crossing96/oncoscreening huggingface dataset:
Management of treatment-naïve limited-stage small cell esophagus carcinoma.	OBJECTIVES: To identify the problems and principles of treatment decisions in treatment-naïve limited-stage small cell esophagus carcinoma (LD-SCEC). METHODS: Clinical data from 39 patients with LD-SCEC treated in the Chinese People's Liberation Army General Hospital, Beijing, China between 2000 and 2013 were retrospectively collected with regard to pathologic characteristics, overall survival (OS), and relevant prognostic factors. RESULTS: The median OS was 21.1 months (95% confidence interval [CI]: 12.4-29.7 months). The one-year OS was 76%, 3-year was 25%, and the 5-year OS was 8%. Depth of invasion, lymph metastasis status, and chemotherapy were independent prognostic factors. Of the 39 cases, only 38.4% (15 cases) were diagnosed as SCEC by the biopsy specimen. Eight of the 15 patients (group A) received chemotherapy and/or radiotherapy, while the remaining 7 patients (group B) and the other 24 patients (group C) received surgery as initial treatment. The one-year survival of group A was 87%, of group B was 69%, and of group C was 74% (p=0.037). The accuracy of the biopsy diagnosis influenced the treatment decisions and prognosis. CONCLUSION: Small cell esophagus carcinoma is a systemic disease, with depth of invasion, lymph metastasis status, and chemotherapy as independent prognostic factors. Systemic therapy based on chemotherapy is recommended. The top priority is to improve the accuracy of diagnosis before deciding on the initial treatment option.	esophagus
Upregulation of the long noncoding RNA PCAT-1 correlates with advanced clinical stage and poor prognosis in esophageal squamous carcinoma.	Recent studies reveal that long noncoding RNAs (lncRNAs) play critical regulatory roles in cancer biology. Prostate cancer-associated ncRNA transcript 1 (PCAT-1) is one of the lncRNAs involved in cell apoptosis and proliferation of prostate cancer. This study aimed to assess the potential role of PCAT-1 specifically in the pathogenesis of esophageal squamous cell carcinoma (ESCC). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression level of PCAT-1 in matched cancerous tissues and adjacent noncancerous tissues from 130 patients with ESCC, 34 patients with non-small cell lung cancer (NSCLC), and 30 patients with gastric carcinoma (GC). The correlation of PCAT-1 with clinicopathological features and prognosis were also analyzed. The expression of PCAT-1 was significantly higher in human ESCC compared with the adjacent noncancerous tissues (70.8%, p < 0.01), and the high level of PCAT-1 expression was significantly correlated with invasion of the tumor (p = 0.024), advanced clinical stage (p = 0.003), lymph node metastasis (p = 0.032), and poor prognosis. However, PCAT-1 mRNA expression had no significant difference between paired primary cancerous tissues and the adjacent noncancerous tissues in 34 cases of NSCLC (p = 0.293) and 30 cases of GC (p = 0.125). High expression of PCAT-1 was specifically correlated with invasion of cancer tissues, metastasis of lymph node, and advanced tumor stage of ESCC. High expression of PCAT-1 might reflect poor prognosis of ESCC and indicate a potential diagnostic target in ESCC patients. Adjuvant therapy targeting PCAT-1 molecule might be effective in treatment of ESCC.	esophagus
[An examination of the utility of high-precise radiation therapies for the recurrence of postoperative esophageal cancer].	We analyzed 16 cases (23 therapeutic sites) of post-operative recurrence of esophageal cancers that were treated with high-precise radiation therapies.The recurrence sites were cervical lymph nodes (5 cases), superior mediastinal lymph nodes (5 cases), posterior mediastinal lymph nodes (3 cases), regional lymph nodes with anastomosis (2 cases), abdominal paraaortic lymph node (3 cases), and regions with hematogenous metastasis (5 cases: liver, lung, spleen, and dissemination to the diaphragm bottom).By recurrence number, 10 cases presented with a single lesion, and 6 cases had multiple lesions.The effect of the treatment was complete response (CR) in all cases, and 6 cases maintained CR.The median of the overall survival after radiotherapy was 562 (132-1,231) days.Analysis of the prognostic factors for the overall survival from a recurrence revealed that the metastatic number (single) (p=0.003), and the metastatic pattern(hematogenous metastasis) (p= 0.004), significantly improved prognosis.We conclude that radiotherapy is an option to extend prognosis in some recurrence cases.	esophagus
