crossing96/oncoscreening huggingface dataset:
Histological type of esophageal cancer might affect response to neo-adjuvant radiochemotherapy and subsequent prognosis.	BACKGROUND: This study investigates response and prognosis after neo-adjuvant chemoradiation (CTx/RTx) in patients with advanced esophageal carcinoma, according to histological type. PATIENTS AND METHODS: Patients with uT3 carcinoma of the esophagus treated with curative-intention esophagectomy from 1997 until 2006 were included in this retrospective analysis. Patients receiving preoperative CTx/RTx (5-fluorouracil, cisplatin, 36 Gy) were compared with those with primary surgery for pT3 tumors. Therapy response after CTx/RTx was evaluated using 'Cologne Regression Grade' (minor response: >or=10% vital residual tumor cells (VRTCs), major response: <10% VRTC or pathologic complete response). Prognosis was evaluated for adenocarcinoma (AC) and squamous cell carcinoma (SCC). RESULTS: Of 297 patients, 52% were SCC and 48% AC. In all, 192 patients underwent CTx/RTx, 100 (65%) SCC and 92 (64%) AC (nonsignificant). In SCC group 51% and in AC group 29% achieved major response (P < 0.01). Patients with major response had a 2-year survival rate (2y-SR) of 78% versus those with minor response or without CTx/RTx, with a 2y-SR of 45% (P = 0.001). Examining patients with major response exclusively, the prognosis of AC (2y-SR 85%) is better than that of SCC (2y-SR 54%) (P < 0.01). CONCLUSION: This retrospective study concludes that in esophageal tumors, response to and prognosis after neo-adjuvant CTx/RTx vary according to histology.	esophagus
Comparison of primary and metastatic malignant melanoma of the esophagus: clinicopathologic review of 10 cases.	CONTEXT: Primary esophageal melanoma (PEM) is a rare disease and is difficult to distinguish from other esophageal malignancies and from metastatic melanoma. OBJECTIVE: To develop diagnostic criteria for PEM, we compared the clinicopathologic features of 5 PEMs and 5 metastatic melanomas to esophagus. DESIGN: Ten cases of esophageal melanoma, including 4 surgically resected specimens, 2 autopsy cases, and 4 cases reported on mucosal biopsies, were reviewed. The histologic parameters used in this study were well-characterized features for cutaneous melanoma, including junctional component (in situ melanoma), radial growth phase, modified Breslow thickness, depth of invasion, lymphovascular invasion, satellitosis, predominant type of cytology, and regional lymph node metastasis. Clinical and follow-up information was obtained by reviewing patients' medical records. RESULTS: Previous history of cutaneous melanoma was present in all 5 cases of metastatic esophageal melanoma but was not present in the 5 patients with PEMs. In situ melanoma and/or radial growth phase were identified in all 5 PEMs but were not present in any of the metastatic cases. Among the 4 resected and 2 autopsy cases, melanocytosis and mixed epithelioid and spindle cell morphology was present in 2 (50%) of 4 PEMs but was not present in 2 (40%) of the metastatic melanomas. Melanin pigment was detectable in all cases. Patients with PEM had better survival than those who had metastatic melanoma to esophagus (P = .03). CONCLUSIONS: The presence of in situ melanoma, radial growth phase, melanocytosis, and mixed epithelioid and spindle cell morphology, in the context of no history of melanoma, distinguishes PEM from metastatic melanoma.	esophagus
Adjuvant chemotherapy in oesophageal cancer: a meta-analysis and experience from the Shanghai Cancer Hospital.	Whether adjuvant chemotherapy increases survival of oesophageal cancer patients has been widely debated. The present study used meta-analysis software to combine data from six studies up to July 2007 that were found and selected as suitable, comprising a total of 1001 oesophageal cancer patients. The results indicated that adjuvant chemotherapy did not significantly improve outcome in oesophageal cancer patients. A trend towards improved outcome from adjuvant chemotherapy was found in lymph node-positive patients, but did not reach significance. In our own study including 270 oesophageal cancer patients, adjuvant chemotherapy did not improve overall patient survival, but did improve survival for patients with metastases in cervical and/or celiac lymph nodes (stage IVa). Although our study had the largest patient sample, more prospective clinical trials with large numbers of patients are necessary to confirm the value of adjuvant chemotherapy in stage IVa patients.	esophagus
