crossing96/oncoscreening huggingface dataset:
Outcomes of esophagectomy in patients with previous foregut surgery: a matched retrospective cohort study.	"BACKGROUND: Esophagectomy is a challenging procedure indicated for esophageal cancer and complex benign esophageal conditions. The primary aim of this study was to determine the impact of previous foregut surgeries on postoperative outcomes following esophagectomy. METHODS: A retrospective cohort study was performed on patients undergoing esophagectomy between March 1st, 2008, and December 17th, 2024. Two groups were identified, patients with previous foregut surgery (PFS) and patients without previous foregut surgery (No-PFS). PFS (N = 37) was matched in a 3:1 ratio to patients with No-PFS (N = 111) by age, gender, race, and smoking status with ""nearest neighbor"" method. Demographics and perioperative variables were collected and compared between both groups. Kaplan-Meier method estimated survival and freedom from long-term complications, such as anastomotic stricture and paraconduit hernia. RESULTS: Of 349 patients undergoing esophagectomy, 37 had PFS. These included 43% anti-reflux procedures, 35% Heller myotomy for achalasia, and 14% bariatric surgeries. Diagnosis of cancer was an indication for esophagectomy in 59.5% of cases. After matching, significant difference was found regarding operative time (PFS: 463 vs No-PFS: 426 min; p = 0.038). No difference was observed in conversions to open, early complications, reinterventions or leak rate (p value > 0.05). In 3 cases, an interposition graft (colon, jejunum) was used as conduit instead of stomach. As regards freedom from late anastomotic stricture, although not statistically significant, a trend toward a lower freedom from anastomotic stricture was observed in PFS group. The survival analysis, limited to patients with esophageal cancer, indicated higher survival rates in the PFS group (p = 0.06). CONCLUSIONS: PFS does not impact the approach or outcomes of esophagectomy and is safe with no increased risk of complications. Patients with PFS who had indication of esophagectomy for cancer tended to have better survival rates due to earlier detection and lower clinical stages at diagnosis because of more frequent follow-ups."	esophagus
Precision Detection of FGFR2b Protein Expression in Solid Tumors.	CONTEXT.—: Immunohistochemistry effectively reveals the heterogeneous nature of fibroblast growth factor receptor 2b (FGFR2b) expression and antigen accessibility across diverse tumor histologic types, a variability significantly influenced by tissue type and fixation quality, both of which profoundly impact target antigen accessibility within formalin-fixed, paraffin-embedded (FFPE) tissue specimens. Retrieval parameters on automated staining platforms can impact staining outcomes and assay sensitivity. A comprehensive optimization of staining procedures, encompassing antigen retrieval, proteolytic enzyme digestion, primary antibody incubation, and detection selections, yielded 2 distinct protocols designed for specific tumor types. The protocols were tailored to maximize performance on their respective tumor types, with one protocol optimized for gastric and gastroesophageal junction (G/GEJ) adenocarcinoma, and the other fine-tuned for non-small cell lung cancer (NSCLC) and a broader spectrum of solid tumors. OBJECTIVE.—: To optimize an FGFR2b (FPR2-D) assay for NSCLC and a broader spectrum of solid tumors through modification of the established VENTANA FGFR2b (FPR2-D) Mouse Monoclonal Antibody assay, originally validated for G/GEJ adenocarcinoma. DESIGN.—: Multiple FGFR2b assay protocols were used to stain sections of FFPE tissue from commercially procured specimens spanning 10 tumor types. Each specimen was evaluated to select the preferred protocol parameters that achieved strong specific staining with minimal background. The assay was then assessed for sensitivity, specificity, and repeatability. RESULTS.—: The optimal gastric cancer tissue staining protocol for the VENTANA FGFR2b (FPR2-D) Mouse Monoclonal Antibody was referenced to develop an assay for other solid tumor types. CONCLUSIONS.—: This investigation shows the importance of parameter screening approaches when evaluating FGFR2b across tumor types in immunohistochemistry to ensure optimal staining performance.	esophagus