[Heavy ion radiotherapy for recurrence of an esophageal primary malignant melanoma].	A 55-year-old man, with a prior diagnosis of primary malignant melanoma of the esophagus, had undergone esophagectomy 6 years prior. During the postoperative follow-up, a flat tumor with black pigmentation, about 2 cm in diameter, was detected during upper gastrointestinal endoscopy. A pathological examination of the biopsy specimen showed a recurrent malignant melanoma. He underwent heavy ion radiotherapy for the tumor, and it disappeared after 6 months. Subsequently, a mediastinal lymph node metastasis was detected a year after radiotherapy. He received heavy ion radiotherapy for that tumor, and it was reduced in size a year after radiotherapy. At present, the patient is alive, 13 years after the initial radiotherapy. Although malignant melanoma is generally considered to be a radioresistant cancer, heavy ion radiotherapy led to a favorable outcome. This is the first reported case of heavy ion radiotherapy for treating the recurrence of a primary malignant melanoma of the esophagus.	esophagus
[A case of ARDS after esophagectomy treated with low-dose steroid therapy].	A 48-year-old woman was found to have an esophageal cancer, and after preoperative chemotherapy with cisplatin (CDDP)/5-fluorouracil (5-FU), radical subtotal esophagectomy was performed. On the fifth day after surgery, her respiratory condition suddenly worsened and a chest radiograph showed low permeability in both lung fields, leading to a diagnosis of acute respiratory distress syndrome (ARDS) and intubation for mechanical ventilation. Since clinical examination did not detect signs of infection on the seventh day, we began administering hydrocortisone at a dose of 300 mg. Her inflammatory response and respiratory condition improved by the next day and the dose of hydrocortisone was gradually reduced. The patient was extubated on the 13th day, administration of steroids was halted on the 22nd day, and she was discharged from the hospital on the 26th day. ARDS remains a refractory disease and no drug has proven to be effective in randomized controlled trials. The use of steroids for ARDS management remains controversial. Our present case suggests that low-dose steroids from an early stage in uninfected ARDS patients may improve prognosis.	esophagus
[Pulmonary embolism in esophageal cancer patients receiving neoadjuvant chemotherapy with CDDP and 5-FU].	We report our experience with 2 male patients (71 and 74 years old, respectively) with advanced esophageal cancer who exhibited pulmonary embolism during treatment with neoadjuvant chemotherapy with cisplatin (CDDP) and 5-fluorouracil (5- FU). The patients had no symptoms associated with pulmonary embolism. The pulmonary emboli were incidentally detected on computed tomography performed to assess the effect of chemotherapy. It was found that the pulmonary emboli were associated with the central venous catheter-associated thrombi. The pulmonary emboli were effectively treated with heparin in both patients. A recent meta-analysis showed that the risk of chemotherapy-associated venous thromboembolism was increased by 1.67-fold when CDDP was included in the chemotherapy regimen. The increased risk was proposed to be associated with CDDP-mediated endothelial cell injury, platelet activation, increased levels of coagulation factors, or renal damage. The pulmonary embolism in our cases may be ascribed to the central venous catheterization and the treatment with CDDP. A possible occurrence of venous thromboembolism should be kept in mind when CDDP is used, particularly with central venous catheterization, for the treatment of esophageal cancer.	esophagus
[A case of pneumatosis cystoides intestinalis after neoadjuvant chemotherapy for esophageal cancer].	A man in his 60s was diagnosed with esophageal cancer (T3, N0, StageII) and treated with 5-fluorouracil and cisplatin as neoadjuvant chemotherapy (NAC). On day 18 of the second NAC course, the patient developed febrile neutropenia, and a computed tomography (CT) scan showed pneumatosis cystoides intestinalis (PCI) of the ascending and transverse colon, free air around the ascending colon, thickening of the gallbladder wall, pleural effusion, and ascites. Because there were no signs of peritoneal irritation and intestinal perforation was ruled out, conservative treatment was selected. Seven days after PCI was diagnosed, CT showed improvement in PCI and the free air had disappeared, and 26 days after the diagnosis, a subtotal esophagectomy was performed. Observation of the abdomen did not show a thickened wall or stenosis of the ascending or transverse colon. PCI could be treated conservatively, even with free air in the abdominal cavity, by comprehensively assessing not only the imaging but also the physical findings. We were able to perform radical resection of the esophageal cancer without excessive treatment for PCI.	esophagus
