crossing96/oncoscreening huggingface dataset:
Neoadjuvant paclitaxel poliglumex, cisplatin, and radiation for esophageal cancer: a phase 2 trial.	PURPOSE: To evaluate the pathologic complete response (CR) rate and safety of paclitaxel poliglumex (PPX), cisplatin, and concurrent radiation for patients with esophageal cancer. PATIENTS AND METHODS: Patients with adenocarcinoma or squamous cell carcinoma of the esophagus or gastroesophageal junction with no evidence of distant metastasis received PPX (50 mg/m(2)/wk) and cisplatin (25 mg/m(2)/wk) for 6 weeks with 50.4 Gy concurrent radiation. Six to eight weeks after completion of chemoradiotherapy, patients underwent surgical resection. RESULTS: Forty patients were enrolled, 37 patients with adenocarcinoma and 3 patients with squamous cell cancer. The treatment-related grade 3 nonhematologic toxicities included esophagitis (7%), nausea (7%), and fatigue (5%). Three patients with clinical endoscopic CR (2 with squamous cell cancer) refused surgery. Twelve of the remaining 37 patients (32%) had a pathologic CR. The 12 patients with pathologic CR all had adenocarcinoma. CONCLUSION: PPX, cisplatin, and concurrent radiation are well tolerated, easily administered regimen for esophageal cancer with a low incidence of significant esophagitis and a high pathologic CR rate consistent with the preclinical data of PPX and radiation.	esophagus
Stents for proximal esophageal cancer: a case-control study.	BACKGROUND: Self-expandable metal stents (SEMSs) are an established palliative therapy for esophageal cancer. SEMS placement for cancers near the upper esophageal sphincter (UES) is controversial because of a perceived increased risk of complications. OBJECTIVE: To compare outcomes after patients stented for proximal esophageal cancer (PC) and distal esophageal cancer (DC). DESIGN: Matched case-control study from a prospective database. SETTING: Tertiary referral center, Tenwek Hospital, Bomet, Kenya. PATIENTS: All patients with PC located within 6 cm of the UES were matched with randomly selected controls with DC. INTERVENTIONS: Outcomes of PC cases were compared with those of DC controls. MAIN OUTCOME MEASUREMENTS: Dysphagia score, complications, median survival. RESULTS: A total of 151 patients with PC were identified and were randomly matched with DC controls. Ninety-three case-control pairs had adequate follow-up information available. Mean dysphagia scores (scale 0-4) improved from 3.4 and 3.3 before stenting for PC and DC, respectively, to 1.5 after stenting for both groups (P = .93). Early complications occurred in 6.5% of PC cases and 9.7% of DC controls (P = .44). Late complications occurred in 20.4% of PC cases and 15.1% of DC controls (P = .25). Median survival was 210 days for PC cases and 272 days for DC controls (P = .25). Outcomes were similar for the subgroup of PC cases whose cancer extended to within 2 cm of the UES. LIMITATION: An important limitation is the absence of adequate follow-up data for 58 of the 151 case-control pairs. CONCLUSIONS: SEMSs effectively palliate dysphagia in PC cases, whereas complication and survival rates are not statistically different from those of DC controls.	esophagus
Effect of oral prednisolone on esophageal stricture after complete circular endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: a case report.	A 74-year-old man with nausea underwent upper gastrointestinal endoscopy, and a 0-IIb type tumor was found in the middle thoracic esophagus. Histological examination with endoscopic biopsies revealed squamous cell carcinoma (SCC), and chromoendoscopy with iodine staining revealed that the superficial SCC involved nearly the entire circumference of the esophageal lumen. There were neither nodal nor distant metastases. Complete circular endoscopic submucosal dissection (ESD) was successfully achieved with tumor-free margins in an en bloc fashion. The histopathological examination confirmed a diagnosis of intramucosal invasive carcinoma limited to the lamina propria mucosae without angiolymphatic invasion. Oral prednisolone was started with 0.5 mg/kg daily on the 3rd post-ESD day, tapered gradually, and then discontinued 8 weeks later without adverse effects. There were no complaints of dysphagia following ESD. On follow-up endoscopy with iodine staining, which was scheduled at 1, 3 and 6 months after ESD, there was no postprocedural esophageal stricture, and neither recurrent nor metachronous lesions were found. Thus, the patient required no sessions of endoscopic balloon dilatation. At the last outpatient clinic visit 7 months after ESD, he remained well without dysphagia. Oral prednisolone administration may offer an effective therapeutic strategy to prevent the post-ESD esophageal stricture after complete circular ESD.	esophagus
