crossing96/oncoscreening huggingface dataset:
Pathogenesis of Barrett's Esophagus: Evolving and Emerging Mechanisms.	This article seeks to provide updated information on the pathogenesis of Barrett's esophagus (BE) including the possible cellular origins of esophageal columnar cells and the impact of chronic esophageal inflammation. Other considerations include clinical exposures and the importance of risk factor modifications such as weight loss and tobacco cessation. The article summarizes genetic risk factors in the pathogenesis of BE and discusses how familial risk and exposures are considered in current guidelines to identify those who may benefit from BE screening. Finally, insights gleaned from postablative therapy are integrated into this article for both clinical providers and researchers.	esophagus
Efficacy and Safety of Dual Therapy with HER2-inhibitors (Pertuzumab and Trastuzumab) in Gastric or Gastroesophageal Tumors: A Systematic Review and Meta-analysis.	BACKGROUND: The benefit of adding dual HER2 inhibition with Pertuzumab (P) and Trastuzumab (T) to chemotherapy (cT) in HER2-positive gastric or gastroesophageal junction (GEJ) cancer is not yet fully elucidated. METHODS: A systematic search of PubMed, Cochrane Central, Embase, Web of Science, SciELO, and LILACS identified clinical trials investigating adjuvant or neoadjuvant regimens combining (P), (T) and (cT). Hazard ratios (HRs) and odds ratios (ORs) for binary endpoints were calculated, with 95% confidence intervals (CIs). RESULTS: Four clinical trials comprising a total of 1,225 patients were included. Dual HER2 blockade plus (cT) showed a significant benefit in survival analysis (HR 0.77, 95% CI 0.69-0.86), especially in terms of overall survival (HR 0.78, 95% CI 0.61-0.99) and progression-free survival (HR 0.73, 95% CI 0.62-0.85). Pathological response rates were higher compared with (cT) alone (OR 1.62, 95% CI 0.98-2.66). Treatment was associated with an increased overall adverse event rate (OR 1.48, 95% CI 1.32-1.66), particularly any-grade diarrhea, hypokalemia, fatigue, and pulmonary infection. Serious adverse events, including deaths and complications, were not significantly different (OR 0.87, 95% CI 0.51-1.49). CONCLUSIONS: This systematic review and meta-analysis of clinical trials demonstrates that adding (P), (T) and (cT) improves survival and pathological response in HER2-positive gastric and GEJ tumors, with a manageable safety profile.	esophagus
Clinical features of early esophageal neoplastic lesions at different stages and efficacy and prognosis after endoscopic submucosal dissection.	BACKGROUND: Esophageal cancer is a common malignancy, and endoscopic submucosal dissection (ESD) is the treatment of choice for early esophageal cancer. AIM: To analyze clinicopathological features, ESD efficacy, and prognostic factors of differentiated esophageal neoplasms to optimize management strategies. METHODS: A total of 264 Lesions in 245 patients treated with ESD (2014-2022) were retrospectively analyzed. Lesions were categorized as low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia, early-stage carcinoma, or superficial carcinoma. Clinicopathological data and outcomes were compared. RESULTS: Early-stage cancers showed more surface vesicles than LGIN (P = 0.002). Intraepithelial papillary capillary loop (IPCL)-A predominated in LGIN, while IPCL-B2 was frequent in cancer (P < 0.001). Superficial carcinomas had higher vertical margin positivity (P < 0.001). Curative resection correlated with differentiation, body mass index (BMI), and symptoms; complications were linked to gender, BMI, and lesion size. The 3-, 5-, and 8-year disease-free survival rates were 96.8%, 91.7%, and 86.4%, respectively. Age [hazard ratio (HR) = 1.018] and prior esophageal cancer (HR = 3.050) predicted poorer survival. CONCLUSION: Differentiated esophageal neoplasms exhibit distinct clinicopathological features. ESD provides durable efficacy, but high-risk patients (older age, prior cancer) require vigilant surveillance.	esophagus
