crossing96/oncoscreening huggingface dataset:
Effect of medical and surgical treatment of Barrett's metaplasia.	Barrett's esophagus (BE) is a change in the esophageal mucosa as a result of long-standing gastroesophageal reflux disease. The importance of BE is that it is the main risk factor for the development of esophageal adenocarcinoma, whose incidence is currently growing faster than any other cancer in the Western world. The aim of this review was to compare the common treatment modalities of BE, with the focus on proton pump inhibitors and operative fundoplication. We performed a literature search on medical and surgical treatment of BE to determine eligible studies for this review. Studies on medical and surgical treatment of BE are discussed with regard to treatment effect on progression and regression of disease. Although there is some evidence for control of reflux with either medical or surgical therapy, there is no definitive evidence that either treatment modality decreases the risk of progression to dysplasia or cancer. Even though there is a trend toward antireflux surgery being superior, there are no definitive studies to prove this.	esophagus
Impact of circumferential resection margin distance on locoregional recurrence and survival after chemoradiotherapy in esophageal squamous cell carcinoma.	BACKGROUND: Close circumferential resection margin (CRM) is an established predictor for locoregional recurrence (LR) in rectal cancer but remains controversial in esophageal malignancy. As yet, little is known about the significance of CRM after chemoradiotherapy (CRT), especially in squamous cell carcinoma (SCC). This study investigated the relationship between CRM distance and recurrence after neoadjuvant CRT in esophageal SCC patients. METHODS: Between 1997 and 2005, esophageal SCC patients who underwent surgery after neoadjuvant CRT and with pathology stage T3N0M0 and T3N1M0 (metastatic lymph nodes <2) were selected. CRM distance was reassessed and divided into three groups (group 1: CRM >1 mm, group 2: uninvolved CRM but <1 mm, group 3: CRM involved). RESULTS: The cohort comprised 145 male and 6 female patients with mean age of 57 years. There were 74, 51, and 26 patients in group 1, 2, and 3, respectively. With median follow-up period of 50 months, LR developed in 30.5% of patients. Both group 2 and group 3 had significantly higher LR than group 1 (37 and 42% vs. 21%, P < 0.05). Meanwhile, mean time from operation to recurrence was also significantly shorter in group 2 and group 3 than in group 1 (267 and 269 days versus 402 days, P < 0.05). Five-year disease-specific survival (DSS) was highest in group 1 (40%). Despite the similarity in LR, 5-year DSS significantly differed between group 2 and group 3 (22 vs. 7%, P < 0.05). The higher rate of distant recurrence (DR) and concomitant LR + DR in group 3 accounted for the survival difference. CONCLUSION: In ypT3 esophageal SCC patients, CRM distance provides useful information for risk stratification in cancer recurrence and survival.	esophagus
High-risk human papillomavirus in esophageal squamous cell carcinoma.	BACKGROUND: Although most cases of esophageal squamous cell carcinoma (ESCC) in western populations have been attributed to high levels of exposure to tobacco and alcohol, infectious agents have been postulated as possible causes, particularly human papillomavirus (HPV). METHODS: To explore this issue, we analyzed HPV DNA prevalence and HPV types together with lifestyle factors, in relation to tumor stage and survival in a low-incidence population. Archived tumor samples from a nationwide cohort of 222 ESCC patients were tested for the presence of HPV DNA by PCR; positive samples were sequenced to determine HPV type, and p16(INK4a) status was assessed by immunohistochemistry. RESULTS: Of 222 ESCC patients, 8 tested HPV positive (prevalence, 3.6%; 95% confidence interval, 1.1-6.1%), of which 6 were HPV-16 positive and 2 were HPV-35 positive. Four of the eight HPV-positive tumors overexpressed p16(INK4a). None of 55 normal esophageal tissue samples from healthy participants had any detectable HPV. Although the numbers were low, it seemed that patients with HPV-positive ESCC tumors were younger than those with HPV-negative tumors (mean age, 60.8 versus 65.3 years, P = 0.18) and had higher body mass index (BMI) throughout life (mean current BMI of 25.1 for HPV positive, 22.2 for HPV negative, P = 0.08; mean BMI at 20 years of 25.8 for HPV positive, 22.1 for HPV negative, P = 0.003). We found no difference between patients with HPV-positive and HPV-negative tumors with respect to other lifestyle factors. CONCLUSIONS: These findings suggest a very low prevalence of HPV DNA in human ESCC. IMPACT: HPV is very unlikely to be a common cause of ESCC in Australia.	esophagus