Mutations in Fanconi anemia genes and the risk of esophageal cancer.	The incidence of esophageal squamous cell carcinoma (ESCC) is very high in northeastern Iran. Previously, we reported a strong familial component of ESCC among Turkmens, who constitute approximately one-half of the population of this region. We hypothesized that the genes which cause Fanconi anemia might be candidate genes for ESCC. We sequenced the entire coding regions of 12 Fanconi anemia genes in the germline DNA of 190 Turkmen cases of ESCC. We identified three heterozygous insertion/deletion mutations: one in FANCD2 (p.Val1233del), one in FANCE (p.Val311SerfsX2), and one in FANCL (p.Thr367AsnfsX13). All three patients had a strong family history of ESCC. In addition, four patients (out of 746 tested) were homozygous for the FANCA p.Ser858Arg mutation, compared to none of 1,373 matched controls (OR = 16.7, 95% CI = 6.2-44.2, P = 0.01). The p. Lys3326X mutation in BRCA2 (also known as Fanconi anemia gene FANCD1) was present in 27 of 746 ESCC cases and in 16 of 1,373 controls (OR = 3.38, 95% CI = 1.97-6.91, P = 0.0002). In summary, both heterozygous and homozygous mutations in several Fanconi anemia-predisposing genes are associated with an increased risk of ESCC in Iran.	esophagus
Primary placement technique of jejunostomy using the entristar™ skin-level gastrostomy tube in patients with esophageal cancer.	BACKGROUND: We developed a skin-level jejunostomy tube (SLJT) procedure for patients undergoing esophagectomy using a skin-level gastrostomy tube (G-tube) (Entristar™; Tyco Healthcare, Mansfield, Mass), in order to improve their nutrition status and quality of life (QOL). We describe the procedure and the adverse effects of SLJT in patients with esophageal cancer (EC). METHODS: Over a 24-month period (March 2008 to March 2010), there were 16 patients (mean age: 61.8 years; age range: 49-75 years; 15 men, 1 woman) who had Stage II or III EC. Primary jejunostomy was performed under general anesthesia during esophagectomy. The technical success and the immediate and delayed complications of the procedure were recorded. JEJUNOSTOMY TECHNIQUES: SLJT placement using the G-tube (20Fr) was performed 20 cm from the Treitz ligament on the side opposing the jejunal mesenterium. The internal retention bolster was exteriorized through an incision in the abdominal wall. A single purse string suture using a 4-0 absorbable suture was performed. The internal retention bolster was then inserted into the jejunal lumen via the small incision. The intestine adjacent to the tube was anchored to the peritoneum using a single stitch. RESULTS: The SLJT was successfully inserted in all 16 patients. No early complications were documented. Follow-up for a median of 107 days (range, 26-320 days) revealed leakage to the skin in four patients, including superficial wound infections in two patients. There were no cases of obstruction of the tube or procedure-related death. CONCLUSIONS: This SLJT placement technique using the G-tube is a safe procedure in patients with EC and allows the creation of a long-term feeding jejunostomy.	esophagus
Correlation between endoscopic macroscopic type and invasion depth for early esophagogastric junction adenocarcinomas.	BACKGROUND: Although correlations between endoscopic macroscopic type and tumor depth have been reported for superficial esophageal squamous cell carcinoma and early gastric and early colorectal adenocarcinomas, there is no published study investigating the correlation between endoscopic macroscopic type and invasion depth for mucosal (M) and submucosal (SM) adenocarcinomas located at the esophagogastric junction (EGJ). We decided to analyze, therefore, the relationship between endoscopic macroscopic type and tumor depth for such cancers. METHODS: We retrospectively reviewed 73 early EGJ adenocarcinomas (M/SM = 33/40; differentiated/undifferentiated type = 70/3) in 73 consecutive patients treated endoscopically and/or surgically between January 2000 and December 2008. The mean age of the patients was 63.9 years (range 37-85 years) and the male/female ratio was 62:11. EGJ adenocarcinoma was defined as junctional carcinoma (type II) according to the Siewert classification. RESULTS: We found polypoid type lesions (0-I) in 14 patients, non-polypoid type without mixed type (0-IIa, 0-IIb, or 0-IIc) in 39, and mixed type (0-IIa + IIc or 0-IIc + IIa) in 20 patients. Non-polypoid type without mixed type (31%; 12/39) lesions had a significantly lower risk for SM invasion compared to polypoid type (79%; 11/14; p < 0.01) and mixed type (85%; 17/20; p < 0.01) lesions. In polypoid type lesions, the risk of SM invasion was significantly lower for the pedunculated subtype (0-Ip) than for the sessile subtype (0-Is) lesions (0%; 0/2 vs. 92%; 11/12; p < 0.05). M lesions (mean size 14.5 ± 7.5 mm) were significantly smaller than SM lesions (24.5 ± 7.7 mm; p < 0.01). CONCLUSIONS: Determination of endoscopic macroscopic type may be useful in accurately diagnosing early EGJ adenocarcinoma invasion depth.	esophagus
