crossing96/oncoscreening huggingface dataset:
The use of self-expanding metallic stents (SEMS) is effective in symptom palliation from recurrent tumor after esophagogastrectomy for cancer.	The efficacy of using self-expanding metallic stent (SEMS) for palliation of symptoms because of tumor recurrence after prior esophagogastrectomy has not been properly assessed despite the well recognized use of SEMS in patients without prior surgery. The aim of this study is to evaluate the efficacy and safety of using SEMS in patients who had prior esophagogastrectomy. The study group included 35 patients with carcinoma of esophagus or cardia documented to have loco-regional recurrence after esophagogastrectomy and in whom SEMS were placed for palliation. The median age was 67 (ranged 41-85). The indications for stenting were dysphagia caused by recurrence at the esophageal anastomosis (n= 4) and in the esophageal remnant (n= 5), or extrinsic compression from mediastinal nodal disease (n= 7); gastric outlet obstruction produced by extrinsic tumor compression (n= 13); and tracheo-esophageal fistulae (n= 6). Forty-three stenting procedures were performed, and the technical success rate was 97.6%. The dysphagia score improved from 4.66 to 2.54 (P < 0.001). All patients with tracheo-esophageal fistula had their symptoms successfully palliated. The immediate complication rate was 14% (n= 5); two patients had stent malpositioning, two had inadequate opening of their stents, and one had a failed stenting procedure. On follow-up, 15 (42.8%) patients required a total of 22 re-intervention procedures for various reasons: endoscopic dilatation (five dilatations in three patients), removal of foreign bodies (nine procedures in four patients), and insertion of a second SEMS related to tumor growth (eight stents in eight patients). There was no procedure-related mortality. The median survival was short at 42 days (range 5-290 days), mostly related to advanced disease stage. SEMS in patients with recurrent tumor after esophagogastrectomy is safe and effective.	esophagus
Influence of ROI definition, partial volume correction and SUV normalization on SUV-survival correlation in oesophageal cancer.	OBJECTIVE: An explanation for the discrepancies in the reported correlations between standardized uptake value (SUV) and survival might be the application of different SUV methodologies. The primary aim of this study was to examine the influence of using different methodologies on SUV-survival correlation. METHODS: Data were used from a prospective cohort study consisting of oesophageal cancer patients in whom preoperative fluorodeoxyglucose positron emission tomography was performed. Various methodologies of SUV calculation/correction were correlated with the default (SUV A41% corrected for body surface area): different volume of interest definitions, different SUV normalization, with and without serum glucose correction, and with (PVC+ ) and without partial volume correction (PVC- ). Receiver operating characteristic (ROC) curves using any type of SUV for the identification of potential correlation with disease-free survival were also compared. RESULTS: Fifty-two patients were included for this study. Significant correlations were found between SUV A41% and all the other described SUVs: SUV 50% (r2=0.99; P< 0.001), SUV A50% (r2= 0.98; P< 0.001), SUVmax (r2= 0.98; P < 0.001), SUV A41% PVC+ (r2= 0.97; P < 0.001) and SUV A41% glucose (r2= 0.93; P <0.001). No correlation was found between volume of interest 41% and SUV A41%, with or without, PVC (P = 0.85 and P = 0.41). Significant correlations were found between SUVmax corrected for body surface area, SUVmax corrected for body weight (r2=0.96; P < 0.001) and SUV corrected for lean body mass (r2= 0.98; P < 0.001). ROC curves for various SUV methodologies showed an almost identical area under the curve for any type of SUV. CONCLUSION: A strong correlation was found between all the investigated SUV methodologies. Moreover, when looking for correlations between SUV and disease-free survival, the areas under the ROC curves were almost identical for any type of SUV methodology.	esophagus
