current evidence supporting a link between aberrant miRNA expression and carcinogenesis and its possible role in improving diagnosis and treatment of cancers, particularly of gastrointestinal origin.	esophagus
A case of primary isolated non-Hodgkin's lymphoma of the esophagus in an immunocompetent patient.	Primary non-Hodgkin's lymphoma of the esophagus is a rare disease. A case of primary isolated non-Hodgkin's lymphoma of the esophagus in a 77-year-old man without acquired immunodeficiency syndrome is presented. We describe the clinical features and the imaging findings (barium swallow, endoscopic ultrasonography and CT) of a biopsy proven B-cell lymphoma with diffuse transmural involvement of the esophagus wall, which was discovered incidentally. We also briefly review the literature.	esophagus
Clinical usefulness of 18F-FDG PET/CT in the restaging of esophageal cancer after surgical resection and radiotherapy.	AIM: To evaluate the clinical usefulness of (18)F-fluorodeoxyglucose positron emission and computed tomography ((18)F-FDG PET/CT) in restaging of esophageal cancer after surgical resection and radiotherapy. METHODS: Between January 2007 and Aug 2008, twenty histopathologically diagnosed esophageal cancer patients underwent 25 PET/CT scans (three patients had two scans and one patient had three scans) for restaging after surgical resection and radiotherapy. The standard reference for tumor recurrence was histopathologic confirmation or clinical follow-up for at least ten months after (18)F-FDG PET/CT examinations. RESULTS: Tumor recurrence was confirmed histopathologically in seven of the 20 patients (35%) and by clinical and radiological follow-up in 13 (65%). (18)F-FDG PET/CT was positive in 14 patients (68.4%) and negative in six (31.6%). (18)F-FDG PET/CT was true positive in 11 patients, false positive in three and true negative in six. Overall, the accuracy of (18)F-FDG PET/CT was 85%, negative predictive value (NPV) was 100%, and positive predictive value (PPV) was 78.6%. The three false positive PET/CT findings comprised chronic inflammation of mediastinal lymph nodes (n = 2) and anastomosis inflammation (n = 1). PET/CT demonstrated distant metastasis in 10 patients. (18)F-FDG PET/CT imaging-guided salvage treatment in nine patients was performed. Treatment regimens were changed in 12 (60%) patients after introducing (18)F-FDG PET/CT into their conventional post-treatment follow-up program. CONCLUSION: Whole body (18)F-FDG PET/CT is effective in detecting relapse of esophageal cancer after surgical resection and radiotherapy. It could also have important clinical impact on the management of esophageal cancer, influencing both clinical restaging and salvage treatment of patients.	esophagus
Centralization of esophageal cancer surgery: does it improve clinical outcome?	BACKGROUND: The volume-outcome relationship for complex surgical procedures has been extensively studied. Most studies are based on administrative data and use in-hospital mortality as the sole outcome measure. It is still unknown if concentration of these procedures leads to improvement of clinical outcome. The aim of our study was to audit the process and effect of centralizing oesophageal resections for cancer by using detailed clinical data. METHODS: From January 1990 until December 2004, 555 esophagectomies for cancer were performed in 11 hospitals in the region of the Comprehensive Cancer Center West (CCCW); 342 patients were operated on before and 213 patients after the introduction of a centralization project. In this project patients were referred to the hospitals which showed superior outcomes in a regional audit. In this audit patient, tumor, and operative details as well as clinical outcome were compared between hospitals. The outcome of both cohorts, patients operated on before and after the start of the project, were evaluated. RESULTS: Despite the more severe comorbidity of the patient group, outcome improved after centralizing esophageal resections. Along with a reduction in postoperative morbidity and length of stay, mortality fell from 12% to 4% and survival improved significantly (P = 0.001). The hospitals with the highest procedural volume showed the biggest improvement in outcome. CONCLUSION: Volume is an important determinant of quality of care in esophageal cancer surgery. Referral of patients with esophageal cancer to surgical units with adequate experience and superior outcomes (outcome-based referral) improves quality of care.	esophagus
