crossing96/oncoscreening huggingface dataset:
Comparison of the clinical usefulness of CXCL-8 and common clinical tumor markers for esophageal cancer diagnosis.	BACKGROUND: This study aimed to investigate serum CXC motif chemokine ligand 8 (CXCL-8) as a potential biomarker for diagnosing esophageal cancer (EC). METHODS: Patients diagnosed with EC (n = 141) were enrolled at the Department of Thoracic Surgery, Fujian Medical University Union Hospital, from July through December 2023. Sixty cases were early esophageal cancer (EEC), whereas 81 were advanced (AEC) based on diagnostic criteria. Healthy volunteers (n = 75) were recruited as controls. Serum CXCL-8 levels were quantified using an enzyme-linked immunosorbent assay. Levels of carcinoembryonic antigen (CEA), cytokeratin 19 fragment (Cyfra211), and squamous cell carcinoma antigen (SCC) were assessed using a chemiluminescent microparticle immunoassay. Clinical and pathological attributes of patients with EC were documented and analyzed. Diagnostic efficacies of CXCL-8, CEA, Cyfra211, and SCC for EC were evaluated using receiver operating characteristic (ROC) curves. RESULTS: Serum concentrations of CXCL-8, CEA, Cyfra211, and SCC were significantly higher in patients with EC than in controls (P < 0.05). In the EC group, areas under the curves (AUCs) for CXCL-8, CEA, Cyfra211, and SCC were 0.906, 0.707, 0.705, and 0.797, respectively. The combined application of CXCL-8+CEA, CXCL-8+Cyfra211, and CXCL-8+SCC yielded AUCs of 0.931, 0.940, and 0.950, respectively, and was significantly higher than that of the combination of CEA+Cyfra211+SCC (0.854). In EEC, the diagnostic performance of CXCL-8 was similar to that in the EC group. The sensitivity of CXCL-8 was greater than that of CEA, Cyfra211, and SCC alone, and the combination of the three markers (P < 0.05). CONCLUSIONS: CXCL-8 could be used to distinguish patients with EC from healthy controls, including EEC.	esophagus
Margin clearance and post-procedure ablation decrease recurrence risk in endoscopic mucosal resections for Barrett's-related neoplasia.	AIMS: Endoscopic mucosal resection (EMR) is widely used for treating Barrett's-related oesophageal dysplasia and low-stage carcinoma. Disease can recur after this procedure. We analysed a large cohort of EMR specimens to assess clinical and histopathologic factors and their relationship to recurrence. METHODS AND RESULTS: We conducted a retrospective study of 129 patients who had in total 290 oesophageal EMRs for glandular neoplasia. Patient age, patient sex, specimen fragmentation, intestinal metaplasia, highest-grade lesion, margin status and clearance, cancer invasion depth, lymphovascular invasion, tumour budding (using published guidelines for colorectal carcinoma), post-procedure cryoablation/radiofrequency ablation and disease recurrence were recorded. Statistical analyses were performed on 227 eligible cases to determine the significance of these factors in local disease recurrence. Adenocarcinoma was the highest-grade lesion in 42% of the 290 specimens, high-grade dysplasia in 36% and low-grade dysplasia in 22%. Mean age at first EMR was 66 years. Among the 227 statistically analysed cases, post-procedure ablation was performed for 111 (49%) and recurrence of same or worse disease was documented in 104 (46%). Tumour depth and budding did not affect recurrence risk. On multivariate analysis, lack of post-procedure ablation was associated with increased recurrence risk for high-grade dysplasia and carcinoma. Additionally, poor differentiation and margin status were associated with increased recurrence risk for specimens with carcinoma. These relationships mostly held true for recurrence of same/worse neoplasia or recurrence of any neoplasia. CONCLUSIONS: Differentiation, margin status and post-EMR ablation influence the risk of local disease recurrence for Barrett's-related adenocarcinoma, while other factors such as tumour budding and lesional depth do not.	esophagus
