crossing96/oncoscreening huggingface dataset:
A novel risk-scoring model for predicting cancer-specific mortality and instituting chemotherapy in elderly patients with esophageal cancer.	Chemotherapy is indispensable to the treatment of esophageal cancer (EC), but its benefits in elderly patients remain unclear due to severe toxicity and side effects. The study aims to develop a risk-scoring model to predict which older patients are likely to benefit from chemotherapy. A total of 10,655 patients aged ≥70 years with pathologically diagnosed with EC were extracted from the Surveillance Epidemiology and End Results database, among whom 5,684 received chemotherapy. Sub-distribution hazard function were used to identify independent risk factors related to prognosis from the perspectives of the whole population, chemotherapy population, and non-chemotherapy population. Multivariate analyses based on the optimal model identified age, marital status, histology, tumor grade, T stage, N stage, M stage, lymph node positive rate, tumor size, surgery therapy, and radiotherapy as prognostic factors for elderly patients with EC. The concordance index of the best model was 0.772. X-tile software was utilized to classify the whole cohort into high-risk, medium-risk, and low-risk according to the total risk score. Sub-distribution hazard ratios was utilized to explore the effect of chemotherapy according to different risk stratifications. Chemotherapy did not impart a survival benefit to low-risk elderly patients with EC (Score ≤202), but did improve survival in patients in the medium-high risk groups (Score>202). Based on the results of the survival nomogram, a novel risk scoring system was constructed to screen for medium-high risk patients, for whom chemotherapy was more likely to bring additional benefit.	esophagus
An interpretable machine learning model using multimodal pretreatment features predicts pathological complete response to neoadjuvant immunochemotherapy in esophageal squamous cell carcinoma.	BACKGROUND: Although neoadjuvant immunochemotherapy (nICT) has revolutionized the management of locally advanced esophageal squamous cell carcinoma (ESCC), the inability to accurately predict pathological complete response (pCR) remains a major barrier to treatment personalization. We aimed to develop and validate an interpretable machine learning (ML) model using pretreatment multimodal features to predict pCR prior to nICT initiation. METHODS: In this retrospective study, 114 ESCC patients receiving nICT were randomly allocated into training (n=81) and validation (n=33) cohorts (7:3 ratio). Predictors of pCR were identified from pretreatment clinical variables, endoscopic ultrasonography, and hematological biomarkers via least absolute shrinkage and selection operator (LASSO) regression. Eight machine learning algorithms were implemented to construct prediction models. Model performance was assessed by area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Shapley Additive Explanations (SHAP) provided feature importance and model interpretability. RESULTS: Following feature selection, 17 variables were incorporated into model construction. The Random Forest (RF) model demonstrated perfect discrimination in the training cohort (AUC = 1.000, sensitivity = 1.000, specificity = 1.000, PPV = 1.000, NPV = 1.000), while maintaining robust predictive ability in the independent validation cohort (AUC = 0.913, sensitivity = 0.733, specificity = 0.889, PPV = 0.846, NPV = 0.800). Decision curve analysis (DCA) confirmed favorable clinical utility. SHAP analysis identified alcohol consumption, circumferential involvement ≥50%, elevated neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), and alanine aminotransferase (ALT) as the key contributors to pCR prediction. CONCLUSIONS: We established a clinically applicable, interpretable ML model that accurately predicts pCR to nICT in ESCC by integrating multimodal pretreatment data. This tool may optimize patient selection for nICT and advance precision therapy paradigms.	esophagus
