crossing96/oncoscreening huggingface dataset:
Spatiotemporal Correlation Analysis for the Incidence of Esophageal and Gastric Cancer From 2010 to 2019: Ecological Study.	BACKGROUND: Esophageal and gastric cancer were among the top 10 most common cancers worldwide. In addition, sex-specific differences were observed in the incidence. Due to their anatomic proximity, the 2 cancers have both different but also shared risk factors and epidemiological features. Exploring the potential correlated incidence pattern of them, holds significant importance in providing clues in the etiology and preventive strategies. OBJECTIVE: This study aims to explore the spatiotemporal correlation between the incidence patterns of esophageal and gastric cancer in 204 countries and territories from 2010 to 2019 so that prevention and control strategies can be more effective. METHODS: The data of esophageal and gastric cancer were sourced from the Global Burden of Disease (GBD). Spatial autocorrelation analysis using Moran I in ArcGIS 10.8 (Esri) was performed to determine spatial clustering of each cancer incidence. We classified different risk areas based on the risk ratio (RR) of the 2 cancers in various countries to the global, and the correlation between their RR was evaluated using Pearson correlation coefficient. Temporal trends were quantified by calculating the average annual percent change (AAPC), and the correlation between the temporal trends of both cancers was evaluated using Pearson correlation coefficients. RESULTS: In 2019, among 204 countries and territories, the age-standardized incidence rates (ASIR) of esophageal cancer ranged from 0.91 (95% CI 0.65-1.58) to 24.53 (95% CI 18.74-32.51), and the ASIR of gastric cancer ranged from 3.28 (95% CI 2.67-3.91) to 43.70 (95% CI 34.29-55.10). Malawi was identified as the highest risk for esophageal cancer (male RR=3.27; female RR=5.19) and low risk for gastric cancer (male RR=0.21; female RR=0.23) in both sexes. Spatial autocorrelation analysis revealed significant spatial clustering of the incidence for both cancers (Moran I>0.20 and P<.001). A positive correlation between the risk of esophageal and gastric cancer was observed in males (r=0.25, P<.001). The ASIR of both cancers showed a decreasing trend globally. The ASIR for esophageal and gastric cancer showed an AAPC of -1.43 (95% CI -1.58 to -1.27) and -1.76 (95% CI -2.08 to -1.43) in males, and -1.93 (95% CI -2.11 to -1.75) and -1.79 (95% CI -2.13 to -1.46) in females. In addition, a positive correlation between the temporal trends in ASIR for both cancers was observed at the global level across sexes (male r=0.98; female r=0.98). CONCLUSIONS: Our study shows that there was a significant spatial clustering of the incidence for esophageal and gastric cancer and a positive correlation between the risk of both cancers across countries was observed in males. In addition, a codescending incidence trend between both cancers was observed at the global level.	esophagus
Multi-omics sequencing of gastroesophageal junction adenocarcinoma reveals prognosis-relevant key factors and a novel immunogenomic classification.	BACKGROUND: Gastroesophageal junction adenocarcinoma (GEJAC) exhibits distinct molecular characteristics due to its unique anatomical location. We sought to investigate effective and reliable molecular classification of GEJAC to guide personalized treatment. METHODS: We analyzed the whole genomic, transcriptomic, T-cell receptor repertoires, and immunohistochemical data in 92 GEJAC patients and delineated the landscape of genetic and immune alterations. In addition to COSMIC nomenclature, the de novo nomenclature was also utilized to define signatures and investigate their correlation with survival. A novel molecular subtype was developed and validated in other cohorts. RESULTS: We found 30 mutated driver genes, 7 novel genomic signatures, 3 copy-number variations, and 2 V-J gene usages related to prognosis that were not identified in previous study. A high frequency of COSMIC-SBS-384-1 and De novo-SV-32-A was associated with more neoantigen generation and a better survival. Using 19 molecular features, we identified three immune-related subtypes (immune inflamed, intermediate, and deserted) with discrete profiles of genomic signatures, immune status, and clinical outcome. The immune deserted subtype (27.2%) was characterized by an earlier KRAS mutation, worse immune reaction, and prognosis than the other two subtypes. The immune inflamed subtypes exhibited the highest levels of neoantigens, TCR/pMHC-binding strength, CD8 + T-cell infiltration, IFN-α/γ response pathways, and survival rate. CONCLUSIONS: These results emphasize the immune reaction and prognostic value of novel molecular classifications based on multi-omics data and provide a solid basis for better management of GEJAC.	esophagus