From conventional minimally invasive to robotic-assisted Ivor Lewis esophagectomy - A Nordic single-center retrospective study.	BACKGROUND: High-quality studies from Asia have demonstrated that robotic assisted minimally invasive esophagectomy (RAMIE) is a feasible and comparable alternative to conventional minimally invasive esophagectomy (MIE), evidence regarding its application to Western patients remains limited. This study evaluates the short-term outcomes during the initial phase of RAMIE implementation in comparison to the previous standard MIE technique in a Nordic center. METHODS: A retrospective single center study of prospectively registered data, comparing short-term outcomes between the final 100 patients operated with MIE and the first 100 patients operated with RAMIE. The primary outcome was the total number of lymph nodes harvested. Secondary outcomes included postoperative pneumonia, anastomotic leakage, serious complications (Clavien Dindo ≥ 3), length of operation, length of hospital stay and resection margin status. An inverse probability weighting model and regression analysis was conducted. RESULTS: 200 patients were included (RAMIE n = 100, MIE n = 100). Matched groups (RAMIE n = 96, MIE n = 97) showed no difference in total number of lymph nodes harvested (RAMIE 22.1 vs. MIE 23.7, p = 0.50). RAMIE had higher postoperative pneumonia risk (OR = 2.3, p < 0.01), longer length of operation (+33.9 min, p < 0.01) and marginally increased risk of anastomotic leakage (OR = 2.4, p = 0.05). Comparing the last 50 patients operated with RAMIE to the MIE group, there was no difference in length of operation (OR = 10.3, p = 0.43). CONCLUSION: The short-term oncological outcomes and safety remain secure even during the initial phases of RAMIE implementation in a Nordic cohort. The perioperative outcome for some measures after RAMIE were inferior to MIE, potentially related to learning curve aspects.	esophagus
Robotic versus open esophagectomy: a propensity score-matched analysis from a tertiary cancer center in India.	Robotic esophagectomy has gained prominence over open esophagectomy for resectable esophageal cancer. However, high-quality comparative data remain limited, particularly from the Indian subcontinent. This study compares perioperative and long-term outcomes between robotic and open esophagectomy using propensity score matching. We analyzed 209 patients who underwent McKeown's total esophagectomy between January 2014 and December 2024 at a tertiary cancer center in India. Patients were divided into robotic (n = 156) and open esophagectomy (n = 53) groups. In robotic, the thoracic component was performed robotically, while cervical and abdominal phases used conventional open techniques. All anastomoses were handsewn in a tensionless, two-layer manner. Propensity score matching created 48 matched pairs. Primary outcomes were overall survival (OS) and disease-free survival (DFS). After propensity matching, the robotic cohort demonstrated superior 5-year overall survival (64.7% vs 53.4%, p = 0.045). Robotic showed significant advantages in reduced blood loss (174 vs 237.7 ml, p < 0.003), hospital stay (11.7 vs 14.4 days, p = 0.013), extubation day (0.4 vs 0.8 days, p = 0.008), and ICU duration (2.2 vs 3.4 days, p = 0.001). Respiratory complications requiring ICU were lower in the robotic cohort (8.3% vs 22.9%, p = 0.049). Robotic esophagectomy offers survival advantages over open esophagectomy with superior perioperative outcomes. This appears driven by reduced perioperative morbidity rather than enhanced cancer control, supporting robot adoption in experienced centers.	esophagus
Pembrolizumab, Radiotherapy, and Chemotherapy in Neoadjuvant Treatment of Malignant Esophago-gastric Diseases (PROCEED): A single-arm phase 2 trial.	INTRODUCTION: Esophagogastric cancers are common and carry a poor prognosis. A standard option for locally advanced disease has been neoadjuvant chemoradiation (CRT) followed by surgical resection. The primary goal of this study was to investigate whether the addition of pembrolizumab to neoadjuvant CRT improves pathologic complete response (pCR) rates, compared to historical controls. METHODS: This is a single-institution, prospective, single-arm phase 2 trial (NCT03064490). Patients received three cycles of pembrolizumab (200 mg every 3 weeks) concurrent with neoadjuvant CRT (45 Gy/25 fractions, concurrent weekly carboplatin and paclitaxel), followed by surgical resection. Patients were eligible to receive three additional cycles of adjuvant pembrolizumab if they did not experience significant toxicity during neoadjuvant treatment. Pathologic response and acute toxicities were evaluated. Survival and recurrence data were tabulated. RESULTS: A total of 35 patients were enrolled over 5 years, with 30 patients completing prescribed neoadjuvant treatment followed by surgical resection. Eleven of 30 patients (36·7%) experienced a pCR and 15/30 patients (50%) experienced a major pathologic response. Rates of grade 3-4 toxicity were comparable to historical controls, and there were no grade 5 toxicities. Median progression-free and overall survival were numerically higher in patients who experienced a major pathologic response. CONCLUSION: The addition of pembrolizumab to neoadjuvant CRT followed by surgical resection was overall well-tolerated and resulted in numerically higher rates of pCR compared to historical controls. Further studies with optimized patient selection are warranted to validate the efficacy of this treatment paradigm.	esophagus