Hepatic Fibrosis Predicts Poor Response to Preoperative Chemotherapy, Postoperative Malnutrition, and Poor Survival in Patients with Esophageal Squamous Cell Carcinoma Undergoing Minimally Invasive Esophagectomy: A Retrospective Analysis.	BACKGROUND: Esophageal squamous cell carcinoma (ESCC) and hepatic cirrhosis (HC) share major risk factors, including alcohol consumption and smoking. Consequently, patients with HC exhibit an elevated incidence of ESCC. Although HC is widely recognized to contribute to poor prognosis following esophagectomy for ESCC, the underlying mechanisms remain poorly understood. This study aimed to investigate the association between hepatic fibrosis evaluated using the fibrosis-4 (FIB-4) index and postoperative outcomes among patients with ESCC undergoing esophagectomy. METHODS: We retrospectively analyzed 461 patients with ESCC who underwent minimally invasive esophagectomy at Kobe University Hospital. Hepatic fibrosis was evaluated using the FIB-4 index, which estimates liver fibrosis based on routine blood test parameters. Patients were stratified into two groups: fibrosis-positive (FIB-4 > 2.67) and fibrosis-negative (FIB-4 ≤ 2.67). RESULTS: Among patients with cT1 tumors, overall survival (OS) did not differ significantly between the two groups. However, among those with ≥cT2 tumors, the fibrosis-positive group showed significantly worse OS than the fibrosis-negative group (P = 0.0148). Additionally, the fibrosis-positive group had a significantly higher incidence of poor response to preoperative chemotherapy (P = 0.0075). Postoperative serum albumin levels were markedly lower at 3, 6, and 12 months in the fibrosis-positive group (P = 0.015, 0.043, and 0.0066, respectively). While albumin levels recovered to baseline in the fibrosis-negative group within 12 months, no such recovery was observed in the fibrosis-positive group. CONCLUSIONS: Preoperative hepatic fibrosis is associated with poor response to preoperative chemotherapy and prolonged postoperative malnutrition, contributing to poorer long-term survival outcomes among patients with ESCC undergoing minimally invasive esophagectomy.	esophagus
18F-FDG PET/CT directed radiotherapy dose escalation in locally advanced esophageal cancer (LAEC), a phase I study.	BACKGROUND AND PURPOSE: To determine the maximum tolerated dose (MTD) of hyperfractionated radiotherapy (HFRT) boost for residual metabolic disease (RMD) as defined by PET/CT following SCRT with concurrent paclitaxel (P) and carboplatin (C) for locally advanced esophageal cancer (LAEC). MATERIALS AND METHODS: Eligible patients received standard chemoradiation therapy(SCRT) with weekly paclitaxel and carboplatin plus preirradiation PET/CT-guided intensity-modulated radiotherapy (IG-IMRT). Patients with RMD received HFRT boost concurrent with the same chemotherapy. Boost doses were escalated using a modified Fibonacci design. Dose limiting toxicity (DLT) was defined as grade ≥4 esophagitis, grade ≥3 non-hematological toxicity (except nausea/vomiting), or grade ≥4 hematological toxicity lasting >7 days. MTD was the highest dose with ≤1 pts experiencing DLT. RESULTS: 21pts were assessable. SCRT was well-tolerated. 4 pts achieved complete metabolic response (CMR). DLT occurred at 28.8 and 36 Gy. The MTD wasn't reached. The most common acute grade ≥ 3 toxicities were esophagitis (17 %), neutropenia (24 %). Late toxicity included grade 1 or 2 esophageal stricture (n = 5). Overall response rate was 88 %. With median follow-up of 9 months, local-regional failure only occurred in 1pt. CONCLUSION: 36 Gy HFRT boost to PET/CT-defined RMD after 50 Gy SCRT using IG-IMRT, resulting in a total composite tumor dose of 86 Gy (BED 100.32 Gy), can be safely delivered concurrent with weekly P/C. MTD remains to be defined.	esophagus
Primary pulmonary histiocytic sarcoma with nodal and esophageal metastasis in a dog-imaging and anatomopathological aspects.	BACKGROUND: This report presents a case of esophageal and nodal metastasis in a primary pulmonary histiocytic sarcoma in a dog. Histiocytic sarcoma is a malignant neoplasm originating from histiocytic cells, characterized by its aggressive nature, high metastatic potential and high mortality rate. Pulmonary involvement occasionally results in pleural effusion and regional lymph node involvement, such as the tracheobronchial, sternal, and mediastinal lymph nodes. Thoracic radiography is the preferred complementary diagnostic test when respiratory disorders are suspected, as it can identify pulmonary masses and associated complications, such as pleural effusion. Similarly, ultrasonography can be used when pulmonary conditions are suspected, helping to differentiate lesions. CASE PRESENTATION: A one-year-old, intact male mixed-breed dog weighing 18 kg was referred for emergency clinical care due to severe inspiratory dyspnea. Thoracic radiography and ultrasonography revealed a large intrathoracic mass located in the mediastinum, displacing adjacent structures, along with associated pleural effusion. The primary diagnostic hypothesis was a neoplasm of cranial mediastinal origin. During the thoracocentesis procedure, the animal decompensated and