Similarity of aberrant DNA methylation in Barrett's esophagus and esophageal adenocarcinoma.	BACKGROUND: Barrett's esophagus (BE) is the metaplastic replacement of squamous with columnar epithelium in the esophagus, as a result of reflux. It is the major risk factor for the development of esophageal adenocarcinoma (EAC). Methylation of CpG dinucleotides of normally unmethylated genes is associated with silencing of their expression, and is common in EAC. This study was designed to determine at what stage, in the progression from BE to EAC, methylation of key genes occurs. RESULTS: We examined nine genes (APC, CDKN2A, ID4, MGMT, RBP1, RUNX3, SFRP1, TIMP3, and TMEFF2), frequently methylated in multiple cancer types, in a panel of squamous (19 biopsies from patients without BE or EAC, 16 from patients with BE, 21 from patients with EAC), BE (40 metaplastic, seven high grade dysplastic) and 37 EAC tissues. The methylation frequency, the percentage of samples that had any extent of methylation, for each of the nine genes in the EAC (95%, 59%, 76%, 57%, 70%, 73%, 95%, 74% and 83% respectively) was significantly higher than in any of the squamous groups. The methylation frequency for each of the nine genes in the metaplastic BE (95%, 28%, 78%, 48%, 58%, 48%, 93%, 88% and 75% respectively) was significantly higher than in the squamous samples except for CDKN2A and RBP1. The methylation frequency did not differ between BE and EAC samples, except for CDKN2A and RUNX3 which were significantly higher in EAC. The methylation extent was an estimate of both the number of methylated alleles and the density of methylation on these alleles. This was significantly greater in EAC than in metaplastic BE for all genes except APC, MGMT and TIMP3. There was no significant difference in methylation extent for any gene between high grade dysplastic BE and EAC. CONCLUSION: We found significant methylation in metaplastic BE, which for seven of the nine genes studied did not differ in frequency from that found in EAC. This is also the first report of gene silencing by methylation of ID4 in BE or EAC. This study suggests that metaplastic BE is a highly abnormal tissue, more similar to cancer tissue than to normal epithelium.	esophagus
Survival trends in patients with gastric and esophageal adenocarcinomas: a population-based study.	OBJECTIVE: To use a population-based approach to describe survival trends in patients diagnosed as having gastric or esophageal adenocarcinoma. PATIENTS AND METHODS: A population-based complete chart review of all inpatient and outpatient records, using the resources of the Rochester Epidemiology Project, was conducted in Olmsted County, Minnesota (population 124,277), a primarily rural county with one large urban area. All residents of Olmsted County who were diagnosed as having gastric or esophageal adenocarcinoma from January 1, 1971, through December 31, 2000, were included in the study. The main outcomes were median survival and 2-year and 5-year survival rates, by decade of diagnosis. RESULTS: From 1971 through 2000, median survival for patients with gastric adenocarcinoma (n=121) decreased from 5.5 months to 3.2 months, whereas median survival for patients with esophageal adenocarcinoma (n=65) increased from 8.5 months to 11.7 months. Decade of diagnosis was not significantly associated with patient survival for either gastric or esophageal adenocarcinoma (P>.05). There was no significant shift in stage of disease at diagnosis during the 30-year period for either gastric or esophageal adenocarcinoma (P>.05). CONCLUSION: No significant change has occurred in the survival rates of this patient population with gastric or esophageal adenocarcinoma, which is representative of the US white population.	esophagus
Mucosal morphology in Barrett's esophagus: interobserver agreement and role of narrow band imaging.	BACKGROUND AND STUDY AIMS: We have recently proposed a classification of mucosal morphology in Barrett's esophagus based on three criteria: regularity of mucosal pattern, regularity of vascular pattern, and presence of abnormal blood vessels. We aimed to evaluate the interobserver agreement with the proposed mucosal morphology classification and to assess the additional value of narrow band imaging (NBI) over high resolution white light endoscopy (HR-WLE). PATIENTS AND METHODS: Five international experts in the field of Barrett's imaging and seven community endoscopists with no expertise in this field independently evaluated magnified still images from 50 areas, obtained with HR-WLE and NBI, in Barrett's esophagus patients. Visual analogue scales (VAS) were