crossing96/oncoscreening huggingface dataset:
Abdominal lymph node metastasis in patients with mid thoracic esophageal squamous cell carcinoma.	BACKGROUND: There are few reports about abdominal lymph node metastasis of mid thoracic esophageal carcinoma. This study was designed to explore the pattern of abdominal lymph node metastasis in patients with mid thoracic esophageal squamous cell carcinoma and to evaluate the prognostic factors. METHODS: The complete data of 368 patients with mid thoracic esophageal squamous cell carcinoma, who underwent modified Ivor-Lewis esophagectomy with two-field lymphadenectomy from January 1998 to January 2003, were reviewed. Survival rate was calculated by Kaplan-Meier method. Cox regression analysis was performed to identify risk prognostic factors. RESULTS: Abdominal lymph node metastasis occurred in 58 (15.8%) patients: 34.5% (20/58) of them were stage T1 and T2. Skipping abdominal node metastasis was recognized in 13.8% (8/58) patients: all were stage T1 and T2. The overall 5-year survival rate of patients with abdominal lymph node metastasis (10.3%) was lower than that of those with thoracic node metastasis (18.3%). The prognosis of patients with distant abdominal lymph node metastasis was poor, and no one could survive more than 5 years. Cox regression analysis showed that five or more positive nodes and distant abdominal node metastasis were independent risk factors of patients with abdominal lymph node metastasis. CONCLUSIONS: Abdominal lymph node metastasis in patients with mid thoracic esophageal squamous cell carcinoma occurred frequently, and the surgery favorable for extensive abdominal lymph node dissection should be selected. The prognosis of patients with abdominal lymph node metastasis was poor, especially those with more positive nodes and distant abdominal node metastasis.	esophagus
Nurse-led follow-up of patients after oesophageal or gastric cardia cancer surgery: a randomised trial.	Between January 2004 and February 2006, 109 patients after intentionally curative surgery for oesophageal or gastric cardia cancer were randomised to standard follow-up of surgeons at the outpatient clinic (standard follow-up; n=55) or by regular home visits of a specialist nurse (nurse-led follow-up; n=54). Longitudinal data on generic (EuroQuol-5D, European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30) and disease-specific quality of life (EORTC QLQ-OES18), patient satisfaction and costs were collected at baseline and at 6 weeks and 4, 7 and 13 months afterwards. We found largely similar quality-of-life scores in the two follow-up groups over time. At 4 and 7 months, slightly more improvement on the EQ-VAS was noted in the nurse-led compared with the standard follow-up group (P=0.13 and 0.12, respectively). Small differences were also found in patient satisfaction between the two groups (P=0.14), with spouses being more satisfied with nurse-led follow-up (P=0.03). No differences were found in most medical outcomes. However, body weight of patients of the standard follow-up group deteriorated slightly (P=0.04), whereas body weight of patients of the nurse-led follow-up group remained stable. Medical costs were lower in the nurse-led follow-up group (2600 euro vs 3800 euro), however, due to the large variation between patients, this was not statistically significant (P=0.11). A cost effectiveness acceptability curve showed that the probability of being cost effective for costs per one point gain in general quality-of-life exceeded 90 and 75% after 4 and 13 months of follow-up, respectively. Nurse-led follow-up at home does not adversely affect quality of life or satisfaction of patients compared with standard follow-up by clinicians at the outpatient clinic. This type of care is very likely to be more cost effective than physician-led follow-up.	esophagus
Association of HTLV1 infection and esophageal squamous cell carcinoma.	BACKGROUND: Both esophageal carcinoma and HTLV-1 (Human T cell lymphotropic virus 1) have high prevalence in northeastern of Iran. OBJECTIVE: To assess the presence of HTLV-1 genome in esophageal cancerous tissue and in tissues from non cancerous individuals. METHODS: Eighty five patients with esophageal squamous cell carcinoma and 48 non-cancerous control patients that underwent esophagogasteroscopy for other reasons were included in this study. All selected subjects are residing in northeastern part of Iran. All specimens were studied histopathologically by H&E staining and were evaluated for HTLV-1 by PCR method. In PCR, the presence of tax, pol, env and LTR segments of HTLV-1 genome were detected. RESULTS: Male to female ratio in the case group was 3 to 5. Average age and standard deviation in case and control group were 56 +/- 17 and 54 +/- 21 years, respectively; which did not have any significant differences. All the patients came from the same area in the northeastern part of Iran. HTLV-1 genome was found in two subjects with esophageal cancer and in one subject in the control group. Statistical analysis showed no significant differences between the two groups (chi square = 0.26, Fisher exact test P value = 0.7, Odd ratio = 1.13 [0.08<OR<32.46]). CONCLUSION: HTLV-1 infection and esophageal squamous cell carcinoma did not appear to have a significant correlation.	