Immune Checkpoint Inhibitors for Mismatch Repair-Deficient Gastroesophageal Adenocarcinoma: Outcomes and Feasibility of Nonoperative Management at Mayo Clinic.	PURPOSE: Neoadjuvant immune checkpoint inhibitors (nICIs) have demonstrated high response rates in deficient mismatch repair/microsatellite instability-high (dMMR/MSI-H) gastroesophageal adenocarcinoma (GEA). The NEONIPIGA and INFINITY trials demonstrated high rates of pathologic complete response (pCR) in this patient population. Furthermore, the INFINITY trial explored the feasibility of managing these patients nonoperatively, demonstrating promising results. This study aimed to evaluate clinical outcomes of nICIs in resectable dMMR/MSI-H GEA, with a focus on the feasibility of nonoperative management (NOM). MATERIALS AND METHODS: This retrospective cohort study included patients with resectable dMMR/MSI-H GEA and treated with nICIs ± surgery at the Mayo Clinic. Patients were identified from institutional records, and clinical data were retrospectively reviewed. Primary outcomes were clinical complete response (cCR) and pCR. Secondary outcomes included event-free survival (EFS), radiologic complete response (rCR), and immune-related adverse events (irAEs). RESULTS: A total of 26 patients treated between April 1, 2017, and July 30, 2025, were identified. Nine patients (34.6%) underwent surgery, of whom six (66.7%) achieved pCR. Seventeen patients (65.4%) pursued NOM, with 10 (71.4%) of 14 evaluable patients achieving cCR and 14 (82.4%) of 17 evaluable achieving rCR. One patient who initially achieved cCR had a local recurrence on surveillance endoscopy and underwent salvage endoscopic resection. At a median follow-up of 19.3 months, 15 (88.2%) of 17 patients in the NOM cohort were alive and metastasis-free, with EFS rates of 87.3% at 12 and 24 months for all patients. irAEs occurred in nine patients (34.6%), with no grade ≥3 toxicities. CONCLUSION: In this retrospective cohort study, nICIs led to high cCR and pCR rates in resectable dMMR/MSI-H GEA, supporting the use of immune checkpoint inhibitors in this setting and the feasibility of NOM in select patients.	esophagus
Clinical application value of modified overlap anastomosis for Siewert type II and III adenocarcinoma of esophagogastric junction.	AIM: To explore the clinical application value of modified overlap anastomosis for Siewert type II and III adenocarcinoma of esophagogastric junction, and to further evaluate its feasibility and safety. METHODS: We retrospectively analyzed clinical data from 222 patients with Siewert type II and III adenocarcinoma of the esophagogastric junction admitted to our hospital between January 2017 to October 2023. All patients underwent laparoscopic total gastrectomy with D2 lymph node dissection. 64 patients underwent esophagojejunostomy with modified overlap anastomosis, and 158 patients were operated using the circular stapled anastomosis. Variables that are statistically different were compared between groups using propensity score matching (PSM). The differences in surgical-related indicators and clinical outcomes for the two groups were compared. Finally, we analyzed the risk factors associated with esophagojejunostomy (EJ)-related complications. RESULTS: There was no statistically significant difference between the two groups of patients in terms of BMI, gender, age, and tumor-related information (P value > 0.05). However, there was then a difference in preoperative hemoglobin between the two groups. To eliminate heterogeneity, we combined patients with PSM. In terms of intraoperative conditions and postoperative recovery after PSM, compared with the circular stapled anastomosis group, the modified overlap group showed the shorter total operation time, shorter the length of the auxiliary incision, shorter time to the soft diet intake, milder postoperative pain. In terms of postoperative complications and overall survival after PSM, the modified overlap group can reduce the probability of abdominal infection and there was no difference in overall survival (OS) and postoperative late complications between the two groups. Multivariate analysis showed that the Siewert type [odds ratio (OR), 0.355; 95% confidence interval (CI) 0.189-0.639, P value = 0.005] was independent risk factors of EJ-related complications. CONCLUSION: Although the modified overlap group had slightly lower total protein after surgery, it had advantages in operation time, the length of the auxiliary incision, the soft diet intake time, postoperative pain, abdominal infection. General surgeons should exercise heightened vigilance in preventing EJ-related complications for patients classified as Siewert type II. In summary, modified Overlap anastomosis is safe and reliable. It has clinical application value.	esophagus