Radiotherapy for cancers of the oesophagus, gastroesophageal junction, and stomach.	Oesophageal and gastric cancers are associated with a poor prognosis, as diagnosis is often delayed in fragile, comorbid patients. Radiotherapy plays a pivotal role in the treatment of oesophageal cancer. It is indicated in combination with chemotherapy for squamous cell carcinoma and for locally advanced, inoperable adenocarcinoma (i.e., non-operable patients or unresectable tumours). Additionally, chemoradiotherapy may be proposed in the preoperative setting for squamous cell carcinoma or for adenocarcinomas when peri-operative chemotherapy is not feasible. For resectable gastric adenocarcinomas, the indications for radiotherapy are limited. However, radiotherapy may be useful in a palliative setting in case of dysphagia or bleeding. Recent technological advances, such as image-guided radiotherapy and conformal intensity-modulated radiotherapy, have considerably improved the tolerance of treatments, particularly in curative approaches. These innovations optimize target volume coverage while limiting toxicity on adjacent organs at risk, notably the heart and lungs. We present here the updated guidelines of the Société française de radiothérapie oncologique (SFRO) regarding the indications and technical modalities of radiotherapy for oesophageal and gastric cancers.	esophagus
Minimally invasive resection of esophageal leiomyoma: 24 year experience.	INTRODUCTION: Esophageal leiomyoma is the most common benign submucosal esophageal tumor, with enucleation as the preferred treatment. This study evaluates our institution's experience with minimally invasive surgical management of esophageal leiomyoma. METHODS: We conducted a retrospective cohort study of patients who underwent surgery for histologically confirmed esophageal leiomyoma between 2000 and 2024. Patients with other submucosal tumors (i.e. GISTs), esophageal carcinoma, or those who underwent endoscopic resection were excluded. RESULTS: 53 patients underwent surgical resection for esophageal leiomyoma during the 24-year study period. Surgical approaches included thoracoscopic enucleation in 33 patients (62.3%), laparoscopic enucleation in 13 patients (24.5%), thoracoscopic conversion to open enucleation in 5 patients (9.4%), and minimally invasive esophagectomy in 2 patients (3.8%). The mean tumor size was 4.92 cm. Perioperative complication rates were infrequent: intraoperative mucosal injury occurred in 3 patients (5.7%), and Clavien-Dindo grade ≤ II postoperative complications were reported in 3 patients (5.7%). Notably, there were no instances of major morbidity or postoperative leaks. The mean hospital length of stay was 4 days. Among patients who underwent thoracoscopic enucleation (mean tumor size: 4.6 cm), dysphagia was the most common presenting symptom (68.8%). In the laparoscopic group (mean tumor size: 3.3 cm), reflux was predominant (76.9%), and 7 patients (53.8%) underwent concomitant fundoplication (4 Nissen, 2 Dor, 1 Toupet). Persistent reflux occurred in 4 patients who did not have concurrent anti-reflux procedures (30.8% of laparoscopic cases), with two patients (15.4%) requiring subsequent fundoplications. CONCLUSIONS: Minimally invasive enucleation may offer a safe and effective treatment for esophageal leiomyoma. Thoracoscopic enucleation may be suitable for proximal to mid-esophageal tumors, while laparoscopic enucleation with anti-reflux surgery may be advisable for distal tumors within 3 cm proximal to the gastrointestinal junction to reduce postoperative reflux and the need for future surgical interventions.	esophagus
Therapeutic Frontiers in Gastroesophageal Cancer: Contemporary Concepts in Management and Therapy.	Gastroesophageal cancer (GEC) represents a global health burden, with rising incidence and high mortality. Despite advancements in early detection and systemic therapies, outcomes remain poor, especially in advanced stages. Management requires a multidisciplinary, multimodal approach that integrates surgery, chemotherapy, radiotherapy, targeted agents, and immunotherapy, tailored by tumor histology, location, and molecular profile. For localized disease, perioperative chemotherapy or chemoradiotherapy is standard, with adjuvant immunotherapy now emerging in selected high-risk cases. In metastatic or unresectable settings, systemic therapy forms the backbone of treatment, with biomarker-driven regimens targeting HER2, PD-L1, MSI-H/dMMR, and CLDN18.2, offering improved outcomes. Novel agents and combinations, including bispecific antibodies, FGFR2 inhibitors, and immunotherapy-based strategies, are actively being explored in clinical trials. This review provides a comprehensive overview of the evolving therapeutic landscape of GEC. It emphasizes the growing role of precision medicine and the integration of emerging clinical data into practice.	esophagus
