crossing96/oncoscreening huggingface dataset:
Clinical study of modified Ivor-Lewis esophagectomy plus adjuvant radiotherapy for local control of stage IIA squamous cell carcinoma in the mid-thoracic esophagus.	OBJECTIVE: To control the postoperative local recurrence is one of the critical factors to improve prognosis of patients with esophageal carcinoma. The aim of this study is to evaluate the effectiveness of modified Ivor-Lewis esophagectomy plus adjuvant radiotherapy for local control of stage IIA squamous cell carcinoma in the mid-thoracic esophagus. METHODS: One hundred and twenty-five patients with stage IIA mid-thoracic esophageal squamous cell carcinoma who underwent modified Ivor-Lewis esophagectomy between June 1999 and June 2002 were included in the retrospective analysis. All the patients were evaluated within 3 years after surgery to detect tumor recurrence. Kaplan-Meier method was used to calculate the survival rate and logistic regression analysis was performed to identify risk factors of locoregional recurrence. RESULTS: The overall 3-year and 5-year survival rate in all patients was 58.4% and 43.2%, respectively. Tumor recurrence occurred in 61 patients (48.8%) within 3 years after operation. The median disease-free interval was 12.6 months. Thirty-three patients (26.4%) developed locoregional recurrence, 23 patients (18.4%) developed distant recurrence and 5 patients (4.0%) developed locoregional and distant recurrence simultaneously. Locoregional recurrence rate of patients with postoperative radiotherapy was significantly lower than that of those without postoperative radiotherapy (p<0.05). Logistic regression analysis showed that adjuvant radiotherapy (p=0.007) was an independent risk factor for tumor locoregional recurrence. Cox regression analysis showed that locoregional recurrence but not adjuvant radiotherapy was a relevant prognostic factor of patients with stage IIA esophageal cancer. CONCLUSIONS: Modified Ivor-Lewis esophagectomy with two-field lymph node dissection plus adjuvant radiotherapy might be an effective strategy to achieve local control of stage IIA mid-thoracic esophageal squamous cell carcinoma.	esophagus
Minimally invasive surgery for esophageal cancer.	Esophageal cancer represents a major public health problem worldwide. Several minimally invasive esophagectomy (MIE) techniques have been described and represent a safe alternative for the surgical management of esophageal cancer in selected centers with high volume and expertise in them. This article reviews the most recent and largest series evaluating MIE techniques. Recent larger series have shown MIE to be equivalent in postoperative morbidity and mortality rates to conventional surgery. MIE has been associated with less blood loss, less postoperative pain, and decreased intensive care unit and hospital length of stay compared with conventional surgery. Despite limited data, conventional surgery and MIE have shown no significant difference in survival, stage for stage. The myriad of MIE techniques complicates the debate of defining the optimal surgical approach for treating esophageal cancer. Randomized controlled trials comparing MIE with conventional open esophagectomy are needed to clarify the ideal procedure with the lowest postoperative morbidity, best quality of life after surgery, and long-term survival.	esophagus
Modern staging and utility of PET imaging in esophageal cancer management.	Esophageal cancer is the eighth most common cancer worldwide, and one of the most fatal diseases despite modern medical treatment. Because correct staging and surveillance of neoadjuvant therapy for esophageal cancer is mandatory for further treatment planning, choosing a modern imaging system is important. The development of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) has provided alternate means of tumor detection distinct from more conventional methods. This modality has extraordinary performance in detecting locoregional lymph node involvement and distant metastatic disease, and has been introduced as a powerful tool in many guidelines. However, some factors still lead to false-negative or -positive results, raising questions of its accuracy. This article discusses the clinical efficacy of PET in staging and surveillance of neoadjuvant therapy in esophageal cancer, comparing its accuracy with conventional imaging modalities.	esophagus
