crossing96/oncoscreening huggingface dataset:
Unchanging trend of esophagogastric junction adenocarcinoma in Korea: experience at a single institution based on Siewert's classification.	The incidence of adenocarcinoma of the esophagogastric junction (AEG) has been increasing in Western countries. It is unclear, however, whether similar changes are occurring in Asia. We therefore investigated the incidence of AEG in Korea, and assessed the clinical characteristics of three types of AEG based on Siewert's classification. We retrospectively reviewed the medical records of 16 811 patients diagnosed with esophageal squamous cell carcinoma (ESC, n= 1450) or gastric noncardiac adenocarcinoma (GNCA, n= 14 751) between 1992 and 2006. The patients were divided into three 5-year cohorts (cohort A [1992-1996], n= 2734, cohort B [1997-2001], n= 5727, and cohort C [2002-2006], n= 8350), and the ratios of AEG (n= 610) to non-AEG (ESC and GNCA) in each cohort were compared. Using Siewert's classification, the tumors were categorized into one of three types, and patient demographic features and 5-year survival rates were compared. The ratio of AEG to non-AEG cases did not change over time (0.037, 0.034, and 0.039 for cohorts A, B, and C, respectively; P= 0.40). Of the 610 patients with AEG, 23 (3.7%) had type 1 tumors, 47 (7.7%) had type 2, and 540 (88.5%) had type 3. The 5-year survival rate of patients with type 1 AEG was much lower (4.8 +/- 4.7%) than that of those with type 2 (47.9 +/- 7.8%) and type 3 (47.4 +/- 2.5%) tumors. Unlike in Western countries, the ratio of AEG to non-AEG cases has not increased over time in Korea. Type 1 AEG was rarer and associated with a more unfavorable prognosis in Korea than in Western countries.	esophagus
Preoperative chemoradiation combined with regional hyperthermia for patients with resectable esophageal cancer.	PURPOSE: To analyse the treatment results of neo-adjuvant chemoradiation combined with regional hyperthermia in patients with resectable esophageal cancer. PATIENTS AND METHODS: Between August 2003 and December 2004, 28 patients entered a phase II study combining chemoradiation over a 4.5-week period with five sessions of regional hyperthermia. Chemotherapy consisted of carboplatin (AUC = 2) and paclitaxel (50 mg/m(2)) and radiotherapy of 41.4 Gy in 1.8 Gy daily fractions. Locoregional hyperthermia was applied using the AMC phased array of four 70 MHz antennas, aiming at a stable tumor temperature of 41 degrees C for one hour. Carboplatin was infused during the hyperthermia session. Esophageal resection was planned at 6-8 weeks after the end of radiotherapy. The majority of the patients had a T3 tumor (86%) and were cN+ (64%). Median follow-up for survivors was 37 months (range 31-46). RESULTS: Twenty-five patients (89%) completed the planned neo-adjuvant treatment and acute toxicity was generally mild. Twenty-six patients were operated on. A pathologically CR, PRmic, PR and SD were seen in 19%, 27%, 31% and 23% respectively. All patients had a R0 resection. In-field locoregional control during follow up for the operated patients was 100%. Quality of life was good for patients without disease progression. Survival rates at one, two and three years were 79%, 57% and 54% respectively. CONCLUSION: Neo-adjuvant chemoradiation combined with regional hyperthermia followed by esophageal resection for patients with esophageal cancer resulted in good locoregional control and overall survival.	esophagus
Phase I study of weekly cisplatin, bolus fluorouracil and escalating doses of irinotecan in advanced solid tumors.	PURPOSE: We performed a phase I study of 5-fluorouracil (5-FU), cisplatin and irinotecan. METHODS: Twenty-nine patients received cisplatin 25 mg/m(2) and bolus 5-FU 425 mg/m(2), along with irinotecan at 40, 50, and 65 mg/m(2) weekly for 4 out of 6 weeks. RESULTS: The maximum tolerated dose (MTD) for untreated patients was irinotecan 65 mg/m(2) while the MTD for previously treated patients was irinotecan 40 mg/m(2). Neutropenia and diarrhea were the major dose-limiting toxicities. Antitumor activity was noted in gastric, esophageal and pancreatic cancers. CONCLUSION: Because of the toxicity profile, combinations with continuous infusion 5-FU or capecitabine should be explored.	esophagus