esophagus
Total endoscopic resection of Barrett esophagus.	Barrett's esophagus with high grade intraepithelial neoplasia is associated with disease progression at rates of greater than 10% per year. Endoscopic resection is a lower risk alternative to surgery for the management of high grade intraepithelial neoplasia and intramucosal cancer. Two endoscopic approaches have been used, namely localized resection of the lesion and total endoscopic resection of all Barrett's mucosa. The latter strategy removes all at-risk mucosa. Currently it is performed mainly using piecemeal endoscopic mucosal resection techniques. In recent years endoscopic submucosal dissection has been attempted to obtain en bloc resection. This review will describe the techniques of total endoscopic resection, and summarize the key published data.	esophagus
Induction of antigen-specific cytotoxic T lymphocytes by using monocyte-derived DCs transfected with in vitro-transcribed WT1 or SART1 mRNA.	To evaluate the usefulness of monocyte-derived dendritic cells transfected with tumor antigen mRNA for dendritic cell-based antitumor immunotherapy, we attempted to generate antigen-specific cytotoxic T cells by priming lymphocytes with monocyte-derived dendritic cells transfected with in vitro-transcribed tumor antigen mRNA. Mature monocyte-derived dendritic cells were generated from microbeads-separated CD14(+) cells by culturing with GM-CSF/IL-4 for 7 days and with TNF-alpha, IL-1alpha, IL-6, and PGE(2) for the last one day. Monocyte-derived dendritic cells, lymphocytes, and target cells, which were positive for HLA-A24, were used in the present study. Although lymphocytes prestimulated with untransfected monocyte-derived dendritic cells did not possess the cytotoxic ability against the target cells in a (51)Cr-release cytotoxicity assay, lymphocytes primed with tumor antigen RNA-transfected monocyte-derived dendritic cells were cytotoxic against the tumor antigen-expressing cells but not against the target cells without the expression of the antigen. The cytotoxic ability of the lymphocytes was blocked by the addition of antibodies against MHC class I but not by antibodies against MHC class II. These findings revealed that monocyte-derived dendritic cells transfected with WT1 or SART1 mRNA are able to induce tumor antigen-specific cytotoxic T cells and applicable for antitumor dendritic cell-based cellular immunotherapy.	esophagus
Prognostic role of PGE2 receptor EP2 in esophageal squamous cell carcinoma.	Prostaglandin E2 (PGE2), a major cyclooxygenase-2 (COX-2) product, has been shown to affect numerous tumorigenic processes. PGE2 acts through G-protein-coupled receptors designated as EPs. Recently it has been documented that PGE2 promotes colon cancer cell growth via EP2. However, the expression and the prognostic role of EP2 in esophageal squamous cell carcinoma (ESCC) remained unknown. From January 1995 to January 2001, tissue samples from 226 patients with ESCC who underwent esophagectomies at our institutions were collected and made into tissue core arrays for study. EP2 expression was examined by immunohistochemical staining and confirmed by Western blot. The clinicopathologic data were then analyzed. EP2 overexpression was observed in 43.4% (98/226) of ESCC. Overexpression of EP2 correlated positively with depth of tumor invasion (T status) (P = 0.016) and was associated with worse overall survival (P = 0.047). In patients without regional or distant lymph node metastasis (N0 or M0), EP2 overexpression was associated with worse overall survival (P = 0.033 and P = 0.003, respectively). Using Cox regression analysis, T status, N status, and M status were the independent factors of overall survival, but EP2 expression was not. However, when focusing on patients with T1-3N0M0 status, EP2 expression became an independent factor of overall survival (P = 0.048). Our results show that EP2 overexpression was associated with worse prognosis, and correlated positively with T status in ESCC. Meanwhile, among those patients at earlier stages, EP2 overexpression significantly disclosed patients at high risks for poor prognosis.	esophagus
