crossing96/oncoscreening huggingface dataset:
INTEROBSERVER AGREEMENT OF INTRAPAPILLARY CAPILLARY LOOPS CLASSIFICATION FOR SUPERFICIAL ESOPHAGEAL SQUAMOUS CELL CARCINOMA IN A WESTERN CENTER.	BACKGROUND: Accurate evaluation of the invasion depth of superficial esophageal squamous cell carcinoma (SESCC) is crucial for optimal treatment. While magnifying endoscopy (ME) using the Japanese Esophageal Society (JES) classification is reported as the most accurate method to predict invasion depth, its efficacy has not been tested in the Western world. This study aims to evaluate the interobserver agreement of the JES classification for SESCC and its accuracy in estimating invasion depth in a Brazilian tertiary hospital. METHODS: We retrospectively selected ME with Narrow Band Imaging (ME-NBI) images of 30 suspected SESCC cases. The best images of each case were included in online forms, which were evaluated by ten endoscopists (five experts and five novices). The evaluators classified the lesions according to the JES-IPCL classification and estimated the depth of invasion. Interobserver agreement was assessed using kappa values. Histological comparison was possible for 17 lesions. RESULTS: The overall interobserver agreement for the JES-IPCL classification was moderate (K=0.455, P<0.001). Agreement among experts (K=0.437) and novices (K=0.483) was also moderate. Sensitivity, specificity, and accuracy for IPCL types were: B1 (41.3%, 78.9%, 59.9%), B2 (75%, 66.7%, 68.7%), and B3 (46%, 91.7%, 78.6%). Overall accuracy of the JES classification for estimating depth of invasion was 47.5%. CONCLUSION: The moderate interobserver agreement suggests the JES-IPCL classification may be useful in the Western world, but extensive training is needed. The findings indicate a longer learning curve for accurate ME-NBI image evaluation using the JES classification.	esophagus
Single-cell analysis of Barrett's esophagus and carcinoma reveals cell types conferring risk via genetic predisposition.	Inherited genetic variants contribute to Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC), but it is unknown which cell types are involved in this process. We performed single-cell RNA sequencing of BE, EAC, and paired normal tissues and integrated genome-wide association data to determine cell-type-specific genetic risk and cellular processes that contribute to BE and EAC. The analysis reveals that EAC development is driven to a greater extent by local cellular processes than BE development and suggests that one cell type of BE origin (intestinal metaplasia cells) and cellular processes that control the differentiation of columnar cells are of particular relevance for EAC development. Specific subtypes of fibroblasts and endothelial cells likely contribute to BE and EAC development, while dendritic cells and CD4(+) memory T cells seem to contribute to BE development. The diagnostic value of markers characterizing the cell types and cellular processes should be explored for EAC prediction.	esophagus
Diagnostic and therapeutic appropriateness in different stages of esophageal/GEJ cancers. The FICOG project.	BACKGROUND: Esophageal cancer is a rare neoplasm, with more than 0.6 million new cases and 0.54 million deaths worldwide in 2020. The distal third of the esophagus and the gastroesophageal junction (GEJ) are mostly involved sites. The diagnosis and therapeutic management of early, locally advanced, and metastatic disease continue to present uncertainties, as existing guidelines may not fully address all clinical questions in these areas. METHODS: A group of Italian Experts produced recommendations for early, locally advanced, and metastatic disease management using the RAND/UCLA Appropriateness Method. Statements were generated by a systematic revision of the literature and voted on twice by a panel of 29 expert physicians; the second vote took place during a meeting of the panelists. RESULTS: Several topics covered diagnosis, staging, treatment, and early, localized, and metastatic disease management. Recommendations were stated. CONCLUSIONS: Interventions considered appropriate to improve compliance and outcomes of esophageal/GEJ cancer patients were identified.	esophagus