Minimally invasive surgery compared to open procedures in esophagectomy for cancer: a systematic review of the literature.	The impact of minimally invasive esophagectomy (MIE) on short term perioperative outcomes as opposed to open transhiatal esophagectomy (THE) and transthoracic esophagectomy (TTE) is still under debate. This systematic review attempts to answer whether minimally invasive surgery has improved short term outcomes compared to conventional open surgery in the management of esophageal cancer. A systematic literature search was performed using synonyms for esophagectomy, cancer and minimally invasive surgery. Ten case-controlled studies were retrieved and one systematic review. Data collection was grouped by surgical approach. Overall MIE data shows decreased blood loss (577 mL for conventional open surgery versus 312 mL for MIE) and reduction of hospital and ICU stay (open 19.6 days versus MIE 14.9 days, and open 7.6 days versus MIE 4.5 days respectively). Total complication rates are 60.4% for open esophagectomy and 43.8% for MIE. Pulmonary complications occur in 22.9% and 15.1% of respective procedures. Mean lymph node retrieval was higher in MIE (open 20.2 versus MIE 23.8). This review confirms the feasibility and safeness of minimally invasive surgery for esophageal cancer. Moreover, the retrieved studies collectively point towards improved short term outcomes after MIE. These results should be confirmed in randomized controlled trials.	esophagus
[Platelet count of peripheral blood is associated with invasion and metastasis of esophageal carcinoma].	OBJECTIVE: To analyze the association between the platelet count of peripheral blood and clincopathologic parameters of esophageal carcinoma. METHODS: Platelets of peripheral blood were measured in 415 cases of esophageal carcinoma and 325 healthy subjects as control. The correlation of platelet counts and clinicopathological features of cancer was analyzed. RESULT: Platelet count in patients with esophageal carcinomas (286+/-88)x10(9)/L was significantly higher than that in the control subjects [(204+/-114)x10(9)/L, P<0.05 ]. Increased platelet counts (>300 x 10(9)/L) was significantly associated with tumor infiltration and lymph node metastasis in patients with esophageal cancer (P<0.05). CONCLUSION: Platelet count of peripheral blood might be associated with the development and progression of esophageal cancer.	esophagus
Maté attenuates DNA damage and carcinogenesis induced by diethylnitrosamine and thermal injury in rat esophagus.	Drinking hot maté has been associated with risk for esophageal cancer in South America. Thus, the aims of this study were to evaluate the modifying effects of maté intake on DNA damage and esophageal carcinogenesis induced by diethylnitrosamine (DEN) and thermal injury (TI) in male Wistar rats. At the initiation phase of carcinogenesis, rats were treated with DEN (8 x 80 mg/kg) and submitted to TI (water at 65 degrees C, 1 ml/rat, instilled into the esophagus). Concomitantly, the animals received maté (2.0%w/v) for 8 weeks. Samples of peripheral blood were collected 4h after the last DEN application for DNA damage analysis. At weeks 8 and 20, samples from esophagus and liver were also collected for histological and immunohistochemical analysis. Maté significantly decreased DNA damage in leukocytes, cell proliferation rates in both esophagus and liver and the number of preneoplastic liver lesions from DEN/TI-treated animals at week 8. A significant lower incidence of esophageal papillomas and liver adenomas and tumor multiplicity was observed in the animals previously treated with maté at week 20. Thus, maté presented protective effects against DNA damage and esophageal and liver carcinogenesis induced by DEN.	esophagus
Esophagectomy without thoracotomy: 25 years of experience over 750 patients.	OBJECTIVE: This study aimed to review and evaluate our experience in 750 patients, who underwent transhiatal esophagectomy (THE) and analyze our data. Special attention was paid to some strategies, which we developed in the course of time, regarding the postoperative management of these patients and formulation of improved guidelines. PATIENTS AND METHODS: This is a retrospective analysis of all THE operations performed between January 1981 until May 2007 in 750 patients: 60 patients (8%) had benign lesions, while 690 (92%) had malignant ones (5.2% of malignancies were located in the upper esophagus, 7.4% in the middle esophagus, 19% in the lower esophagus, and 68.4% at the cardioesophageal junction). THE and esophageal reconstruction were performed at the same operation in all patients. The stomach was our esophageal substitute of