used for scoring imaging quality. Interobserver agreement for mucosal morphology and yield for identifying early neoplasia were assessed. RESULTS: Imaging qualities of NBI were rated more highly than HR-WLE, when evaluated separately as well as in a side-by-side comparison. The interobserver agreement ranged from 0.40 to 0.56 and did not significantly differ between expert and non-expert endoscopists. The overall yield for correctly identifying images of early neoplasia was 81 % for HR-WLE, 72 % for NBI and 83 % for HR-WLE + NBI, with no significant difference between experts and non-experts. CONCLUSION: Interobserver agreement for the classification of mucosal morphology was moderate. Although NBI was rated more highly than HR-WLE for imaging quality, this did not result in improved interobserver agreement or increased yield for identifying early neoplasia in Barrett's esophagus. This applied to non-expert as well as expert endoscopists.	esophagus
EMP3 as a tumor suppressor gene for esophageal squamous cell carcinoma.	EMP3, epithelial membrane protein 3, was recently reported to be a tumor suppressor gene in neuroblastomas and gliomas. We found that EMP3 was commonly repressed in esophageal squamous cell carcinoma (ESCC) cell lines by oligonucleotide microarrays. Its overexpression in ESCC cell lines caused growth inhibition with morphological changes and TERT repression. In addition to promoter hypermethylation, TSA caused repression of EMP3, indicating the involvement of histone deacetylase-regulated repressors. The post-recurrent survival after radical surgery was poorer in ESCC patients with lower EMP3 expression. We propose that EMP3 may be a tumor suppressor gene at the late step of ESCC carcinogenesis.	esophagus
Penile metastasis from esophageal squamous carcinoma after curative resection.	The penis is an uncommon site of metastasis; with only about 300 cases reported in literature. The majority (75%) of primary tumors are located in the pelvis, and they arise from the genitourinary tract and rectum. We report on a patient with esophageal squamous carcinoma who underwent a curative resection and later developed metastatic nodules over the penis and perineum. We believe this is the first instance of this unusual presentation. He was offered palliation with weekly taxanes and had symptomatic relief with this regimen.	esophagus
[The impact of mtDNA mutations on proteins structure in selected types of cancer].	Recently published papers report a large number of mitochondrial DNA mutations in many different cancer types, but their significance for electron transport chain proteins remains unknown. This review covers structural mutations of mitochondrial genes, choosing prostate cancer, esophageal cancer and epithelioma as research models. As all mitochondrial genes encode subunits of the electron transport chain, the review focuses on the consequences of structural mutations on cell metabolism.	esophagus
Benign bronchogastric fistula as a late complication after transhiatal oesophagogastrectomy: evaluation with multidetector row CT.	The late development of a bronchogastric fistula is a rare complication of oesophagectomy, although the anatomical relationship between the tracheobronchial tree and the neo-oesophagus is close. Its early diagnosis can be difficult and may result in a poor prognosis owing to the development of recurrent pulmonary infection and malnutrition. Multidetector row CT (MDCT) can provide excellent three-dimensional and multiplanar reconstruction images; therefore, the potential benefit of MDCT in diagnosing bronchogastric fistula is early and accurate detection. We present our experience with a late onset bronchogastric fistula evaluated using MDCT. Evaluation of bronchogastric fistulae using MDCT could help to confirm the diagnosis of this condition, and increase our understanding of the anatomical relationship between the neo-oesophagus and the bronchus. Therefore, it could provide valuable information for establishing a treatment plan.	esophagus
Minimally invasive resection of gastrointestinal stromal tumors.	Gastrointestinal stromal tumors (GISTs) are rare neoplasms. The advent of electron microscopy and immunohistochemistry has led to the realization that these tumors originate from a pleuropotential cell known as the interstitial cell of Cajal (ICC). The morphologic features demonstrated as most predictive of recurrence or metastases are tumor size and mitotic rate. There is oncologic justification for minimally invasive resection techniques with gross margins for GISTs. Minimally invasive resection provides advantages to patients in terms of morbidity and recovery. A variety of endoscopic, laparoscopic, and hybrid techniques are described for surgically excising GISTs in different anatomic locations.	esophagus
