crossing96/oncoscreening huggingface dataset:
Current Endoscopic Approaches for the Treatment of Barrett Esophagus.	Barrett esophagus (BE) is the only identifiable premalignant condition for esophageal adenocarcinoma (EAC), a cancer associated with a poor 5-year survival rate. The stepwise pathologic progression of BE to invasive cancer provides an opportunity to halt progression and potentially decrease incidence and ultimately the morbidity and mortality related to this lethal cancer. Endoscopic eradication therapy (EET) in patients at increased risk of progression to invasive EAC (intramucosal EAC, high-grade dysplasia, and low-grade dysplasia) is a practice that is endorsed by multiple societies and has replaced esophagectomy as the standard of care for these patients. Although the effectiveness, safety, and durability of EET have been demonstrated in several studies, this review addresses the several challenges with EET that need to be considered to optimize patient outcomes. Finally, the critical role of training, competence, and quality indicators in EET are emphasized in this era of value-based health care practice.	esophagus
Expression of CAS/CSE1L, the Cellular Apoptosis Susceptibility Protein, Correlates With Neoplastic Progression in Barrett's Esophagus.	BACKGROUND: Identifying the molecular switch responsible for the neoplastic progression of Barrett's esophagus (BE) and initiation of adenocarcinoma (ADC) is clinically essential and it will have a profound impact on patient diagnosis, prognosis, and treatment. The cellular apoptosis susceptibility gene CAS/CSE1L is overexpressed in various cancers, including a rare report on esophageal ADC; however, its expression in BE neoplasia has not been addressed. MATERIALS AND METHODS: We investigated the expression of the CAS/CSE1L protein immunohistochemically in 56 esophageal resection specimens for ADC arising in BE. For each specimen, a full representative section of the invasive ADC was selected to include, when possible, BE, low-grade dysplasia (LGD) and high-grade dysplasia (HGD). Samples were stained for CAS/CSE1L expression using a rabbit polyclonal antibody recognizing the N-terminus of human CAS/CSE1L. Protein expression levels were measured using the Allred semiquantitative scoring system. The data were evaluated using χ statistical analysis. Gene expression Omnibus was queried for CAS/CSE1L and BE neoplasia. RESULTS: We found minimal to absent CAS/CSE1L in all BE tissue samples; however, CAS/CSE1L was upregulated in 60% of LGD and overexpressed in HGD and ADC. The results were statistically significant (P<0.05). The localization of CAS/CSE1L protein was nuclear in BE; it became nuclear and cytoplasmic in LGD and HGD, and predominantly cytoplasmic in ADC. A similar progressive increase was observed for CAS/CSE1L gene expression. CONCLUSION: These findings show changes in CAS/CSE1L during BE progression. CAS/CSE1L may represent a potential marker for dysplasia/carcinoma.	esophagus
ABCB1 Is Upregulated in Acquisition of Taxane Resistance: Lessons from Esophageal Squamous Cell Carcinoma Cell Lines.	Esophageal cancer is one of the common malignancies worldwide, particularly in eastern African and Asian countries including Japan. Taxane (paclitaxel or docetaxel) is one of the effective chemotherapeutic reagents for patients with esophageal cancer, but acquisition of chemoresistance frequently occurs; this is one of the most frequent causes for therapeutic failure. In this study, we established three taxane resistant esophageal squamous cell carcinoma cell lines and explored possible mechanisms for the acquisition of chemoresistance. Microarray analyses indicated that the ABCB1 (ATP binding cassette subfamily B member 1) gene was significantly upregulated in taxane resistant esophageal cancer cell lines. Moreover, we found that siRNA mediated ABCB1 knockdown successfully restored drug sensitivity in both paclitaxel and docetaxel resistant esophageal cancer cell lines. In conclusion, we propose that ABCB1 might play a pivotal role in acquisition of taxane resistance and could be a promising target for treatment of patients with esophageal cancer after acquisition of taxane resistance.	esophagus