died. Necropsy revealed a large, multilobulated tumor mass in the mediastinum, showing direct extension into the esophagus, as well as another nodule similar to the mediastinal mass in the left caudal lung lobe. Histopathological analysis supported the diagnosis of pulmonary histiocytic sarcoma with esophageal and nodal metastasis, confirmed through an immunohistochemical panel. CONCLUSIONS: The involvement of cranial mediastinal and tracheobronchial lymph nodes, as well as the presence of pleural effusion, are common features associated with HS. However, the occurrence of esophageal metastases is considered uncommon, highlighting the uniqueness of this case, as well as supporting the potential for its occurrence. Thoracic radiography and ultrasonography played a crucial role in the initial suspicion of neoplasia, emphasizing their importance in early diagnostic approaches.	esophagus
Rare primary malignant melanoma of the esophagus with gastric cardia adenocarcinoma: A case report.	RATIONALE: This case report presents an unusually rare instance of primary malignant melanoma of the esophagus (PMME) occurring concurrently with gastric cardia adenocarcinoma. It emphasizes diagnostic pitfalls in amelanotic melanoma and provides evidence supporting the role of adjuvant radiotherapy in achieving prolonged disease-free survival for this aggressive malignancy. PATIENT CONCERNS: A 60-year-old male with chronic tobacco and alcohol use presented with a 2-week history of progressive dysphagia. Endoscopy identified an obstructive esophageal mass and a gastric cardia ulcer, initially misdiagnosed as poorly differentiated carcinomas due to the absence of melanin pigmentation. DIAGNOSES: The patient received a diagnosis of PMME in conjunction with gastric cardia adenocarcinoma. INTERVENTIONS: Transthoracic esophagectomy with lymphadenectomy followed by adjuvant radiotherapy (5000 cGy/DT/25F) targeting the surgical bed and regional lymphatics. OUTCOMES: No recurrence or metastasis was observed over 7 years posttreatment, surpassing typical survival outcomes for PMME. LESSONS: Amelanotic PMME poses significant diagnostic challenges due to its resemblance to poorly differentiated carcinoma, necessitating immunohistochemical confirmation (S-100, HMB-45, Melan-A). This case highlights the potential survival benefit of combining surgery with adjuvant radiotherapy in PMME, contrasting with historical outcomes in cases managed by surgery alone. Clinicians should maintain a high index of suspicion for synchronous malignancies in high-risk patients, particularly those with chronic carcinogen exposure. Emerging therapies, including immune checkpoint inhibitors targeting programmed cell death-1/CTLA-4 or NF-1 mutation-driven pathways, warrant exploration in PMME management. The unique lymph node metastasis pattern underscores the importance of comprehensive nodal sampling and tailored adjuvant strategies in dual-primary malignancies.	esophagus
Automated segmentation of esophageal squamous cell carcinoma in contrast-enhanced free-breathing 3D-GRE: a comparative study of UNet, nnUNet, and UMamba for tumor delineation.	BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is a highly prevalent and aggressive malignancy associated with poor prognosis. Accurate tumor segmentation is critical for the detection and characterization of ESCC. However, manual segmentation remains labor-intensive and time-consuming. Deep learning presents a promising approach for automating this process. MATERIALS AND METHODS: This retrospective study assessed the performance of three deep learning models-UNet, nnUNet-2D/3D, and UMamba-for ESCC segmentation using contrast-enhanced free-breathing 3DGRE MRI with 1 mm isotropic resolution. The dataset comprised 192 patients, divided into 171 for training and 21 for validation. Manual annotations excluded calcifications and hemorrhage, with maximum tumor cross-sections utilized for 2D model training and full volumetric tumor layers employed for 3D architectures. Segmentation performance was evaluated using the Dice Similarity Coefficient (DSC), Hausdorff Distance (HD), and mean surface distance (MSD). RESULT: UMamba achieved the highest DSC of 0.764, significantly outperforming nnUNet-3D (0.738) and nnUNet-2D (0.702). Additionally, UMamba demonstrated superior boundary delineation, as evidenced by the lowest HD of 5.048 mm and MSD of 1.088 mm. These results highlight the importance of 3D contextual analysis over traditional 2D approaches, as illustrated by the 5.1% improvement in DSC observed with nnUNet-3D compared to nnUNet-2D. Furthermore, the computational efficiency of each model was evaluated, revealing that 3D models exhibited longer inference times than their 2D counterparts. CONCLUSION: UMamba demonstrates superior performance for automated ESCC segmentation on high-resolution MRI, providing a robust tool that has the potential to reduce manual segmentation time and inter-observer variability in clinical practice.	esophagus
