crossing96/oncoscreening huggingface dataset:
Clinicopathologic characteristics of esophagectomy for esophageal carcinoma in elderly patients.	AIM: To evaluate the risk of esophagectomy for carcinoma of the esophagus in the elderly (70 years or more) compared with younger patients (< 70 years) and to determine whether the short-term outcomes of esophagectomy in the elderly have improved in recent years. METHODS: Preoperative risks, postoperative morbidity and mortality in 60 elderly patients (> or = 70 years) with esophagectomy for carcinoma of the esophagus were compared with the findings in 1782 younger patients (< 70 years) with esophagectomy between January 1990 and December 2004. Changes in perioperative outcome and short-time survival in elderly patients between 1990 to 1997 and 1998 to 2004 were separately analyzed. RESULTS: Preoperatively, there were significantly more patients with hypertension, pulmonary dysfunction, cardiac disease, and diabetes mellitus in the elderly patients as compared with the younger patients. No significant difference was found regarding the operation time, blood loss, organs in reconstruction and anastomotic site between the two groups, but elderly patients were more often to receive blood transfusion than younger patients. Significantly more transhiatal and fewer transthoracic esophagectomies were performed in the elderly patients as compared with the younger patients. Resection was considered curative in 71.66% (43/60) elderly and 64.92% (1157/1782) younger patients, which was not statistically significant (P>0.05). There were no significant differences in the prevalence of surgical complications between the two groups. Postoperative cardiopulmonary medical complications were encountered more frequently in elderly patients. The hospital mortality rate was 3.3% (2/60) for elderly patients and 1.1% (19/1 782) for younger patients without a significant difference. When the study period was divided into a former (1990 to 1997) and a recent (1997 to 2004) period, operation time, blood loss, and percentage of patients receiving blood transfusion of the elderly patients significantly improved from the former period to the recent period. The hospital mortality rate of the elderly patients dropped from the former period (5.9%) to the recent period (2.3%), but it was not statistically significant. CONCLUSION: Preoperative medical risk factors and postoperative cardiopulmonary complications after esophagectomy are more common in the elderly, but operative mortality is comparable to that of younger patients. These encouraging results and improvements in postoperative mortality and morbidity of the elderly patients in recent period are attributed to better surgical techniques and more intensive perioperative care in the elderly.	esophagus
Primary liposarcoma of esophagus: a case report.	Liposarcoma is the most common soft tissue sarcoma in adult life while esophageal liposarcoma is an extremely rare tumor. In the world literature, only 14 cases of esophageal liposarcomas have been described. We report a 72-year old male patient who was urgently admitted to our hospital for acute epigastric pain with a burning retrosternal sensation, persistent nausea, vomiting and dysphagia. Barium swallow, upper gastrointestinal (GI) endoscopy, esophageal manometry and CT scan, failed to accurately diagnose the lesion. After surgical resection of an esophageal polypoid tumor, the histological examination revealed a well-differentiated grade I liposarcoma. Diagnostic and therapeutic tools were discussed and the results of literature were reviewed.	esophagus
Cancer mortality among butchers: a 24-state death certificate study.	OBJECTIVE: The objective of this study was to document cancer mortality among American butchers. METHODS: Death certificates collected in 24 American states were used to calculate mortality odds ratios (ORs) and their confidence intervals (CIs) for 18,639 butchers. RESULTS: Butchers experienced an increased mortality of cancer of the oral cavity (OR, 1.40; 95% CI = 1.09-1.81), esophagus (OR, 1.19; 95% CI = 1.01-1.40), pharynx (OR, 1.22; 95% CI = 0.91-1.64), and larynx (OR, 1.19; 95% CI = 0.92-1.54), as well as a reduced mortality from melanoma (OR, 0.70; 95% CI = 0.52-0.94), non-Hodgkin lymphoma (OR, 0.82; 95% CI = 0.69-0.97), and breast cancer (OR, 0.76; 95% CI = 0.58-0.99). CONCLUSIONS: It is likely that occupational exposures experienced by butchers have contributed to the increased risk of cancers of the oral cavity and esophagus.	esophagus