Gene expression alterations in formalin-fixed, paraffin-embedded Barrett esophagus and esophageal adenocarcinoma tissues.	BACKGROUND AND AIM: Widespread applicability of tissue-based mRNA expression screening for Barrett esophagus (BE) is likely to require (1) accurate methods for assaying archival formalin-fixed, paraffin-embedded (FFPE) histopathology specimens taken at endoscopy, and (2) validation studies of promising biomarkers in different patient cohorts. RESULTS: 30 genes were significantly differentially expressed by histopathology tissue type. The direction and magnitude of the differences were very similar to those found in previous studies using fresh frozen tissues. Novel upregulated genes were TSPAN8 (also known as CO-029), TSPAN24 (CD151), EGR1 and TCIRG1. Novel downregulated genes were DPYD, TSPAN29 (CD9) and Ets1. Strong associations between histopathology type and gene expression were observed with the overexpressed genes: cyclo-oxygenase-2 (COX-2), for which histopathology type explained 77.7% of the variation in expression, TSPAN1 (73.5%), TSPAN8 (62.9%), SPARC (62.1%), MMP7 (50.8%); and the under-expressed genes ADH7 (53.7%), APC (58.2%), RAR-gamma (51.3%). METHODS: mRNA was isolated from 54 FFPE small endoscopic biopsies from patients with Barrett intestinal metaplasia (BE), esophageal adenocarcinoma (EAC), or control patients with a normal squamous-lined esophagus. Multiplexed tandem PCR (MT-PCR) was used to quantitate 50 selected candidate genes for BE and control genes in duplicate. Principal component analysis (PCA) was conducted to explore the presence of global differences in gene expression profiles. One-way analysis of variance (ANOVA) of the transformed data was used to identify genes that were differentially expressed between different histological subtypes. Differentially expressed genes with a fold change of ≥2 (upregulated) or ≤-2 (downregulated) are reported with the p value for each comparison (EAC vs. normal, EAC vs. BE and BE vs. normal). The Benjamini-Hochberg method was used to control the false discovery rate at 0.01 for all comparisons. CONCLUSIONS: Alterations in expression of select genes are strongly associated with BE or EAC or both. This study's findings for many highly differentially expressed genes are very similar to those previously reported, suggesting that these genes should be tested further in longitudinal studies for their potential role as biomarkers of progression to more advanced Barrett disease.	esophagus
Quality of life and fear of cancer recurrence after endoscopic and surgical treatment for early neoplasia in Barrett's esophagus.	BACKGROUND AND STUDY AIMS: Endoscopic treatment of early neoplasia in Barrett's esophagus preserves the esophagus and is minimally invasive compared with surgical treatment. However, the influence of endoscopic therapy on quality of life (QOL) and fear of cancer recurrence is unknown. We explored QOL and fear of cancer recurrence 12 - 60 months after endoscopic and surgical treatment for early Barrett's neoplasia, using a cross-sectional design. PATIENTS AND METHODS: A total of 81 patients with early Barrett's neoplasia underwent endoscopic treatment and 33 patients underwent surgery. The choice of treatment was based on tumor size, depth of penetration or patient preference. QOL was measured using the SF-36, EORTC-QLQ-C30, and the EORTC-QLQ-OES18 questionnaires. Anxiety and fear of recurrence were measured using the Hospital Anxiety and Depression Scale (HADS) and the Worry Of Cancer Scale (WOCS). RESULTS: In total, 66 endoscopy patients and 29 surgery patients were eligible for the study. Questionnaires were completed by 64/66 (97 %) endoscopy patients and 27 / 29 (93 %) surgery patients. Multivariate analyses were conducted, with sex, age, comorbidity, and histology of the resected specimen used as covariates. Patients in the surgery group reported significantly more eating problems (OR = 18.3; P < 0.001) and reflux symptoms (OR = 3.4; P = 0.05) on the EORTC-OES18 questionnaire, whereas endoscopy patients reported more fear of recurrence on the WOCS than surgery patients ( P = 0.003). No significant differences were found between the two groups on the other outcomes. CONCLUSION: Preservation of the esophagus after endoscopy treatment, which is preferred from a clinical perspective, may induce fear of cancer recurrence. Proper patient education with specific attention to fear of cancer recurrence may therefore be required.	esophagus
Impact of the method of reconstruction after oncologic oesophagectomy on quality of life--a prospective, randomised study.	OBJECTIVE: For patients undergoing oncologic surgery, the quality of life (QoL) is generally accepted as an important outcome parameter in addition to long-term survival, mortality and complication rates. This study focussed on the QoL in patients after oesophagectomy for cancer, comparing the method of reconstruction (narrow gastric tube vs whole stomach). METHODS: In a prospective randomised single-centre study from 2007 to 2008, 104 patients underwent oesophagectomy for cancer. To assess the QoL, a questionnaire in reference to the EORTC-QLQ-C30 and the QLQ-OES24 was administered at 3 weeks, 6 months and 1 year after surgery. Clinical data were collected prospectively, and follow-up was performed regularly. RESULTS: There were no significant differences between the narrow gastric tube group (NGT group, n=52) and the whole-stomach group (WS group, n=52) with regard to patient and cancer characteristics, operative procedure, postoperative intensive care unit (ICU) hospitalisation, and