Survival Outcome of Thoraco-Laparoscopic McKeown Esophagectomy Versus Endoscopic Submucosal Dissection for Early-Stage Esophageal Squamous Cell Carcinoma: A Propensity Score-Matched Analysis.	OBJECTIVE: To evaluate thoraco-laparoscopic McKeown esophagectomy (TLME) versus endoscopic submucosal dissection (ESD) for clinical-T1N0 esophageal squamous cell carcinoma (ESCC) depending on invasion depth. BACKGROUND: Early-stage ESCC has been widely treated by endoscopic resection. While ESD is safer than esophagectomy perioperatively, its survival benefits for clinical-T1N0M0 ESCC, especially high-risk T1b tumors, are unclear. METHODS: A retrospective study was conducted on clinical-T1N0 ESCC patients at the First Affiliated Hospital of Zhengzhou University comparing TLME (cT1a, n = 352; cT1b, n = 205) with ESD (cT1a, n = 499; cT1b, n = 62). Overall survival (OS), disease-specific survival (DSS), relapse-free survival (RFS), and metastasis-free survival (MFS) were analyzed depending on invasion depth after propensity score matching to account for selection bias. RESULTS: ESD group had better OS (hazard ratio: 0.54, p = 0.029) but worse RFS (hazard ratio: 6.83, p < 0.001) than TLME group in general terms. T1a cancers showed no difference in DSS and MFS between groups. T1b subgroup with ESD had lower DSS (hazard ratio: 5.65, p = 0.036) and MFS (hazard ratio: 3.54, p = 0.069). R1-resection in ESD group linked to poorer OS (hazard ratio: 5.89, p = 0.006) and DSS (hazard ratio: 3.67, p = 0.006). CONCLUSION: ESD can be safe in the treatment of clinical-T1aN0 ESCC. However, concerning oncologic curability, TLME should be recommended for patients with clinical-T1bN0 ESCC in terms of favorable DSS, RFS, and MFS.	esophagus
Dietary inflammatory index and the risk of esophageal cancer: a systematic review and meta-analysis.	BACKGROUND AND AIM: It is well-recognized that inflammation is an adaptive pathophysiological response in many types of cancer. Research on nutrition's critical role in inflammation, a risk factor for all forms of cancer, is growing. The dietary inflammatory index (DII) was created lately to assess if a diet is pro- or anti-inflammatory in terms of inflammation. Indeed, several studies have demonstrated the correlation between DII and the risk of several cancer types. This meta-analysis set out to look into the relationship between DII and the different forms of esophageal cancer. METHOD: PubMed, Cochrane library, Embase, Scopus, and Web of Science databases were searched up to May 2024 to retrieve relevant articles. RAYYAN intelligent tool for systematic reviews was incorporated for the screening of studies. Original articles written in English Studies that investigated the inflammatory index of diet in individuals who developed esophageal cancer were included in this study.STATA v18 software was used to conduct the meta-analysis. Egger's test for publication bias assessment was implemented. Newcastle Ottawa scale was used to evaluate the qualities of the included studies. A plot digitizer was used to extract digital data. RESULT: A total of 13 studies were included in the systematic review, with 6 studies contributing to the meta-analysis, comprising 10,150 participants. The participants were categorized into high and low DII groups, with the low DII group (n = 3,403) serving as the reference. The meta-analysis demonstrated a significant association between high DII and increased risk of esophageal cancer. Specifically, individuals in the high DII group were 29% more likely to develop esophageal cancer, with a pooled odds ratio (OR) of 1.29 (95% Confidence Interval [CI]: 1.16-1.43), as calculated using a random-effects model. Moderate heterogeneity was observed (I(2) > 50%). Egger's test indicated evidence of publication bias (p < 0.05). Subgroup and sensitivity analyses confirmed the robustness of this association across populations and study designs. CONCLUSION: our study concludes that a higher level of DII is associated with a higher risk of esophageal cancer development. This study suggests that modifying inflammatory properties of dietary patterns can reduce the risk of incidence of esophageal cancer.	esophagus
Detection of Barrett's Esophagus Prior to Development of Esophageal and Esophagogastric Junction Adenocarcinoma.	BACKGROUND & AIMS: Guidelines differ on the definition of Barrett's esophagus (BE). We aimed to estimate the detection rate of esophagogastroduodenoscopy (EGD) with biopsy for BE, using longitudinal outcome of adenocarcinoma of the esophagus or esophagogastric junction (EAC, EGJAC) as the gold standard. METHODS: We performed retrospective analyses of US Veterans with EAC/EGJAC between 2017 and 2021 who had an EGD before cancer diagnosis. We reviewed a random sample of 200 cases of EAC and 100 cases of EGJAC to tabulate the detection rate of EGD with biopsy, stratified by Siewert classification (S1 or S2). RESULTS: After manual review, there were 136 S1 and 108 S2 cases. Among patients with endoscopic suspicion of BE who had biopsies, 96.8% of S1 and 97.9% of S2 had intestinal metaplasia (IM). BE defined as ≥1 cm with IM had