Association between legume consumption and risk of esophageal cancer among Chinese adults: a 17-year prospective cohort study.	PURPOSE: Epidemiological studies have reported the influence of legume consumption on multiple cancers risk, but the association in esophageal cancer (EC) remains unclear. This study aimed to investigated the prospective associations between legume consumption and EC risk, especially among Chinese populations. METHODS: We conducted a prospective cohort study with 15,184 participants aged 40 to 69 years from two high-risk areas of EC in China between 2005 and 2009, with follow-up until 2022. A validated questionnaire was used to collect the consumption frequency of major food groups at baseline and subsequent resurveys, including legume. The Cox proportional hazard regression was used to evaluate the multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for the association of legume consumption and EC risk. To quantify the linear association of legume consumption and EC risk and to account for regression dilution bias, the mean usual consumption amount for each baseline group was estimated by combining the consumption level at both baseline and the second resurvey. RESULTS: The final study sample included 15,184 participants in the cohort (mean [SD] baseline age, 51.8 [7.5] years). During a follow-up of 219,365 person-years, a total of 176 new EC cases were identified. Legume consumption was inversely associated with EC risk, with a 63% reduction in risk for participants who consumed legume regularly compared with nonconsumption (HR: 0.37; 95% CI 0.16, 0.84; p for trend = 0.022). After correction for regression dilution bias, each 10 g/day increased legume consumption was associated with a HR of 0.35 (0.13, 0.96) for esophageal squamous cell carcinoma (ESCC) risk. The associations were consistent across most subgroups and sensitivity analyses. CONCLUSION: Higher frequency of legume consumption was associated with lower risk of EC among Chinese adults, particularly ESCC. Our findings suggest legume consumption may play an important role in preventing the development of EC.	esophagus
CBX6 induces CD8(+) T cell exhaustion and tumor development in esophageal squamous cell carcinoma through SMARCD1-mediated CCL8 secretion and lactate efflux.	This study investigates the functions of chromobox 6 (CBX6) in esophageal squamous cell carcinoma (ESCC) and delves into its functional mechanisms. The bioinformatics insights suggested that CBX6 was overexpressed in ESCC and linked to dismal prognosis. Cbx6 knockdown was induced in mouse mEC25 cells. This procedure curbed the proliferation and migration of mEC25 cells and reduced exhaustion of the co-cultured CD8(+) T cells. In vivo, Cbx6 knockdown in mEC25 cells reduced tumorigenesis while enhancing immune activity in mice. Further experiments showed that CBX6 reduced CD8(+) T cell cytotoxicity by secreting C-C motif chemokine ligand 8 (CCL8) and promoting monocarboxylate transporter 4 (MCT4)-mediated lactate transport. Regarding the mechanism, CBX6 regulated the expression of SWI/SNF related BAF chromatin remodeling complex subunit D1 (Smarcd1) to modulate chromatin remodeling, thus promoting transcription of Ccl8 and Slc16a3 (encoding MCT4). Smarcd1 overexpression restored metabolic activity in mEC25 cells, reduced activity of co-cultured CD8(+) T cells, and promoted tumorigenesis in vivo. Tissue microarrays analysis suggested that CBX6 and SMARCD1 were linked to immunosuppression and poor prognosis in clinical samples. In conclusion, this study suggests that CBX6 induces CD8(+) T cell exhaustion and tumor development in ESCC through SMARCD1-mediated CCL8 secretion and lactate efflux.	esophagus