overall survival at 1 year. Regarding the postoperative complication, there were more cases of postoperative reflux oesophagitis and impairment of pulmonary function in the WS group (P<0.05). Regarding the QoL investigation, the scores of QoL dropped for all patients at 3 weeks after surgery. Slowly, recovery was found at both 6 months and 1 year in both groups. Patients in the NGT group reported significantly (P<0.05) better scores of QoL at both 6 months and 1 year. CONCLUSIONS: Patients who underwent gastric tube reconstruction develop less postoperative digestive tract complications, and have a quicker recovery and a better QoL during the follow-up period. Further investigation and data collection will allow the assessment of this procedure beyond 1 year after operation.	esophagus
Squamous cell carcinoma arising in a communicating bronchopulmonary-foregut malformation.	Communicating bronchopulmonary-foregut malformation, a variant of bronchopulmonary sequestration, is a rare anomaly characterized by communication between an isolated portion of the respiratory tree and the gastrointestinal tract. We report herein a unique case involving a 43-year-old man with squamous cell carcinoma arising in communicating bronchopulmonary-foregut malformation. This patient had a workup for a chief complaint of exacerbation of constitutional dysphagia, resulting in detection of squamous cell carcinoma involving the lower esophagus. Under the clinical diagnosis of esophageal carcinoma, esophagectomy was performed after neoadjuvant chemoradiotherapy. Pathologic findings showed that squamous cell carcinoma had arisen in malformed bronchopulmonary tissue constituting part of the distal esophagus segmentally. This case was unique in that squamous cell carcinoma developed in an extremely rare type of congenital abnormality that had functioned as a passageway for food from birth, as a result of chronic irritation for more than 4 decades.	esophagus
Esophageal stents for the palliation of malignant dysphagia and fistula recurrence after esophagectomy.	BACKGROUND: Despite advances in staging methods, surgical techniques, and adjuvant treatment, recurrent cancer after esophagectomy is a major cause of morbidity and mortality. OBJECTIVE: Our purpose was to investigate the safety and efficacy of a self-expandable metal stent (SEMS) in patients with dysphagia or fistula caused by recurrent cancer after esophagectomy. DESIGN: Prospective, observational study with standardized treatment and follow-up. SETTING: Single university center. PATIENTS: In 81 patients with recurrent cancer after previous surgical esophagectomy, 100 esophageal SEMSs were inserted for dysphagia (n = 66) or fistula formation (n = 15). INTERVENTIONS: Stent placement. MAIN OUTCOME MEASUREMENTS: Technical and functional outcome, complications, and survival. RESULTS: The SEMSs restored luminal patency in 65 (98%) of 66 patients and sealed malignant fistulae in 14 (93%) of 15 patients. Stent dysfunction occurred in 24 (30%) of 81 patients. They all were successfully managed by subsequent endoscopic intervention. After stent placement, a total of 16 complications were observed. Major complications occurred in 9 (11%) of 81 patients, mild complications occurred in 7 (9%) of 81 patients. The overall 30-day mortality rate after stent insertion was 25%. Progression of the disease resulted in death after a median interval of 70 days (range 1 day to 91 months). LIMITATIONS: Nonrandomized design. CONCLUSIONS: SEMS placement in recurrent esophageal cancer after surgical resection offers adequate palliation by relieving dysphagia and sealing off esophageal respiratory fistulae. Therefore, in these patients who have a relatively short life expectancy, SEMS placement should be considered the treatment of choice.	esophagus
Technique of minimally invasive Ivor Lewis esophagogastrectomy with intrathoracic stapled side-to-side anastomosis.	OBJECTIVE: An intrathoracic linear stapled side-to-side anastomosis for gastroesophageal junction malignancy is feasible, results in low leak rates and less stenosis. DESIGN: Retrospective case series. SETTING: University tertiary care center. PATIENTS: Between March 2008 and January 2009, six patients with gastroesophageal junction malignancy undergoing minimally invasive esophagectomy with an intrathoracic linear stapled side-to-side anastomosis were identified and their clinicopathological data analyzed. MAIN OUTCOME MEASURES: Technique of a 6-cm side-to-side stapled intrathoracic esophagogastric anastomosis. RESULTS: Six patients underwent a minimally invasive esophagectomy with a side-to-side stapled intrathoracic esophagogastric anastomosis. Median age was 61.5 years. All patients had gastroesophageal junction adenocarcinoma and completed neoadjuvant chemoradiation therapy. The median operative time was 360 min. No patient received a blood transfusion. The 30-day mortality was 0. The median length of hospital stay was 8 days. The median number of nodes harvested was 18. At a median follow-up of 9 months, all patients were alive. There have been no anastomotic strictures to date. CONCLUSION: A 6-cm side-to-side stapled intrathoracic esophagogastric anastomosis is feasible and is associated with a low anastomotic leak rate.	esophagus