Are insufficient diagnostic criteria for anastomotic leakage after esophagectomy harming our patients?	Current diagnostic criteria for anastomotic leakage (AL) after esophagectomy are insufficient for early diagnosis and treatment because of their oversimplified binary approach to the complication. A diagnostic spectrum is proposed, introducing the category of possible leak (PoL), leading to increased consideration of AL exclusion, and justifying PoL treatment options.	esophagus
Number of Examined Lymph Nodes in the Highest Quartile Enhances Staging and Prognosis for Patients with Esophageal Cancer Receiving Neoadjuvant Therapy.	BACKGROUND: The optimal number of examined lymph nodes (ELN) for accurate staging and prognosis for esophageal cancer patients receiving neoadjuvant therapy remains controversial. This study aimed to evaluate the impact of ELN count on pathologic staging and survival outcomes and to develop a predictive model for lymph node positivity in this patient population. METHODS: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and a multicenter cohort. The inverse probability-weighting and propensity score-matching method was used to balance baseline characteristics. Patients were stratified into four ELN count groups based on quartiles: Q1 (1-9), Q2 (10-14), Q3 (15-20), and Q4 (≥ 21). A nomogram predicting pathologic lymph node positivity was constructed using least absolute shrinkage, selection operator regression, and multivariate logistic regression, incorporating variables such as age, sex, T stage, cN stage, and ELN count. RESULTS: The training cohort included 1736 patients from the SEER database. After matching, the Q4 group demonstrated significantly superior 5 year overall survival compared with the other three groups, whereas the Q2 and Q3 groups exhibited comparable outcomes. The Q1 group had the worst prognosis. The nomogram demonstrated strong discriminatory ability, with area under the curve values of 0.654 (training cohort) and 0.816 (validation cohort). Higher ELN counts, particularly in the Q4 group, were associated with increased detection of lymph node metastases. CONCLUSION: Examination of 21 or more lymph nodes significantly enhances the accuracy of pathologic lymph node staging and improves long-term survival for esophageal cancer patients undergoing neoadjuvant therapy.	esophagus
Associations Between Non-Genetic Risk Factors and DNA Methylation Alterations in Barrett's Esophagus and Its Progression to Esophageal Adenocarcinoma.	Esophageal cancer (EC) is one of the most aggressive cancers of the digestive system, with two main subtypes: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). Over four decades, the frequencies of EAC and Barrett's esophagus (BE), the known precursor lesion for EAC, have sharply increased in North America and Europe. This is mainly due to lifestyle and risk factors such as gastroesophageal reflux disease (GERD), obesity, and smoking. BE development to EAC involves numerous molecular modifications, including genetic and epigenetic alterations. Epigenetic changes, such as aberrant DNA methylation, play a critical role in the pathogenesis and progression of BE. This review discusses how non-genetic risk factors contribute to DNA methylation changes driving the transformation from BE to EAC, providing insights into the potential of developing methylation-based biomarkers for early diagnosis, risk stratification, and therapeutic intervention.	esophagus
Short middle overlap anastomosis reinforced with Toupet-like fundoplication (SMART): a novel antireflux technique for lower mediastinal esophagogastrostomy after esophagogastric junction cancer surgery.	BACKGROUND: Lower mediastinal esophagogastrostomy after proximal gastrectomy with lower esophagectomy for esophagogastric junction (EGJ) cancer remains technically demanding owing to the high risk of anastomotic leakage and reflux. We developed a novel reconstruction technique, the short middle overlap anastomosis reinforced with Toupet-like fundoplication (SMART) method, to address these challenges. METHODS: From March 2017 to April 2025, 40 patients underwent radical surgery for EGJ cancer at our institution. Among them, 10 patients with ≤3-cm esophageal invasion received laparoscopic/robotic SMART esophagogastrostomy. The procedure consisted of an 8-cm esophageal overlap with the anterior gastric wall, a 2.5-cm linear stapled anastomosis at the midpoint, closure by Albert-Lembert suturing, and bilateral fixation of the esophagus to the stomach in a Toupet-like fashion. Short-term surgical outcomes were retrospectively analyzed. RESULTS: The median operative time and hospital stay were 452 min and 9 days, respectively. No patients experienced anastomotic leakage or stenosis. Mild reflux symptoms and endoscopic reflux esophagitis were observed in 2 patients (grades A and B). The mean body weight loss at 6 months postoperatively was 5.5% compared with baseline. CONCLUSION: The SMART method seems to be a safe, feasible, and antireflux reconstruction technique for lower mediastinal esophagogastrostomy after EGJ cancer surgery. Although preliminary, our findings suggest that it may offer a promising option, warranting further investigation.	esophagus