Comparative evaluation between re-irradiation and demand endoscopic dilatation vs endoscopic dilatation alone in patients with recurrent/reactivated residual in-field esophageal malignancies.	BACKGROUND: Esophageal cancer has emerged as a major health challenge in many regions of the world, including the valley of Kashmir, which is situated adjacent to the esophageal cancer belt on its Southern side. Radiotherapy is one of the main modalities of treatment. However, residual/recurrent disease is common and salvage options for these patients are limited. Scarce literature is available regarding the use of re-irradiation in this setting though re-irradiation has been successfully used in recurrent tumors at various other anatomical sites. AIM: In the present study, external beam re-irradiation with demand dilatation vs per-oral endoscopic dilatation alone were compared with regard to the impact of these modalities on symptom control, survival, and quality of life of the patients. Treatment-related sequelae were also compared. SETTING AND DESIGN: Prospective and randomized. MATERIALS AND METHODS: The study included 34 cases who were palliated with re-irradiation and 35 cases who refused to enter the experimental protocol and, therefore, received per-oral demand dilatation alone, with the disease being allowed to follow its natural course. Both groups were statistically cross-matched with regard to their demographic and clinical parameters. STATISTICAL METHOD USED: Mann-Whitney U-test, Chi-square test, Student's t-test, and Kaplan-Meier test for survival analysis. RESULTS: The results favor the use of re-irradiation as it significantly improves dysphagia-free survival and quality of life. The treatment-related complications/morbidity of this protocol was acceptable. CONCLUSION: A trial of re-irradiation with external beam is justified in selected patients.	esophagus
[Increase of BIRC5 gene expression in non-small cell lung cancer and esophageal squamous cell carcinoma does not correlate with expression of genes SMAC/DIABLO and PML encoding its inhibitors].	Survivin (BIRC5) is one of the members of IAP-family apoptosis inhibitors. The BIRCS gene is expressed in most human embryonic tissues and malignant tumors but not in normal differentiated tissues of adult human. It was suggested that BIRC5 proteins inhibit apoptosis and play an essential role in tumorigenesis, makings surviving an attractive target for anticancer therapy. The mechanisms regulating level of survivin are not completely understood. It was supposed that natural inhibitors of survivin, namely SMAC and PML, play an important role in these processes. Using RT-PCR and immunoblotting we analyzed the transcription level of BIRC5, SMAC and PML genes and content of corresponding proteins in normal and tumor human tissues in non-small cell lung cancer and esophageal squamous cell carcinoma. It was demonstrated that BIRC5 is transcribed only in tumor tissues, whereas expression levels of SMAC and PML are the same in normal and tumor tissues. The contents of proteins correspond to levels of mRNA of the respective genes. Thus the increase of level of survivin in tumor tissues is not the result of decrease in content of its inhibitors SMAC and PML, as their content in tumor and normal cells is the same.	esophagus
A fresh look at esophageal cancer incidence among Asian/Pacific Islanders and Caucasians.	This is a retrospective study comparing esophageal cancer incidence among Asian/Pacific Islanders and Caucasians between Hawai'i and nationally, identifying patterns specific to Hawai'i. SEER*SAT was used for statistical analysis. In Hawai'i, esophageal cancer incidence between the two study groups were similar, but nationally higher in Caucasians. These findings are unique to Hawai'i. More detailed and consistent registries are needed.	esophagus
Application of unsedated transnasal esophagogastroduodenoscopy in the diagnosis of hypopharyngeal cancer.	BACKGROUND: This study evaluates the efficacy of unsedated transnasal esophagogastroduodenoscopy (EGD) in the diagnosis of hypopharyngeal cancer and screening of esophageal lesions. METHODS: Twenty-seven patients with newly diagnosed hypopharyngeal cancer were evaluated by transnasal EGD without conscious sedation. RESULTS: Twenty-two hypopharyngeal cancers arose from the pyriform sinus, and the other 5 tumors were from the posterior hypopharyngeal wall. Seventeen tumors were classified as T3-T4. Twenty-four hypopharyngeal tumors were pathologically proved malignancy by this technique. Regarding simultaneous esophageal lesions, esophageal dysplasia was noted in 4 patients and esophageal cancer occurred in 6 patients. The procedures were performed without difficulty except in 1 patient with huge posterior wall tumor. The mean procedure time was 22 minutes. All patients tolerated the procedure well, without significant bleeding or respiratory distress during examination. CONCLUSION: Unsedated transnasal EGD is a safe, tolerable, and accurate endoscopic technique for diagnosis of hypopharyngeal cancer and screening of simultaneous esophageal cancer.	esophagus