[Stage IV small cell esophageal carcinoma that responded to various chemotherapeutic regimens with relative longevity - a case report].	Small cell carcinoma of the esophagus is reported to be both rare and aggressive, and is commonly associated with a short post-diagnosis survival period. We report a case of Stage IV small cell carcinoma of the esophagus involving a relatively long survival period of 2 years. The patient was a 70-year-old man with a chief complaint of epigastric discomfort. Upper gastrointestinal endoscopy by a local physician showed a protruding tumor at the mid-thoracic esophagus. Tumor biopsy revealed small cell carcinoma. Chest-abdominal computed tomography revealed multiple liver metastases, and swelling of a number of regional lymph nodes. The diagnosis was cT3N4M1, cStage IVb esophageal small cell carcinoma. According to the regimen used for lung small cell carcinoma, we administered CDDP/CPT-11. After administration of four courses, the primary lesion, liver metastases, and lymph node metastases significantly reduced, indicating a partial response. However, after completion of eight courses, liver metastasis and lymph node swelling recurred. The patient subsequently received other therapeutic regimens such as CBDCA/VP-16, AMR, NGT, and CDGP/5-FU. However, the tumor gradually progressed, and the patient died approximately 2 years after the first treatment.	esophagus
[A case of esophageal cancer with lung metastases successfully resected after chemotherapy].	Herein, we report a case of esophageal cancer with lung metastases that was successfully resected after chemotherapy. A 61-year-old man was diagnosed with a middle thoracic esophageal squamous cell carcinoma showing lung metastases. The clinical Stage diagnosis was T4NxM1, Stage IVb. After systemic chemotherapy with 1 course of cisplatin/5-fluorouracil (CDDP/5-FU)and 3 courses of nedaplatin/5-FU (CDGP/5-FU), lung metastases could not be detected by using computed tomography (CT). We added 2 courses of CDGP/5-FU, followed by 3 courses of docetaxel. The patient underwent esophagectomy and was alive without recurrence for 6 months after surgery.	esophagus
[Long-term survival of a patient with esophageal cancer with brain metastasis after multidisciplinary therapy - a case report].	A 70-year-old woman was admitted for difficulty in swallowing. Esophageal cancer (MtLt, type 3, T4N3M0, cStage IVa) was diagnosed in May 2010. The cancer was unresectable, and chemoradiotherapy (CRT) with TS-1 was initiated in June 2010, and a partial response (PR) was observed. After CRT, TS-1 was continued, but a brain metastasis was detected owing to the development of right hemiplegia in April 2012. Craniotomy and tumorectomy were performed, and the right hemiplegia improved. Pathological examination of the brain tumor indicated squamous cell carcinoma. Because of a recurrence of brain metastasis, a gamma knife procedure was performed in May 2012. Subsequently, several recurrences of brain metastases were diagnosed, and a total of 7 gamma knife procedures were performed up to January 2014. Although systemic chemotherapy (5-fluorouracil and cisplatin [FP], 5 courses)was administered, the patient showed progressive lung metastases in February 2013. The chemotherapy regimen was changed from FP to docetaxel (TXT), but the lung metastases continued to progress up to June 2013. The patient died in March 2014. Patients with esophageal cancer and metastases to the brain have poor prognosis, but the present patient survived approximately 2 years after first diagnosis of metastases to the brain after multidisciplinary therapy.	esophagus