Quality indicator survey of clinical practice guidelines for esophagogastric junction cancer 2023.	Clinical practice guidelines for esophagogastric junction cancer (EGJ GLs) were published in 2023. In order to evaluate how EGJ GLs have been adopted into clinical practice worldwide and to identify any outstanding clinical questions to be addressed in the next edition, this survey was conducted. An electronic questionnaire was developed. The questionnaire comprised 16 questions designed to assess the adoption of the guideline. Responses were collected online. The survey was conducted by the EGJ working group of International Gastric Cancer Association (IGCA) following approval from the guideline committee of The International Society for Diseases of the Esophagus (ISDE). As results, we received 344 valid and complete responses. 55% of respondents were from East Asia followed by Europe, Central/South America, and Central/West Asia. 80% of respondents recognized and followed the guidelines to some extent. There was still diversity in the extent of lymphadenectomy for EGJ cancers with an esophageal invasion of 2-4 cm. Although white light imaging (WLE) alone was recommended in the EGJ GLs, both WLE and image enhanced endoscopy were used in 86% of respondents. The perioperative treatment was shown to be highly diverse worldwide. While 50% of respondents provided perioperative chemotherapy, preoperative chemotherapy without adjuvant treatment and upfront surgery were still the first treatment option in 15% of respondents. In conclusion, the current survey conducted by IGCA and ISDE identified the current standard and remaining issues of EGJ cancers.	esophagus
Bayesian Counterfactual Machine Learning Individualizes Radiation Modality Selection to Mitigate Immunosuppression.	PURPOSE: Lymphocytes play critical roles in cancer immunity and tumor surveillance. Radiation-induced lymphopenia (RIL) is a common side effect observed in patients with cancer undergoing chemoradiation therapy (CRT), leading to impaired immunity and worse clinical outcomes. Although proton beam therapy (PBT) has been suggested to reduce RIL risk compared with intensity-modulated radiation therapy (IMRT), this study used Bayesian counterfactual machine learning to identify distinct patient profiles and inform personalized radiation modality choice. METHODS: A novel Bayesian causal inferential technique is introduced and applied to a matched retrospective cohort of 510 patients with esophageal cancer undergoing CRT to identify patient profiles for which immunosuppression could have been mitigated from radiation modality selection. RESULTS: BMI, age, baseline absolute lymphocyte count (ALC), and planning target volume determined the extent to which reductions in ALCs varied by radiation modality. Five patient profiles were identified. Significant variation in ALC nadir between PBT and IMRT was observed in three of the patient subtypes. Notably, older patients (age >69 years) with normal weight experienced a two-fold reduction in mean ALC nadir when treated with IMRT versus PBT. Mean ALC nadir was reduced significantly for IMRT patients with lower ALC at baseline (<1.6 k/µL) who were overweight or obese when compared with PBT, whereas overweight patients with higher baseline ALC showed clinical equipoise between modalities. CONCLUSION: Individualized radiation therapy selection can be an important tool to minimize immunosuppression for high-risk patients. The Bayesian counterfactual modeling techniques presented in this article are flexible enough to capture complex, nonlinear patterns while estimating interpretable patient profiles for translation into clinical protocols.	esophagus
Prognostic relevance of CT-defined body composition in esophageal cancer patients undergoing curative treatment.	INTRODUCTION: Body composition including low skeletal muscle mass (LSMM) defined by skeletal muscle index (SMI) and subcutaneous and visceral adipose tissue (SAT and VAT) can be assessed using cross-sectional imaging techniques. Previous studies have shown promising prognostic value for several tumour entities, including esophageal cancer (EC). The aim of this study was to analyse possible associations of body composition parameters in patients with esophageal cancer undergoing curative treatment. METHODS: All patients with EC undergoing curative treatment were retrospectively evaluated between 2016 and 2023. A total of 145 patients (17 female, 11.7 %) with a mean age of 65.9 ± 10.2 years were included in the present analysis. For all patients, staging computed tomography (CT) was used to calculate LSMM, VAT, and SAT. The primary study end point was all-cause overall survival. For statistical analysis group differences were calculated using the Mann-Whitney test. Kaplan-Meier curves and multivariable Cox regression analysis was used to test the effect of body composition parameters on mortality. RESULTS: In total, 51 patients (35.2 %) of the patient cohort died within the observation period. According