Neoadjuvant chemotherapy in Barrett's carcinoma - prognosis and response prediction.	In spite of endoscopic surveillance programs, 90% of patients initially presenting with Barrett's carcinoma have locally advanced disease. In these patients, preoperative chemotherapy increases the chance of a curative resection in responding patients. Unfortunately, response occurs in only 50% of patients after chemotherapy with cisplatin, 5-fluorouracil and leucovorin. Response prediction seems to be possible by measuring metabolic activity by positron emission tomography (PET) scan. Differentiation of responders from non-responders even before starting chemotherapy might be possible using microarray technology and immunhistology in tumour biopsies. A pattern of at least two-fold differentially regulated genes comparing responding and non-responding oesophageal adenocarcinomas was identified. The strongest difference can be seen for tumour necrosis factor, polyribonucleotide nucleotidyltransferase and the ephrin-B3-receptor. In conclusion, our experience suggests that it may be possible to characterize patients responding to chemotherapy by PET two weeks after starting the chemotherapy or even before treatment using customized microarray analysis.	esophagus
Optimal endoluminal treatment of Barrett's esophagus: integrating novel strategies into clinical practice.	Endoluminal therapy has become the first-choice treatment over the last 5 years for early Barrett's neoplasia limited to the mucosa. Long-term follow-up data on endoscopic resection have demonstrated the oncological safety of endoscopic resection in comparison to surgery. However, there is a high rate of recurrent disease, which can be avoided using additional ablation of the remaining Barrett. Radiofrequency ablation was recently introduced as an efficacious means to ablate Barrett's epithelium with a better safety profile than older ablation techniques. Recent studies show that endoscopic resection can be safely combined with radiofrequency ablation for treating dysplastic Barrett's after removal of visible lesions. This constitutes a completely new treatment paradigm that will be integrated in routine clinical practice in the forthcoming years.	esophagus
Better postoperative oxygenation in thoracoscopic esophagectomy in prone positioning.	Intrathoracic procedures can be performed with thoracoscopy in esophagectomy because the laparoscopic technique has recently been developed. During intrathoracic procedures, prone positioning of the patient allows gravity to facilitate optimal exposure of the esophagus, thereby affording a superb surgical view. In the current study, we compared the influence of prone positioning with lateral decubitus positioning on oxygenation in esophagectomy. We enrolled 18 patients and divided them into two groups: patients who underwent esophagectomy via thoracoscopy in the prone position (group P) and patients who underwent thoracotomy in the lateral decubitus position (control group, group L). Arterial blood gas analyses were performed before the operation was started (T1), 20 min after the initiation of one-lung ventilation (OLV) (T2), and two other points. The P/F ratio at T2 in group P was higher. Further, percent (%) change of the P/F ratios from T1 and thereafter in group P was higher at all points. We thought the reason why the prone position had contributed to maintenance oxygenation was as follows. First, the functional residual capacity and ventilation/perfusion matching in the prone position are satisfactory. Second, a bronchial blocker might contribute to reduction of atelectasis. Third, minimally invasive esophagectomy might reduce respiratory complications and blood loss because this procedure reduces edema and inflammation in the lung. In conclusion, the oxygenation provided by prone positioning is better than that provided by the lateral decubitus position during OLV in esophagectomy.	esophagus