Structured surgical training in minimally invasive esophagectomy (MIE) increases textbook outcome-a risk-adjusted learning curve.	BACKGROUND: Minimally Invasive Esophagectomy (MIE) is a complex surgical procedure that has become a cornerstone in the management of esophageal cancer. This study aims to delineate the learning curve associated with MIE and its impact on patient outcomes. METHODS: A retrospective analysis was conducted on 191 patients who underwent MIE between 2015 and 2022. The cohort was divided into two groups according to the level of competence: Trainer (n = 100) and Trainee (n = 91). Patient demographics, tumor characteristics, and surgical parameters were examined. RA-CUSUM methodology was employed to monitor patient outcomes, adjusting for variations in risk profiles using varying-coefficient logistic regression models to establish the MIE proficiency learning curve. RESULTS: The trainee achieved competence in terms of operative time within 47 cases, following risk adjustment. Similarly, the learning curve in terms of major complications was completed after the 55th consecutive case. The LC was completed in terms of increased incidence of TO achievement in the trainee group after 83 cases (Trainer vs. Trainee, 27.00% vs. 40.66%, p = 0.046). Anastomotic leakage (Trainer vs. Trainee, 10.00% vs. 7.69% (p = 0.575)) could be identified with consistent rates for both trainer and trainee during the observational period. Pulmonary complications accounted for the majority of complications. After a follow-up of 2 years, no effect of the learning curve on overall (p = 0.436) or disease-free (p = 0.305) survival could be concluded, indicating consistent quality and patient safety during the surgical training. CONCLUSIONS: While technical competence can be achieved after approximately 55 cases, achievement of 'textbook outcome' (TO) requires 83 cases. The findings demonstrate that structured surgical training can progress in tandem while maintaining oncological safety for patients. While technical competence is crucial, the ultimate goal should be achieving a TO.	esophagus
Discussion on the mechanism of HER2 resistance in esophagogastric junction and gastric cancer in the era of immunotherapy.	Human epidermal growth factor receptor 2 (HER2) is a critical biomarker and therapeutic target in gastric/gastroesophageal junction (G/GEJ) cancers, despite the initial success of HER2-targeted therapies, such as trastuzumab, resistance to these drugs has emerged as a major impediment to effective long-term treatment. This review examines the mechanisms of drug resistance in HER2-positive G/GEJ cancer, the primary mechanisms of resistance explored include alterations in the HER2 receptor itself, such as mutations and changes in expression levels, as well as downstream signaling pathways, and interactions with the tumor microenvironment (TME). Furthermore, the review discusses the Novel therapeutic approaches, including the use of antibody-drug conjugates (ADCs) and combination therapies are assessed for their potential to enhance outcomes. By integrating recent research findings and clinical trials, this review aims to provide oncologists and researchers with insights into developing more effective treatments for patients with drug-resistant HER2-positive G/GEJ cancer.	esophagus
Surgical and long-term outcomes of combined organ resection for esophageal cancer invading adjacent organs: Experience of 90 consecutive cases.	OBJECTIVE: To evaluate the feasibility of and long-term survival with combined organ resection for esophageal cancer (EC). The optimal treatment strategy for EC that is invading adjacent organs is not established. METHODS: Ninety patients with EC invading adjacent organs who underwent combined organ resection after induction treatments during the time period 2003-2023 in our institute were eligible for the study. Short- and long-term outcomes were assessed, and survival analysis was performed to identify prognostic parameters in this cohort. RESULTS: Most patients had primary tumors (78.9% vs 21.1% with recurrent disease). The resected organs were the trachea/bronchus in 75.6%, large vessels in 24.4%, and both in 5.6%. All but 1 patient underwent chemotherapy or chemoradiotherapy as prior induction treatment, and had R0 resection. The overall complication rate (Clavien-Dindo grade II or greater) was 54.4%, and in-hospital mortality was 2.2% (30- and 90-day mortality: 0% and 2.2%, respectively). Of the deaths, 47 (87.0%) were attributed to EC and 7 (13.0%) to other causes. Median disease-free survival was 6.5 months, and overall survival (OS) was 18.9 months. The 2-year OS values were 47.2% with trachea/bronchus resection, 38.4% with large-vessel involvement, and 37.5% if both were involved. Univariate analysis of OS demonstrated significant associations of operation time (hazard ratio [HR], 2.11; P = .0080), blood loss (HR, 2.85; P = .0003), all-layer tracheal resection (HR, 3.51; P = .0045), ypT (HR, 2.04; P = .022), and pathologic response (HR, 2.77; P = .0089). CONCLUSIONS: If patient selection is highly selected, combined organ resection may be a feasible and promising option as a part of the multidisciplinary treatment for EC invading an adjacent organ.	esophagus