Primary incisional therapy with a modified method for patients with benign anastomotic esophageal stricture.	BACKGROUND: Benign anastomotic esophageal stricture after surgical resection is not uncommon and requires repeated dilation sessions to maintain patency because of the significant recurrence rate with bougie or balloon dilation. OBJECTIVE: Our study was designed to evaluate whether a modified method of incisional therapy is effective and maintains a good patency in a benign anastomotic esophageal stricture. DESIGN: A prospective outcome study. SETTING: Tertiary-care academic medical centers. PATIENTS: A total of 24 patients with benign anastomotic esophageal strictures after esophagojejunostomy. INTERVENTIONS: Under direct vision through a transparent hood, radial incisions parallel to the longitude of the esophagus were performed by pulling up the Iso-Tome or insulated-tip-knife. MAIN OUTCOME MEASUREMENTS: Efficacy, safety, and long-term patency after procedures were evaluated. RESULTS: During 24 months of follow-up observations, 21 of 24 patients (87.5%) who received only 1 dilation session resumed eating solid meals and had no dysphagia. Only 3 patients (12.5%) developed restricture at a mean of 1.6 months. Of the patients with a recurrence, 2 experienced no recurrence after one additional dilation session, and another patient was refractory and underwent 5 dilation sessions. The occurrence of restricture after incisional therapy was statistically more prevalent in long-segment stricture (>1 cm) (2/3 [66.7%]) than short-segment stricture (<1 cm) (1/21 [4.8%]) (P = .032). There were no significant procedure-related complications. LIMITATION: Our study included a small number of patients. Therefore, further prospective randomized controlled trials are needed. CONCLUSIONS: A modified method of incisional therapy as a primary treatment is safe and feasible, and appears to maintain a longer duration of patency in benign anastomotic esophageal stricture.	esophagus
Confocal laser endomicroscopy for superficial esophageal squamous cell carcinoma.	BACKGROUND AND STUDY AIMS: Confocal laser endomicroscopy (CLE) allows subsurface imaging of gastrointestinal mucosa in vivo. The goal of the present study was to compare the endomicroscopic characteristics of cells and intrapapillary capillary loops (IPCLs) in normal and superficial esophageal squamous cell carcinoma (SESC). PATIENTS AND METHODS: We recruited consecutive patients with SESC diagnosed by conventional endoscopy and confirmed by histopathology between July 2006 and May 2008. The confocal endoscopic images of these patients were collected and compared with the corresponding histology. The characteristic patterns of cells and IPCLs was then analyzed from these images of malignant and normal mucosa. The quality of images and interobserver variations of two endoscopists were also evaluated. RESULTS: Overall, 64 samples from 57 subjects (27 SESCs, 30 controls) were examined by CLE. The confocal images corresponded to the hematoxylin and eosin staining from the same sites. The confocal images showed that there was a significantly higher proportion of squamous epithelial cells with irregular arrangement (79.4 % vs. 10.0 %, P < 0.001), increased diameter of IPCLs (26.0 microm vs. 19.2 microm, P < 0.001), and irregular shape IPCLs (82.4 % vs. 36.7 %, P = 0.0002) in the SESC group compared with the controls. Massive IPCLs with tortuous vessels (44.1 % vs. 0 %, P < 0.0001), and long branching IPCLs (23.5 % vs. 3.3 %, P = 0.0204) were frequently observed in the SESC group. In this study, about 35.5 % of images were graded as good quality, and the interobserver agreement for the prediction of cancerous mucosa was graded as substantial. CONCLUSIONS: CLE can be used to distinguish cancerous from normal epithelium, which gives it potential value for early detection of esophageal carcinoma. The difficulty in obtaining good images in the esophagus by CLE is a latent problem.	esophagus
In situ nuclear morphology measurements using light scattering as biomarkers of neoplastic change in animal models of carcinogenesis.	Light scattering spectroscopy measurements can be used to determine the structure of tissue samples. Through refined data acquisition and signal processing techniques, quantitative nuclear morphology measurements may be obtained from light scattering data. These data have been used primarily as a biomarker of neoplastic change in a wide range of settings. Here, we review the application of light scattering to assessing the health status of tissues drawn from animal models of carcinogenesis, in particular, the rat esophagus and the golden Syrian hamster trachea carcinogenesis models. In addition, we present results from ex vivo human tissues to demonstrate the relevance of the use of animal models which are excellent surrogates for several human cancers. These models provide the opportunity to develop biomarkers and test chemopreventive and therapy strategies before application in humans.	esophagus
