crossing96/oncoscreening huggingface dataset:
Effect of thoracic size on postoperative outcomes in transabdominal gastrectomy for Siewert type II/III adenocarcinoma of the esophagogastric junction.	BACKGROUND: The surgery of adenocarcinoma of the esophagogastric junction (AEG) is a complex procedure that increases postoperative morbidity compared to distal gastric cancer. In this study, we included thoracic anatomical parameters of patients for the first time to investigate their impact on the postoperative outcomes of transabdominal gastrectomy for Siewert type II/III AEG. METHODS: All patients with Siewert type II or III AEG of our institution who underwent transabdominal proximal or total gastrectomy from January 2015 to December 2022 were included in this study. We measured thoracic anatomical parameters on the level of the lower edge of the sternum using preoperative computer tomography. The anteroposterior diameter of the thorax was measured as the distance from the posterior edge of the sternum to the anterior edge of the spine, while the transverse diameter was the maximum distance between the ribs on both sides. Patients' data and postoperative details were retrospectively collected. Correlation between thoracic anatomical parameters with postoperative complications were analyzed. RESULTS: Overall, 647 patients were eligible for this study. The incidence of postoperative complications was 28.1%, with postoperative pulmonary complications occurring in 24.7%. In multivariate analysis, anteroposterior thoracic diameter > 10.2 cm was an independent risk factor for postoperative complications (OR = 1.891, 95% CI: 1.137-3.146, p = 0.014), transverse thoracic diameter > 23.3 cm was an independent risk factor for postoperative pulmonary complications (OR = 2.243, 95% CI: 1.234-4.079, p = 0.004). In open group, transverse thoracic diameter over 23.3 cm correlated independently with postoperative complications (OR = 2.451, 95% CI: 1.219-4.927, p = 0.012) and postoperative pulmonary complications (OR = 2.988, 95% CI: 1.407-6.347, p = 0.004). However, this correction was not significant in laparoscopy-assisted group. CONCLUSIONS: Thoracic size is an independent risk factor affecting the postoperative outcomes of transabdominal gastrectomy for Siewert type II and III AEG. Patients with larger thoracic cage are at a higher risk of postoperative complications, particularly pulmonary complications. For those patients, laparoscopic surgery may be a viable option.	esophagus
Conversion from Radical Esophagectomy to Definitive Chemoradiotherapy After Neoadjuvant Chemotherapy for Advanced Esophageal Squamous Cell Carcinoma: Treatment Options Based on Chemotherapy Response.	BACKGROUND: Radical esophagectomy after neoadjuvant chemotherapy (NAC) is the established strategy for resectable advanced esophageal cancer. However, some patients are converted to definitive chemoradiotherapy (dCRT) after NAC due to reasons such as their wishes or disease progression, and their prognosis remains uncertain. This study aimed to investigate the prognosis of patients who converted to dCRT. METHODS: Patients who underwent NAC for resectable advanced esophageal squamous cell carcinoma between 2006 and 2020 were enrolled in this study retrospectively. The prognostic impact of subsequent treatment after NAC, planned surgery, or conversion to dCRT, was compared. RESULTS: The study analyzed 686 patients, 70 who were converted to dCRT (dCRT group) and 616 who underwent surgery (Surg group). The dCRT group had a poorer prognosis than the Surg group, with more advanced tumors and poorer response to NAC. Therefore, further analysis was performed by categorizing patients as Responders (complete or partial response) and Non-responders (stable or progressive disease) to NAC. Among the Responders in the dCRT group, 76.7 % achieved a complete response, and the 5-year esophageal preservation survival rate was 66.9 %. The 5-year survival rates for Responders were 77.5 % in the dCRT group and 71.3 % in the Surg group. Multivariable analysis showed that dCRT did not worsen prognosis (P = 0.706; hazard ratio, 1.13; 95 % confidence interval, 0.59-2.16). Conversely, among the Non-responders, dCRT had a significantly poorer prognosis, with 5-year survival rates of 22.3 % in the dCRT group and 45.1 % in the Surg group (P < 0.001). CONCLUSIONS: For patients responding to NAC, conversion to dCRT is considered a potential treatment option.	esophagus