[Antitumor effect of docetaxel against human esophagus tumor cell lines and tumor xenografts in nude mice].	The antitumor effect of docetaxel against cultured human esophagus tumor cell lines and tumor xenografts in nude mice was investigated. In the in vitro study, docetaxel showed concentration-dependent inhibition of the growth of 4 tumor cell lines having different degrees of differentiation (T. T, TE-5, TE-9 and TE-15) with IC(50) values ranging from 0.84 to 1.68 ng/ml when exposed for 72 h. These values represent ca. 1/2,700-1/1,400 of the mean maximum plasma concentration of 2.27 microg/ml attained in the clinical setting. In addition, the activity was found to be ca. two-fold stronger than that of paclitaxel, and much more potent than fluorouracil and cisplatin. The in vivo antitumor effect of docetaxel was also investigated against xenografts of human esophagus squamous cell carcinoma H-190 (highly differentiated) and H-204 (moderately differentiated) in nude mice. Docetaxel at its Maximum Tolerated Dose (MTD) and the lower dose (4.5, 6.7 mg/kg/dose, q 4 d x 3, iv) showed a significant growth inhibition of ca. 100% against H-190 tumor, resulting in the tumor shrinkage. Paclitaxel (6.7, 10 mg/kg/dose, q 4 d x 3, iv) showed a tumor-shrinking effect similar to that seen with docetaxel. In the H-204 xenograft model, docetaxel (4.5, 6.7, 10 mg/kg/dose) exhibited a dose-dependent effect in delaying the tumor growth, while paclitaxel failed to suppress the tumor growth even at its MTD. These results demonstrated that docetaxel has potent antitumor efficacy against human esophagus tumor cells, leading to the expectation that it will be useful as a therapeutic agent for esophagus cancer.	esophagus
Validation of the quality of histological images obtained of fresh and formalin-fixed specimens of esophageal and gastric mucosa by laser-scanning confocal microscopy.	BACKGROUND AND STUDY AIMS: We have previously reported the success of a method of virtual histology using laser-scanning confocal microscopy (LCM) in vitro on untreated fresh specimens obtained from the gastrointestinal mucosa. In the present study, we aimed to apply LCM to both fresh and formalin-fixed specimens, without additional treatment, in order to validate and compare the quality of the images obtained. METHODS: We obtained 18 specimens from 11 patients, either by endoscopic biopsy or following surgical resection. First, we observed the fresh, saline-immersed specimen with LCM using the Fluroview microscope (Olympus Co. Ltd., Tokyo, Japan). We then fixed the specimen with formalin and obtained further LCM images 1 hour, 3 hours, and 24 hours after fixation. Three independent observers observed the images and were asked to assess the origin of the samples, the treatment of the samples, the time after formalin fixation, and whether they showed benign or malignant lesions. We used kappa statistics to compare the agreement among the three observers in each of these four areas of interest. RESULTS: Between January and March 2003, we obtained 191 LCM images from 18 specimens. Thirty images were randomly selected for observation. The overall accuracy for differentiating between esophagus and stomach specimens was 96.6 %. The accuracy of differentiating normal from cancerous lesions was 92.2 %. The differentiation between saline-immersed and formalin-fixed specimens was 59.7 % accurate and the assessment of the time interval after formalin fixation was only 37.3 % accurate. The kappa statistics showed that there was strong interobserver agreement on the differentiation of specimen origin and of cancerous from benign lesions. However, there was no agreement among the observers on the method of specimen preparation or on the estimated time interval after formalin fixation. CONCLUSIONS: We concluded that images obtained from fresh specimens using LCM were of a quality good enough to make an accurate diagnosis of upper gastrointestinal carcinoma.	esophagus