Phase II evaluation of nedaplatin and paclitaxel in patients with metastatic esophageal carcinoma.	PURPOSE: To evaluate the efficiency and toxicities of nedaplatin and paclitaxel in patients with metastatic carcinoma of the esophagus. METHODS: Thirty-nine untreated patients with confirmed metastatic tumors were enrolled. Patients were treated with nedaplatin 80 mg/m(2) and paclitaxel 175 mg/m(2) on day 1. Treatment was repeated every 21 days. RESULTS: Thirty-six patients were eligible to be evaluated to have had a response. The overall response rate was 43.6% (17/39), with complete response and partial response rates of 2.6 and 41%, respectively. The median progression-free survival and overall survival time was 6.1 and 10.3 months, respectively. Grade 3/4 toxicities were only observed in six patients [neutropenia in three patients (7.7%) and nausea/vomiting in three patients (7.7%)]. CONCLUSION: Comparing to other regimens, combination of nedaplatin and paclitaxel achieved an encouraging clinical outcome, with relatively minimal toxicities for patients with metastatic esophageal carcinoma.	esophagus
An oncofetal protein IMP3: a new molecular marker for the detection of esophageal adenocarcinoma and high-grade dysplasia.	Accurate diagnosis of dysplasia and adenocarcinoma in patients with Barrett esophagus is critical for clinical decision-making and patient management. IMP3 is an oncofetal protein and has been demonstrated to be associated with aggressive tumor behavior. The aim of this study was to establish the expression pattern and diagnostic value of IMP3 in Barrett esophagus, dysplasia, and carcinoma. A total of 217 cases (resection, n=56; biopsy, n=161) with 302 lesions (invasive esophageal adenocarcinoma, n=147; metastatic esophageal adenocarcinoma, n=14; high-grade dysplasia of the esophagus, n=52; low-grade dysplasia of the esophagus gland, n=21; and Barrett esophagus, n=68) were examined by immunohistochemistry for IMP3 expression. IMP3 showed strong cytoplasmic granular staining in 138 of 147 (94%) of invasive esophageal adenocarcinomas, 13 of 14 (93%) of metastatic esophageal adenocarcinomas, and 49 of 52 (94%) of high-grade dysplasias. In contrast, 3/21 (14%) of low-grade dysplasia and 5/68 (7%) Barrett esophagus were positive for IMP3. Expression of IMP3 was not found in adjacent benign squamous and glandular mucosa. Our findings indicate that IMP3 is a highly sensitive and specific biomarker for the diagnosis of invasive esophageal adenocarcinoma and high-grade dysplasia. The data also suggest that IMP3, an oncofetal protein, may play an important role in malignant transformation in esophageal adenocarcinoma.	esophagus
Effect of tumor characteristics and duplication of the muscularis mucosae on the endoscopic staging of superficial Barrett esophagus-related neoplasia.	Endoscopic mucosal resection (EMR) is being advocated as a diagnostic, staging, and therapeutic technique for the management of Barrett esophagus (BE)-related neoplasia. With the emergence of new endoluminal therapy including EMR for the treatment of BE-related superficial adenocarcinomas, accurate staging has become crucial to select patients for different treatment arms. Intramucosal adenocarcinomas can be successfully treated by endoluminal techniques, whereas submucosal invasive tumors with a greater risk of lymph node metastasis are likely candidates for esophagectomy. Endoscopic ultrasound (EUS) is used to stage superficial BE-related neoplasms, yet endoscopic staging can be incongruent to that obtained after pathologic examination. In this study, we sought to determine morphologic factors, which may influence EUS staging in 35 cases with intramucosal adenocarcinoma diagnosed by subsequent EMR, focusing on tumor characteristics and structural changes associated with BE. Among the latter duplication of the muscularis mucosae, either fragmented or well-organized, was seen in 64% of 11 cases that were overstaged as having submucosal invasion by EUS, compared with 38% of those accurately staged. A greater vertical thickness of the tumor was also associated with overstaging by EUS (1.61+/-0.75 mm in the discordant vs. 1.16+/-0.67 mm in the concordant groups, P=0.028). The results illustrate how morphologic factors may affect EUS staging of superficial esophageal adenocarcinomas. EUS alone is not sufficient for staging these neoplasms precisely, and to accurately stratify patients into different treatment arms, EMR should play a role as a complementary staging modality.	esophagus