to the sarcopenia threshold of the SMI, 99 patients (68.2 %) were classified as sarcopenic and according to the VAT threshold, 102 patients (70.3 %) were classified as visceral obese. Sarcopenia and visceral obesity were associated with mortality with a hazard ratio (HR) of 2.05 (95%confidence interval (CI) 1.17, 3.57, p = 0.01) and 2.47 (95%CI 1.39, 4.37, p = 0.002) in univariable analysis, respectively. Only the combination of both, sarcopenic obesity was significantly associated in multivariable analysis (HR 2.47, 95 %CI 1.39; 4.37, p = 0.002) CONCLUSIONS: The combination of CT-defined sarcopenia and visceral obesity showed a strong prognostic relevance in EC undergoing curative resection. The effect of sarcopenia and visceral obesity considered separately was of lesser prognostic significance. CT-defined body composition may help to better stratify patients with EC at risk of worse outcome in clinical practice.	esophagus
RNF217-KEAP1-NRF2 feedback loop confers therapeutic resistance by inhibiting ferroptosis in esophageal squamous cell carcinoma.	Resistance to chemoradiotherapy is a crucial factor limiting the efficacy of therapy and prognosis of esophageal cancer. It is necessary to elucidate the key genes and regulatory mechanisms responsible for therapeutic resistance in esophageal squamous cell carcinoma (ESCC). In this study, we found a relationship between ferroptosis and therapeutic sensitivity in ESCC and identified the ring finger protein 217 (RNF217) as a new regulator of ferroptosis associated with resistance to chemoradiotherapy in ESCC. Mechanistically, RNF217 interacts with kelch like ECH associated protein 1 (KEAP1) and promotes its ubiquitination and degradation, resulting in nuclear factor erythroid 2-related factor 2 (NRF2) evading KEAP1-mediated degradation and, consequently, enhanced NRF2 signaling and led to ferroptosis resistance. Furthermore, NRF2 facilitated the transcription of RNF217 by binding to antioxidant response elements in the RNF217 promoter upon irradiation. Overall, our findings indicate that the RNF217-KEAP1-NRF2 feedback loop is a previously unrecognized mechanism regulating resistance to chemoradiotherapy in ESCC and could be a target to overcome therapeutic resistance in ESCC.	esophagus
Treatment choices after endoscopic resection for pMM/SM1 esophageal squamous cell cancer: a retrospective study in China.	BACKGROUND: Treatment choices for patients with pathological muscularis mucosa/submucosal layer (pMM/SM1) esophageal squamous cell cancer (ESCC) after endoscopic resection (ER) are controversial. MATERIALS AND METHODS: A single-center retrospective study at Beijing Cancer Hospital in China was conducted. Between February 2012 and November 2023, we retrospectively recruited patients with pMM/SM1 ESCC who underwent ER with or without subsequent adjuvant therapy. Survival was compared between groups. RESULTS: Overall, 93 patients were screened, and 73 patients were included. Kaplan‒Meier analysis revealed that a length of invasive cancer ≤ 10 mm (OS, P = 0.025; DFS, P = 0.059) was a high-risk factor. Compared with the follow-up group, patients who underwent radical surgery (SR) immediately after ER demonstrated significantly shorter overall survival (OS) and disease-free survival (DFS) (OS, P < 0.01; DFS, P < 0.001). High-risk patients (pMM/SM1 patients with an invasive cancer length ≤ 10 mm) may benefit from chemoradiotherapy (CRT), but low-risk patients may not. CONCLUSION: The length of invasive cancer ≤ 10 mm may be a newly identified high-risk factor. CRT after ER is recommended for high-risk patients but not for low-risk patients. SR is not recommended for any patient.	esophagus
Effect of radical radiotherapy dose on the prognosis of limited-stage thoracic small cell carcinoma of the esophagus: A multicenter retrospective trial from China (CHiSCEC).	BACKGROUND: The optimal radiation dose for the treatment of small cell carcinoma of the esophagus (SCEC) has not been established. This study aimed to investigate the treatment outcomes and toxicities in patients with limited-stage SCEC (LS-SCEC) treated by radiotherapy. METHODS: Patients with LS-SCEC from 14 institutions were retrospectively identified between December 2000 and October 2021. The primary endpoints of the study included overall survival (OS), progression-free survival (PFS), and local regional control (LRC), and the secondary endpoints were treatment-related toxicity parameters. Patients were categorized into a high-dose (HD, ≥ 60 Gy) group and low-dose (LD, <60 Gy) group based on the radiation dose. Additionally, they were classified