Concurrent chemoradiation alone with curative intent for limited-disease small-cell esophageal cancer in nine Japanese patients.	Small-cell carcinoma of the esophagus is a rare and aggressive tumor with early widespread dissemination. In this retrospective study, we report clinical outcomes of limited-disease small-cell carcinoma of the esophagus from the analysis of nine patients. Between 2003 and 2006, nine consecutive patients with small-cell carcinoma of the esophagus were treated in our single institution, representing 2.8% of all esophageal malignancies treated with curative concurrent chemoradiation during this period. All the patients received four cycles of etoposide (100 mg/m(2), days 1-3), combined with cisplatin (80 mg/m(2), day 1), plus radiation therapy (50 Gy in daily doses of 2 Gy, 5 days/week). At the time of analysis, the median follow-up time was 10.8 months (range: 4.2-42.8 months) and 21.8 months in five living patients (56%). Of all the nine patients, five patients (56%) had a complete response, and the actuarial 3-year overall survival rate was 55.6%. This regimen resulted in a favorable 3-year survival rate. We conclude that the optimum treatment seems to be the same as for small-cell carcinomas of the lung, that is, a multidrug combination chemotherapy regimen used with concurrent radiation.	esophagus
Anastomotic strictures and delayed gastric emptying after esophagectomy: incidence, risk factors and management.	The aim of this study was to report the incidence, risk factors, and management of gastric conduit dysfunction after esophagectomy in 177 patients over a 3-year period in a single center. Patients with anastomotic strictures or delayed gastric emptying (DGE) were identified from a prospective database. Anastomotic strictures occurred in 48 patients (27%). Eighty-three percent of early anastomotic strictures (<1 year) were benign, and all late strictures (>1 year) were malignant. Dilatation was effective in 98% of benign and 64% of malignant strictures. DGE occurred in 21 patients (12%), and was associated with both anastomotic leak (P = 0.001) and anastomotic stricture (P = 0.001). 4/8 patients with late DGE (>3 months postesophagectomy) were tumor-related. Pyloric dilatation was effective in 92% of early and 63% of late DGE. Pyloric stents were inserted in 3 patients with tumor-related DGE. After esophagectomy, early anastomotic strictures (within 1 year) and early delayed gastric emptying (within 3 months) are usually benign and respond to dilatation. However, patients presenting later with tumor-related obstruction are unlikely to respond to anastomotic or pyloric dilatation and should be stented.	esophagus
Risk factors for malnutrition after oesophageal and cardia cancer surgery.	BACKGROUND: Oesophageal cancer surgery is often followed by malnutrition, but the factors causing weight loss are unknown. The aim of this population-based study was to identify such risk factors. METHODS: Data were collected from a nationwide Swedish organization for research on surgery for oesophageal cancer. A total of 340 patients (75.9 per cent of those eligible) responded to a study-specific questionnaire concerning height and weight, just before and 6 months after surgery. Factors influencing malnutrition, defined as loss of body mass index of at least 15 per cent 6 months after operation, were identified by logistic regression. RESULTS: Neoadjuvant therapy (received by 10.6 per cent of all patients) and female sex were associated with at least a twofold increased risk of weight loss (odds ratio (OR) 2.41 (95 per cent confidence interval 1.01 to 5.77) and 2.14 (1.07 to 4.28) respectively), whereas preoperative weight loss was associated with a decreased risk (OR 0.13 (0.03 to 0.65)). Age, tumour stage and location, type of oesophageal substitute, suture technique and postoperative complications did not influence the risk. CONCLUSION: Neoadjuvant therapy and female sex appear to be associated with an increased risk of malnutrition after oesophageal cancer surgery.	esophagus
