crossing96/oncoscreening huggingface dataset:
Superficial adenocarcinoma of the esophagogastric junction: long-term results of endoscopic submucosal dissection.	BACKGROUND: Endoscopic submucosal dissection (ESD) was recently introduced as a treatment option for superficial adenocarcinoma of the esophagogastric junction (EGJ); however, its long-term clinical outcomes have not been fully evaluated. OBJECTIVE: To assess the long-term outcomes of ESD for patients with superficial adenocarcinoma of the EGJ. DESIGN: Retrospective review from a single institution. SETTING: University hospital. PATIENTS: Fifty-eight patients, 46 men and 12 women (mean 69.3 years), with 39 T1m and 19 T1sm adenocarcinomas of the EGJ treated from June 2000 to May 2009. INTERVENTIONS: ESD procedures were performed with typical sequences. MAIN OUTCOME MEASUREMENTS: Complications, en bloc resection rate, curative resection rate, local recurrence, and distant metastases after ESD were evaluated. Curative resection is histologically defined as being free of resection margins and any evidence of deep submucosal invasion, undifferentiated carcinoma, and lymphovascular invasion. RESULTS: There were no major complications except for 3 patients with ulcer bleeding without the need for blood transfusion and 1 patient with esophageal stenosis. The rates of en bloc resection and curative resection were 100% and 79%, respectively. Twelve resections were histologically considered noncurative; these patients underwent additional ESD (n = 1) or surgical resection (n = 8). Local or distant recurrences were not observed in any patient achieving curative resection during follow-up (median 36.6 months, range 4-94 months). LIMITATIONS: Retrospective design and single-site data collection. CONCLUSIONS: Long-term outcomes after ESD are favorable. ESD may be adopted as a treatment of choice for superficial adenocarcinoma of the EGJ.	esophagus
Elevated serum CRP levels after induction chemoradiotherapy reflect poor treatment response in association with IL-6 in serum and local tumor site in patients with advanced esophageal cancer.	BACKGROUND AND OBJECTIVES: Elevated serum CRP levels are associated with tumor progression and poor prognosis of esophageal cancer. The aim of this study was to clarify the clinical significance of CRP in relation to response to chemoradiotherapy in patients with esophageal cancer. METHODS: The relationship between serum CRP levels and response to chemoradiotherapy and prognosis was analyzed in 34 patients with advanced esophageal squamous cell carcinoma who underwent induction chemoradiotherapy followed by surgery. The relationship between response to chemoradiotherapy and interleukin-6 (IL-6) expression in sera and tumor tissues was also analyzed. RESULTS: Although elevated serum CRP levels were associated with poor response to chemoradiotherapy, significant difference in CRP levels between pathological responders (n = 18) and non-responders (n = 16) was observed after chemoradiotherapy, but not before. Patients with elevated CRP levels had shorter cause-specific survival, but significant difference was observed only after chemoradiotherapy. In addition, serum levels of IL-6 were also associated with poor treatment response following chemoradiotherapy and were correlated with residual tumor volume. IL-6 expression was detected in residual tumor tissues by immunohistochemistry. CONCLUSIONS: Elevated serum CRP levels after chemoradiotherapy may predict poor response to chemoradiotherapy more accurately than before chemoradiotherapy, and IL-6 may be a possible target associated with chemoradiotherapy resistance.	esophagus
Transillumination instrument facilitates faster and more accurate dissection of right colon segment for oesophageal reconstruction.	BACKGROUND: Venous insufficiency of a right colon interposition in oesophageal reconstruction can be a fatal complication. The right colon segment could allow restoration of swallowing and speech in reconstruction of the entire oesophagus. The right colon segment is a good choice because of the large middle colic artery and isoperistaltic direction. However, because of the anatomical variation of the veins and the tiny venous network of the right colon, its success rate is lower compared with that of the left colon segment. Therefore, we devised a simple instrument of transillumination that can provide an improved view during surgery of the venous network of the right colon and ileocecal region when dissecting this important structure. METHODS: Thirty-six patients underwent oesophageal reconstruction with a right colon segment using the instrument. The instrument of transillumination was used in all cases while exploring the pedicle vessels and the venous network of the right colon. RESULTS: No patients developed complications related to the use of the instrument. CONCLUSION: The instrument of transillumination is a simple and useful tool for facilitating dissection of the right colon segment. In the future, the technique could be used for all types of bowl dissection.	esophagus
[Role of papillomavirus in adenocarcinoma of esophagogastric junction].	OBJECTIVE: To determine if human papillomavirus (HPV) infection could be associated with the development of adenocarcinoma of esophagogastric junction (AEG). METHODS: A total of 106 consecutive AEG patients and 59 consecutive gastric carcinoma patients who accepted surgery at our department between January 2004 and December 2006 were selected. Specimens from tumors and uninvolved mucosa were obtained intra-operatively. Genomic DNA was extracted by the phenol-chloroform-isoamyl alcohol extraction protocol. The HPV infection was determined by PCR using primer set SPF1 and GP6+. Specificity of the amplified products was confirmed by sequencing. RESULTS: The HPV infection rates in AEG and gastric cancer were 10.4% (11/106) and 10.2% (6/59) separately (P = 0.966). CONCLUSION: HPV is not a major factor in the carcinogenesis of AEG type II, AEG type III or stomach.	esophagus