[Short-term outcomes of minimally invasive Sweet esophagectomy for Siewert type Ⅱ esophagogastric junction adenocarcinoma].	Objective: To describe the technique for minimally invasive Sweet esophagectomy and to evaluate the feasibility, safety and the short-term clinical outcomes of this approach in the treatment of Siewert type Ⅱ esophagogastric junction adenocarcinoma. Methods: The clinical data of 122 patients with Siewert type Ⅱ esophagogastric junction adenocarcinoma who received Sweet esophagectomy between October 2013 and June 2015 in Department of Thoracic Surgery, Anhui Provincial Hospital Affiliated with Anhui Medical University was analyzed retrospectively. The study group consisted of 87 men and 35 women, and the ages ranged from 48 to 78 years (median: 67 years). Of those 122 patients, 47 underwent minimally invasive approach and 75 underwent open left transthoracic sweet esophagectomy. This study included 16 stage Ⅰa patients, 35 stage Ⅰb patients, 32 stage Ⅱa patients, 28 stage Ⅱb patients, and 11 stage Ⅲa patients. The clinicopathologic factors, operational factors and postoperative complications of the two groups were compared by t test and χ(2) test. Results: The two groups were similar in terms of gender, age, American Society of Anesthesiologists grade, preoperative staging and incidence of comorbidities (P>0.05). The minimally invasive approach was associated with significant increase in the number of total lymph nodes dissected or the stations of the total lymph nodes dissected (18.1±2.7 vs. 15.0±2.5, t= 6.612, P=0.001; 8.9±1.1 vs. 6.7±1.2, t=9.960, P=0.003), significant decrease in surgical blood loss ((88±32) ml vs. (120±34) ml, t=5.052, P=0.001), chest tube duration ((8±4) d vs. (10±4) d, t=3.110, P=0.002) and postoperative stay ((9±5) d vs. (12±4) d, t=3.167, P=0.002) relative to the open approach. The postoperative in-hospital mortality and total morbidity did not differ between the two groups (P>0.05). The minimally invasive approach was associated with significantly fewer respiratory complications than the open approach (8.5% vs. 22.7%, χ(2)=4.063, P=0.044). Conclusion: Minimally invasive technique for Siewert type Ⅱ esophagogastric junction adenocarcinoma can be safely and effectively performed for intrathoracic anastomosis with favorable early outcomes.	esophagus
Effect of prehabilitation in gastro-oesophageal adenocarcinoma: study protocol of a multicentric, randomised, control trial-the PREHAB study.	INTRODUCTION: Perioperative chemotherapy is the gold standard treatment of the resectable gastro-oesophageal adenocarcinoma. However, 70% of patients cannot receive the complete sequence because of a postoperative complication or a decrease in functional and nutritional reserves. Recently, a new concept appeared in digestive surgery: prehabilitation. This interventional process consists of patient preparation, between surgical consultation and surgery, and is based on 3 components: (1) physical management, (2) nutritional care and (3) psychological care. Prehabilitation should decrease postoperative complications and improve nutritional and physical status during the preoperative and postoperative periods. Therefore, it is becoming essential to evaluate the effect of prehabilitation, compared to conventional care, on the percentage of patients reaching the complete oncological treatment. METHODS AND ANALYSIS: The PREHAB trial aimed to evaluate the efficacy of prehabilitation compared to conventional care, in patients with gastro-oesophageal cancer with perioperative chemotherapy. This trial is a prospective, randomised, controlled, open-blind and interventional study in 4 centres. Patients (n=60 per group) will be randomly assigned for management with either prehabilitation or conventional care. The primary outcome is the percentage of patients reaching the complete oncological treatment decided in a multidisciplinary tumour board. The secondary outcomes are the postoperative morbidity, disease-free survival, overall survival, feasibility of the protocol, length of stay, variation of the functional reserve after the preoperative chemotherapy (defined by the VO(2peak), ventilatory threshold and 6-min walk test), preoperative and postoperative nutritional status, preoperative anxiety, quality of life, 30-day and 90-day mortality and cumulative dose of cytotoxic treatment received. ETHICS AND DISSEMINATION: The study was approved by an independent medical ethics committee (IRB00008526, CPP Sud-Est VI, Clermont-Ferrand, France) and by the competent French authority (ANSM, Saint Denis, France) and registered on Clinicaltrial.gov. The results will be disseminated in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT02780921.	esophagus
Minimally invasive oesophagectomy versus open esophagectomy for resectable esophageal cancer: a meta-analysis.	