[A Case of Salvage Lymphadenectomy with a Median Sternotomy after Definitive Chemoradiotherapy for Esophageal Cancer].	A 73-year-old man with middle thoracic esophageal squamous cell carcinoma(SCC)underwent definitive chemoradiotherapy( dCRT)with cisplatin and 5-fluorouracil(CF)concurrently administered with 60 Gy radiotherapy. Clinical complete response was achieved, but thoracic tracheal lymph node metastases(No. 106recL and No. 106pre)were detected 19 months after the completion of dCRT. Following 2 courses of CF therapy, salvage lymphadenectomy was performed via median sternotomy. Combined partial resection of tracheal cartilage and the left recurrent laryngeal nerve ensued due to suspected tumor invasion. Histopathological analysis confirmed the SCC metastases in the No. 106recL and No. 106pre lymph nodes, affirming R0 resection. Adjuvant chemotherapy with S-1 was administered for 24 months. Despite the emergence of multiple lung and left supraclavicular lymph node metastases 24 months after surgery, no local recurrence within the surgical field was noted. A durable response to CF therapy combined with pembrolizumab was achieved, and the patient remains under treatment, exhibiting no signs of disease progression. In the context of salvage lymphadenectomy, attainment of R0 resection within an optimal surgical field holds paramount importance for effective local disease control.	esophagus
[A Case of Esophageal Squamous Cell Carcinoma with Gastric Intramural Metastasis Showing Pathological Complete Response after Neoadjuvant Chemotherapy with Docetaxel, Cisplatin, and 5-Fluorouracil].	A 75-year-old man presenting with dysphagia was referred to our hospital and diagnosed with advanced esophageal squamous cell carcinoma(ESCC)accompanied by an intramural metastasis in the gastric wall. Following completion of 3 courses of neoadjuvant chemotherapy(NAC)with docetaxel/cisplatin/5-fluorouracil(DCF), the patient underwent minimally invasive esophagectomy with 3-field lymph node dissection. Histopathological examination showed no viable cancer cells in the esophageal and gastric wall, confirming a complete response. The patient was alive with no evidence of disease as of the 5-year postoperative follow-up. According to the results of a clinical trial conducted by the Japan Clinical Oncology Group (JCOG1109), DCF has become the standard NAC regimen for clinical Stage Ⅱ/Ⅲ ESCC. Although ESCC with a gastric intramural metastasis is notorious for its dismal prognosis, multidisciplinary treatment with intensive NAC and radical surgery may provide a cure for even for patients with highly advanced disease.	esophagus
Outcomes after radical endoscopic resection of high risk T1 esophageal adenocarcinoma: an international multicenter retrospective cohort study.	Post-endoscopic resection (ER) management of high risk T1 esophageal adenocarcinoma (EAC) is debated, with conflicting reports on lymph node metastasis (LNM). We aimed to assess outcomes following radical ER for high risk T1 EAC.We identified patients who underwent radical ER (tumor-negative deep margin) of high risk T1 EAC, followed by surgery or endoscopic surveillance, between 2008 and 2019 across 11 international centers.106 patients (86 men; mean [SD] age, 70 [11] years) were included. Of these, 26 (age, 64 [11] years) underwent additional surgery, with residual T1 EAC found in five patients (19%) and LNM in two (8%). After a median [IQR] follow-up of 47 [32-79] months, 2/26 patients (8%) developed LNM/distant metastasis, with one EAC-related death (4%), one unrelated death (4%), and four patients lost to follow-up (15%). Of the 80 patients (age, 71 [9] years) who entered endoscopic surveillance, 5/80 (6%) developed LNM/distant metastasis, with four EAC-related deaths (5%) over 46 (IQR 25-59) months follow-up; there were 15 unrelated deaths (19%), and 10 patients lost to follow-up (13%). The overall rates (95%CI) were: LNM, 6% (2%-12%); LNM/distant metastasis, 7% (3%-13%); EAC-related mortality, 5% (2%-11%); overall mortality, 20% (95%CI 13-29).Our findings present low rates of LNM after radical ER of high risk T1 EAC, consistent with other endoscopy-focused studies. Post-surgical patients are still at risk for metastasis and disease-specific mortality. These results suggest that endoscopic surveillance is suitable for selected cases, but further prospective studies are needed to refine patient selection and confirm optimal outcomes.	esophagus