Systemic Immune-Inflammation Index as a Prognostic Marker in Gastric and Gastroesophageal Junction Cancers Receiving Perioperative FLOT Therapy.	Background and Objectives: The systemic immune-inflammation index (SII), derived from peripheral blood parameters, has emerged as a novel marker reflecting the balance between host immunity and tumor-related inflammatory burden. This study aimed to investigate the prognostic impact of baseline SII on survival outcomes in patients with gastric or gastroesophageal junction (GEJ) cancer undergoing perioperative FLOT (5-fluorouracil, leucovorin, oxaliplatin, and docetaxel) chemotherapy. Materials and Methods: In this retrospective study, 168 patients with histologically confirmed gastric or GEJ cancer who received perioperative FLOT therapy were included. SII was calculated using the formula: SII = (Platelets × Neutrophils)/Lymphocytes. ROC curve analysis determined the optimal SII cutoff for predicting mortality. Patients were categorized into low (SII ≤685) and high (SII >685) groups. Overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan-Meier analysis and compared via the log-rank test. Cox proportional hazards regression models were used for univariate and multivariate analysis. Results: The optimal cutoff value for SII was determined to be 685 (AUC: 0.652, 95% CI: 0.558-0.747, p = 0.003). High SII was significantly shorter OS (17.4 vs. 28.2 months, p = 0.001) Multivariate analysis identified high SII (HR = 1.88, 95% CI: 1.36-2.89, p = 0.039), advanced T stage (HR = 3.693, p < 0.001), poor treatment response (HR = 0.36, p < 0.001), and ECOG-PS ≥1 (HR = 3.297, p < 0.001) as independent predictors of mortality. Conclusions: Elevated baseline SII is an independent predictor of worse OS and DFS in gastric and GEJ cancer patients receiving perioperative FLOT chemotherapy. SII may serve as a practical and inexpensive biomarker to support risk stratification and personalized treatment decisions.	esophagus
Risk factors and prognosis of postoperative early relapse after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma: a retrospective study.	BACKGROUND: This study aimed to identify risk factors associated with early postoperative relapse and evaluate their impact on survival outcomes after neoadjuvant therapy for locally advanced esophageal squamous cell carcinoma (LA-ESCC), thereby informing strategies to optimize postoperative clinical management. METHODS: Patients with LA-ESCC who underwent neoadjuvant therapy followed by surgical resection at West China Hospital between January 2018 and December 2023 were screened and enrolled. Patients were categorized into early relapse (≤ 6 months) and late relapse (> 6 months) groups based on the interval from surgery to relapse. RESULTS: A total of 183 LA-ESCC patients who received neoadjuvant therapy followed by surgical resection were included, with 79 experiencing early relapse and 104 experiencing late relapse. Logistic regression analysis showed that postoperative TNM stage III-IV, ypN + stage, R1 resection, lymphovascular invasion (LVI), perineural invasion (PI), and absence of postoperative adjuvant therapy were risk factors for early relapse (p < 0.05). Multivariate regression further identified R1 resection as an independent predictor (p < 0.05). Cox regression analysis demonstrated that LI was a prognostic factor for overall survival (OS) in patients with early relapse (p = 0.045). Kaplan-Meier analysis revealed significantly reduced OS (12.5 months vs. 26.9 months, HR = 2.96, p < 0.001) and survival after relapse (SAR) (5.9 months vs. 11.0 months, HR = 1.81, p < 0.001) in the early relapse group compared to the late relapse group. However, relapse patterns did not differ significantly between groups (p > 0.05). CONCLUSION: R1 resection is an independent risk factor for rapid postoperative relapse in LA-ESCC patients following neoadjuvant therapy. Furthermore, LVI significantly affects patients survival outcomes, and early relapse was strongly associated with reduced overall survival (OS).	esophagus