Expression of the sperm fibrous sheath protein CABYR in human cancers and identification of α-enolase as an interacting partner of CABYR-a.	Calcium-binding tyrosine phosphorylation regulated protein (CABYR), a family of isoforms resulting from alternative splicing, has been identified as a cancer/testis antigen (CT88) in lung cancer and hypothesized to be a promising target for immunotherapy. Here, we report the expression of CABYR in various cancer tissues/cell lines. Expression profiles of individual isoforms were different among cancers. Furthermore, protein and mRNA levels did not correlate for individual isoforms. While CABYR-c/d were the most abundant splicing variants, CABYR-a was the predominant protein isoform. Finally, CABYR-a, but not CABYR-c, was found to interact with α-enolase in vivo. Collectively, the data indicate that CABYR is a CT antigen widely expressed in diverse cancer cells. However, individual protein isoforms may be differentially regulated by post-transcriptional and post-translational mechanisms and may have a unique role in carcinogenesis. The protein expression pattern of various CABYR isoforms is important with regard to the consideration of using CABYR as a target antigen for the development of vaccines for cancer therapy.	esophagus
Overexpression of Interleukin-6 suppresses cisplatin-induced cytotoxicity in esophageal squamous cell carcinoma cells.	Interleukin-6 (IL-6) expression at local tumor sites or in systemic circulation is associated with disease progression and poor prognosis of esophageal cancer. The aim of this study was to investigate the possible influence of IL-6 on biological activities of esophageal cancer cells in terms of chemosensitivity. Human esophageal cancer cell lines TE13 and KYSE170 were transfected with a plasmid vector expressing IL-6 and stable transfectants overexpressing IL-6 were thus established. The sensitivity of IL-6 transfectants to cisplatin was evaluated using a WST-8 assay and cell-cycle analysis. In addition, the inhibitory effects of IL-6-specific siRNAs were investigated. IL-6 transfectants showed significantly reduced sensitivity to cisplatin compared to control transfectants. In addition, the reduced cisplatin sensitivity of IL-6 transfectants was restored by pretreatment with IL-6-specific siRNA. These results suggest that intracellular IL-6 expression in tumor cells may acts as a resistance factor against cisplatin-based treatments for esophageal cancer.	esophagus
Do we still need EUS in the workup of patients with early esophageal neoplasia? A retrospective analysis of 131 cases.	BACKGROUND: EUS is often used for locoregional staging of early esophageal neoplasia. However, its value compared with that of endoscopic examination and diagnostic endoscopic resection (ER) may be questioned because diagnostic ER allows histological assessment of submucosal invasion and other risk factors for lymph node metastasis, eg, poor differentiation/lymphovascular invasion. OBJECTIVE: To evaluate how often patients were excluded from endoscopic treatment of esophageal neoplasia based on EUS findings. DESIGN: Retrospective cohort study. SETTING: Tertiary care institution. PATIENTS: Patients with early esophageal neoplasia. INTERVENTIONS: EUS, diagnostic ER. MAIN OUTCOME MEASUREMENTS: Number of patients excluded from endoscopic treatment based on EUS results. RESULTS: A total of 131 patients were included (98 men, 33 women; age 66 ± 13 years). In 105 of 131 patients (80%), EUS findings were unremarkable. In 25 of 105 patients (24%), diagnostic ER showed submucosal invasion (n = 17), deep resection margins positive for cancer (n = 2, confirmed at surgery), or poor differentiation/lymphovascular invasion (n = 6). In 26 of 131 patients (20%), EUS findings raised the suspicion of submucosal invasion and/or lymph node metastasis. In the 14 of 26 patients (54%) with abnormal EUS findings, endoscopy results were unremarkable. Diagnostic ER showed submucosal invasion in 7 of 14 (50%) patients, whereas no lymph node metastasis risk factors were found in 7 of 14 patients (50%), who subsequently underwent curative endoscopic treatment. In 12 of 26 patients (46%) with abnormal EUS, endoscopy also raised doubts on whether curative endoscopic treatment could be achieved. After diagnostic ER, no risk factors for lymph node metastasis were found in 3 of 12 patients (25%). LIMITATION: Retrospective study. CONCLUSIONS: This study shows that EUS has virtually no clinical impact on the workup of early esophageal neoplasia and strengthens the role of diagnostic ER as a final diagnostic step.	esophagus