Minimally invasive surgical enucleation for esophageal leiomyoma: report of seven cases.	Benign esophageal tumor is a rare entity, with leiomyoma being the most common lesion. We present our experience with enucleation of esophageal leiomyomas using a minimally invasive approach. Between March 1998 and June 2008, seven patients with esophageal leiomyoma underwent right thoracosopic enucleation (n=4) or laparoscopic transhiatal enucleation (n=3). A Dor (n=2) or Toupet fundoplication (n=1) were added for laparoscopic procedure. The mean tumor size was 3.9 cm (range, 1.5-5.5 cm). Tumor locations were upper (n=2), middle (n=1), and lower (n=4) thirds of the esophagus. No major morbidities including postoperative leakage or mortalities occurred. At a mean follow-up period of 60.1 months (range, 14-260 months), no evidence of recurrences were observed. Thoracoscopic and laparoscopic transhiatal enucleation for esophageal leiomyomas is a safe and feasible procedure. The optimal approaches should be tailored based on the location and size of the tumor.	esophagus
[Advanced esophageal carcinoma recanalization].	Advanced esophageal carcinoma has poor prognosis with 5-year survival of less than 20%. This poor prognosis is the same for squamous cell carcinoma and adenocarcinoma. Surgical therapy, external radiation and chemotherapy with curative intent are usually impossible because of the advanced disease. Dysphagia is the most frequent symptom affecting quality of life. Bougies or balloon dilation improves dysphagia only short-term (few days). Nd-YAG laser, ACP and photodynamic therapy all have mid-range effect and require repetition after few weeks. Brachytherapy and esophageal self-expanding stent insertion have longer benefit. Stent insertion provides fastest improvement of dysphagia; however, complications in later setting occur in30% and require further endoscopic treatment. Brachytherapy has slower onset of benefit but has fewer complications and longer benefit. Brachytherapy is suitable for patients wit expected lifespan more than 3 months. Most important contraindication of brachytherapy is tracheo-esophageal fistula.	esophagus
Clinical significance of 14-3-3 zeta in human esophageal cancer.	We recently found 14-3-3 zeta to be overexpressed in esophageal squamous cell carcinomas (ESCCs) by differential display. In the present study we determined the clinical significance of 14-3-3 zeta in esophageal tumorigenesis. Immunohistochemical analysis was carried out in 61 ESCCs, 33 dysplasia samples, 14 hyperplasia samples and 7 matched histologically normal esophageal tissues and correlated with clinicopathological parameters. Cytoplasmic expression of 14-3-3 zeta protein was observed in 95% of ESCCs; 63% of tumors also showed nuclear localization. All hyperplastic and dysplastic tissues distant from ESCCs as well as dysplastic endoscopic biopsies showed cytoplasmic immunopositivity for 14-3-3 zeta, while nuclear localization was observed in 58% of dysplasia and 36% of hyperplasia samples. Matched distant histologically normal epithelia either showed basal cytoplasmic expression of 14-3-3 zeta or no detectable nuclear expression of the protein. Interestingly, immunopositivity observed in normal esophageal tissues and early hyperplasia was confined to cytoplasm only, though significant nuclear expression was detected in dysplasia and ESCC. Immunoblotting and RT-PCR analyses further confirmed 14-3-3 zeta expression in dysplasia and ESCC. To our knowledge, this is the first report demonstrating overexpression of 14-3-3 zeta in esophageal hyperplasia, dysplasia and squamous cell carcinoma, suggesting that alteration in its expression occurs in early stages and is associated with esophageal tumorigenesis.	esophagus
Spindle cell lipoma of the esophagus.	Esophageal lipomas are benign tumors representing less than 0.5% of all gastrointestinal lipomas. They are typically detected incidentally but occasionally present with local symptoms and rarely with life-threatening complications. We describe a case of a 60-year-old man with progressive dysphagia and weight loss, who presented with several episodes of near asphyxiation secondary to regurgitation and aspiration of the pedunculated mass. Preoperative investigations included a barium meal, esophagoscopy and computerized tomography. The pedunculated lipoma was excised via a cervical approach and found, at final pathology, to be a spindle cell lipoma, a rare variant not previously described in relation to the esophagus.	esophagus