Immunonutrition to improve the quality of life of upper gastrointestinal cancer patients undergoing neoadjuvant treatment prior to surgery (NEOIMMUNE): double-blind randomized controlled multicenter clinical trial.	BACKGROUND: Malnutrition is common with esophagogastric cancers and is associated with negative outcomes. We aimed to evaluate if immunonutrition during neoadjuvant treatment improves patient's health-related quality of life (HRQOL) and reduces postoperative morbidity and toxicities during neoadjuvant treatment. METHODS: A multicenter double-blind randomized controlled trial (RCT) was undertaken. Included patients had untreated nonmetastatic esophagogastric tumor, aged 18 ≥ years with a life expectancy of >3 months. The study was powered for 80% power to detect a clinically relevant difference in EORTC-QLQC30 with standard deviation of 15 between groups. Primary end point was the quality of life as measured by the global health status at 30 days after surgery. An intention-to-treat analysis was employed. RESULTS: The study was terminated at the interim analysis stage. About 300 patients were randomized: 149 to the IMPACT group and 151 to the control-formula group. Patient groups were well-balanced in terms of age, sex, body mass index, WHO performance status, and clinical tumor stage. Analysis of the primary end point for the study of global health status at 30-day postoperatively failed to show any significant differences between the groups (55.4 ± 18.6 [IMPACT] vs. 55.9 ± 19.8 [control]; P = 0.345). No significant differences between the groups were detected in the majority of domains from EORTC QLQC30 and OG25 tools after neoadjuvant therapy and 30 days postoperatively. Finally, no significant differences were seen between groups in neoadjuvant therapy or postoperative complications, or tumor response. CONCLUSION: The results of this multicenter double-blind RCT fail to demonstrate any HRQOL benefits to the utilization of immunonutrition during neoadjuvant therapy in patients with esophagogastric cancer.	esophagus
SUMO-Specific Peptidase 5 Promotes Oesophageal Squamous Cell Carcinoma Growth through the NF-κB-SLC1A3 Axis.	BACKGROUND: This study investigates the role of small ubiquitin-like modifier (SUMO)-specific peptidase 5 (SENP5), a key regulator of SUMOylation, in esophageal squamous cell carcinoma (ESCC), a lethal disease, and its underlying molecular mechanisms. METHODS: Differentially expressed genes between ESCC mouse oesophageal cancer tissues and normal tissues were analysed via RNA-seq; among them, SENP5 expression was upregulated, and this gene was selected for further analysis. Immunohistochemistry and western blotting were then used to validate the increased protein level of SENP5 in both mouse and human ESCC samples. The Kaplan‒Meier method and multivariate analysis were used to analyse the relationship between SENP5 expression and ESCC prognosis. Stable SENP5-knockdown (KD) cell lines and conditional knockout (cKO) mice were established to verify the biological function of SENP5. Further RNA-seq comparisons between short hairpin SENP5 (shSENP5)- and short hairpin negative control (shNC)-transfected ESCC cell lines were conducted, and the nuclear factor kappa B (NF-κB)-SLC1A3 axis was identified through bioinformatics analysis. The correlation of SENP5 with signalling pathway components was validated via real-time quantitative PCR (qPCR), western blotting (WB), and immunoprecipitation. RESULTS: Our study revealed that SENP5 was upregulated in human and mouse ESCC samples, and clinical data analysis revealed a correlation between high SENP5 expression and poor patient prognosis. SENP5 knockdown inhibited tumorigenesis and growth in vivo and suppressed the proliferation, migration, and invasion of ESCC cell lines in vitro. Our study also revealed that SENP5 knockdown enhanced the SUMO1-mediated SUMOylation of NF-kappa-B inhibitor alpha (IκBα), thereby inhibiting the activation of the NF-κB-SLC1A3 axis, which subsequently suppresses ESCC cell energy metabolism and impedes ESCC progression. CONCLUSIONS: Suppression of SENP5 slows the development of ESCC by inhibiting the NF-κB‒SLC1A3 axis through SUMO1-mediated SUMOylation of IκBα. Our research suggests that SENP5 could serve as a prognostic indicator and a target for therapeutic intervention for ESCC patients.	esophagus