GROβ and its downstream effector EGR1 regulate cisplatin-induced apoptosis in WHCO1 cells.	Cisplatin is one of the most widely used chemotherapeutic agents employed for treatment of a wide variety of solid tumors, including human esophageal squamous cell carcinoma (ESCC). However, a major limitation of cisplatin-based chemotherapy of ESCC is the rather low-effective rate. Understanding the molecular events of limited efficacy of cisplatin-based chemotherapy of ESCC could lead to strategies resulting in improved therapeutic benefits. The CXC chemokine family has been reported to be related to inflammatory reaction, injure recovery, cell proliferation, apoptosis and even to be involved in the regulation of chemotherapeutic agent-induced apoptosis. CXCL2 chemokine, also known as GROβ (growth-related gene product β), belongs to the CXC chemokine group. The known functions of GROβ are related to attracting neutrophils to sites of inflammation, modulation of the neurotransmitter release, cell proliferation and apoptosis. However, little is known about the relationship between GROβ and chemotherapeutic agent-induced apoptosis. This study was designed to provide insights into the possible role of GROβ in the regulation of cisplatin-induced apoptosis in ESCCs. We report here that inhibition of expression of GROβ can decrease cisplatin-induced apoptosis in WHCO1 cells. EGR1 is a downstream factor regulated by GROβ. Silencing expression of EGR1 can also decrease cisplatin-induced apoptosis in WHCO1 cells. The activation of caspase 9 was delayed in cells in which GROβ and EGR1 were knocked down after cisplatin treatment. All these results indicate that GROβ and its downstream factor EGR1 are involved in regulating cisplatin-induced apoptosis in WHCO1 cells, and during this process the intrinsic apoptotic pathway is activated. It may be useful to examine the expression levels of GROβ and EGR1 in ESCC patients to select those likely to respond well to cisplatin.	esophagus
Her-2/neu gene amplification in esophageal adenocarcinoma and its influence on survival.	BACKGROUND: HER-2/neu (c-erbB-2, HER2) gene amplification and protein overexpression have been associated with poor prognosis in several solid tumors, including breast and gastric cancer. Its incidence and significance in esophageal adenocarcinoma is unknown. MATERIALS AND METHODS: Tissue microarrays were successfully constructed from 89 paraffin-embedded archival specimens of esophageal adenocarcinomas for HER2 gene amplification by silver-enhanced in situ hybridization (SISH). No patients had undergone neoadjuvant therapy. Protein overexpression was tested with immunohistochemistry (IHC) using automated immunostaining (Ventana Benchmark). Incidence of HER2 positivity, correlation to clinicopathological variables in esophageal cancer patients, and concordance between SISH and IHC were determined. RESULTS: True HER2 gene amplification was detected in 14 esophageal cancer specimens (16%), and 92% of those with high-level HER2 amplification showed positive HER2 protein overexpression. No significant associations were found among gene amplification and clinicopathological factors. The 5-year survival rates were 57% for esophageal cancer patients with HER2 amplification compared with 32% without, but the difference in overall survival was not significant (P = .37). The correlation between SISH and IHC was statistically significant (P < .0001). CONCLUSION: While molecular targeting may be possible for approximately 16% of esophageal adenocarcinoma patients, HER2 oncogene amplification did not influence survival in this study.	esophagus
From GERD to Barrett's esophagus: is the pattern in Asia mirroring that in the West?	Gastroesophageal reflux disease (GERD) is a known predisposing factor for Barrett's esophagus. Amongst individuals with symptomatic GERD, the prevalence of Barrett esophagus is estimated to be more than 10%, and an individual with Barrett's esophagus is more likely than the general population to develop esophageal adenocarcinoma. In Western Europe and North America, incidence of esophageal adenocarcinoma had been on the upward trend for many decades. In comparison, although the prevalence of GERD and reflux esophagitis has increased several fold in some parts of Asia, the prevalence of esophageal adenocarcinoma and Barrett's esophagus remains generally low in the region. Rising incidence of esophageal adenocarcinoma has been observed in regions witnessing increasing prevalence of GERD. If the recent increase in prevalence of GERD in parts of urbanized Asia is any indication of the beginning of an upsurge in the incidence of Barrett's esophagus and associated adenocarcinoma, would we be witnessing a pattern of epidemiological shift mirroring that in the West? Given that more than 90% of Barrett's esophagus in Asian patients is of the short-segment type, which is reported to have lesser propensity to develop to adenocarcinoma, could the ongoing epidemiologic transition take Asia on the same trail as that which the West has taken? This article will draw on relevant findings from various parts of Asia and take an in-depth look at prevailing disease trends to see where Asia stands now in the changing epidemiology of GERD, Barrett's esophagus and associated adenocarcinoma.	esophagus