Self expandable metallic stent endoscopic insertion in esophageal cancer.	OBJECTIVE: To determine the safety of self expandable metallic stent (SEMS) placement under endoscopic guidance without fluoroscopy. STUDY DESIGN: Quasi experimental study. PLACE AND DURATION OF STUDY: Section of Gastroenterology and Hepatology, Departments of Medicine, Isra University Hospital and Liaquat University of Medical and Health Sciences (LUMHS), Hyderabad, from April 2006 to March 2009. METHODOLOGY: In 80 patients with inoperable carcinoma of esophagus, SEMS made-up of nickel titanium alloy and mesh shaped with distal release system were placed without the use of fluoroscope under endoscopic guidance. Patients with proximal location of tumour in esophagus were excluded. They were followed at one week after deployment. All the complications were recorded. Dysphagia score was assessed before and after stent placement. Mean pre- and poststenting scores were compared using t-test. RESULTS: Fluoroscopy was needed in only 2 patients. In 75 patients the stent was successfully placed with endoscope control only, without fluoroscope. Dysphagia score improved significantly from 4.26+/-1.07 before stenting to 1.02+/-0.57 later, (p<0.001). Minor complications like retrosternal pain occurred in 30 (37.5%) patients and major complications in 8 (10.0%) patients amongst which 4 (5.0%) developed upper gastrointestinal bleeding and 4 patients (5.0%) had aspiration. CONCLUSION: Insertion of self expandable metallic stent in esophageal carcinoma without fluoroscope was safe and effective in relieving dysphagia at short term follow-up.	esophagus
Reconstruction of the esophagus and voice.	BACKGROUND: Esophageal defects are reconstructed using a variety of methods and tissue types. The choice depends on the location of the defect, the condition of the patient, and the flaps that are available for reconstruction. Often, patients with esophageal defects also lack a mechanism for voice production following a total laryngectomy procedure. METHODS: A review of the literature was performed for esophagus reconstruction and voice rehabilitation following laryngectomy. Methods of voice restoration using intestinal transfers are presented based on the authors' experience. RESULTS: Several methods of esophagus and voice restoration can achieve excellent functional outcomes. CONCLUSION: Esophagus reconstruction and voice rehabilitation following esophageal resection and total laryngectomy are possible using a variety of flaps with good functional outcomes.	esophagus
Four-dimensional measurement of the displacement of internal fiducial markers during 320-multislice computed tomography scanning of thoracic esophageal cancer.	PURPOSE: To investigate the three-dimensional movement of internal fiducial markers placed near esophageal cancers using 320-multislice CT. METHODS AND MATERIALS: This study examined 22 metal markers in the esophageal wall near the primary tumors of 12 patients treated with external-beam photon radiotherapy. Motion assessment was analyzed in 41 respiratory phases during 20 s of cine CT in the radiotherapy position. RESULTS: Motion in the cranial-caudal (CC) direction showed a strong correlation (R(2) > 0.4) with the respiratory curve in most markers (73%). The average absolute amplitude of the marker movement was 1.5 ± 1.6 mm, 1.6 ± 1.7 mm, and 3.3 ± 3.3 mm in the left-right (LR), anterior-posterior (AP), and CC directions, respectively. The average marker displacements in the CC direction between peak exhalation and inhalation for the 22 clips were 1.1 mm (maximum, 5.5 mm), 3.0 mm (14.5 mm), and 5.1 mm (16.3 mm) for the upper, middle, and lower thoracic esophagus, respectively. CONCLUSIONS: Motion in primary esophagus tumor was evaluated with 320-multislice CT. According to this study, 4.3 mm CC, 1.5 mm AP, and 2.0 mm LR in the upper, 7.4 mm CC, 3.0 mm AP, and 2.4 mm LR in the middle, and 13.8 mm CC, 6.6 mm AP, and 6.8 mm LR in the lower thoracic esophagus provided coverage of tumor motion in 95% of the cases in our study population.	esophagus
Peri-operative and complication management for adenocarcinoma of the oesophagus and oesophagigastric junction.	