[The distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area].	OBJECTIVE: To observe the distribution of the pre-cancerous condition and pathological changes of esophageal cancer of the community residents in high-incidence area, and to provide etiological evidences for secondary prevention. METHODS: An iodine-staining endoscope census was conducted in 9536 residents with high-risk factors at Feicheng, a high esophageal cancer incidence community in Shandong province. Of which, 1507 pathologic biopsies were performed and chi2 test administrated. RESULTS: There was no statistical significance found in biopsy pathologic diagnosis between females and males among 1507 samples. The mild and medium atypical hyperplasia was taken as pre-cancerous condition and severe atypical hyperplasia was taken as pre-cancerous lesion. Taking all the population attending census as denominator, the detection rate of the precancerous state and precancerous lesion were 6.98% (294/4214) and 1.23% (52/4214) for the males, and 3.68% (196/5322) and 0.47% (25/5322) for the females, respectively. A statistical significance was observed when comparing males with females (chi2 were 52.349 and 15.267, respectively, P < 0.05). Analyzed by age group, severe atypical hyperplasia pathological changes were mainly distributed in the age group of 50- and 65-. The constituent ratio between 45 - and 50 - was the highest for CIS. Early carcinoma was mainly distributed in five age groups from 45- to 65-. It showed that high incidence town had a high detection rate of cancer and pathological changes of esophageal cancer in the analysis of urban and rural distribution. CONCLUSION: The distribution of the pre-cancerous state and pathological changes of esophageal cancer of the residents should have provided a scientific basis for the primary and secondary prevention.	esophagus
[Role of AIB1 gene in development of esophageal squamous cell carcinoma and its clinicopathologic significance].	OBJECTIVE: To investigate the role of AIB1 gene in the development of esophageal squamous cell carcinoma (ESCC) and its clinicopathologic significance. METHODS: Two tissue microarrays, including 203 cases of ESCC, were prepared. Fluorescence in-situ hybridization (FISH) and immunohistochemistry were performed to detect the amplification of AIB1 gene and expression of its encoded protein in ESCC. The results were correlated with various clinicopathologic parameters. RESULTS: In the 203 cases of ESCC studied, FISH was successful in 115 cases. Amongst those, amplification/gain of AIB1 gene was observed in 15 cases, including high-level amplification in 5 cases (4.3%) and low-level gain in 10 cases (8.7%). As for immunohistochemical study, AIB1 protein was overexpressed in 94 cases of ESCC. There was a significant association of AIB1 overexpression and tumor staging. AIB1 was overexpressed in 66 of the 123 cases in advanced T stages (T3 to 4), compared with 25 of the 80 cases in early T stages (P = 0.008). Those cases with high-level amplification of AIB1 also showed overexpression of its encoded protein. On the other hand, 8 of the 10 cases with low-level gain of AIB1 showed protein overexpression. The remaining 41 of the 100 cases which did not have AIB1 gene amplification/gain demonstrated overexpression of AIB1 protein. CONCLUSION: Overexpression of AIB1 protein caused by gene amplification/gain or other molecular mechanisms may play an important role in the development and/or progression of a subset of ESCC.	esophagus
Downregulation of HLA Class I molecules in the tumour is associated with a poor prognosis in patients with oesophageal squamous cell carcinoma.	As antigenic peptides in the context of human leukocyte antigen (HLA) class I molecules are recognised by cytotoxic T lymphocytes (CTL), the downregulation of HLA class I molecules is one of the reasons why tumour cells can evade CTL-mediated anti-tumour immunity. In this study, we investigated HLA class I expression in oesophageal squamous cell carcinoma (ESCC) (n=70) and in their metastatic lesions (lymph nodes (n=40) and liver (n=3)), by immunohistochemistry with anti-HLA class I monoclonal antibody (EMR8-5). As a result, the downregulation of HLA class I expression in primary lesions of ESCC was observed in 43%, and that in metastatic lymph nodes was noted in 90%. Furthermore, patients with preserved HLA class I expression in primary tumours showed a better survival in comparison to those with downregulated HLA class I molecules (P<0.01). Furthermore, multivariate analysis using Cox's proportional hazards model revealed that the downregulated expression of HLA class I in primary lesions was an independent, unfavourable prognostic factor (P<0.01). In conclusion, the downregulation of HLA class I expression frequently occurred in primary tumour and, to a greater extent, in metastatic lesions of patients with ESCC and was associated with patient survival.	esophagus