first choice with the colon and jejunum being acceptable alternatives in patients with prior gastric surgery and those necessitating synchronous gastrectomy for cancer invasion. A gastric tube was used as an esophageal substitute in 624 patients (83.2%), the whole stomach in 70 (9.4%), the colon in 43 (5.73%), and a jejunal loop in 13 (1.73%). RESULTS: The overall in-hospital mortality rate was 2.93% (22 patients). There was no intraoperative death. Major complications included atelectasis or pneumonia (4.8%), pleural effusion (22.7%), myocardial infarction (0.5%), recurrent laryngeal nerve paralysis (1.33%), and three tracheal lacerations (0.4%). The anastomotic leak rate decreased gradually over time from 29.4% to 11.1% in the last 6 years. The average intraoperative blood loss was 315 ml and 82% of the patients did not receive any blood transfusion. Late functional results were good or excellent in 93%. The average length of hospital stay was 11 days and intensive care unit stay was 2.3 days. The actuarial 5-year survival rate after THE for carcinoma was 21%. CONCLUSION: THE is a safe and effective method of esophageal resection with low morbidity and mortality rates and good functional results when performed by experienced surgeons. We believe that our strategies concerning the way of dissecting the cervical esophagus, avoidance of performing pyloromyotomy, the delayed removal of the cervical drain and the delayed advance to oral feeding have reduced, noticeably, morbidity and mortality in our series.	esophagus
Significance of Jab1 expression in human esophageal squamous cell carcinoma.	GOAL: The aim of the present study was to examine the expression of Jun activation domain-binding protein 1(Jab1) and p27 and to elucidate its clinicopathologic significance in a larger series of squamous cell carcinoma (SCC) of the esophagus. BACKGROUND: Reduced expression of p27 has been associated with poor prognosis in most human cancers, including esophageal SCCs. Jab1 is known as a coactivator of AP-1 transcription factor, which contributes to tumor progression by degrading the p27 protein. STUDY: Immunohistochemical and Western blot analysis were performed in 90 cases of esophageal SCCs and ECA109 cells. Survival analyses were performed by using the Kaplan-Meier method. RESULTS: Immunohistochemical analysis showed that Jab1 expression was negatively associated with p27 level and significantly associated with unfavorable clinicopathologic variables. Overexpression of Jab1 in ECA109 cells resulted in decreased p27 level and this decrease was sensitive to 26S proteasome inhibitors. Subcellular fractionation confirmed Jab1 could lead to nuclear export of p27. Survival analysis revealed that Jab1 overexpression was significantly associated with overall survival (P<0.001). When Jab1 and p27 are combined, patients with Jab1(+)/p27(-) revealed poorer overall survival (P<0.001), what's more, patients with the phenotype of Jab1(+)/lymph node(+) had poorer disease-free and overall survival than others (P<0.001). CONCLUSIONS: These findings suggest that Jab1 is involved in the pathogenesis of esophageal SCC and that elevated levels of Jab1 expression may indicate a poor prognosis for patients with esophageal SCC.	esophagus
Extracapsular lymph node involvement is a negative prognostic factor after neoadjuvant chemoradiotherapy in locally advanced esophageal cancer.	INTRODUCTION: To assess prognosis depending on whether lymph node involvement (LNI) is intracapsular or with extracapsular breakthrough in patients with a locally advanced esophageal cancer treated with neoadjuvant chemoradiation and surgery. METHODS: Ninety-four consecutive patients with an esophageal cancer staged IIB (n = 17) and III (n = 77) received neoadjuvant chemoradiation followed by transthoracic esophagectomy with two-field lymphadenectomy. Histology was squamous cell carcinoma (n = 46) and adenocarcinoma (n = 48). Neoadjuvant therapy consisted of association of 5-fluorouracil/cisplatin concomitantly with a 45-Gy radiation therapy. Disease-free survival (DFS) excluding the in-hospital mortality was analyzed according to the nodal status and the invaded/resected lymph node ratio (LNR). Clinical factors affecting survival or predictors of extracapsular invasion were investigated by multivariate analysis. RESULTS: Five-year DFS rates were 46, 36, and 11% in N0 patients (n = 56), intracapsular LNI patients (n = 18), and extracapsular LNI patients (n = 10), respectively (p = 0.002). Intracapsular LNI patients with an LNR <0.1 (n = 12) had a 5-year DFS rate similar to N0 patients (44 