Surgical resection of oesophageal cancer still offers the only chance of cure for this disease. Nevertheless, oesophageal surgery may be accompanied by relevant mortality and morbidity, the causes of which can be both directly related to surgical technique as well as a large spectrum of non-surgical complications. In the last few years, improvements in patient selection and technical advances, as well as elaborated peri- and post-operative management, have helped to reduce these threats.The following article addresses important aspects of patient selection and evaluation, pre-operative preparation, anaesthesia, operative prophylaxis of complications, immediate post-operative care and complication management. All these factors are important contributions to improve the outcome in this challenging medical condition. Nowadays, experienced centres report operative mortality rates of around 5% for radical transthoracic resections (Low et al. 2007; Or-ringer et al. 2007; Ando et al. 2000; Karl et al. 2000; Whooley et al. 2003), down from rates of up to 30 or 40% in previous decades (Earlam and Cunha-Melo 1980). Many factors have contributed to these improvements; some authors claim large volume centres have a tendency to improve results, mostly due to more aggressive management of post-operative complications (Forshaw et al. 2006; van Lanschot et al. 2001; Smith et al. 2008). The following article summarizes the factors that have been identified in the past decades to influence the outcome of major surgery for the resection of adenocarcinoma of the oesophagus.	esophagus
Quality indicators of surgery for adenocarcinoma of the esophagus and gastroesophageal junction.	Surgical treatment of adenocarcinoma of the esophagus and gastroesophageal junction is complex and challenging. Huge variation exist in the immediate and long term outcomes of such interventions and it is generally accepted that this is a direct consequence of the experience of the surgical team. However beside surgical quality many other indicators of quality management may influence outcome. Definition of the gastroesophageal junction remains controversial and the performance of staging procedures i.e. CT scan, endoscopy and fine needle aspiration, PET scan still suboptimal. As a result there is disagreement on the selection of patients for surgery, type of surgical approach in particular in relation to the extent of lymph node dissection as well as the extent of esophageal and/or gastric resection. In the design of randomized controlled trials comparing primary surgery versus multimodality treatment surgical quality criteria are notoriously lacking. It therefore remains a matter of debate which patients eventually will benefit from primary surgery versus those who will benefit from induction therapy. A lack of surgical quality indicators is also very prominent when assessing the value of new surgical technologies such as minimally invasive surgery or robotic surgery. Improvements in this wide spectrum of aspects is mandatory and will certainly be of great value to further improve both short and long term outcome after surgery for these complex cancers.	esophagus
Endoscopic mucosal resection for staging and therapy of adenocarcinoma of the esophagus, gastric cardia, and upper gastric third.	Minamally invasive endoscopic resection techniques allow definitive histological staging for dysplasia and early cancer and in many cases curative treatment. In Barrett's esophagus with High Grade Dysplasia (HGD) or early mucosal cancer, endoscopic mucosal resection (EMR) should be considered both as diagnostic and therapeutic first line procedure, with the possibility to repeat the procedure in case of residual Barrett's dysplasia or mucosal cancer. In early cancer of the the submucosa, surgical resection should be discussed. Endoscopic submucosal dissection (ESD) is a useful therapeutic option for HGD or early cancer in the squamous epithelium of the esophagus or in the stomach when en bloc resection is needed in large lesions.	esophagus
Whole tumour first-pass perfusion using a low-dose method with 64-section multidetector row computed tomography in oesophageal squamous cell carcinoma.	PURPOSE: To propose a low-dose method at tube current-time product of 50 mAs for whole tumour first-pass perfusion of oesophageal squamous cell carcinoma using 64-section multidetector row computed tomography (MDCT), and to assess the original image quality and accuracy of perfusion parameters. MATERIALS AND METHODS: Fifty-nine consecutive patients with confirmed oesophageal squamous cell carcinomas were enrolled into our study, and underwent whole tumour first-pass perfusion scan with 64-section MDCT at 50 mAs. Image data were statistically reviewed focusing on original image quality demonstrated by image-quality scores and signal-to-noise (S/N) ratios; and perfusion parameters including perfusion (PF, in ml/min/ml), peak enhanced density (PED, in HU), time to peak (TTP, in seconds) and blood volume (BV, in ml/100 g) for the tumour. To test the interobserver agreement of perfusion measurements, perfusion analyses were repeatedly performed. RESULTS: Original image-quality scores were 4.71±0.49 whereas S/N ratios were 5.21±2.05, and the scores were correlated with the S/N ratios (r=0.465, p<0.0001). Mean values for PF, PED, TTP and BV of the tumour were 33.27±24.15 ml/min/ml, 24.06±9.87 HU, 29.42±8.61 s, and 12.45±12.22 ml/100 g, respectively. Intraclass correlation coefficient between the replicated measurements of each perfusion parameter was greater than 0.99, and mean difference of the replicated measurements of each parameter was close to zero. CONCLUSION: Whole tumour first-pass perfusion with 64-section MDCT at low-dose radiation could be reproducible to assess microcirculation in oesophageal squamous cell carcinoma without compromising subjective original image quality of the tumour.	esophagus