Predicting recurrence and metastasis of primary esophageal cancer with or without lymph node metastasis.	We studied 42 patients, consisting of 11 stage I/II patients who were node-negative (LN-) and 31 stage II/III patients who were node-positive (LN+). In the LN- patients, detection of occult neoplastic cells (ONCs) in lymph nodes had a sensitivity of 0.0% (0/5), a false-positive (FP) rate of 33.3% (2/6), a specificity of 66.7% (4/6), a false-negative (FN) rate of 100% (5/5), a positive predictive value (PPV) of 0.0% (0/2), and a negative predictive value (NPV) of 44.4% (4/9). In the LN+ patients, the sensitivity of ONCs was 25.0% (5/20), FP rate was 36.4% (4/11), specificity was 63.6% (7/11), FN rate was 75.0% (15/20), PPV was 55.6% (5/9), and NPV was 31.8% (7/22). In LN- patients, positivity for at least 2 of the 3 high-risk criteria had a sensitivity of 20.0% (1/5), FP rate of 16.7% (1/6), specificity of 83.3% (5/6), FN rate of 80.0% (4/5), PPV of 50.0% (1/2), and NPV of 55.6% (5/9). In LN+ patients, these criteria had a sensitivity of 75.0% (15/20), FP rate of 9.1% (1/11), specificity of 90.9% (10/11), FN rate of 25.0% (5/20), PPV of 93.8% (15/16), and NPV of 66.7% (10/15). These results suggest that the high-risk criteria may be useful for predicting recurrence or metastasis in stage II/III lymph node-positive patients with esophageal cancer.	esophagus
A comparative longitudinal quality of life study using the Spitzer quality of life index in a randomized multicenter phase III trial (FFCD 9102): chemoradiation followed by surgery compared with chemoradiation alone in locally advanced squamous resectable thoracic esophageal cancer.	BACKGROUND: The aim of the study was to compare the longitudinal quality of life (QoL) between chemoradiation with or without surgery in patients with locally advanced squamous resectable esophageal cancer included in a randomized multicenter phase III trial (FFCD 9102). MATERIALS AND METHODS: All patients with locally advanced resectable (T3-4 N0-1 M0) epidermoid or glandular esophageal cancer (n = 451) received induction chemoradiation. Responders (n = 259) were randomized between surgery (arm A) and continuation of chemoradiation (arm B). The Spitzer QoL Index was scored (0-10) at inclusion and at each follow-up, every 3 months during 2 years. QoL at baseline and longitudinal changes were respectively compared with univariate ANOVA and mixed-model analysis of variance for repeated measurements. The time interval between the follow-up was assessed and the same analyses were performed among survivors with 2 years of follow-up. RESULTS: The squamous histology was predominant in both arms. The mean QoL score decreased between baseline and the first follow-up and between the first and the second follow-ups. QoL scores at the first follow-up were comparatively worse in arm A than in arm B (7.52 versus 8.45, P < 0.01), whereas the longitudinal QoL study showed no difference between treatments (adjusted P = 0.26). Furthermore, the longitudinal QoL was not different (adjusted P = 0.23) among survivors with 2 years of follow-up. CONCLUSIONS: Among patients responding to induction chemoradiation, surgery and continuation of chemoradiation had the same impact on QoL in patients with locally advanced, resectable esophageal cancer although a significantly greater decrease in the Spitzer Index was observed in the postoperative period.	esophagus
Trends in incidence and management of esophageal adenocarcinoma in a well-defined population.	OBJECTIVES: Little epidemiological data is available concerning esophageal adenocarcinomas in France. The aim of this study was to study epidemiological characteristics and management of esophageal adenocarcinoma in a well-defined population. METHODS: Data were collected by the Burgundy Digestive Cancer Registry covering a population of 1 052 000, over a 28-year period (1976-2001). Incidence, treatment and stage at diagnosis were noted. Univariate and multivariate analysis of survival was performed. RESULTS: Age standardized incidence rates were 1.60/100,000 in men and 0.15/100,000 in women. The mean increase in incidence rates by 5-year periods were respectively + 68.1% (P<0.001) and + 97.4% (P<0.001). Overall, 69.9% of the cancers were located in the lower third of the esophagus. Surgical resection was performed in 32.1% of patients. Among the surgical patients, the tumor was limited to the esophageal wall in 11.4%, lymph node metastases were present in 18.1% and non-resectable distant metastases in 70.5%. There was no improvement of stage at diagnosis over time. Survival rates were 14.4% at 3 years and 9.2% at 5 years. Five-year survival rates varied from 38.4% for cases limited to the esophageal wall to 1.8% for metastatic and non resectable cases. Stage at diagnosis was the only significant prognostic factor in the multivariate analysis. CONCLUSION: Esophageal adenocarcinomas are rare cancers characterized by a sharp rise in incidence over the past years in France. Stage at diagnosis and prognosis are worse than reported in hospital statistics.	esophagus