versus 46%, p = 0.95). Intracapsular LNI patients with an LNR > or =0.1 (n = 6) had a DFS rate similar to extracapsular LNI patients (18 versus 11%, p = 0.69). Multivariate analysis revealed that the sole independent factor affecting DFS was the extracapsular LNI (HR = 3.9, p = 0.026). The number of invaded LN seemed to be the sole significant predictive factor for the development of ECLNI (HR = 2.39, p = 0.008). CONCLUSION: After neoadjuvant chemoradiotherapy, there was a significant difference on DFS depending on whether LNI was intracapsular or extracapsular. Extracapsular invasion seems to be an independent negative prognostic factor affecting survival, and its presence is related to the number of invaded LN.	esophagus
Can we consider always an esophageal carcinoma as radiation associated cancer after irradiation for breast cancer?	OBJECTIVE: To assess in a large-scale single-institution study whether radiotherapy (RT) for breast cancer increases the incidence of esophageal carcinoma as reported in a meta-analysis and in population studies, or does not increase incidence as suggested by smaller single-institution studies that take account of RT technique, dose, and possible confounding factors such as disease stage, smoking history, and the use of chemotherapy or hormone therapy. PATIENTS AND METHODS: We reviewed the cases of esophageal cancer after RT in our prospective institutional database of 16,705 patients treated for nonmetastatic BC between 1981 and 1997. RESULTS: We found 5 cases of esophageal cancer among the RT patients (n = 13,472) and 1 case among nonirradiated patients (n = 3233). The relative risk of developing esophageal cancer after RT was 0.76 (95% confidence interval: 0.54-1.07); P = 0.118. However, the estimated dose delivered to the esophagus according to radiation field positions and energies was low (< or =0.5 Gy) in all patients except one (2 Gy). All 6 patients were smokers and all 5 irradiated patients were also regular consumers of alcohol. CONCLUSION: The risk of a secondary esophageal carcinoma is low but the prognosis is severe. There was a probable association between esophageal cancer and factors such as smoking, alcohol consumption, and chronic inflammatory disease, rather than RT. Confounding factors should be investigated in large epidemiologic studies and evaluated for each patient.	esophagus
In vitro effects of 2-methoxyestradiol on cell numbers, morphology, cell cycle progression, and apoptosis induction in oesophageal carcinoma cells.	The influence of 2-methoxyestradiol (2-ME) was investigated on cell numbers, morphology, cell cycle progression, and apoptosis induction in an oesophageal carcinoma cell line (WHCO3). Dose-dependent studies (1 x 10(-9)M-1 x 10(-6)M) revealed that 2-ME significantly reduced cell numbers to 60% in WHCO3 after 72 h of exposure at a concentration of 1 x 10(-6)M compared to vehicle-treated cells. Morphological studies entailing light-, fluorescent-, as well as transmission electron microscopy (TEM) confirmed 2-ME's antimitotic effects. These results indicated hallmarks of apoptosis including cell shrinkage, hypercondensation of chromatin, cell membrane blebbing, and apoptotic bodies in treated cells. Flow cytometric analyses demonstrated an increase in the G(2)/M-phase after 2-ME exposure; thus preventing cells from proceeding through the cell cycle. beta-tubulin immunofluorescence revealed that 2-ME caused spindle disruption. In addition, increased expression of death receptor 5 protein was observed further supporting the proposed mechanism of apoptosis induction via the extrinsic pathway in 2-ME-exposed oesophageal carcinoma cells.	esophagus
Diagnostic strategies for pre-treatment staging of patients with oesophageal cancer.	BACKGROUND/AIMS: Current guidelines for staging oesophageal cancer recommend a series of preoperative investigations. There is no consensus on the recommended order for these investigations or whether all investigations are necessary in all patients. Our aim was to determine an efficient strategy for pre-treatment staging of patients with oesophageal cancer. METHODS: We retrospectively compared 15 staging strategies, based on all possible orders of all possible subsets of three staging modalities (computed tomography, endoscopic ultrasonography and external ultrasonography of the neck). We assumed that if distant metastases or local irresectability were found and confirmed, no further investigations would be performed. Main outcome was the minimal number of investigations needed to detect all patients with incurable disease. RESULTS: Using all three investigations in all 412 patients would lead to performance of 1,236 investigations. Both strategies starting with computed tomography or endoscopic ultrasonography and ending with external ultrasonography were most efficient, using a total of 1,112 investigations. CONCLUSION: The use of a conditional staging strategy with a specific order of imaging can reduce the number of tests necessary to identify incurable patients with oesophageal cancer by 10%. In our opinion, this is not enough to recommend implementation of a logistically more complex diagnostic system.	esophagus