into two groups based on the treatment sequence: concurrent chemoradiotherapy (CCRT) and sequential chemoradiotherapy (SCRT). A 1:1 propensity score matching (PSM) approach was applied to balance the observable potential confounding factors between the groups. RESULTS: Of the 150 patients included in the study, 56 received LD, and 94 received HD radiotherapy. After 1:1 PSM, the OS, PFS, and LRC in the HD group were higher than those in the LD group; however, the difference was not statistically significant (P > 0.05). No significant differences in survival and the occurrence of treatment-related toxicity were observed between the CCRT and SCRT groups. CONCLUSIONS: Neither CCRT nor SCRT was significantly associated with longer survival in LS-SCEC when a higher radiation dose was selected. A lower radiation dose might be a preferable time-dose fraction scheme; however, additional studies are required to validate these findings.	esophagus
Efficacy and safety of talaporfin sodium photodynamic therapy as a salvage treatment for locally recurrent esophageal squamous cell carcinoma.	BACKGROUND: Esophageal squamous cell carcinoma (ESCC) presents significant treatment challenges, with chemoradiotherapy (CRT) leading to local recurrence in 30-40% of cases. Limitations of traditional salvage therapies have driven interest in photodynamic therapy with talaporfin sodium (TS-PDT), a minimally invasive treatment with reduced phototoxicity, which has been increasingly utilized since its approval in Japan. METHODS: This retrospective study at the Nagoya City University Hospital (May 2016-December 2023) assessed the efficacy of TS-PDT for esophageal cancer after CRT or radiotherapy in 29 patients who met specific inclusion criteria. The evaluated outcomes included adverse events, local complete response (L-CR), progression-free survival (PFS), and overall survival (OS). RESULTS: Among the patients (23 men and 6 women; median age, 72 years), TS-PDT achieved an L-CR rate of 81.5% per patient and 87.8% per lesion, with a higher success rate against T1b lesions. The median local PFS was 44.1 months, and OS had not yet been reached, with a 1-year survival rate of 91.9%. The adverse events included esophageal strictures and perforations. CONCLUSION: TS-PDT is a potentially effective salvage treatment for ESCC, offering efficient local control and favorable survival outcomes. Despite some adverse events, its reduced phototoxicity and versatility make it a viable option, particularly for elderly patients. Further multicenter trials are warranted to validate its role in esophageal cancer management.	esophagus
Tumor deposits in locally advanced esophageal cancer: redefining TNM staging and prognostic implications after surgical resection.	BACKGROUND: Tumor deposits (TDs), also known as cancer nodules, were initially identified in patients with colorectal adenocarcinoma. In addition, TDs are defined as localized accumulations of tumor cells within the peritumoral adipose tissue. In addition, similar tumor nodules have been observed in patients with esophageal cancer (ESCA). Although evidence suggests a correlation between TDs and poor prognosis in ESCA, their qualitative, staging, and prognostic implications remain contentious. This study aimed to clarify the function and survival implications of TDs in ESCA. METHODS: A retrospective analysis was conducted on 482 individuals with ESCA who underwent esophagectomy treatment between 2014 and 2022. Patients were categorized into the TD-positive (TDP) group and the TD-negative (TDN) group according to the presence or absence of TDs in postoperative specimens. The clinicopathological features of the 2 groups were compared. The predictive significance of TDs underwent examination using Cox regression models, whereas the effect of TDs on the TNM staging framework received additional evaluation. RESULTS: Among the 482 patients with TNM stage III and IV ESCAs, 433 (89.8%) were in the TDN group, and 49 (10.2%) were in the TDP group. Both in the overall cohort and within the TNM stage III and IV subgroups, the TDP group had a worse prognosis than the TDN group. No significant prognostic difference was observed between patients with TNM stage III with positive TDs and those with TNM stage IV with negative TDs. Within each N stage subgroup, the TDP group consistently exhibited inferior outcomes than the TDN group. CONCLUSION: TDs are associated with a poorer prognosis in ESCA and represent an independent risk factor for adverse outcomes. Subsequent updates to the TNM staging system should consider the inclusion of TDs to improve its prognostic precision.	esophagus