Synthesis, anticancer activities, interaction with DNA and mitochondria of manganese complexes.	Two new complexes [(Etdpa)MnCl(2)] and [(Adpa)Mn(Cl)(H(2)O)] (Etdpa = ethyl bis(2-pyridylmethyl)amino-2-propionate; Adpa = bis(2-pyridylmethyl)amino-2-propionic acid) were synthesized and characterized by spectral methods. The crystal structure of [(Etdpa)MnCl(2)] shows that the Mn(II) atom is coordinated by three N atoms (N1, N2, N3), one oxygen atom (O1) of the ligand (Etdpa) and two chloride atoms (Cl1, Cl2), forming a distorted octahedral geometry. The binding interaction between ct-DNA and the synthesized complexes was relatively weak, but they can inhibit the induced swelling of Ca(2+)-loaded mitochondria in a dose-dependent manner. The [(Adpa)Mn(Cl)(H(2)O)] can cause the obvious decrease of mitochondria membrane potential. The MTT (3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenpyltetra-zolium bromide) assay shows that the two Mn(II) complexes are more active against cancer cells. Especially [(Adpa)Mn(Cl)(H(2)O)] can inhibit the proliferation of glioma cells with IC(50) 9.5 μM. Experimental results indicate that the [(Adpa)Mn(Cl)(H(2)O)] could be a new potential antitumor complex to target the mitochondria.	esophagus
Narrow-band imaging with magnifying endoscopy for the screening of esophageal cancer in patients with primary head and neck cancers.	BACKGROUND AND STUDY AIM: Although narrow-band imaging (NBI) in endoscopy can improve detection of early-stage esophageal malignancies in patients with head and neck cancers, false-positive results may be obtained in areas with nonspecific inflammatory changes. This study evaluated the feasibility of primary screening with NBI and magnification for the presence of esophageal malignancies in these cancer patients. PATIENTS AND METHODS: Sixty-nine patients with documented head and neck cancers were enrolled from April 2008 to January 2009. All patients underwent a meticulous endoscopic examination of the esophagus using a conventional white-light system followed by re-examination using the NBI system and final confirmation with NBI plus magnification. RESULTS: Twenty-one patients (30.4 %) were confirmed to have esophageal neoplasia. Among these 21, 16 (76.2 %) had synchronous lesions, 9 (42.9 %) were asymptomatic, and 10 (47.6 %) had early-stage neoplasia. The incidence of multiple esophageal neoplasia was 57.1 %. NBI was more effective than conventional endoscopy in detecting neoplastic lesions (35 lesions in 21 patients vs. 22 lesions in 18 patients) and was particularly effective in patients with dysplasia (13 lesions in 9 patients vs. 3 lesions in 3 patients). The sensitivity and accuracy of detection were 62.9 % and 64.4 % for conventional endoscopy, 100 % and 86.7 % for NBI alone, and 100 % and 95.6 % for NBI with high magnification, respectively. CONCLUSIONS: Compared with current approaches, NBI followed by high magnification significantly increases the accuracy of detection of esophageal neoplasia in patients with head and neck cancers. The result warrants conducting prospective randomized controlled study to confirm its efficacy.	esophagus
[Advancements in endoscopic surgery for gastric and esophageal cancer].	Laparoscopic surgery against malignant tumors in upper gastrointestinal tract was introduced in Japan back in 1991. Now listed on Pubilc Health Insurance and treatment guidelines, cases are increasing significantly year by year. With patients' increased awareness for minimally invasive treatment and with advancements of related medical devices, it is being adapted to surgeries requiring more advanced lymph node dissection and difficult reconstruction. This paper explains current developments of laparoscopic D2 lymph node dissection and reconstruction for total gastrectomy in gastric cancer, and thoracoscopic esophagectomy in esophageal cancer.	esophagus