[Analysis of thoracic esophageal squamous cell carcinoma with single lymph node metastasis].	BACKGROUND: We studied cases with single lymph node metastasis from thoracic esophageal squamous cell carcinoma. METHODS: We reviewed the site of nodal metastasis in 73 cases with a single metastatic site. RESULTS: The lymph node metastases of the upper thoracic cases were located in the cervical, superior mediastinal, middle mediastinal, lower mediastinal, and abdominal lymph nodes in 5, 10, 3, 0, and 0 cases, respectively. The lymph node metastases of the middle thoracic cases were located in the cervical, superior mediastinal, middle mediastinal, lower mediastinal, and abdominal lymph nodes in 1, 18, 6, 0, and 11 cases, respectively. The depth of tumor in the middle thoracic case that had metastasis in a cervical lymph node was T1b, and the location of the metastatic lymph node was number 104 L. The lymph node metastases of the lower thoracic cases were located in the cervical, superior mediastinal, middle mediastinal, lower mediastinal, and abdominal lymph nodes in 0, 2, 2, 4, and 11 cases, respectively. The depth of tumor in the lower thoracic cases with metastasis in a superior mediastinal lymph node was T1b and T4. CONCLUSION: Even in superficial thoracic esophageal squamous cell carcinoma cases, distant metastasis was observed at an early stage. Therefore, the range of lymph node dissection should be decided carefully in these cases.	esophagus
[Continuous dissection of the posterior mediastinal and abdominal lymph nodes using a laparoscopic transhiatal approach for esophageal cancer].	We began performing laparoscopic transhiatal esophagectomies in patients with esophageal cancer in 2009. By June 2014, 172 patients had undergone this procedure. The main advantage of this method was that the dissection of the posterior mediastinal and abdominal lymph nodes(LNs)could be performed continuously under a magnified videoscopic view. An abdominal wall sealing device was placed in the upper abdomen, and 4 ports were inserted. The esophageal hiatus was opened, and carbon dioxide was introduced into the mediastinum. The posterior plane of the pericardium was separated and extended, and the anterior side of each posterior mediastinal LN was separated. The thoracic aorta's adventitia was exposed, and the posterior sides of the LNs were then separated. While lifting the LNs like a membrane, they were resected along the border of the left mediastinal pleura. Subsequently, dissection of the posterior mediastinal LNs was extended towards the caudal side from the crural diaphragm to the celiac artery. Thus, the LNs along the celiac and left gastric artery were dissected en bloc from the left side. Our surgical procedure allowed good views during surgery, and the continuous dissection of the posterior mediastinal and abdominal LNs was performed safely.	esophagus
[Self-expanding antireflux stents for malignant esophageal stenosis - a report of three cases].	Use of a standard open stent or self-expanding metal stent for patients with malignant dysphagia is associated with a risk of gastroesophageal reflux especially when placed across the esophagogastric junction. We report 3 cases of malignant esophageal stenosis treated with a long cover-type Niti-STM stent with an antireflux mechanism. Case 1: A 87-year-old man presented with dysphagia due to esophageal cancer at the middle thoracic esophagus. Two months after surgery using a standard open stent, the dysphagia relapsed because of tissue overgrowth. Case 2: A 73-year-old woman presented with lung cancer and severe dysphagia due to enlarged mediastinal lymph nodes. Case 3: A 66-year-old man presented with dysphagia due to esophageal cancer at the lower thoracic esophagus. All 3 patients received an antireflux stent across the esophagogastric junction. In cases 1 and 2, dysphagia was relieved immediately without complications. In case 3, the patient experienced severe reflux and chest pain associated with stent placement and could not ingest any solid food. We conclude that the antireflux stent may be useful for palliation in patients with severe malignant esophageal obstruction; however, patients should be informed about the risk of failure to prevent reflux.	esophagus
[Lymphadenectomy performed along the left recurrent laryngeal nerve after anterior detachment of the esophagus via thoracoscopic esophagectomy in the prone position under artificial pneumothorax].	Thoracoscopic esophagectomy was performed in the prone position under artificial pneumothorax and did not affect the surgical area during lung ventilation; tracheal mobility was also improved. Lymphadenectomy around the left recurrent laryngeal nerve was performed by separating the left main bronchus and trachea between the esophagus and pericardium before detaching the dorsal side of the esophagus.	esophagus