Small cell carcinoma of the esophagus: a report of 16 cases from a single institution and literature review.	BACKGROUND: The optimum treatment for small cell carcinoma of the esophagus (SCEC) has not been established. We reviewed our experience in the management of patients with SCEC. METHODS: The clinical data from 16 patients with SCEC were retrospectively collected with regard to demographics, use of tobacco or alcohol, presenting symptoms, tumor characteristics, staging, treatment, response, outcome, and survival. RESULTS: Of the 16 patients, 4 of 8 patients with limited disease underwent curative resection followed by adjuvant chemotherapy. Three patients are still alive at 221, 75, and 34 months after treatment with no evidence of disease. The other 4 patients with limited disease received chemotherapy with or without surgery, and all died of disease within 21 months after treatment. The other 8 patients had extensive disease at presentation. One of these patients had chemotherapy followed by surgery. The prognosis for this group of patients was poor. The median survival of all patients was 13.5 months (range, 4 days to 221 months). The median survival of patients with limited disease was 20.5 months (range, 5 to 221), whereas it was 4.5 months for patients with extensive disease (range, 4 days to 44 months). CONCLUSIONS: Small-cell carcinoma of the esophagus is a rare and highly malignant tumor with dismal prognosis. The treatment strategies for SCEC varied. Systemic chemotherapy should always be part of multimodality treatment. For patients with limited disease, curative resection followed by chemotherapy can provide long-term survival and can be considered as primary treatment for select patients.	esophagus
[The carotid artery as recipient vessel: troubleshooting for free jejunal transfer after esophagectomy in preradiated patients].	BACKGROUND: In the treatment of esophageal cancer neoadjuvant radiotherapy often leads to vascular damage of the usual recipient arteries for free jejunal transfer. End-to-side anastomosis to the carotid artery could be a potential alternative. PATIENTS AND METHODS: A total of 70 patients with locally advanced carcinoma of the esophagus underwent esophagectomy after neoadjuvant radiochemotherapy. In all patients reconstruction was carried out with a free jejunal transfer. Smaller vessels could be used for anastomoses in 54 of these patients and in 16 cases the jejunal flap artery was attached to the carotid artery. RESULTS: Out of 54 patients 9 (17%) with microvascular anastomoses to the smaller vessels needed surgical intervention for ischemia. In 16 patients with anastomosis to the carotid artery no significant failure of perfusion occurred. CONCLUSION: The carotid artery as recipient vessel in free jejunal transfer seems to be a safe therapeutic option for intestinal reconstruction of preradiated esophageal cancer with good functional results.	esophagus
Eight-year experience in esophageal cancer surgery.	AIM: Esophageal cancer remains a major and lethal health problem. In Nepal, not much has been explored about its management. The aim of this study was to conduct a retrospective review of esophageal cancer patients undergoing surgery or combined modality treatment at a cancer hospital in Nepal. MATERIALS AND METHODS: Resectable cases were treated primarily with surgery. Locally advanced cases with doubtful or obviously unresectability underwent preoperative chemo/radiation or chemoradiation followed by surgery. RESULTS: Among 900 patients, 103 were treated with curative intent. Mean age of patients was 54 years, and 100% of the patients presented with complaint of dysphagia. Surgery as a single modality of treatment was done in 57% of cases, and the remaining underwent combined modality treatment. Transthoracic and transhiatal approaches were used in 95% and 5% of cases, respectively. Nodal sampling, two-field (2-FD), and three-field lymphadenectomy (3-FD) were done in 18%, 59%, and 20% of cases, respectively. A majority of patients had pathological stage III disease (46.6%). In-hospitality mortality was 5%, and anastomotic leakage rate was 14%. In 87% of patients, R0 resection was achieved. Overall, 4-year survival was 20%. A R0 resection, early-stage disease and 3-FD favored the survival advantage (P < 0.05). CONCLUSION: The mortality, complication, and survival results were in the acceptable range. R0 resection and radical nodal dissection should be standard practice.	esophagus