Individualized symptom experience and predictors in cancer patients after oesophagectomy: A latent profile analysis.	"PURPOSE: In the care for oesophageal cancer, symptom assessment was mainly carried out from the perspective of the total score using scales, which ignored individual differences in symptom experience among patients. To provide personalized symptom management, individual differences among patients with oesophageal cancer warranted further investigation. The objective was to identify the different symptom profiles of patients after oesophagectomy and examine the risk factors affecting the symptom profiles. METHODS: It was a descriptive study with cross-sectional design. A total of 258 participants were recruited. Latent profile analysis was used to identify different profile of symptoms, and multiple logistic regression was used to identify risk factors. RESULTS: Three distinct profiles were identified: the ""complex symptoms group"" (32.6%), the ""throat symptoms group"" (25.2%), and the ""single fatigue group"" (42.2%). Patients with higher prognostic nutritional index (OR = 0.797), higher resilience scale score (OR = 0.907), living in city or town (OR = 0.396), and stage II cancer (OR = 0.413) were more likely to be classified as ""single fatigue group"". Patients with higher prognostic nutritional index (OR = 1.233) and cervical anastomosis (OR = 4.586) tended to be classified as the ""throat symptoms group"". Unemployed patients (OR = 0.204) tended to belong to the ""complex symptoms group,"" whereas patients with higher prognostic nutritional index were less likely to be in the ""complex symptoms group."" CONCLUSION: Individual differences existed in the symptom experience of patients undergoing surgery for oesophageal cancer. Precise symptom management programs should be designed and implemented according to the individualized characteristics of the patient's symptom experience to promote patients' recovery."	esophagus
Ex vivo intravascular methylene blue instillation in oesophagectomy and gastrectomy specimens and its implication in tumour histopathological assessment.	Surgical resection and lymphadenectomy are the mainstay of curative treatment for oesophagogastric cancer. In this study we evaluate the results of intravascular methylene blue injection into oesophagectomy and gastrectomy specimens as a tool to increase lymph node detection. A prospective and descriptive study was run on 24 patients (11 oesophagus, 13 stomach cases). The most frequent histological type was adenocarcinoma (oesophagus 29.2%, stomach 90.9%). All patients with oesophageal cancer received neoadjuvant treatment, compared to 8 with gastric cancer. The anatomopathological analysis of oesophagectomies showed a median of 42 isolated nodes, compared to 46 in gastrectomies. In oesophageal cancer, a total of 8 (72.7%) patients did not show lymphatic involvement, whereas, in gastric cancer patients, 76.9% of patients had lymph nodes, with a median number of positive nodes of 3 (RIC = 0.5-7). Instillation of methylene blue enables a large number of nodes to be analysed and could therefore improve staging, treatment and prognosis for patients with oesophagogastric cancer.	esophagus
Prolonged vs standard thromboprophylaxis in patients with esophageal cancer undergoing surgery: a randomized controlled study.	BACKGROUND: Recent guidelines recommend prolonged thromboprophylaxis after esophagectomy due to cancer. However, to our knowledge, no previous studies have examined if prolonged prophylaxis is superior to standard in-hospital prophylaxis. OBJECTIVES: We aimed to perform the first clinical randomized study testing the efficacy of a prolonged 1-month thromboprophylaxis with low-molecular-weight heparin vs the standard treatment. METHODS: The study was an open-label, randomized, controlled trial including patients undergoing esophagectomy. The primary endpoint was the difference in prothrombin fragment 1 + 2 (F1 + 2) levels 1 month after surgery between the standard group and the intervention group. The secondary endpoints were the incidence of venous thromboembolic events and mortality. RESULTS: The study was terminated before reaching the expected sample size of 100 patients due to low accrual. We included 79 patients. At follow-up 1 month after surgery, F1 + 2 levels did not differ between the standard group and the intervention group (P = .41). Incidence of venous thrombosis was similar in the 2 groups, with 13% in the standard group and 15% in the intervention group. Preoperative F1 + 2 levels were significantly higher in patients who developed a venous thrombosis within 1 month after surgery than in those who did not (P = .01). The odds ratio of venous thromboembolism per 50 pmol/L increase in F1 + 2 was 1.64 (95% CI, 1.17-2.54). No patients died within 1 month after surgery. CONCLUSION: No benefit of prolonged thromboprophylaxis after esophagectomy was found. Preoperative F1 + 2 levels were found to be a predictor for the incidence of postoperative thromboembolism.	esophagus