[Lymphadenectomy in surgery for cancers of the stomach and esophagus].	Lymph node invasion is the principal prognostic factor in cancers of the stomach and esophagus which have a tendency to early lymphatic spread.The anatomy of regional lymph node groupings is described and standard and extended types of lymphadenectomy are defined. We discuss he role of lymph node dissection - particularly extended lymphadenectomy - and assess whether there is demonstrable benefit in terms of morbidity and mortality, loco-regional recurrence, and survival. Articles from the surgical literature with the highest levels of evidence are analyzed. Practical guidelines for treatment choice are proposed.	esophagus
The combination of 5-fluorouracil, leukovorin, etoposide, and cisplatin (FLEP) in patients with metastatic esophageal cancer. A single-institution experience.	BACKGROUND: A retrospective analysis was carried out on the efficacy and toxicity of the combination of 5-fluorouracil, leucovorin, etoposide and cisplatin (FLEP) in patients with metastatic esophageal cancer treated at our institution. PATIENTS AND METHODS: Patients received intravenous 5-fluorouracil 500 mg/m2, leucovorin 300 mg/m2, etoposide 100 mg/m2 and cisplatin 30 mg/m2, on days 1 to 3. Courses were repeated every 4 weeks until progression or up to a maximum of 6 courses. Patients were evaluated for response after every three courses using computed tomography. RESULTS: Eighteen patients received a total of 76 courses (median 4, range 1-6). The median time to progression was 9.2 months and the overall response rate was 22% (one complete response i.e. 5%, and three partial responses i.e. 17%). Seven patients (39%) had stable disease, while another 7 progressed during therapy. The median survival for all patients was 10.2 months. The most common hematological toxicities were leukocytopenia and neutropenia grade 3, which occurred in two patients (11%) each, while grade 3 and 4 infection was seen in one patient each (5%). Anemia grade 3 occurred in 2 patients (11%). Nonhematological toxicities consisted of nausea/vomiting grade 3 in 3 (17%), diarrhea grade 3 in one (5%) and mucositis grade 3 in 3 patients (17%). CONCLUSION: We conclude that the FLEP combination is a safe and active regimen for patients with metastatic esophageal cancer.	esophagus
International survey on esophageal cancer: part II staging and neoadjuvant therapy.	The outcome of esophagectomy could be improved by optimal diagnostic strategies leading to adequate preoperative patient selection. Neoadjuvant therapy could improve outcome by increasing the number of radical resections and by controlling metastatic disease. The purposes of this study were to gain insight into the current worldwide practice of staging modalities and neoadjuvant therapy in esophageal cancer, and to detect intercontinental differences. Surgeons with particular interest in esophageal surgery, including members of the International Society for Diseases of the Esophagus, the European Society of Esophagology - Group d'Etude Européen des Maladies de l'Oesophage, and the OESO, were invited to participate in an online questionnaire. Questions were asked regarding staging modalities, neoadjuvant therapy, and response evaluation applied in esophageal cancer patients. Of 567 invited surgeons, 269 participated resulting in a response rate of 47%. The responders currently performing esophagectomies (n= 250; 44%) represented 41 countries across the six continents. Esophagogastroscopy with biopsy and computed tomography (CT) scanning were routinely performed by 98% of responders for diagnosing and staging esophageal cancer, while endoscopic ultrasound (EUS) and barium esophagography were routinely applied by 58% and 51%, respectively. Neoadjuvant therapy is routinely administered by 33% and occasionally by 63% of responders. Of the responders that administer identical neoadjuvant regimens to esophageal adenocarcinoma (AC) and squamous cell carcinoma, 54% favor chemoradiotherapy. For AC, chemotherapy is preferred by 31% of the responders that administer neoadjuvant therapy, whereas for squamous cell carcinoma, the majority of responders (38%) prefer chemoradiotherapy. Response to neoadjuvant therapy is predominantly assessed by CT scanning of the chest and abdomen (86%). Barium esophagography, EUS, and combined CT/PET scan are requested for response monitoring in equal frequency (25%). Substantial differences in applied staging modalities and neoadjuvant regimens were detected between surgeons from different continents. In conclusion, currently the most commonly applied diagnostic modalities for staging and restaging esophageal cancer are CT scanning of the chest and abdomen, gastroscopy, barium esophagography and EUS. Neoadjuvant therapy is routinely applied by one third of the responders. Intercontinental differences have been detected in the diagnostic modalities applied in esophageal cancer staging and in the administration of neoadjuvant therapy. The results of this survey provide baseline data for future research and for the development of international guidelines.	esophagus