[Comparative study on soil and vegetation characteristics from high- and low risk areas of esophageal cancer in China].	OBJECTIVE: To study the types of soil and vegetation as well as soil organic carbon densities (SOCD) from high and low risk areas of esophageal cancer (EC) in China. METHODS: Database from EC mortality survey in 1990-1992 in China was established in Excel. Digital polygon maps of study areas were created in ArcGIS 9.1 and linked with the database. The types of soil and vegetation from sampling areas were extracted from digital maps of soil type, vegetation type while the map of distribution on EC mortality was using the polygon overlay analysis. SOCD at depths of 100 cm and 20 cm of these areas were calculated, and spearman correlation analysis was used to evaluate the relationship between EC mortality and SOCD. RESULTS: The types of soil and vegetation and related distributions from high and low risk areas of EC in China showed obvious differences. There were both negative correlations between EC mortality and SOCD at depths of 100 cm and 20 cm. The correlation coefficients for man were -0.504 and -0.575 (P = 0.004, 0.001 respectively), and that for woman were -0.487 and -0.526 (P = 0.003, 0.001 respectively). CONCLUSION: Mortality rate of esophageal cancer might correlate to SOCD, the types of soil and vegetation which called for further studies.	esophagus
Genetic polymorphisms of VEGF, interactions with cigarette smoking exposure and esophageal adenocarcinoma risk.	Vascular endothelial growth factor (VEGF) is a major regulator of angiogenesis in the process of tumor growth and metastasis in esophageal adenocarcinoma (EA). Polymorphisms in the VEGF gene have been associated with altered VEGF expression and plasma VEGF levels. We hypothesized that polymorphisms of VEGF may contribute to EA risk. Functional polymorphisms in the VEGF gene (-460C/T, +405C/G and +936C/T) were determined in 308 patients with EA and 546 healthy controls. Logistic regression analysis was employed to assess the associations between genotypes, haplotypes of VEGF and EA risk, adjusting for multiple confounding factors. Compared with the +936CC genotype, the combined +936CT+TT genotypes were significantly associated with increased risk of developing EA, with adjusted odds ratio (OR) = 1.49 [95% confidence interval (CI), 1.05-2.12; P = 0.027]. The -460CT+CC were associated with increased risk of EA in smokers (adjusted OR = 1.57; 95% CI, 1.07-2.30; P = 0.021), whereas the -460CT/CC were associated with decreased risk of EA (adjusted OR = 0.47; 95% CI, 0.25-0.91; P = 0.025) in non-smokers. Compared with non-smokers with the +460TT, smokers with the +460CT+CC had significantly higher risk of EA (adjusted OR = 3.32; 95% CI, 1.56-7.10; P = 0.002). No overall or interacting association with EA risk was found for the +405C/G polymorphism. Haplotype CGT (-460C/+405G/+936T) was significantly associated with higher risk of EA (adjusted OR = 1.70; 95% CI, 1.04-2.73; P = 0.034). These results suggested that cigarette smoking modifies the association between VEGF polymorphisms and EA risk among Caucasians.	esophagus
Chemoprevention and Barrett's esophagus: decisions, decisions.	The incidence of esophageal adenocarcinoma continues to increase at a rate greater than that of any other cancer in the western world. Current strategies to deal with this situation are problematic, and the time has come for new approaches to this problem. Chemoprevention is one such approach. In this issue of the American Journal of Gastroenterology, Hur et al. examined Barrett's esophagus patient preferences for cancer chemoprevention with either aspirin or celecoxib. They found that 93% of their patients were willing to take one of these two drugs, but that nearly five times as many patients preferred aspirin to celecoxib (76%vs 15%). The most important reason for willingness to use celecoxib or aspirin was cancer prevention, while the most important reason for not using celecoxib was risk of myocardial infarction and for aspirin gastrointestinal adverse events. While this study indicates that there is a strong interest among Barrett's esophagus patients for chemoprevention, it is still premature for our patients to embark on such an approach. The role of chemoprevention in Barrett's esophagus still awaits the results of ongoing clinical trials in the United Kingdom and North America.	esophagus