Impact of APOBEC3s on the occurrence, development and prognosis of esophageal squamous cell carcinoma.	Esophageal squamous cell carcinoma (ESCC) is a severe malignant tumor of the digestive system that poses a significant threat to human health. Despite its significance, the complex molecular mechanism regulating the occurrence and development of ESCC remain elusive. The apolipoprotein B mRNA editing enzyme catalytic polypeptide-like 3 (APOBEC3) members constitute a pivotal subfamily of the APOBEC family that possess cytidine deaminase activity. In recent years, APOBEC3s (A3s) have received increasing attention due to their pivotal roles in the occurrence, development, and prognosis of ESCC. This comprehensive review systematically summarizes the latest research progress on the mechanisms of action of A3s in ESCC and discusses their impact on the development and therapeutic considerations for ESCC, with a particular focus on their potential role in immunotherapy. These insights may be of great value in continued exploration of ESCC pathogenesis and provides a theoretical foundation for the development of clinical treatment strategies for ESCC.	esophagus
[Health economic evaluation of minimally invasive surgery in treatment of digestive tract cancers: a Meta-analysis].	Objective: To compare minimally invasive surgery with traditional open surgery, analyze the current application status of health economic evaluations in the treatment of digestive tract cancers, such as esophageal cancer, gastric cancer, and colorectal cancer by minimally invasive surgery and provide evidence for the rational selection of clinical treatment, alleviation of disease-related economic burdens, and rational allocation of healthcare resources. Methods: By using five databases, i.e. China National Knowledge Infrastructure, Wanfang data, Chinese Biomedical Literature Database, PubMed, and Embase, a database was established to retrieve all the papers about health economic studies of minimally invasive surgery for esophageal cancer, gastric cancer, and colorectal cancer published until December 31, 2023. Literature was analyzed by using software NoteExpress 3.8, and data were processed using Excel 2021. The quality of included papers was evaluated using the CHEERS 2022 checklist, and Meta-analysis was conducted by using software Stata 17.0. Results: A total of 10 919 relevant papers were retrieved, and 59 studies were included. Only 14 studies (23.7%) used standard health economic evaluation methods. Meta-analysis results revealed no significant differences in direct medical expenditure and total expenditure between minimally invasive surgery and open surgery. However, the expenditure for minimally invasive surgery exhibited a significant increase [mean difference (MD)=5 973.12 yuan, P<0.001], while hospital stay and indirect expenditure significantly decreased (MD: -4.85 days and -733.79 yuan, P<0.001). In China, for gastric cancer, the direct medical expenditure of endoscopic surgery was lower than that of open surgery (MD=-33 000.00 yuan) with no significant difference (P<0.001). In colorectal cancer cases, the direct medical and surgical expenditures for laparoscopic surgery were higher than those for open surgery (MD: 4 277.94 yuan and 4 267.80 yuan, P<0.001), while the indirect and total medical expenditures decreased (MD: -768.34 yuan and -159.10 yuan). Hospital stays in patients who had minimally invasive surgery for all three types of cancer were shorter than those who had open surgery (P<0.001). Conclusions: In the treatment of gastrointestinal cancer, compared with open surgery, minimally invasive surgery shows higher expenditure, but has advantages, such as shorter hospital stay and lower indirect expenditure, and there were no significant differences in direct medical and total expenditures between the two approaches. When conducting health economic evaluation, factors such as postoperative complications, hospital stay, and patient's economic status should be considered for their impact on total medical expenditure. It is necessary to pay attention to the application of health economic evaluations in healthcare decision-making.	esophagus