Natural and synthetic compounds targeting ferroptosis in esophageal squamous cell carcinoma: Research progress and application potential.	Esophageal Squamous Cell Carcinoma (ESCC) is a prevalent malignant tumor of the human digestive system, characterized by high incidence and mortality rates. Most patients are diagnosed at advanced stages, marked by metastasis and drug resistance, significantly limit the efficacy of conventional therapies. Ferroptosis, an iron-dependent form of regulated cell death driven by dysregulated iron metabolism, lipid peroxidation, and compromised antioxidant defense system, has shown great potential in inhibiting the biological activity of cancer cells and improving prognosis. Thus, inducing ferroptosis could become a promising approach for cancer treatment. Bioactive small-molecule compounds, both natural and synthetic, offer unique advantages in the treatment of ESCC due to their distinct properties and potential efficacy. Modulating tumor cells survival via ferroptosis-whether through natural or synthetic agents-represents a crucial direction for precision ESCC therapy. In this review, we systematically outline the core mechanisms of ferroptosis and the roles of ferroptosis in ESCC. We also summarize a range of natural and synthetic compounds that target ferroptosis in ESCC cells, discussing their mechanisms of action and therapeutic potential. This review demonstrates that targeting ferroptosis with natural and synthetic compounds could be effective for ESCC treatments, and highlights a promising therapeutic avenue that could be utilized to prevent ESCC. This review article aims to shed light on developing novel therapeutic regimens by pharmacological induction of ferroptosis to treat ESCC efficiently in the future.	esophagus
The biology and therapeutic implications of heterogeneity in Barrett oesophagus and oesophageal adenocarcinoma.	Oesophageal adenocarcinoma (OAC) and its precursor condition, Barrett oesophagus, are characterized by phenotypic and molecular intertumoural and intratumoural heterogeneity. This heterogeneity arises in space and time through a complex and still poorly understood interplay between cancer-cell-intrinsic factors, the tumour microenvironment and external influences, such as exposure to anticancer therapies. Together, these elements contribute to a high degree of resistance to therapy while limiting the development of novel targeted therapies and the identification of predictive biomarkers. This situation is exacerbated both in Barrett oesophagus and OAC by a historical clinical reliance on biopsy samples that reflect disease status only at a single location and timepoint. A better understanding of heterogeneity is therefore vital to improve efforts to intercept the development of and optimize treatments for OAC. In this Review, we provide an overview of current and future directions of research on the heterogeneity of Barrett oesophagus and OAC, summarizing our knowledge of the factors that influence heterogeneity, and its consequences across the spectrum of these diseases.	esophagus
Stratified and propensity score matching analysis of the effectiveness of fibrin glue in preventing postoperative bleeding after endoscopic submucosal dissection.	BACKGROUND: Endoscopic submucosal dissection (ESD) is a commonly used treatment for superficial lesions of the upper gastrointestinal tract, of which the most common complication is postoperative bleeding. This retrospective study mainly aimed at assessing the effect of intraoperative fibrin glue (FG) spraying on postoperative bleeding in patients with early esthe ophageal cancer (EEC) and early gastric cancer (EGC). METHODS: A retrospective analysis of FG uses during ESD was conducted in 362 patients with early upper gastrointestinal malignancy. 