Determination of the irradiation field for clinical T1-T3N0M0 thoracic/abdominal esophageal cancer based on the postoperative pathological results.	OBJECTIVE: In patients with thoracic/abdominal esophageal cancer with no clinical evidence of lymph node metastasis, there is no consensus about whether the irradiation field should include regional lymph nodes. In this study, the extent of the irradiation field for clinical stage T1-3N0M0 esophageal cancer was determined based on the postoperative pathological results. METHODS: From July 1989 to June 2008, 103 patients diagnosed with clinical stage T1-3N0M0 thoracic/abdominal esophageal cancer underwent standard esophagectomy and regional lymph node dissection at the Aichi Cancer Center Hospital. Of these 103 patients, the pathological results of the resected specimens could be confirmed in 95 (92%) patients. The pathological lymphatic spread was reviewed retrospectively, and the extent of the irradiation field was determined based on the postoperative pathological results. RESULTS: Of 95 patients with clinical stage T1-3N0M0 esophageal cancer, 40 (42.1%) had pathological lymph node metastases, and the frequency of nodal metastases was studied by tumor location. The rates of lymph node metastases for the upper, middle, lower and abdominal esophagus were 37.5%, 32.5%, 46% and 70%, respectively. CONCLUSIONS: Pathological lymph nodes metastases are often seen after operation in clinical stage T1-3N0M0 esophageal cancer. In the present study, the optimal lymph nodes to be included in the irradiation field were determined according to the primary site in the esophagus.	esophagus
Extracapsular lymph node involvement differs between squamous cell and adenocarcinoma of the esophagus.	There is increasing evidence regarding extracapsular lymph node involvement (LNI) as a prognostic factor for recurrence and poor prognosis in gastrointestinal malignancies. The aim of this study was to assess the prevalence and prognostic impact of LNI in patients with resected esophageal cancer, comparing adenocarcinoma (AC) and squamous cell carcinoma (SCC). Between 1997 and 2006, 243 consecutive patients with resected esophageal cancer without neoadjuvant therapy (103 SCC, 140 AC) were studied. A total of 738 lymph node metastases were reexamined. Survival was analyzed according to intra- and extracapsular LNI. Median survival in patients with extracapsular LNI was 13 months [range 11-14 months, 95% confidence interval (CI)] compared with 28 months (21-34 months, 95% CI) for those with intracapsular LNI alone (p = 0.017). Node-positive patients with AC showed a prevalence of 66% extracapsular LNI compared with 35% in patients with SCC (p < 0.001). The number of resected lymph nodes and the frequency of pN1 cases were comparable between AC and SCC. However the number of infiltrated LN was significantly (p = 0.005) higher in patients with pN1 AC (median = 5) compared with pN1 SCC (median = 3). We conclude that extracapsular LNI is an independent negative prognostic factor which occurs more frequently in esophageal AC than SCC.	esophagus
Neoadjuvant chemoradiation followed by surgery versus surgery alone for patients with adenocarcinoma or squamous cell carcinoma of the esophagus (CROSS).	BACKGROUND: A surgical resection is currently the preferred treatment for esophageal cancer if the tumor is considered to be resectable without evidence of distant metastases (cT1-3 N0-1 M0). A high percentage of irradical resections is reported in studies using neoadjuvant chemotherapy followed by surgery versus surgery alone and in trials in which patients are treated with surgery alone. Improvement of locoregional control by using neoadjuvant chemoradiotherapy might therefore improve the prognosis in these patients. We previously reported that after neoadjuvant chemoradiotherapy with weekly administrations of Carboplatin and Paclitaxel combined with concurrent radiotherapy nearly always a complete R0-resection could be performed. The concept that this neoadjuvant chemoradiotherapy regimen improves overall survival has, however, to be proven in a randomized phase III trial. METHODS/DESIGN: The CROSS trial is a multicenter, randomized phase III, clinical trial. The study compares neoadjuvant chemoradiotherapy followed by surgery with surgery alone in patients with potentially curable esophageal cancer, with inclusion of 175 patients per arm.The objectives of the CROSS trial are to compare median survival rates and quality of