Small-cell carcinoma of the esophagus associated with a paraneoplastic neurological syndrome: a case report documenting a complete response.	We describe a case of small-cell carcinoma of the esophagus associated with a paraneoplastic neurological syndrome. Sensorimotor neuropathy had developed 3 years earlier, and neurological symptoms had slowly worsened. Small-cell carcinoma of the esophagus was incidentally diagnosed while investigating the cause of the neurological symptoms. A paraneoplastic neurological syndrome was diagnosed on the basis of cancer and exclusion of other known causes of neurological symptoms. The patient was given combination chemoradiotherapy. There was a complete response to three courses of chemoradiotherapy, with no evidence of disease recurrence 6 years after the diagnosis. There was no progression of paraneoplastic neurological symptoms after the complete response.	esophagus
[The present state of esophageal laparoscopic surgery].	Laparoscopic surgery has changed the therapeutic approach in the most frequent esophageal diseases. With the excellent results in the control of symptoms and the low associated morbidity, surgical treatment is increasingly indicated in benign esophageal pathology as a superior alternative to a chronic and less efficient medical treatment. For the hiatus hernia and gastroesophageal reflux, Nissen's fundoplication by laparoscopy is the technique of choice. The best results in the treatment of achalasia are obtained with Heller's laparoscopic myotomy. This growing experience includes the resection of tumours of the esophagus combining thoracoscopy and laparoscopy with similar results to those of open surgery.	esophagus
Gefitinib, an epidermal growth factor receptor blockade agent, shows additional or synergistic effects on the radiosensitivity of esophageal cancer cells in vitro.	Human esophageal cancers have been shown to express high levels of epidermal growth factor receptor (EGFR) and a relationship between high EGFR expression and local advance, the number of lymph node metastases, life expectancy, and sensitivity to chemo-radiotherapy has been demonstrated. We examined the use of gefitinib, an orally active EGFR-selective tyrosine kinase inhibitor, as a new strategy for treatment of esophageal carcinoma. The effects of gefitinib were evaluated in monotherapy and in combination with radiotherapy in human esophageal carcinoma cell lines. Gefitinib produced a dose-dependent inhibition of cellular proliferation in all of the 8 esophageal carcinoma cell lines examined, with IC50 values ranging from 5.7 microM to 36.9 microM. In combination, gefitinib and radiotherapy showed a synergistic effect in 2 human esophageal carcinoma cell lines and an additive effect in 5 cell lines. Western blotting demonstrated that gefitinib blocked activation of the EGFR-extracellular signal-regulated kinase (Erk) pathway and the EGFR-phosphoinositide-3 kinase (PI3K)-Akt pathway after irradiation. These results suggest that further evaluation of EGFR blockade as a treatment for esophageal cancer should be performed, and that radiotherapy combined with EGFR blockade may enhance the response of esophageal carcinoma to therapy.	esophagus
Moderate alcohol consumption and the gastrointestinal tract.	BACKGROUND: A high alcohol intake is significantly associated with diseases of the gastrointestinal tract, but less is known about the effects of moderate consumption, specifically moderate average volume of alcohol consumption. METHODS: A systematic computer-assisted literature review was completed in order to review current scientific knowledge surrounding this topic. RESULTS: Moderate alcohol consumption is associated with a number of gastrointestinal health risks, including liver diseases, oropharyngeal cancer, esophageal cancer and pancreatitis but may play a positive role in gastritis and cholelithiasis. CONCLUSION: Moderate alcohol consumption may play a positive or negative role in disease etiology, but the overall conclusion is that moderate alcohol intake is not a high risk factor for many of the gastrointestinal diseases associated with high levels of consumption. The etiology of alcohol diseases is also linked to patterns of drinking, so this is an important area for future research in this area.	esophagus