Integrative single-cell and bulk transcriptomic analysis reveals the landscape of T cell mitotic catastrophe associated genes in esophageal squamous cell carcinoma.	BACKGROUND: Mitotic catastrophe (MC) is a well-recognized endogenous mechanism of tumor cell death, characterized as a delayed cell death process associated with aberrant mitosis. However, its prognostic significance in the context of intratumoral heterogeneity in esophageal squamous cell carcinoma (ESCC) remains largely unexplored. METHODS: We performed an in-depth analysis of single-cell RNA sequencing (scRNA-seq) data from ESCC obtained from the Gene Expression Omnibus (GEO) database. MC scores for individual cells were calculated using the AddModuleScore function, and T cell specific gene modules were identified via the high-dimensional weighted gene co-expression network analysis (hdWGCNA) framework. To further elucidate the developmental trajectories and intercellular interactions of T cells, pseudotime analysis and cell-cell communication inference were conducted. A prognostic risk model was then constructed using three machine learning algorithms combined with multivariate Cox regression analysis. Following risk stratification, we performed immune infiltration profiling, drug sensitivity analysis, and molecular docking to comprehensively assess the functional implications of the risk model in ESCC. Based on preliminary results from quantitative Real-time PCR (qRT-PCR) and Western blotting (WB), we selected the hub gene SLF2 for functional validation using wound healing, Cell Counting Kit-8 (CCK-8) assay, Transwell, and colony formation assays. RESULTS: Based on T cell mitotic catastrophe associated genes (MCAGs) and utilizing machine learning algorithms, we established a robust prognostic risk model for ESCC. The model demonstrated excellent stratification capability in predicting patient outcomes and effectively revealed the heterogeneity of the tumor immune microenvironment (TIME) and drug sensitivity. Furthermore, functional experiments confirmed that knockdown of the hub gene SLF2 significantly inhibited the migration, invasion, and proliferation of ESCC cells. CONCLUSION: The prognostic model based on MCAGs we developed serves as an effective tool for predicting outcomes in ESCC.T cell-specific MCAGs drive intratumoral heterogeneity in ESCC, serving as potential prognostic biomarkers and therapeutic targets.	esophagus
The Effect of Nutrition Impact Symptoms on Nutrition Status After Completion of Curative-Intent Treatment for Gastric, Oesophageal, and Pancreatic Cancer: A Systematic Review.	Background/Objectives: Gastric, oesophageal, and pancreatic cancers are common worldwide, with low but improving survival rates due to advances in curative treatments. However, these treatments often cause long-term nutrition impact symptoms that are frequently overlooked, leading to malnutrition and poorer health outcomes. This review explored the types of nutrition impact symptoms following curative-intent treatment for upper gastrointestinal (UGI) cancers and assessed their impact on nutrition status. Methods: A systematic search of four electronic databases identified studies involving adults treated with curative intent for UGI cancers. Included studies reported both nutrition impact symptoms and nutrition outcomes using validated tools. Study quality was assessed, and results were synthesised narratively. Results: Eleven studies (n = 953 participants), predominantly from the Asia-Pacific region, met the inclusion criteria. Participants were mostly male (68%), with surgery as the primary treatment (91%). Most studies (n = 10) used validated assessment tools to identify nutrition impact symptoms. Reflux was the most commonly reported symptom (n = eight studies), followed by abdominal pain and diarrhoea. Nutrition status was assessed using various validated tools: Patient-Generated Subjective Global Assessment (n = six studies, 55%), Mini Nutritional Assessment (n = two studies, 18%), and Global Leadership Initiative on Malnutrition as well as Subjective Global Assessment and Prognostic Nutritional Index (both n = one study, 9%). Malnutrition prevalence was up to 87% one year post-treatment. Conclusions: Nutrition impact symptoms are common and persistent after curative-intent treatment for UGI cancers. Future research should incorporate validated assessment tools and extend follow-up beyond 12 months. Integrating long-term, tailored dietetic support to identify and manage symptoms post-treatment is vital to improve outcomes for patients.	esophagus