life (before, during and after treatment), pathological responses, progression free survival, the number of R0 resections, treatment toxicity and costs between patients treated with neoadjuvant chemoradiotherapy followed by surgery with surgery alone for surgically resectable esophageal adenocarcinoma or squamous cell carcinoma. Over a 5 week period concurrent chemoradiotherapy will be applied on an outpatient basis. Paclitaxel (50 mg/m2) and Carboplatin (Area-Under-Curve = 2) are administered by i.v. infusion on days 1, 8, 15, 22, and 29. External beam radiation with a total dose of 41.4 Gy is given in 23 fractions of 1.8 Gy, 5 fractions a week. After completion of the protocol, patients will be followed up every 3 months for the first year, every 6 months for the second year, and then at the end of each year until 5 years after treatment. Quality of life questionnaires will be filled out during the first year of follow-up. DISCUSSION: This study will contribute to the evidence on any benefits of neoadjuvant treatment in esophageal cancer patients using a promising chemoradiotherapy regimen. TRIAL REGISTRATION: ISRCTN80832026.	esophagus
Cancer incidence in men: a cluster analysis of spatial patterns.	BACKGROUND: Spatial clustering of different diseases has received much less attention than single disease mapping. Besides chance or artifact, clustering of different cancers in a given area may depend on exposure to a shared risk factor or to multiple correlated factors (e.g. cigarette smoking and obesity in a deprived area). Models developed so far to investigate co-occurrence of diseases are not well-suited for analyzing many cancers simultaneously. In this paper we propose a simple two-step exploratory method for screening clusters of different cancers in a population. METHODS: Cancer incidence data were derived from the regional cancer registry of Umbria, Italy. A cluster analysis was performed on smoothed and non-smoothed standardized incidence ratios (SIRs) of the 13 most frequent cancers in males. The Besag, York and Mollie model (BYM) and Poisson kriging were used to produce smoothed SIRs. RESULTS: Cluster analysis on non-smoothed SIRs was poorly informative in terms of clustering of different cancers, as only larynx and oral cavity were grouped, and of characteristic patterns of cancer incidence in specific geographical areas. On the other hand BYM and Poisson kriging gave similar results, showing cancers of the oral cavity, larynx, esophagus, stomach and liver formed a main cluster. Lung and urinary bladder cancers clustered together but not with the cancers mentioned above. Both methods, particularly the BYM model, identified distinct geographic clusters of adjacent areas. CONCLUSION: As in single disease mapping, non-smoothed SIRs do not provide reliable estimates of cancer risks because of small area variability. The BYM model produces smooth risk surfaces which, when entered into a cluster analysis, identify well-defined geographical clusters of adjacent areas. It probably enhances or amplifies the signal arising from exposure of more areas (statistical units) to shared risk factors that are associated with different cancers. In Umbria the main clusters were characterized by high risks for cancers with alcohol and tobacco both as risk factors. Tobacco-only related cancers formed a separate cluster to the alcohol- and tobacco-related sites. Joint spatial analysis or investigation of hypothesized exposures might be used for further investigation into interesting geographical clusters.	esophagus
Safety of nab-paclitaxel plus sunitinib: analysis of three cases.	BACKGROUND: Second-line treatment options are limited in controlling advanced thoracic cancer in patients who have progressed following first-line chemotherapy. CASE REPORT: The safety of combination therapy with nab-paclitaxel, an albumin-bound paclitaxel, and sunitinib, a tyrosine kinase receptor inhibitor, was evaluated retrospectively in three patients with advanced, previously treated metastatic esophageal cancer, non-small cell lung cancer (NSCLC), and small cell lung cancer (SCLC), respectively. RESULTS: Grade 3 and 4 toxicities were mainly hematological and manageable. A notable improvement in cancer symptoms and reduction in tumor size were seen in all three patients. CONCLUSION: Based on the easily managed toxicities and apparent efficacy of the regimen of weekly nab-paclitaxel and daily sunitinib, we conclude that further evaluation is warranted to assess the efficacy of this combination therapy in previously chemotherapy-treated patients with advanced thoracic cancer.	esophagus