Prognostic factors of radiotherapy in patients with node-positive thoracic esophageal squamous cell carcinoma after radical surgery.	The aim of this study was to retrospectively analyze and assess the outcomes and prognostic factors of radiotherapy in patients with node-positive thoracic esophageal squamous cell carcinoma after radical surgery. One hundred twenty-six patients with node-positive thoracic esophageal squamous cell carcinoma who had undergone adjuvant therapy (postoperative radiotherapy alone or postoperative sequential chemoradiotherapy without receiving postoperative concurrent chemoradiotherapy) after radical surgery, were retrospectively reviewed from January 1996 to December 2003. Univariate and multivariate analyses were performed using log-rank and Cox proportional hazard models, and survival curves were estimated using the Kaplan-Meier method. The 1-, 3- and 5-year overall survival rates of all 126 patients were 71.4, 39.1, and 22.0%, and disease-free survival rates were 64.3, 36.4, and 21.5%, respectively. Lymph node ratio (the ratio of the number of metastatic lymph nodes to the number of lymph nodes removed, LNR) > or = 0.2 (P= 0.006), pT3 + pT4 (P= 0.06) and sequential chemoradiotherapy (P= 0.08) were associated with a poorer survival by univariate analysis. In multivariate analysis, LNR (P= 0.01, hazard ratio = 0.57, 95% confidence interval, 0.37-0.87) and tumor depth of invasion (P= 0.03, hazard ratio = 0.62, 95% confidence interval, 0.41-0.96) were the independent predictors of survival. Sequential chemoradiotherapy receded survival tendency without significant difference (P= 0.09, hazard ratio = 0.64, 95% confidence interval, 0.37-1.08). Therefore, LNR and tumor depth of invasion were the independent prognostic factors of radiotherapy in patients with node-positive thoracic esophageal squamous cell carcinoma after radical surgery. The addition of chemotherapy does not seem to confer a survival benefit.	esophagus
Squamous cell carcinoma in a large epiphrenic esophageal diverticulum.	Carcinoma is rare in an esophageal diverticulum. The case of a 53-year-old man with a large mass in a long-standing symptomatic epiphrenic esophageal diverticulum is presented in this study. Squamous cell carcinoma in the diverticulum with pleural invasion was diagnosed after surgical diverticulectomy. The patient underwent subtotal esophagectomy with locoregional lymph node dissection and reconstruction with gastric tube because of micro-invasion at the surgical margin. The patient developed malignant pleural effusion at 6 months after surgery, and he eventually expired 3 months later. Carcinoma can develop in esophageal diverticula and is usually diagnosed at an advanced stage with poor prognosis.	esophagus
Time trends in peptic ulcer, erosive reflux oesophagitis, gastric and oesophageal cancers in a multiracial Asian population.	BACKGROUND: Dramatic changes in the prevalence and pattern of gastrointestinal disease has taken place in Asia in recent years. AIM: To compare the prevalence of duodenal (DU) and gastric ulcers (GU), erosive oesophagitis (EO), gastric cancer (GCA) and oesophageal cancer (OCA) and Helicobacter pylori infection over a 10-year interval of time in a multiracial South-East Asian population. METHODS: Endoscopy records of first time gastroscopy in the University of Malaya Medical Centre, Kuala Lumpur, Malaysia were reviewed for 1989/1990 and 1999/2000. RESULTS: In the period of 1989-1990, 3252 records and in 1999-2000, 4615 records were analysed. Both DU (21.1-9.5%) and GU (11.9-9.4%) had decreased significantly (P < 0.001). EO had increased significantly from 2.0% to 8.4% (P < 0.001). Both GCA and OCA had declined in the 10-year interval. Helicobacter pylori prevalence had decreased from 51.7% to 30.3% (P < 0.001).The decrease in DU and GU was seen in all racial groups. The increase in EO was most marked in Indians and the decrease in GCA in Chinese. The proportion of H. pylori-associated DU and GU had also decreased with time. CONCLUSIONS: Peptic ulcers and H. pylori infection had declined over a 10-year period of time and showed an opposing time trend with EO, which had increased dramatically. Both GCA and OCA had declined in prevalence.	esophagus