a detection rate of 66.2% for S1 and 39.8% for S2. When restricted to EGDs with appropriate biopsies, the detection rate of ≥1 cm with IM improved to 70.3% in S1 and 41.4% in S2. Seventy-three percent of S1 cases and 90% of S2 cases without BE diagnosed were related to lack of endoscopic suspicion for BE. BE or a visible lesion was present in 70% of photographs from EGDs not suspected of having BE by the original endoscopist. CONCLUSIONS: IM seems required for development of EAC and likely EGJAC. EGD with biopsy had only modest rate for detecting a precursor state for subsequent adenocarcinoma and was lower for S2 compared with S1. Variability in endoscopic suspicion, including segments <1 cm, are potential areas for improvement in detection of BE by EGD.	esophagus
Prognosis of Robot-Assisted Esophagectomy with Thoracic Duct Resection in Esophageal Squamous Cell Carcinoma.	BACKGROUND: The authors' previous study found no significant difference in short-term clinical outcomes between patients undergoing robot-assisted esophagectomy (RAE) with or without thoracic duct resection (TDR). However, the impact of RAE-TDR on long-term prognosis remains unclear. METHODS: From January 2019 to July 2020, the study prospectively and consecutively enrolled 127 thoracic duct (TD)-preserved and 73 TD-resected patients who underwent standard McKeown RAE surgery. The overall survival (OS) and recurrence-free survival (RFS) were compared between these two groups. RESULTS: During a median follow-up period of 48.6 months, the 3-year OS rates were 70.6% and 70.9% in the TD-preserved and TD-resected group, and the 3-year RFS rates were 61.9% and 55.5%, respectively. The TD-preserved and TD-resected groups did not differ significantly in local-regional (12.6% vs. 15.1%; p = 0.623), distant (23.6% vs. 28.8%; p = 0.422), or mixed (2.4% vs. 4.1%; p = 0.670) recurrence. However, among the eight (11%) patients with TD lymph node (LN) metastasis in the TD-resected group, six patients experienced recurrences (1 local-regional and 5 distant). The patients who had thoracic duct lymph node (TDLN) metastasis experienced significantly worse RFS than those who did not (p = 0.04). Additionally, TDLN metastasis was significantly associated with advanced nodal stage (cN2-3, 6/8; p = 0.001) and bulky tumors (pT3, 7/8; p = 0.028). CONCLUSION: In ESCC, RAE-TDR does not improve recurrence or survival outcomes. However, identification of TDLN metastasis through TDR carries significant prognostic implications considering its strong association with aggressive tumor biology and inferior oncologic outcomes. Therefore, TDR should not be routinely performed, but its selective application for patients with advanced tumors may provide critical staging information to guide tailored postoperative strategies.	esophagus
Somatic mosaicism in the buccal mucosa reflects lifestyle and germline risk factors for esophageal squamous cell carcinoma.	Clones harboring cancer driver mutations can expand in normal tissues, known as somatic mosaicism, and can be influenced by age and environmental and germline factors. Somatic mosaicism in the blood predicts the risk of hematological malignancies; however, the relevance of somatic mosaicism to solid tumors remains unclear, in part because of limited sample availability. Lifestyle habits, including alcohol consumption and tobacco smoking, and pathogenic germline variants increase the risk of developing esophageal squamous cell carcinoma (ESCC). Because somatic mosaicism in the esophagus is known to be associated with aging and lifestyle habits and considering the contiguity of squamous epithelium from the esophagus to the oral cavity, we noninvasively collected buccal mucosa samples from patients with and without ESCC using swabs of different sizes and conducted deep error-corrected sequencing of 26 cancer driver genes to obtain comprehensive landscapes of tissue remodeling by driver-mutant clones. We found that the number of mutations increased with drinking, but only in individuals with germline risks. Moreover, across positively selected genes in the buccal mucosa, mutations increased with age and smoking regardless of germline risks, whereas drinking affected only those with germline risks. The buccal mucosa of patients with ESCC was extensively remodeled, and models predicting the presence of ESCC demonstrated high accuracy with smaller swab sizes, possibly because of their higher sensitivity in detecting small mutant clones. In conclusion, we showed that buccal mucosal remodeling reflects lifestyle and germline risks, as well as age, which might be exploited for noninvasive risk assessment of ESCC.	esophagus