Discovery of 2,4-diaminopyrimidine derivatives as potent inhibitors of FAK capable of activating the Hippo pathway for the treatment of esophageal squamous cell carcinoma.	In this work, we report the discovery of 2,4-diaminopyrimidine derivatives bearing a urea moiety as FAK inhibitors capable of activating the Hippo pathway in Esophageal Squamous Cell Carcinoma (ESCC). Extensive structure-activity relationship studies were conducted based on the lead FAK inhibitor TAE-226 to enhance the inhibitory potency, and the most potent compound 8b (MY-1576) as a FAK inhibitor ultimately was identified. Compound MY-1576 exhibited potent FAK inhibitory activity, in vitro anticancer activities, and acceptable PK properties. Notably, MY-1576 could activate the Hippo pathway, resulting in impeding YAP/TAZ regulation. MY-1576 also effectively suppressed the tumor growth in the KYSE30 xenograft mouse models with good safety profiles, and potently down-regulated the autophosphorylation of FAK and the levels of YAP/TAZ in vivo. Taken together, these results indicate that MY-1576, functioning as a FAK inhibitor capable of activating the Hippo pathway, is a promising candidate against ESCC.	esophagus
National trends in operative approach to esophagectomy: utilization rates, outcomes, and overall survival.	BACKGROUND: Although open esophagectomies (OE) have traditionally been favored, minimally invasive approaches are increasingly utilized and associated with improved outcomes. We investigated the adoption rates of robotic-assisted minimally invasive esophagectomy (RAMIE) and minimally invasive esophagectomy (MIE) compared with OE. Utilization rates by surgical approach, post-operative outcomes, and overall survival were analyzed. METHODS: The National Cancer Database was queried for patients who underwent OE, MIE, and RAMIE for esophageal cancer from 2010 to 2019. Adoption rates of RAMIE, MIE and OE were determined for all patients. Patients with primary cervical esophageal cancer, stage 4 disease, unknown staging, or missing follow-up data were excluded. Multivariable Cox regression models compared overall survival based on surgical approach. RESULTS: A total of 17,765 patients underwent an esophagectomy for stage I, II, and III disease (OE: n = 10,039; MIE: n = 5388; RAMIE: n = 2338). Between 2010 and 2019, OE decreased by 52%, while MIE and RAMIE increased by 49% and 704%, respectively. The overall conversion rate of MIE and RAMIE to OE decreased significantly over the study time period. On multivariable analysis, the odds of 30-day and 90-day mortality was lower for MIE (p < 0.001; p < 0.001) and trended towards lower for RAMIE when compared to OE, though was not a statistically significant difference. Further, the overall 5-year survival was higher in the MIE and RAMIE cohort compared to the OE cohort. Like short-term survival, patients who underwent MIE had a significantly lower mortality (p < 0.001) while those who underwent RAMIE trended towards lower mortality. CONCLUSION: This contemporary review of a national cohort demonstrates the rapid adoption of minimally invasive esophagectomy techniques, without compromise in short-term or long-term outcomes.	esophagus
Risk of serum circulating environmental chemical residues to esophageal squamous cell carcinoma: a nested case-control metabolome-wide association study.	Esophageal squamous cell carcinoma (ESCC) is the primary histological subtype of esophageal carcinoma, yet research on environmental exposure risks and associated metabolic alterations preceding ESCC is limited. In a nested case-control cohort of 396 adults (199 diagnosed with ESCC and 197 healthy controls (HC)), we combined exposomics and metabolomics to assess circulating chemical residues and early serum metabolic changes linked to ESCC risk. A cell experiment further evaluated the proliferative impact of 1H,1H,2H,2H-perfluorooctanesulfonic acid (6:2 FTS), identifying it as a risk factor for ESCC, primarily through lipid metabolism-related chronic inflammation. Significant metabolic disruptions were observed in ESCC cases, characterized by increased carnitines, phosphatidylcholines (PCs), and triglycerides (TGs) alongside reduced lysophosphatidylcholines (LPCs) and ether lysophosphatidylcholines (LPC-Os). An early-warning biomarker panel, including glutamic acid, methionine, choline, LPC-O 18:0, TG (14:0_18:2_20:5), and PC (18:0_20:4)/LPC 18:0, showed improved predictive capacity when combined with 6:2 FTS. Metabolome-exposome-wide association studies largely confirmed 6:2 FTS as a potential ESCC risk factor through lipid mediation. This study offers novel insights for ESCC prevention and early diagnosis through a combined biomarker panel integrating metabolic and environmental risk indicators.	esophagus