Does previous fundoplication alter the surgical approach to esophageal adenocarcinoma?	OBJECTIVE: The primary aim of this study was to test the widespread assumption that the viability of the gastric fundus is compromised by fundoplication, thereby limiting the use of stomach to reconstruct the upper gastrointestinal tract after esophageal resection. METHODS: Between February 1991 and February 2006, a consecutive series of 142 patients with esophageal adenocarcinoma (EADC) underwent esophageal resection. To reconstruct the upper gastrointestinal tract, all patients had a narrow gastric tube (greater curvature of stomach based on the right gastroepiploic artery) transposed through the posterior mediastinum to the left neck where an anastomosis to the cervical esophagus was performed. From a prospective database, 15 patients were identified to have undergone an 'open' fundoplication (transabdominal Nissen, n=11; transthoracic Belsey, n=4) from 12 to 23 years earlier. Outcomes were compared between patients with EADC who had undergone previous fundoplication, and patients with EADC who never had antireflux surgery. RESULTS: Gastric transposition and cervical esophagogastrostomy were technically feasible in all patients. No significant differences in outcome were found between patient groups. Gastric necrosis developed in only one patient, who had not undergone previous fundoplication. Anastomotic leak rates after esophageal resection and reconstruction were not statistically different based on whether patients had undergone previous fundoplication (2/15, 13.3%) or not (16/127, 12.6%; p=0.99). CONCLUSIONS: With careful attention to surgical technique, previous fundoplication does not preclude the use of stomach to reconstruct the foregut after esophageal resection, refuting the notion that previous antireflux surgery is a relative contraindication to, or alters the approach to esophageal cancer surgery.	esophagus
Interaction of EGFR 497Arg>Lys with EGF +61A>G polymorphism: modulation of risk in esophageal cancer.	Genetic polymorphisms in EGFR 497Arg>Lys and EGF +61A>G genes influence cell cycle progression, apoptosis, angiogenesis, and metastasis. Therefore, we assessed association of esophageal cancer (EC), its clinical characteristics, and environmental interactions with these polymorphisms in 174 patients with EC and 196 controls. No association of EGFR 497Arg/Arg genotype was observed (OR 1.48, p = 0.067) but EGF +61A/A genotype was significantly associated with risk of EC (OR 1.65, p = 0.025), particularly in males (OR 1.76, p = 0.031). Patients with EGF +61A/A genotype were at risk for squamous cell carcinoma (SCC) (OR 1.70, p = 0.021) and tumor at upper anatomical location (OR 3.11, p = 0.009). Interaction of EGF or EGFR genotypes with environmental exposure did not modulate EC risk. However, in gene-gene interaction, EGFR 497Arg/Arg*EGF +61A/A showed significant risk for EC (OR 2.47, p = 0.011). In conclusion, EGF +61A>G gene polymorphisms influenced EC susceptibility and its clinical characteristics. Gene-gene interaction of EGFR 497Arg>Lys and EGF +61A>G polymorphisms enhanced risk for EC, indicating additive effects.	esophagus
Evaluation of quality of life and psychological response in cancer patients treated with radiotherapy.	PURPOSE: The importance of the quality of life (QOL) and mental condition of patients being treated for cancer is now recognized. In this study, we evaluated QOL and mental condition in patients with cancer before and after radiotherapy. MATERIALS AND METHODS: The subjects were 170 patients who had undergone radiotherapy. The examination of QOL was performed using the quality of life questionnaire for cancer patients treated with anticancer drugs (QOL-ACD), and mental condition (anxiety and depression) was examined using the hospital anxiety and depression scale (HADS). These examinations were performed at the start of radiotherapy and immediately after radiotherapy. RESULTS: The QOL score was slightly higher in all patients after the completion of radiotherapy than before the start of radiotherapy. In the palliative radiotherapy group, QOL score was significantly improved by treatment. Anxiety and depression were improved after radiotherapy. There was a correlation between the degrees of improvement of the HADS and QOL score. CONCLUSION: We could treat cancer patients by radiotherapy without reducing their QOL, and improvement in QOL was significant in the palliative radiotherapy group. Mental condition was also improved after radiotherapy.	esophagus