Development and validation a radiomics combined clinical model predicts treatment response for esophageal squamous cell carcinoma patients.	PURPOSE: This study is aimed to develop and validate a machine learning model, which combined radiomics and clinical characteristics to predicting the definitive chemoradiotherapy (dCRT) treatment response in esophageal squamous cell carcinoma (ESCC) patients. METHODS: 204 advanced ESCC patients were included who underwent dCRT at our hospital. Patients were randomly divided into training cohort and validation cohort with a ratio of 7:3. The radiomics features were selected by LASSO algorithm. The clinical features were selected by multivariate logistics analysis (p < 0.05). Subsequently, a combined radiomics and clinical model was established and validated to predict the treatment response in ESCC patients by logistic regression model. The performance of the model was evaluated by receiver operating characteristic (ROC) curve, decision curve analysis (DCA), nomogram, and calibration curve. RESULTS: Total of 944 radiomics features were extracted from the pre-treatment contrasted enhanced CT images (CECT). After feature selection, 3 radiomics features and 3 clinical features were identified as the most predictive variables. The combined model shows better prediction performance among radiomics model or clinical model. The radiomics model's AUC values in training and validation cohort are 0.71,0.69. As for clinical model the AUC values were 0.74,0.75 in training and validation cohort. However, the AUC values in combined model are 0.79, 0.78 in training cohort and validation cohort, respectively. DCA and calibration curve also demonstrated good performance for the combined model. CONCLUSION: The radiomics combined clinical features model demonstrates superior treatment response prediction ability for ESCC patients received dCRT. This model has the potential to assist clinicians in identifying non-responsive patients before treatment and guide individualized therapy for advanced ESCC patients.	esophagus
Clinical Implications of The Cancer Genome Atlas Molecular Classification System in Esophagogastric Cancer.	PURPOSE: The Cancer Genome Atlas (TCGA) project defined four distinct molecular subtypes of esophagogastric adenocarcinoma: microsatellite instable (MSI), Epstein-Barr virus (EBV)-associated, genomically stable (GS), and chromosomally instable (CIN). However, an association between molecular subtypes and clinical outcomes has not been clearly demonstrated. Given few actionable biomarkers, we investigated the clinical relevance of TCGA classification system. EXPERIMENTAL DESIGN: We identified all patients with esophagogastric adenocarcinoma whose tumors underwent prospective next-generation sequencing using the Memorial Sloan Kettering-IMPACT assay from 2014 to 2023. We classified all tumors in accordance with TCGA methodology and correlated molecular subtypes with high-quality clinicopathologic data. RESULTS: Among 1,438 included patients, 941 had CIN, 344 had GS, 103 had MSI, and 50 had EBV tumors. Accounting for the clinical stage and tumor grade, molecular classification was independently associated with overall cancer-specific survival (P < 0.001) on Cox multivariable analysis. Furthermore, genomic signatures, patient demographics, pathologic responses to neoadjuvant therapy, patterns of recurrence, and metastatic organotropism differed significantly by molecular subtype. Although most distal esophageal and gastroesophageal junction tumors were CIN, up to 25% of these included GS, MSI, or EBV subtypes in contrast to TCGA. Random forest machine learning demonstrated that the molecular subtype is more influential in predicting response to treatment than tumor location. CONCLUSIONS: Molecular classification is independently prognostic and may warrant inclusion in future staging and treatment guidelines. Routine molecular profiling is clinically feasible and may play a role in the management of patients to help guide appropriate treatment selection and clinical trial enrollment in the place of tumor location.	esophagus