Tislelizumab-associated toxic epidermal necrolysis in an esophageal cancer patient: a case report.	BACKGROUND: Tislelizumab, a humanized IgG4 anti-programmed cell death 1 (PD-1) monoclonal antibody approved in China in 2019 for advanced solid tumors such as esophageal cancer, functions by blocking the PD-1/PD-L1 pathway to reactivate anti-tumor immunity. Common adverse reactions include fever and rash; however, toxic epidermal necrolysis (TEN)-a rare, life-threatening drug hypersensitivity reaction-is reported in fewer than 0.1% of patients receiving PD-1 inhibitors, with limited real-world evidence specifically linking it to tislelizumab. CASE PRESENTATION: A 70-year-old male with esophageal squamous cell carcinoma received two cycles of neoadjuvant therapy (nab-paclitaxel, cisplatin, and tislelizumab 200 mg) followed by partial esophagectomy. On day 86 after the first tislelizumab infusion, he developed a diffuse rash progressing to skin exfoliation, vesiculation, and a positive Nikolsky sign, leading to a diagnosis of TEN. Upon admission, his SCORTEN was 3 (predicting 35% mortality) and ALDEN score was 5, indicating a probable association with tislelizumab. Management included intravenous methylprednisolone, immunoglobulin, topical treatments, and nutritional support. The patient achieved complete recovery two months after symptom onset. CONCLUSION: This case illustrates that tislelizumab can induce TEN after a prolonged incubation period (86 days in this instance). It underscores the importance of vigilant monitoring of skin and mucous membranes during treatment, early recognition and intervention, and adequate glucocorticoid dosing in managing this serious immune-related adverse event, offering valuable clinical insight for oncologists.	esophagus
Albumin-bound paclitaxel and cisplatin with radiotherapy in locally advanced oesophageal squamous cell carcinoma: a single-arm, phase II trial.	BACKGROUND: We conducted a Phase II study to assess the efficacy and toxicity of nab-paclitaxel (nab-PTX) and cisplatin in combination with concurrent radiotherapy in patients with locally advanced oesophageal squamous cell carcinoma (ESCC). METHODS: Forty-two patients with locally advanced ESCC received nab-paclitaxel (75 mg/m²) and cisplatin (25 mg/m²) on days 1, 8, 15, 22, and 29 of radiotherapy, with total radiation doses ranging from 50 to 64 Gy. The overall response rate (ORR) and disease control rate (DCR) were defined as primary endpoints, while progression-free survival (PFS), overall survival (OS), and treatment-related toxicity were considered secondary endpoints. RESULTS: Between February 2019 and April 2023, 42 patients who met the inclusion criteria participated in the study, 36 (85.7%) of whom were male, with a median age of 62.5 years (IQR: 57.0-66.3). All participants were classified as having clinical stage III or IV disease. Of the 42 patients, 28 (66.7%) completed all planned chemoradiotherapy sessions, whereas 35 (83.4%) completed at least four cycles of chemotherapy, with a median of five cycles (range: 1-5). In the efficacy assessment, the ORR was 73.8%, and the DCR was 90.5%. After a median follow-up of 28.1 months (IQR: 19.9-55.8), the 1-year PFS and 1-year OS rates were 57.1% and 88.0%, respectively. The most common grade 3 or 4 adverse event (AE) was leukopenia (38.1%), with no treatment-related deaths observed. CONCLUSIONS: The combination of nab-paclitaxel and cisplatin, administered on a weekly schedule with concurrent radiotherapy, demonstrated promising antitumour activity and an acceptable safety profile in patients with ESCC. TRIAL REGISTRATION: The trial was registered at https://clinicaltrials.gov under the identifier ChiCTR1900021079 in January 2019.	esophagus
Involvement of long non-coding RNA NORAD in short-term poor prognosis of neoadjuvant chemotherapy in adenocarcinoma of esophagogastric junction.	BACKGROUND: Adenocarcinoma of the esophagogastric junction (AEG) is a common upper gastrointestinal malignancy. AIM: This study investigates the impact of long non-coding RNA NORAD on the short-term efficacy of oxaliplatin-based neoadjuvant chemotherapy in AEG. METHODS: Patients with advanced AEG received oxaliplatin-based neoadjuvant chemotherapy. Oxaliplatin- sensitive (PDCs) and oxaliplatin-resistant (PDC-Rs) primary tumor cell lines were established, and NORAD- knockdown PDC-R cells (shNORAD PDC-R) were generated. NORAD expression in pretreatment tumor tissues was measured by qRT-PCR. The half-maximal inhibitory concentration (IC50) was determined for all cell lines. RESULTS: NORAD expression correlated with Lauren classification. The low-expression group showed higher overall response rate, tumor regression grade, and pathological remission rate after chemotherapy. Pretreatment NORAD expression was an independent predictor of 3-year disease-free survival (DFS). IC50 values for PDC, PDC-R, and shNORAD PDC-R cells were 2.32, 21.41, and 3.82 μg/mL oxaliplatin, respectively. CONCLUSIONS: High pretreatment NORAD expression is an independent risk factor for poor response to neoadjuvant chemotherapy. Downregulating NORAD restores oxaliplatin sensitivity in resistant cells.	esophagus