362 patients who received ESD were divided into the FG group and the conventional group, comparing their postoperative bleeding rate, acute postoperative bleeding rate, and delayed postoperative bleeding rate using stratified analysis and propensity score matching (PSM) to eliminate potential confounding factors. Univariate and multivariate logistic regression were implemented to investigate the risk variables for surgical hemorrhage following early upper gastrointestinal malignancy. RESULTS: The results of stratification based on intraoperative bleeding showed that the use of FG in the intraoperative bleeding group of EGC patients undergoing ESD could effectively reduce bleeding within 48 h after surgery (p = 0.039), whereas the application of FG did not affect postoperative bleeding in patients with early esophageal cancer after ESD. After utilizing PSM, 102 pairs of matched subjects were obtained, eliminating differences in age, lesion size and depth, and intraoperative bleeding between the two groups. The postoperative bleeding rate in the FG group was 2.9%, while in the conventional group, it was 12.7% (p = 0.009); the bleeding rates within 48 h after ESD were 1.0% and 7.8%, respectively (p = 0.035), which were statistically significant. A logistic regression analysis revealed that intraoperative bleeding was a risk factor for postoperative bleeding (OR, 4.00; 95% CI, 1.47-10.84; p = 0.006). CONCLUSIONS: Intraoperative spraying of FG may help to reduce the incidence of postoperative bleeding after ESD, especially acute postoperative bleeding in patients with EGC.	esophagus
Location characteristics of superficial esophageal squamous cell carcinoma.	The location-specific characteristics of superficial esophageal squamous cell carcinoma (ESCC) have not been determined. This study analyzed the locational characteristics of superficial ESCC. Medical records of patients with superficial ESCC treated between December 2008 and November 2024 at Pusan National University Yangsan Hospital were retrospectively reviewed. ESCC locations and final pathological results confirmed by surgery or endoscopic resection were compared. A total of 150 patients with 163 superficial ESCCs were analyzed. Lesions were located in in the upper thoracic (n = 16, 9.8%), mid-thoracic (n = 104, 63.8%), and lower thoracic regions (n = 43, 26.4%). Although upper thoracic lesions had higher deep submucosal cancer (62.5% vs. 29.8%, p = 0.015) and poorly differentiated carcinoma (37.4% vs. 9.6%, p = 0.005) rates than mid-thoracic lesions, no lymph node metastasis or lympho-vascular invasion was detected. In contrast, the deep submucosal cancer rate was less for lower thoracic lesions than mid-thoracic lesions (14.0% vs. 29.8%, p = 0.049), but lymph node metastasis (7.0% vs. 5.8%, p = 0.782) and lympho-vascular invasion (7.0% vs. 4.8%, p = 0.600) rates tended to be higher. Superficial ESCCs in the upper thoracic region had more features requiring surgery but had less lymph node metastasis or lympho-vascular invasion, whereas lesions in the lower thoracic region showed the opposite trend. The results of our study may be helpful when deciding between surgery and endoscopic resection for some patients with superficial ESCC.	esophagus
Aerodigestive fistulas in adults: a focus on airway interventions and review of recent literature.	PURPOSE OF REVIEW: Aerodigestive fistulas (ADFs) cause significant morbidity and mortality, especially in advanced malignancies. This review summarizes current knowledge on etiology, diagnostic, and management strategies. RECENT FINDINGS: Esophageal carcinoma is the predominant cause of malignant ADFs with their development influenced by tumor location, most often involving the upper and middle thirds of the esophagus, and by prior interventions such as radiotherapy or esophageal stenting.Benign acquired ADFs typically result from iatrogenic injuries including pressure necrosis from cuffed tubes, stent erosion, endoscopy, and surgery. Diagnosis often is delayed by nonspecific symptoms, requiring combined imaging and endoscopic evaluation. Benign ADFs are typically amenable to surgical repair, whereas malignant fistulas usually require individualized palliation, notably airway and esophageal stenting. Dual airway-esophageal stenting has advantages over single stenting for malignant ADFs due to superior quality of life and survival outcomes. Emerging minimally invasive techniques include endoscopic clips, occluder devices, and tissue adhesives. SUMMARY: Optimal management of ADFs requires high clinical vigilance, timely diagnostic evaluation, and individualized multidisciplinary approaches. Further research into emerging therapies and standardized management algorithms is essential for improving patient outcomes and guiding evidence-based clinical practice.	esophagus