Over-expression of p53 protein in esophageal squamous cell carcinoma of women.	BACKGROUND/AIMS: Most physicians naturally accept the etiological aspect that the incidence of esophageal squamous cell carcinoma (ESCC) is excessively more frequent in men than that in women. However, a definitely scientific confirmation to explain it has not been found. In the current study, we investigated the relationship between gender and p53 over-expression, which might resolve the difference between the genders in the mechanism for carcinogenesis in ESCC. METHODOLOGY: Immunohistochemical expression of p53 was examined for 134 ESCCs, and the correlation of the gender with the clinicopathologic features and over-expression of p53 was compared. RESULTS: The proportion of p53 over-expression in women was 23.8% (5 out of 21) and this incidence proportion was significantly lower than that in men (48.7%, 55 out of 113; p=0.031). CONCLUSIONS: This biological modulation might be correlated with the lower incidence of ESCC in women.	esophagus
The prognostic value of circumferential resection margin involvement in oesophageal malignancy.	AIM: Our aim was to assess the effect on survival of circumferential resection margin (CRM) involvement in patients with resected oesophageal malignancy. METHODS: Patients undergoing potentially curative oesophageal resection between January 1994 and December 2003 were retrospectively analysed. CRM status was defined as either clear or involved (microscopic tumour within 1 mm of the inked resection margin). Univariate and multivariate survival analyses were performed using the Kaplan-Meier method and Cox proportional hazard model. Overall survival was used as the endpoint. RESULTS: The case records of 249 patients were analysed. CRM status was clear in 170 patients (T1-T3 tumours) and involved in 79 patients (all T3 tumours). Median survival in these groups was 37 months (range 28-47) and 18 months (range 13-23), respectively (p = 0.0001). When T3 tumours were analysed separately there was a trend for T3 CRM involved tumours to have a worse prognosis than T3 CRM clear tumours (p = 0.074). Substratification by percentage of lymph nodes involved by metastases (< or = or >25%) revealed that CRM status had a greater prognostic effect in T3 tumours with a low metastatic lymph node burden (p = 0.04). CONCLUSION: CRM involvement predicts poor prognosis in patients with resected oesophageal malignancy and was an independent prognostic factor in our study. There was only a trend for worse prognosis when T3 tumours were analysed separately. However, patients with T3 tumours and a low percentage of lymph node metastases had a better prognosis if the CRM was negative.	esophagus
Genotoxic effects of myosmine in a human esophageal adenocarcinoma cell line.	The incidence of esophageal adenocarcinoma is rapidly rising in Western populations. Gastroesophageal reflux disease (GERD) is thought to be one of the most important risk factors. However, the mechanisms by which GERD enhances tumor formation at the gastroesophageal junction are not well understood. Myosmine is a tobacco alkaloid which has also a wide spread occurrence in human diet. It is readily activated by nitrosation and peroxidation giving rise to the same hydroxypyridylbutanone-releasing DNA adducts as the esophageal carcinogen N'-nitrosonornicotine. Therefore, the genotoxicity of myosmine was tested in a human esophageal adenocarcinoma cell line (OE33). DNA damage was assessed by single-cell gel electrophoresis (Comet assay). DNA strand breaks, alkali labile sites and incomplete excision repair were expressed using the Olive tail moment (OTM). The Fapy glycosylase (Fpg) enzyme was incorporated into the assay to reveal additional oxidative DNA damage. DNA migration was determined after incubation of the cells for 1-24h. Under neutral conditions high myosmine concentrations of 25-50mM were necessary to elicit a weak genotoxic effect. At pH 6 genotoxicity was clearly enhanced giving a significant increase of OTM values at 5mM myosmine. Lower pH values could not be tested because of massive cytotoxicity even in the absence of myosmine. Co-incubation of 25 mM myosmine with 1mM H(2)O(2) for 1h significantly enhanced the genotoxicity of H(2)O(2) but not the oxidative lesions additionally detected with the Fpg enzyme. In the presence of the peroxynitrite donor 3-morpholinosydnonimine (SIN-1) a dose-dependent significant genotoxic effect was obtained with 1-10mM myosmine after 4h incubation. NS-398, a selective inhibitor of cyclooxygenase 2, did not affect the SIN-1 stimulated genotoxicity of myosmine. Finally, the 23 h repair of N-methyl-N'-nitro-N-nitrosoguanidine-induced DNA lesions was significantly inhibited in the presence of 10mM myosmine. In conclusion, myosmine exerts significant genotoxic effects in esophageal cells under conditions which may prevail in GERD such as increased oxidative and nitrosative stress resulting from chronic inflammation.	esophagus