BACKGROUND: Open esophagectomy (OE) is associated with significant morbidity and mortality. Minimally invasive oesophagectomy (MIO) reduces complications in resectable esophageal cancer. The aim of this study is to explore the superiority of MIO in reducing complications and in-hospital mortality than OE. METHODS: MEDLINE, Embase, Science Citation Index, Wanfang, and Wiley Online Library were thoroughly searched. Odds ratio (OR)/weighted mean difference (WMD) with a 95% confidence interval (CI) was used to assess the strength of association. RESULTS: Fifty-seven studies containing 15,790 cases of resectable esophageal cancer were included. MIO had less intraoperative blood loss, short hospital stay, and high operative time (P < 0.05) than OE. MIO also had reduced incidence of total complications; (OR = 0.700, 95% CI = 0.626 ~ 0.781, P (V)  < 0.05), pulmonary complications (OR = 0.527, 95% CI = 0431 ~ 0.645, P (V)  < 0.05), cardiovascular complications (OR = 0.770, 95% CI = 0.681 ~ 0.872, P (V)  < 0.05), and surgical technology related (STR) complications (OR = 0.639, 95% CI = 0.522 ~ 0.781, P (V) < 0.05), as well as lower in-hospital mortality (OR = 0.668, 95% CI = 0.539 ~ 0.827, P (V)  < 0.05). However, the number of harvested lymph nodes, intensive care unit (ICU) stay, gastrointestinal complications, anastomotic leak (AL), and recurrent laryngeal nerve palsy (RLNP) had no significant difference. CONCLUSIONS: MIO is superior to OE in terms of perioperative complications and in-hospital mortality.	esophagus
Long-term results of definitive concurrent chemoradiotherapy using paclitaxel plus oxaliplatin in unresectable locally advanced esophageal cancer: a prospective phase II trial.	This prospective study aimed at assessing the efficiency and safety of concurrent chemoradiotherapy (CCRT) using paclitaxel (PTX) plus oxaliplatin (OHP) in unresectable locally advanced esophageal cancer patients. Between January 2006 and December 2010, 34 patients with unresectable locally advanced esophageal cancer were enrolled in this study. Radiotherapy was delivered with a daily fraction of 2.0 Gy to a total dose of 60 Gy over 6 weeks. Concurrent PTX (135 mg/m², d(1) ) and OHP (130 mg/m², d(1) ) were administered on Day 1 and Day 29 of radiotherapy. Of these patients, 76.5% completed the treatment course with a response rate of 73.5%, including eight (23.5%) patients with complete response and 17 (50.0%) patients with partial response. The median overall survival (OS) time was 23.7 months (range: 4.0-65.5 months) with 1-, 3- and 5-year OS rates were 64.3%, 36.6% and 25.8%, respectively. The median progression-free survival (PFS) time was 21.2 months with 1-, 3- and 5-year PFS rates were 63.8%, 30.9% and 20.4%, respectively, During the CCRT course, the main grade 3 or greater acute toxicities were leukopenia (38.2%), esophagitis (14.7%), and dysphagia (11.8%), with late toxicity being infrequent. Although this study did not meet its primary endpoint, the application of CCRT with PTX and OHP in unresectable locally advanced esophageal carcinoma yielded satisfactory clinical outcomes and manageable toxicities.	esophagus
Computational analysis reveals microRNA-mRNA regulatory network in esophageal squamous cell carcinoma.	MicroRNAs (miRNAs) are known to regulate post-transcriptional gene expression. They are involved in carcinogenesis and tumor progression. The aim of this study was to explore the microRNA-mRNA regulatory network in esophageal squamous cell carcinoma (ESCC) using comprehensive computational approaches. In this study we have selected a total of 11 miRNAs from one previously reported study in ESCC. The mRNA targets of these miRNAs were predicted using various algorithms. The expression profiles of these mRNA targets were identified on DNA microarray experiment dataset across ESCC tissue samples. Based on the miRNA-mRNA regulatory relationships, the network was inferred. A total of 23 miRNA-mRNA regulatory interactions, with 11 miRNAs and 13 mRNA targets, were inferred in ESCC. The miRNA-mRNA regulatory network with increased confidence provides insights into the progression of ESCC and may serve as a biomarker for prognosis or the aggressiveness of ESCC. However, the results should be examined with further experimental validation.	esophagus
Prognostic Significance of Inflammatory and Nutritional Parameters in Patients with Esophageal Cancer.	BACKGROUND: We evaluated the following preoperative prognostic factors in patients who underwent esophagectomy for esophageal cancer: C-Reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), serum albumin, prognostic nutritional index (PNI), and body mass index (BMI). PATIENTS AND METHODS: This retrospective study included 173 men and 19 women with a mean age of 65.8 years (range=42-86 years) who were scheduled to undergo esophagectomy for esophageal cancer. The association of CRP, NLR, albumin, PNI, and BMI with various clinicopathological factors and prognosis were evaluated. RESULTS: Univariate analysis revealed that male sex, depth of invasion, nodal metastasis, pStage, high CRP, low PNI, high NLR, and low BMI were significant risk factors for a poor prognosis. Multivariate analysis identified depth of invasion, pStage, and BMI as significant prognostic factors in the Cox proportional hazard model. CONCLUSION: The preoperative nutritional status affected the postoperative survival time in patients with esophageal cancer. In particular, a low BMI was an independent prognostic factor for poorer survival in the multivariate analysis.	esophagus