Sex-specific risk factor profile in oesophageal adenocarcinoma.	A nationwide Swedish case-control study of 388 men and 63 women with adenocarcinoma of the oesophagus and gastro-oesophageal function and 676 men controls and 140 women investigated whether sex differences in aetiology contribute to male predominance. Compared with men, women seemed more vulnerable to reflux (odds ratio (OR)=4.6, 95% confidence interval (CI)=2.0-10.5 vs OR=3.4, 95% CI=2.5-4.6), obesity (OR=10.3, 95% CI=2.6-42.3 vs OR=5.4, 95% CI=2.6-10.8) and smoking (OR=5.3, 95% CI=2.0-14.1 vs OR=2.8, 95% CI=1.9-4.2), less harmed by low intake of fruit and vegetables (OR=0.9, 95% CI 0.3-2.4 vs OR=1.6, 95% CI=1.1-2.2) and less protected by Helicobacter pylori infection (OR=0.5, 95% CI=0.3-0.8 vs OR=1.6, 95% CI=0.5-5.4).	esophagus
Oesophageal and gastric intestinal-type adenocarcinomas show the same male predominance due to a 17 year delayed development in females.	BACKGROUND AND AIMS: Upper gastrointestinal adenocarcinomas show an unexplained male predominance that is more apparent in oesophagus than stomach and in intestinal than diffuse histological subtype. We have conducted a population-based study to determine whether the gender phenomenon is primarily related to the anatomical site or the histological subtype. METHOD AND MATERIALS: Of 3270 gastric and oesophageal cancers recorded in the West of Scotland Cancer Registry, 1998-2002, 812 were randomly selected for detailed analysis. The Lauren histological subtype of adenocarcinoma was determined by reviewing 1204 original reports and 3241 biopsies. RESULTS: Analysis included 405 non-cardia cancers, 173 cardia cancers and 209 oesophageal adenocarcinomas. Crude incidence rate of intestinal subtype was higher in males (23.86/100,000 person-years) versus females (9.00/100,000 person-years), giving a male/female (M/F) ratio of 2.65 whereas diffuse subtype was similar for both genders (5.58 vs 5.20/100,000 person-years) yielding M/F of 1.07. The M/F ratios for oesophageal, cardia and non-cardia gastric cancer were 3.5, 2.0 and 1.6, respectively. Multiple logistic regression indicated that the odds of male gender was related to the histological subtype rather than anatomical location (odds ratio 2.6, 95% confidence interval 1.78 to 3.9). Curve fitting of the age-specific incidence of intestinal subtype indicated that similar functions describe the rise in incidence with age in males and in females. However, the age-specific incidence of female intestinal subtype was delayed by 17.3 years. The M/F ratio of intestinal subtype was 3.41 at age <50 years, peaked at 7.86 at age 50-59 years and then showed a progressive decrease after 50-60 years of age. CONCLUSION: Male predominance of upper gastrointestinal adenocarcinoma is related to the intestinal histological subtype rather than tumour location and is due to marked delayed development of this subtype in females prior to 50-60 years of age.	esophagus
Galectin-3 in urine of cancer patients: stage and tissue specificity.	PURPOSE: Galectin-3 has been implicated in advanced stage of cancer disease. In the current study we examined the possibility of urinary galectin-3 levels to stage cancer disease and to follow up therapy. EXPERIMENTAL DESIGN: Urine was collected from all types of cancer patients at different stages including patients undergoing radio/chemotherapy. Galectin-3 level was determined by anti-galectin-3 based ELISA and agglutination assays. Immunoblotting and purification on lactosyl affinity column further confirmed the presence of galectin-3. RESULTS: Cancer samples exhibited stage dependent expression of galectin-3 approx. ranging from 1.0 to 3.3, 4.4 to 5.4, 5.4 to 24.7, 13.1 to 31.9, 13.9 to 32.9 ng/mg C (creatinine) for stage I-V, respectively, at P approximately <0.05 level. Galectin-3 levels were decreased by approx. threefolds after 5th day of therapy. CONCLUSIONS: Sample collection being simple and non-invasive, urinary galectin-3 may be used as a potential diagnostic tool for monitoring or follow up of the stage of cancer disease.	esophagus
Endoscopic repair of a complete post-radiation esophageal obstruction.	We describe a 64-year-old man with squamous cell carcinoma of the esophagus who presented with an obstruction of the esophagus following radiation therapy and chemotherapy. Initial upper gastrointestinal barium swallow studies showed a complete stoppage of the barium column, not unlike that of a congenital esophageal atresia. Therapeutic endoscopy was performed using a two-endoscope, two-operator system that reestablished patency of the esophagus. Repeated endoscopy was then used to continue esophageal dilation with eventual placement of a permanent stent. A video and a comprehensive review of the literature regarding combined antegrade-retrograde dilation techniques used to date are also provided.	esophagus