Efficacy of dendritic cell-cytokine-induced killer immunotherapy plus intensity-modulated radiation therapy in treating elderly patients with esophageal carcinoma.	We investigated the clinical efficacy of adoptive cytokine-induced killer (CIK) cell and dendritic cell (DC) therapy plus intensity-modulated radiation therapy (IMRT) for treating elderly patients with esophageal carcinoma (EC). In total, 68 elderly patients with EC were randomized to receive IMRT plus DC-CIK immunotherapy (study group, N = 34) or IMRT only (control group, N = 34). Clinical efficacy, immune function, toxicity and side effects, and life quality were evaluated after treatment. The efficacy rate was significantly higher in the study group than in the control group. Remarkable increases were noted for quality of life and immune function in the study group relative to the control group. Regarding toxicity and side effects, compared with the control group, the study group displayed a higher fever rate, a lower incidence rate of bone marrow suppression, and a similar rate of digestive tract reactions. DC-CIK immunotherapy plus IMRT exhibited better short-term efficacy than IMRT alone in elderly patients with EC. The therapy could improve patients'quality of life and immune function, decrease bone marrow suppression, and lengthen survival time.	esophagus
External validation of the Ferguson pulmonary risk score for predicting major pulmonary complications after oesophagectomy†.	OBJECTIVES: Pulmonary complications remain a frequent cause of morbidity in patients undergoing oesophagectomy. Risk screening tools assist in patient stratification. Ferguson proposed a risk score system to predict major pulmonary complications after oesophagectomy. Our objective was to externally validate this risk score system. METHODS: We analysed our institutional database for patients undergoing oesophagectomy for cancer from August 2009 to December 2012. We analysed patients who had complete documentation of variables used in the Ferguson risk score calculation: forced expiratory volume in the 1 s, diffusion capacity of the lung for carbon monoxide, performance status and age. One hundred and thirty-six patients qualified for analysis in the validation study. Outcome variables measured included major pulmonary complications, defined as need for reintubation for respiratory failure and pneumonia. The risk score was then calculated for each individual based on the model. Incidence of major pulmonary events was assessed in the five risk class groupings to assess the discriminative ability of the Ferguson score. RESULTS: Major pulmonary complications occurred in 35% of patients (47/136). Overall mortality was 6% (8/136). Patients were grouped into five risk categories according to their Ferguson pulmonary risk score: 0-2, 8 patients (6%); 3-4, 24 patients (18%); 5-6, 49 patients (36%); 29 patients (21%); 9-14, 26 patients (19%). The incidence of major pulmonary complications in these categories was 0, 17, 20, 41 and 77%, respectively. The accuracy of the risk score system for predicting major pulmonary complications was 76% (P < 0.0001). CONCLUSIONS: This pulmonary risk scoring system is a reliable instrument to be used during the preoperative phase to differentiate patients who may be at higher risk for pulmonary complications after oesophagectomy. These data can assist in patient selection, and in patient education/informed consent and can guide postoperative management.	esophagus
Androgen receptor promotes esophageal cancer cell migration and proliferation via matrix metalloproteinase 2.	Esophageal squamous cell carcinoma (ESCC) is one of the most common malignancies worldwide. Androgen receptor (AR) plays an important role in many kinds of cancers. However, the molecular mechanisms of AR in ESCC are poorly characterized. In the present study, Western blot analysis and real-time quantitative PCR were performed to identify differentially expressed AR in 40 ESCC tissue samples, which revealed that the messenger RNA (mRNA) and protein expression of AR is upregulated in the ESCC tissue samples. AR overexpression induced increases in ESCC cell invasion and proliferation in vitro. Silencing of AR inhibited the proliferation of KYSE450 cells which have a relatively high level of AR, and the invasion of KYSE450 cells was distinctly suppressed. Furthermore, AR knockdown led to substantial reductions in matrix metalloproteinase 2 (MMP2) and p-AKT levels in ESCC cell lines, but no significant change in AKT and MMP9 expression. These results suggest that AR is involved in tumor progression, and thus, AR could represent selective targets for the molecularly targeted treatments of ESCC.	esophagus