The surgical management of esophago-gastric junctional cancer.	The best available surgical strategy in the treatment of resectable esophago-gastric junctional (EGJ) cancer is a controversial topic. In this review we evaluate the current literature and scientific evidence examining the surgical treatment of locally advanced EGJ cancer by comparing esophagectomy with gastrectomy, transhiatal with transthoracic esophagectomy, minimally invasive with open esophagectomy, and less extensive with more extensive lymphadenectomy. We also assess endoscopic procedures increasingly used for early EGJ cancer. The current evidence does not favor any of the techniques over the others in terms of oncological outcomes. Health-related quality of life may be better following gastrectomy compared to esophagectomy. Minimally invasive procedures might be less prone to surgical complications. Endoscopic techniques are safe and effective alternatives for early-stage EGJ cancer in the short term, but surgical treatment is the mainstay in fit patients due to the risk of lymph node metastasis. Any benefit of lymphadenectomy extending beyond local or regional nodes is uncertain. This review demonstrates the great need for well-designed clinical studies to improve the knowledge in how to optimize and standardize the surgical treatment of EGJ cancer.	esophagus
Preoperative computed tomography diagnosis of non-recurrent laryngeal nerve in patients with esophageal carcinoma.	BACKGROUND: The non-recurrent laryngeal nerve (NRLN) is a rare but potentially serious anomaly that is commonly associated with the aberrant right subclavian artery (ARSA). It is easy to damage during surgical resection of esophageal cancer, leading to severe complications. METHODS: Preoperative enhanced thoracic computed tomography (CT) scans of 2697 patients with esophageal carcinoma treated in our hospital between January 2010 and December 2013 were examined. We classified the positional relationship between the right subclavian artery and the membranous wall of the trachea into two types and used this method to predicate NRLN by identifying ARSA. RESULTS: Twenty-six patients (0.96%) were identified with ARSA, all of which were cases of NRLN by CT. NRLN was identified during surgery in the 26 patients, and a normal right recurrent laryngeal nerve was observed in 2671 patients. The ARSA was detected on the dorsal side of the membranous wall of the trachea in all 26 NRLN cases, while it was detected on the ventral side in all 2671 recurrent laryngeal nerve cases. CONCLUSION: Enhanced CT scanning is a reliable method for predicting NRLN by identifying ARSA. Preoperative recognition of this nerve anomaly allows surgeons to avoid damaging the nerve and abnormal vessels during esophagectomy.	esophagus
Obesity and Oesophageal Cancer.	A substantial increase in the incidence of oesophageal adenocarcinoma has been observed in Western countries during the past 30 years, which may be related to the parallel rise of the obesity prevalence. On the other hand, incidence rates of oesophageal squamous cell carcinomas, the other major histological type of oesophageal cancer, have remained relatively stable. Epidemiological research of the past decades has identified obesity as risk factor for oesophageal adenocarcinoma. Studies investigating general obesity as assessed by body mass index (BMI) provide evidence for a strong positive association with oesophageal adenocarcinoma. Studies investigating abdominal obesity in relation to oesophageal adenocarcinoma observed also positive associations, which may be independent of general obesity. Some studies indicate that early life obesity is also associated with higher risk of oesophageal adenocarcinoma, but it is as to date unclear whether these associations are independent of adult obesity. Part of the positive association between obesity and oesophageal adenocarcinoma may be explained through obesity-related mechanical promotion of gastroesophageal reflux disease, which is one of the main risk factors for oesophageal adenocarcinoma. Other lines of evidence point to an independent role of metabolic pathways modulating cell proliferation, apoptosis and cell growth such as pro-inflammatory cytokines, adipokines and insulin resistance, the role of which in oesophageal carcinogenesis is, however, as to date insufficiently understood. Studies investigating obesity in relation to squamous cell carcinoma observed inverse relationships, but the underlying mechanisms remain unclear.	esophagus