Preoperative Anemia Is an Independent Prognostic Factor for Esophageal Cancer Patients Who Receive Curative Treatment.	BACKGROUND/AIM: We retrospectively evaluated the clinical impact of anemia during the perioperative period on both short- and long-term oncological outcomes in patients with resectable esophageal cancer who received curative treatment. PATIENTS AND METHODS: We retrospectively reviewed the medical records and collected data from consecutive patients with esophageal cancer who underwent curative resection at Yokohama City University from 2005 to 2022. RESULTS: A total of 198 patients were included in this study. According to previous studies and the 3- and 5- year overall survival rates, a hemoglobin level of 11 g/dl was selected as the optimal cutoff value in the present study; preoperative hemoglobin of <11 g/dl and >11 g/dl were observed in 34 patients (Hb-low group) and 164 patients (Hb-high group), respectively. The 3- and 5-year OS rates were 39.1% and 34.8%, respectively, in the Hb-low group and 70.3% and 62.1% in the Hb-high group. There were significant differences between the two groups (p=0.003). Univariate and multivariate analyses demonstrated that the preoperative Hb level was as an independent prognostic factor for OS [hazard ratio (HR)=1.809; 95% confidence interval (CI)=1.073-3.050, p=0.026]. Moreover, the 3- and 5-year recurrence-free survival (RFS) rates were 16.6% and 16.6%, respectively, in the Hb-low group and 51.8% and 45.1% in the Hb-high group (p<0.001). In the multivariate analysis, the preoperative Hb status was also selected as an independent prognostic factor for RFS (HR=1.977; 95%CI=1.240-3.151 p=0.004). CONCLUSION: Preoperative anemia is an independent prognostic factor in patients with esophageal cancer. Our results suggest its potential significance in the treatment and management of these patients.	esophagus
The Efficacy and Safety of Nivolumab Combined with Nab-Paclitaxel or Oxaliplatin as a First-Line Treatment for Advanced or Metastatic Gastric Cancer and Gastroesophageal Junction Cancer.	OBJECTIVE: This study aims to assess the therapeutic efficacy and safety of nivolumab combined with chemotherapy as a first-line treatment for advanced or metastatic gastric cancer, specifically comparing the outcomes of oxaliplatin-based versus albumin-bound paclitaxel (nab-paclitaxel)-based therapies. METHODS: We retrospectively analyzed 93 patients with advanced gastric cancer or gastroesophageal junction adenocarcinoma treated at the First Medical Center of Chinese PLA General Hospital from September 2017 to November 2022. Patients were categorized into the nivolumab + oxaliplatin (N-OX group) or nivolumab + nab-paclitaxel (N-AP group) based on the chemotherapy regimen. Progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and safety were evaluated as endpoints. RESULTS: At the end of the follow-up period on September 31, 2023, we reported an ORR of 65.6% and DCR of 95.7% across all patients. The median PFS was 8.4 months, with no significant difference between the N-OX and N-AP groups (median, 7.8 vs 9.5 months; P = 0.450). Notably, patients with diffuse gastric cancer in N-AP group showed a 44.7% reduction in tumor progression risk compared with the N-OX group (P = 0.046). The overall safety profile was acceptable in two groups. CONCLUSIONS: Our study suggested that nivolumab combined with chemotherapy was effective and safe as a first-line intervention for advanced gastric cancer. While both oxaliplatin and nab-paclitaxel regimens showed similar efficacy, the nab-paclitaxel may offer additional benefits for patients with diffuse gastric cancer. Further research is encouraged to confirm these findings and refine treatment strategies.	esophagus
TGFBR2 as a prognostic marker and therapeutic target in benzo(a)pyrene-associated esophageal cancer: insights from multi-omics analysis.	BACKGROUND: Benzo(a)pyrene (BaP) is an environmental pollutant linked to several cancers, including esophageal cancer (ESCA). Understanding its impact on gene expression and associated molecular pathways in ESCA is crucial for developing targeted therapies. METHODS: Using the TCGA-ESCA dataset, we identified differentially expressed genes (DEGs) related to BaP exposure. Enrichment analyses and protein-protein interaction (PPI) network construction were performed to explore the biological significance of these DEGs. Molecular docking studies assessed the interactions between BaP and core subnetwork genes. Survival analysis and immune cell infiltration analysis were conducted to evaluate the prognostic value of TGFBR2. Chemotherapy drug sensitivity was analyzed based on TGFBR2 expression levels. RESULTS: We identified 5757 DEGs in ESCA, with 33 genes linked to both BaP exposure and ESCA. Enrichment analyses revealed significant pathways, including p53 signaling and apoptosis. Key genes (ACTB, CDKN2A, TGFBR2) were verified for their differential expression. Molecular docking demonstrated strong BaP binding to several core proteins. High TGFBR2 expression correlated with better survival, enhanced immune infiltration, and altered sensitivity to chemotherapeutic agents. CONCLUSION: Our study highlights the molecular mechanisms by which BaP influences ESCA, with TGFBR2 emerging as a potential prognostic marker and therapeutic target. These insights pave the way for personalized treatments in BaP-induced esophageal carcinogenesis.	esophagus