Evaluation of MTHFR677C>T polymorphism in prediction and prognosis of esophageal squamous cell carcinoma: a case-control study in a northern Indian population.	Early diagnosis and better prognosis of esophageal squamous cell carcinoma (ESCC) is still a challenge. Besides environmental risk factors, nutritional deficiencies have an established role in pathogenesis of ESCC. Folate deficiency and functional polymorphisms in folate metabolizing genes such as methylene tetrahydrofolate reductase (MTHFR) 677C>T may have oncogenic role through disruption of normal DNA methylation pattern, synthesis, and impaired DNA repair. MTHFR677C>T or A222V (rs1801133) polymorphism has conflicting role in susceptibility to ESCC among different populations. Thus, we aimed to study the role of MTHFR677C>T polymorphism in susceptibility, survival, and interaction with environmental risk factors in ESCC patients from a northern Indian population. A case control study was performed in 208 ESCC incident cases (including 114 follow-up cases) and 223 healthy controls, and genotyping was done by PCR-RFLP. Our results show no significant association of MTHFR677C>T polymorphism with ESCC, tumor locations, or gender of subjects. However, we found a trend of decreased risk of ESCC due to interaction of MTHFR677CT genotype with smoking and alcohol intake. Kaplan Meier, and Cox regression survival analysis showed no prognostic impact of MTHFR677C>T polymorphism in ESCC patients. In conclusion, MTHFR677C>T polymorphism does not seem to have significant role either in susceptibility or survival of ESCC in a northern Indian population.	esophagus
Increased platelet counts after transthoracic en bloc resection for esophageal cancer is associated with significantly improved survival.	BACKGROUND: We analyzed perioperative platelet counts as a potential clinical marker for survival after transthoracic en bloc resection for esophageal cancer. Recent data described preoperative thrombocytosis in malignancies to be associated with poor prognosis. METHODS: A retrospective analysis from a prospective database (1997-2006) was performed for 291 consecutive patients with esophageal cancer who underwent transthoracic en bloc esophagectomy and extended lymphadenectomy. Squamous cell cancer was found in 47.0% and adenocarcinoma in 50.9% (2.1% had rare histologies). Neoadjuvant chemoradiation was performed in 152 (52%) patients. Platelet counts before surgery and on postoperative days (PODs) 1, 10, and 30 were evaluated. We used the published cutoff value of 293 × 10(9)/l (mean of 80 healthy controls ± standard deviation) for platelet counts. RESULTS: High platelet counts before surgery missed significance for poorer survival (p = 0.054). Following a perioperative fall in thrombocytes, a significant rise at POD 10 after surgery was evident. Platelet counts of more than 293 × 10(9)/l at this time correlated with a significantly improved survival rate (p = 0.027). Patients with no increase in thrombocytes until POD 10 had significantly poorer survival (p = 0.012). Multivariate analysis confirmed that a thrombocyte increase between the preoperative count and that on POD 10 is an independent prognostic indicator (p = 0.035) for patients with completely (R0) resected tumors. CONCLUSIONS: An increase in platelet counts measured on POD 10 following transthoracic en bloc esophagectomy and extended lymphadenectomy is an independent prognostic indicator for improved survival in patients with esophageal cancer.	esophagus
Genome-wide catalogue of chromosomal aberrations in barrett's esophagus and esophageal adenocarcinoma: a high-density single nucleotide polymorphism array analysis.	To better understand the molecular mechanisms behind esophageal adenocarcinoma (EAC) tumorigenesis, we used high-density single nucleotide polymorphism arrays to profile chromosomal aberrations at each of the four sequential progression stages, Barrett's metaplasia (BM), low-grade dysplasia (LGD), high-grade dysplasia (HGD), and EAC, in 101 patients. We observed a significant trend toward increasing loss of chromosomes with higher progression stage. For BM, LGD, HGD, and EAC, respectively, the average numbers of chromosome arms with loss per sample were 0.30, 3.21, 7.70, and 11.90 (P for trend = 4.82 x 10(-7)), and the mean percentages of single nucleotide polymorphisms with allele loss were 0.1%, 1.8%, 6.6%, and 17.2% (P for trend = 2.64 x 10(-6)). In LGD, loss of 3p14.2 (68.4%) and 16q23.1 (47.4%) was limited to narrow regions within the FHIT (3p14.2) and WWOX (16q23.1) genes, whereas loss of 9p21 (68.4%) occurred in larger regions. A significant increase in the loss of other chromosomal regions was seen in HGD and EAC. Loss of 17p (47.6%) was one of the most frequent events in EAC. Many recurrent small regions of chromosomal loss disrupted single genes, including FHIT, WWOX, RUNX1, KIF26B, MGC48628, PDE4D, C20orf133, GMDS, DMD, and PARK2, most of which are common fragile site regions in the human genome. However, RUNX1 at 21q22 seemed to be a potential tumor suppressor gene in EAC. Amplifications were less frequent than losses and mostly occurred in EAC. 8q24 (containing Myc) and 8p23.1 (containing CTSB) were the two most frequently amplified regions. In addition, a significant trend toward increasing amplification was associated with higher progression stage.	esophagus