Feasibility of Preoperative Chemotherapy with Docetaxel, Cisplatin, and 5-Fluorouracil versus Adriamycin, Cisplatin, and 5-Fluorouracil for Resectable Advanced Esophageal Cancer.	BACKGROUND: Neoadjuvant chemotherapy for resectable advanced esophageal squamous cell carcinoma (ESCC) requires reassessment. We have conducted a trial aiming at the comparison between DCF and ACF concerning perioperative adverse events. METHODS: Patients were randomly assigned to receive either DCF [docetaxel 70 mg/m2, cisplatin 70 mg/m2 on day 1, and 5-fluorouracil (5-FU) 700 mg/m2 for 5 days] every 3 weeks or ACF (adriamycin 35 mg/m2, cisplatin 70 mg/m2 on day 1, and 5-FU 700 mg/m2 for 7 days) every 4 weeks. Each group consisted of 81 patients. Two cycles of preoperative chemotherapy were planned, after which patients underwent subtotal esophagectomy via a right thoracotomy with lymphadenectomy. Chemotherapy- and surgery-related adverse effects were assessed. RESULTS: Grade 3-4 neutropenia and febrile neutropenia occurred in 90 and 39% of patients, respectively, in the DCF group compared with 69 and 17% of patients, respectively, in the ACF group (p < 0.01). Perioperative complications did not differ significantly between the groups. The overall response rates of DCF and ACF were 61 and 40%, respectively, while the histopathological complete responses were 15 and 3%, respectively (p < 0.01). CONCLUSION: The DCF and ACF regimens were found to be equally feasible in patients with resectable advanced ESCC; however, DCF delivered an antitumor effect and therefore potentially improved the long-term outcomes.	esophagus
Serum concentrations of receptor for interleukin 8 in patients with esophageal cancer.	INTRODUCTION A specific receptor for interleukin 8, known as C-X-C chemokine type‑2 receptor (CXCR‑2), is one of the 7‑transmembrane G‑protein‑coupled receptors. Its involvement in the development of numerous malignancies, including esophageal cancer (EC), has been suggested. OBJECTIVES The aim of this study was to assess the diagnostic and prognostic usefulness of serum CXCR‑2 level measurement in patients with EC, in comparison with C‑reactive protein (CRP) levels and classic tumor markers such as carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC‑Ag).  PATIENTS AND METHODS The study included 72 individuals: 42 patients with EC and 30 healthy volunteers. Serum CXCR‑2 concentrations were measured by an immunoenzymatic assay. The levels of classic tumor markers were measured using the chemiluminescent method, and CRP levels were measured using the immunoturbidimetric method. RESULTS Serum CXCR‑2 concentrations were significantly higher in patients with EC than in the control group, similarly to CEA and CRP levels. Moreover, CXCR‑2 concentrations were significantly higher in patients with poorly differentiated EC (G3) compared with those with G2 tumors. The diagnostic sensitivity and accuracy, as well as the negative predictive value of the serum CXCR‑2 assay were higher than those observed for classic tumor markers and slightly lower than those observed for CRP levels. The highest diagnostic sensitivity was found for the combined analysis of CXCR‑2 and CRP. CONCLUSIONS Our results suggest the role of CXCR‑2 in the development of EC. Thus, further research is needed to clarify the significance of chemokines and their receptors as potential tumor markers of EC.	esophagus
[Review of medical or combined treatment of local or locally advanced oesophageal cancer].	More than 800 oesophageal tumours are diagnosed each year in Hungary. The disease is characterized by high mortality. The curative treatment traditionally surgical, although the study results of recent decades pointed out that patient outcome can be improved with the proper application of radio- and chemotherapy. The diverse study designs, the low number of recruited patients and the sometimes conflicting results make the determination of optimal treatment difficult. The aim of this work is to facilitate the choice of treatment modality with the best outcome, especially with the view of medical oncologists. The treatment remains surgery for very early tumours (up to pT1b) and palliative therapy for tumours with metastasis. In other cases additional therapy, such as chemotherapy, radiotherapy, or their combinations, and targeted therapies, may result in improved survival. There are data mostly for neoadjuvant therapy because patients after surgery are rarely candidates for adjuvant therapy. Neoadjuvant chemotherapy may improve survival over surgery alone, but this improvement is more pronounced and supported by more evidence for neoadjuvant chemoradiotherapy (CRT). Certain results suggest that in selected cases after neoadjuvant CRT omission of surgery might not compromise survival, but the routine omission of surgery is not advised. However, the agent given concomitantly to radiotherapy may have importance. Besides cisplatin and fluorouracil other platinum derivatives (carboplatin, oxaliplatin) and taxanes (docetaxel, paclitaxel) can be used without compromising survival but with more favourable toxicity profile.	esophagus