Association of nutritional and inflammatory status with patient self-reported symptoms in oesophageal cancer patients: A multicentre cross-sectional study.	"PURPOSE: Nutritional and inflammatory status is heterogeneous among oesophageal cancer patients and affects the recovery of patients' postoperative symptoms. We conducted this study to identify classes of nutritional and inflammatory status in oesophageal cancer patients, providing a basis for precise interventions to improve long-term prognosis and survival. METHODS: Patients' preoperative nutritional and inflammatory status was obtained based on haematological tests. Self-reported symptoms were measured using the Recovery Symptom Assessment Scale for Patients Undergoing Oesophageal Cancer Resection. Latent class analysis analyses were used to identify heterogeneity in inflammation and nutrition in oesophageal cancer patients. Analysis of variance was used to test for differences in symptoms among patients with different inflammatory and nutritional status. RESULTS: The Latent class analysis identifies three classes of body composition: ""Low Inflammation-Good nutrition Group"", ""High Inflammation-Good nutrition Group "" and ""High Inflammation-Poor nutrition Group"". Analysis of variance showed that the recovery of early postoperative symptoms and early recovery symptoms differed between the classes of oesophageal cancer patients. CONCLUSIONS: Different classes of preoperative nutritional and inflammatory status exist in oesophageal cancer patients, and there are differences between early recovery symptoms and psychosocial symptoms between these classes. Therefore, early assessment of the class of body composition in patients with oesophageal cancer is essential to improve their symptoms. Scientific and effective symptomatic interventions should be further explored in the future to improve the long-term prognosis of oesophageal cancer patients."	esophagus
Pan-cancer and multi-omics analysis: NDUFA1 is a potential therapeutic target and prognostic marker for esophageal cancer.	OBJECTIVES: The study examined the NDUFA1 expression and its prognostic value in pan-cancer, especially in esophageal cancer (ESCA). Its carcinogenic effect on ESCA was further elucidated. MATERIALS AND METHODS: TCGA database was used to examine NDUFA1 expression and its prognostic value in 33 cancer types. GO and KEGG were performed for function and pathway enrichment of NDUFA1-related genes. The carcinogenic effect on ESCA was verified in both KYSE-30 cell and Xenograft mouse model. RESULTS: Abnormal high expression of NDUFA1 was detected in pan-cancer, and related to immune cell infiltration. TCGA database indicated an elevated value of NDUFA1 in ESCA tumor tissues, which was linked to patients' poor prognosis. NDUFA1-related genes were mainly enriched in oxidative stress and immune response in ESCA. NDUFA1 knockdown significantly suppressed ESCA cell proliferation, migration and invasion. Similarly, tumor growth of ESCA xenograft mice was inhibited by NDUFA1 knockdown. Activated PI3K-Akt signaling was detected in both ESCA cell lines and tumor tissues, which was reversed by NDUFA1 knockdown. CONCLUSION: Multi-omics analysis showed that NDUFA1 might be adopted as a potential therapeutic goal and prognostic indicator for a variety of cancers, especially for ESCA. NDUFA1 knockdown inhibited ESCA tumor growth, which may have the participation of the PI3K/Akt signaling pathway.	esophagus
Post-oesophagectomy hiatal hernia.	This video tutorial presents the laparoscopic repair of a post-oesophagectomy hiatal hernia in a 69-year-old patient who had an oesophagectomy 5 years previously for distal oesophageal cancer. He presented acutely with epigastric pain, nausea and hiccups. During the operation, the herniated small bowel was reduced and found to be viable. The defect was sealed by suturing the conduit to the diaphragm. At a follow-up examination 23 months after the repair, the patient is asymptomatic and there is no evidence of recurrence.	esophagus
Comparative study on different endoscopic submucosal dissection techniques for the treatment of superficial esophageal cancer and precancerous lesions.	BACKGROUND: This study aims to compare the effectiveness and safety of traditional endoscopic submucosal dissection (ESD), endoscopic submucosal tunneling dissection (ESTD), and endoscopic submucosal dissection with C-shaped incision (ESD-C) in the treatment of superficial esophageal cancer and precancerous lesions, providing reference and guidance for the treatment of esophageal cancer. METHODS: A retrospective analysis was conducted on the clinical data of patients who underwent ESD (n = 96), ESTD (n = 103), and ESD-C (n = 98) for superficial esophageal cancer or precancerous lesions between January 2017 and December 2022. Through comparative analysis, the effectiveness and safety of the three