Multiple cutaneous metastases from esophageal adenocarcinoma.	INTRODUCTION: Cutaneous metastases from internal malignancies are very uncommon. [corrected] We describe an extremely rare case of multiple cutaneous metastases from esophageal adenocarcinoma. CASE REPORT: A month before the patient came to us, he had presented to the ER for evaluation of skin lesions and was sent home on a 1-week course of oral antibiotics. He later presented with dysphagia and was diagnosed with esophageal adenocarcinoma and biopsy of the skin lesions revealed metastases. DISCUSSION: This report stresses the importance that newly appearing skin lesions may be the first presentation of esophageal carcinoma.	esophagus
Development of gastro-lymphatic fistula during chemoradiotherapy for advanced esophageal cancer: a case report.	This is a case report of a gastro-lymphatic fistula which appeared during chemoradiotherapy for advanced esophageal cancer. A 60-year-old male was referred to the University of the Ryukyus Hospital because of a 10 kg monthly weight loss and dysphagia. Computed tomography (CT) scans indicated thickened esophageal wall at the lower thoracic esophagus and a swollen lymph node attached to the lesser curvature of the stomach. Histological analysis of the biopsy specimen revealed poorly differentiated squamous cell carcinoma and the diagnosis was of advanced esophageal cancer. A combination of chemotherapy (nedaplatin and 5-fluorouracil) and radiotherapy was initiated. After radiotherapy (20 Gy), CT scans revealed that the swollen lymph node penetrated the gastric wall resulting in a gastro-lymphatic fistula. Although gastrostomy and intestinal fistula repair were performed for gastric decompression and tube feeding, respectively, the patient's general status did not improve and he died two months after interruption of his chemoradiotherapy. The results indicate that there may be some risks of gastro-lymphatic fistula in patients treated with concurrent chemoradiotherapy for advanced esophageal cancer when there are possible signs of involvement by CT scans.	esophagus
Preoperative therapy for esophageal cancer.	This article examines the role of combined-modality therapy for treating locally advanced esophageal cancer. Although surgery remains a cornerstone of treatment, recent studies have demonstrated that pre- or perioperative chemotherapy is associated with improved survival for patients who have adenocarcinoma histology. Primary chemoradiotherapy is the accepted standard of care for medically inoperable patients. Recent studies also suggest that definitive chemoradiotherapy is acceptable for patients who have squamous histology, while subsequent surgery improves local control without conferring a clear survival benefit. Neoadjuvant chemoradiotherapy continues to be investigated but is associated with several advantages over neoadjuvant chemotherapy alone, including an improvement in the pathologic complete response rate and resectability. Patients who achieve a pathologic complete response also appear to have improved survival. Adjuvant chemoradiotherapy may be considered for patients who undergo primary resection of lower esophageal/gastroesophageal junction adenocarcinoma.	esophagus
The role of FDG-PET and staging laparoscopy in the management of patients with cancer of the esophagus or gastroesophageal junction.	The effort to improve outcomes in esophageal cancer has included attempts at improving staging and patient selection. 2-Deoxy-2-[(18)F]fluoro-Dglucose positron emission tomography (FDG-PET) has been extensively studied in this context and has been widely accepted as a staging tool. Its role in restaging or assessing therapeutic response is investigational and promising. Laparoscopy has also been studied as a means for improving staging, but its role may be limited in the era of PET. This article discusses the literature assessing these modalities, particularly with regard to the practical management of the patient in the clinic.	esophagus