Comparison of utilization trends, outcomes, and costs between open and minimally invasive esophagectomy.	BACKGROUND: Many surgeons have adopted minimally invasive esophagectomy (MIE) as an alternative to open esophagectomy (OE). However, limited population-level data exist comparing clinical outcomes and costs by surgical approach. This study evaluated contemporary utilization trends, outcomes, and costs between MIE and OE using real-world data. METHODS: We conducted a retrospective cohort study of patients who underwent MIE or OE using data from the Healthcare Cost and Utilization Project Florida State Inpatient Database from 2016 to 2021. Utilization trends were analyzed using Cochran-Armitage tests. Multivariable regression models were utilized to evaluate the association of surgical approach with postoperative outcomes and hospitalization costs. RESULTS: Of 2550 total patients, 1218 (47.8%) and 1332 (52.2%) underwent MIE and OE, respectively. Utilization of MIE increased significantly over time, as MIE grew from 43.4% of annual esophagectomy volume in 2016 to 57.7% by 2021 (trend P < 0.001). MIE patients had a higher prevalence of esophageal or esophagogastric junction cancer compared to OE patients (75.7% vs. 60.1%; P < 0.001), but exhibited a comparable overall comorbidity burden (e.g., 2-3 comorbidities: 44.1% vs. 43.5%; P = 0.061). MIE patients had significantly shorter hospital stays (median: 8 vs. 10 days, P < 0.001). MIE was associated with reduced risk-adjusted odds of postoperative complications (adjusted odds ratio 0.560, confidence interval 0.474-0.661, P < 0.001). Operating room costs were significantly higher with MIE compared to OE (median: $13,964 vs. $10,618, P < 0.001), whereas intensive care unit costs were lower (median: $2325 vs. $5706, P < 0.001). Index hospitalization (median: $41,795 vs. $40,289, P = 0.340) and 90-day costs (median: $46,509 vs. $45,408, P = 0.550) were comparable between groups. In subgroup analyses, in-hospital mortality was significantly lower with MIE at low-volume (< 20 esophagectomies annually) hospitals (2.5% vs. 5.3%, P = 0.010). However, this difference was not statistically significant at high-volume (≥ 20 esophagectomies annually) hospitals (2.9% vs. 5.0%, P = 0.072). CONCLUSION: MIE has had rapid growth in utilization. MIE appears to provide a viable, cost-effective alternative to OE, with fewer postoperative complications, shorter hospital stays, and comparable overall costs.	esophagus
Artificial neural networks as a prognostic tool using hyperspectral imaging on pretherapeutic histopathological specimens of esophageal adenocarcinoma.	PURPOSE: The integration of artificial intelligence (AI) with hyperspectral imaging (HSI) offers a promising avenue for improving pre-therapeutic prognosis, a key factor in optimizing cancer treatment strategies. This study explores the potential of artificial neural networks (ANNs) to predict the effectiveness of preoperative chemo- or radiochemotherapy in esophageal adenocarcinoma (EAC), using HSI data derived from histopathological tissue samples. METHODS: HSI data were obtained from pre-therapeutic histopathological samples of 21 patients with EAC. Following annotation and spectral extraction, the data underwent pre-processing steps including normalization, shuffling, and batch organization. Three artificial neural network (ANN) models-2D convolutional neural networks (2D-CNNs), 3D convolutional neural networks (3D-CNNs), and Hybrid-Spectral Networks (Hybrid-SN)-were trained to predict treatment response. Model performance was assessed using sensitivity, specificity, accuracy, and F1-score, offering insights into their clinical utility RESULTS: The 3D-CNN model achieved the highest accuracy (0.68 ± 0.09) and F1-score (0.66 ± 0.08), highlighting its strength in capturing both spatial and spectral information. The Hybrid-SN model demonstrated the highest sensitivity (0.79 ± 0.19), indicating strong performance in identifying responders to neoadjuvant therapy. In contrast, the 2D-CNN model achieved the highest specificity (0.73 ± 0.15), reflecting its effectiveness in correctly identifying non-responders. CONCLUSION: This study demonstrates the potential of combining HSI with ANNs to predict treatment response in EAC. Among the models evaluated, the 3D-CNN showed the most balanced performance, effectively leveraging spatial and spectral features, while the Hybrid-SN and 2D-CNN models excelled in sensitivity and specificity, respectively. These findings underline the feasibility of using AI-driven analysis of histopathological HSI data to support personalized treatment planning in EAC, paving the way for more accurate and tailored therapeutic strategies.	esophagus