surgical methods were evaluated, and the risk factors for postoperative esophageal stricture were explored. RESULTS: In terms of total operative time and dissection time, the ESD group > ESTD group > ESD-C group; in terms of dissection speed, the ESD group < ESTD group < ESD-C group; in terms of dissection area, the ESD group < ESTD group and ESD-C group; and in terms of wound treatment time, the ESD group > ESTD group and ESD-C group. In terms of surgical outcomes, the en bloc resection rate was 100% in all three groups, with complete resection rates of 86.84%, 90.79%, and 88.16% in the ESD, ESTD, and ESD-C groups, respectively. The risk factors for postoperative esophageal stricture included dissection area, circumferential proportion of the lesion, and injury to the muscularis propria. CONCLUSION: Among the three surgical approaches, ESD-C demonstrated superior performance in operative time, resection speed, and procedural efficiency. Increased circumferential involvement of the lesion, larger resection area, and greater injury to the muscularis propria were associated with a heightened risk of postoperative esophageal stricture.	esophagus
The implementation of eras in Belgian esophageal surgery centers.	Esophagectomy for cancer is a highly invasive procedure with significant post-operative morbidity and mortality. The literature suggests a clear volume outcome correlation. Since 2019, esophageal surgery has been centralized in Belgium. In 2019, enhanced recovery after surgery (ERAS) guidelines were published for esophagectomy. The purpose of this study was to evaluate the level of implementation of these ERAS guidelines in Belgium. Surgeons from centralized esophageal surgery centers in Belgium were questioned. A Delphi questionnaire regarding peri-operative ERAS care and center-specific outcome data were sent to all participating surgeons. An ERAS scoring system was created to estimate and compare the level of ERAS implementation. Length of stay, post-operative pneumonia, anastomotic leakage and 30-day and 90-day mortality were evaluated. A high response rate of 94.1% was achieved. All surgeons used a peri-operative protocol in their center. The mean ERAS score for Belgian surgeons was 15.5 out of 20. The highest ERAS score per center is 18.6. Anastomotic leakage rate is 14.6% and post-operative pneumonia rate is 20.8% in Belgium. The mean length of stay is 12 days. Mortality after 30 days and 90 days are, respectively, 3.2% and 6.6%. This study gives an overview of the Belgian situation regarding the implementation of ERAS protocols in esophageal surgery centers. The overall implementation of ERAS guidelines in Belgium is good, but there is room for improvement in terms of uniformity nationally.	esophagus
Correlation Between Histopathological Response of Esophageal Squamous Cell Carcinoma to Neoadjuvant DCF Therapy and the Clinical Efficacy of Palliative Chemotherapy for Recurrence.	BACKGROUND: Docetaxel-cisplatin-5-fluorouracil (DCF) is a new standard neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma (ESCC) in Japan. However, some patients experience recurrence and require further systemic platinum-containing chemotherapy. It is unclear whether such regimens are appropriate after a poor histopathological response to neoadjuvant DCF. METHODS: Data were retrospectively collected on patients with recurrence of ESCC treated with palliative chemotherapy after neoadjuvant DCF at our institution between February 2014 and June 2022. We defined patients with a grade 0-1 histopathological response as insufficient responders (IRs) and those with grade 2-3 as good responders (GRs). The correlation between the histopathological response and the response to palliative chemotherapy was investigated. RESULTS: Thirty-two patients (median age 63.5 years, range 46-76) were included. Performance status was 0 in 12 (37.5%), 1 in 16 (50.0%), and 2 in 4 (12.5%). Histopathological response grades 0/1/2/3 were 3.1%/68.7%/21.9%/6.3%, respectively. Platinum-containing chemotherapy was administered to 13 patients (56.5%) in the IR group and 9 (100%) in the GR group. The overall response rate was 34.8%, and median progression-free survival was 2.431 months in the IR group and 44.4% and 4.041 months, respectively, in the GR group. Multivariate analysis identified a chemotherapy-free interval of < 6 months as an independent prognostic factor (HR 4.096, 95% CI 1.116-15.037) but not the histopathological response (HR 1.137, 95% CI 0.309-4.177). CONCLUSIONS: Histopathological response to neoadjuvant DCF therapy did not affect the efficacy of first-line chemotherapy for recurrent ESCC.	esophagus