{2-[(3-Carboxy-1-oxopropyl) amino]-2-deoxy-D-Glucose} suppresses proliferation and induces apoptosis in the human esophageal cancer cell line.	The aim of this study was to investigate the molecular mechanisms of apoptosis induced by {2-[(3-Carboxy-1-oxopropyl) amino]-2-deoxy-D-Glucose} (COPADG) in the esophageal cancer cell line Eca-109 and to establish a relationship between the rate of apoptosis and Fas and Bcl-2 protein expression. Eca-109 cells were cultured under standard condition. Cell growth was measured by MTT assay. Apoptosis and cell proliferation were determined by flow cytometry. Expressions of apoptosis-regulated genes Fas and Bcl-2 were detected by immunohistochemical methods and image analysis. COPADG dose- and time-dependently inhibited the growth of Eca-109 cells in vitro. Incubation of Eca-109 cells with 40 μmol/l of COPADG for 48 h induced significant apoptosis. After drug treatment, Fas protein expression was increased, while Bcl-2 protein expression was decreased. COPADG is able to induce apoptosis in the esophageal cancer cell line Eca-109. The mechanism of apoptosis in these cells may be related to up-regulation of Fas gene expression and the down-regulation of Bcl-2, which may serve as the experimental evidence for development of new drugs for the non-surgical management of human esophageal cancer.	esophagus
Endoscopic missed rates of upper gastrointestinal cancers: parallels with colonoscopy.	Recent publications assessing colonoscopy missed rates of colorectal cancer have generated efforts toward colonoscopy quality improvement. To date, esophagogastroduodenoscopy (EGD) has escaped similar scrutiny in Western populations. Raftopoulos et al. (1) report an upper gastrointestinal cancer missed rate of up to 6.7% in a cohort of 28,000 patients who underwent EGD at a hospital-based endoscopy unit in Perth, Western Australia. Of the missed esophageal and gastric cancers, approximately 80% of patients had alarm symptoms and 73% had abnormalities reported at the time of EGD. The missed cancers may not have been visualized, or were visualized and either not biopsied or biopsied inadequately, or interpreted incorrectly by pathologists. There was no difference in survival between the missed cancers and those detected at the index EGD.	esophagus
Periostin, a cell adhesion molecule, facilitates invasion in the tumor microenvironment and annotates a novel tumor-invasive signature in esophageal cancer.	Human squamous cell cancers are the most common epithelially derived malignancies. One example is esophageal squamous cell carcinoma (ESCC), which is associated with a high mortality rate that is related to a propensity for invasion and metastasis. Here, we report that periostin, a highly expressed cell adhesion molecule, is a key component of a novel tumor-invasive signature obtained from an organotypic culture model of engineered ESCC. This tumor-invasive signature classifies with human ESCC microarrays, underscoring its utility in human cancer. Genetic modulation of periostin promotes tumor cell migration and invasion as revealed in gain-of-loss and loss-of-function experiments. Inhibition of epidermal growth factor receptor signaling and restoration of wild-type p53 function were each found to attenuate periostin, suggesting the interdependence of two common genetic alterations with periostin function. Collectively, our studies reveal periostin as an important mediator of ESCC tumor invasion and they indicate that organotypic (three-dimensional) culture can offer an important tool to discover novel biological effectors in cancer.	esophagus
Bortezomib sensitizes human esophageal squamous cell carcinoma cells to TRAIL-mediated apoptosis via activation of both extrinsic and intrinsic apoptosis pathways.	Esophageal squamous cell carcinoma (ESCC) is one of the most aggressive human cancers, and novel treatment modalities are required. We investigated the therapeutic potential of the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL/Apo2L) in combination with the proteasome inhibitor bortezomib (Velcade) on human ESCC cell lines. Bortezomib enhanced the susceptibility to TRAIL in 12 of the 15 ESCC cell lines tested, although most showed low sensitivity to TRAIL as a single agent. The enhancement of TRAIL-induced apoptosis by bortezomib was caspase dependent. Increased processing of caspase-8 often accompanied enhancement of TRAIL-induced apoptosis by bortezomib. However, the increased cell surface expression of death receptors observed on bortezomib treatment did not seem to be crucial for this effect. For some ESCC, bortezomib treatment resulted in a more efficient recruitment of caspase-8 and the Fas-associated death domain to the death-inducing signaling complex. Additional downregulation of the cellular FLICE-inhibitory protein long isoform [c-FLIP(L)] could cooperate in the activation of the extrinsic pathway in some cases. For other ESCC, the crucial effect of bortezomib treatment seemed to be increased signaling via the intrinsic apoptotic pathway on subsequent exposure to TRAIL. Thus, bortezomib could sensitize ESCC to TRAIL apoptosis by multiple molecular mechanisms of action. Therefore, the combination of bortezomib and TRAIL might be a novel therapeutic strategy for ESCC patients who fail to respond to standard chemoradiotherapy that predominantly targets the mitochondrial apoptotic pathway.	esophagus