Computer-assisted brush-biopsy analysis for the detection of dysplasia in a high-risk Barrett's esophagus surveillance population.	BACKGROUND: Barrett's epithelial dysplasia, the direct precursor to esophageal adenocarcinoma, is often unapparent and frequently missed during surveillance of Barrett's esophagus with four-quadrant forceps biopsy protocol. AIM: To determine whether the detection of dysplasia is improved by adding computer-assisted brush biopsy (EndoCDx©) to four-quadrant biopsy protocol. METHODS: Patients with a history of Barrett's esophagus with dysplasia scheduled for endoscopic surveillance were recruited from four academic medical centers. Patients underwent brush biopsy followed by four-quadrant biopsy every 1-2 cm. The results from brush and forceps biopsy were reviewed independently by pathologists blinded to the other's results. RESULTS: Among 151 patients enrolled (124 men, 27 women; mean age: 65), 117 (77.5%) had forceps and brush-biopsy specimens adequate for interpretation. The mean number of forceps biopsies was 11.9 (median 10, range 2-40) and brush biopsies was 2.0 (median 2, range 1-4). The overall yield of forceps alone was 25.2% (n = 38). Brush biopsy added an additional 16 positive cases increasing the yield of dysplasia detection by 42% (95% CI: 20.7-72.7). The number needed to test (NNT) to detect one additional case of dysplasia was 9.4 (95% CI: 6.4-17.7). There were no significant differences in results among different centers, between standard versus jumbo forceps, or between forceps biopsies taken every 1 cm versus every 2 cm. CONCLUSIONS: These data suggest that computer-assisted brush biopsy is a useful adjunct to standard endoscopic surveillance regimens for the identification of dysplasia in Barrett's esophagus.	esophagus
Prognostic relevance of skip metastases in esophageal cancer.	BACKGROUND: Presence of nodal skip metastasis is an established prognostic factor for patients with non-small cell lung cancer. Little is known about this form of lymphatic spread in esophageal cancer. The aim of this study was to assess nodal skip metastasis and its clinical importance for patients with cancer of the esophagus. METHODS: Resected lymph nodes of 128 patients with esophageal cancer and pN1 status (adenocarcinoma, n = 67; squamous cell cancer, n = 61) were mapped according to the Japanese lymph-node classification for esophageal cancer. Skip metastases were defined as tumor-free N1 lymph nodes, whereas N2 through N4 lymph nodes harbor metastases. RESULTS: Skip metastases were present in 26 of 128 (20%) patients. There was a higher rate of skip metastasis in early tumors (39% versus 23% versus 14% for T1, T2, and T3 tumors; p = 0.032) and tumors in the middle and upper third of the esophagus (37% versus 15% for upper- and middle-third and lower-third tumors; p = 0.022). Patients with skip metastasis had a significantly better 5-year survival rate than patients with continuous metastasis (53% versus 15%; p < 0.0001). Multivariate analysis revealed skip metastasis as an independent prognostic factor. CONCLUSIONS: Skip metastasis is a common form of lymphatic spread in esophageal cancer, which is associated with a favorable prognosis.	esophagus
Barrett's esophagus, esophageal and esophagogastric junction adenocarcinomas: the role of diet.	Identification of modifiable risk factors is an attractive approach to primary prevention of esophageal adenocarcinoma (EAC) and esophagogastric junction adenocarcinoma (EGJAC). We conducted a review of the literature to investigate the association between specific dietary components and the risk of Barrett’s esophagus (BE), EAC and EGJAC, supposing diet might be a risk factor for these tumors. Consumption of meat and high-fat meals has been found positively associated with EAC and EGJAC. An inverse association with increased intake of fruit, vegetables and antioxidants has been reported but this association was not consistent across all studies reviewed. Few studies have examined the association between diet and BE. Additional research is needed to confirm the aforementioned association and clarify the mechanisms by which dietary components affect the risk of developing EAC and EGJAC. Future studies could advance our knowledge by emphasizing prospective designs to reduce recall bias, by using validated dietary intake questionnaires and biological measures and by considering important confounders such as gastro-esophageal reflux disease (GERD) symptoms, tobacco and alcohol use, biometrics, physical activity, and socioeconomic factors.	esophagus
A new partially covered metal stent for palliation of malignant dysphagia: a prospective follow-up study.	BACKGROUND: Metal stents are frequently used for palliation of malignant dysphagia. Recently, a new stent design, the partially covered Wallflex stent (Boston Scientific, Natick, Mass), has been introduced. OBJECTIVE: To determine clinical effectiveness and safety of the esophageal Wallflex stent for the palliation of dysphagia. DESIGN: A prospective follow-up study evaluating a new stent design. SETTING: Three tertiary-care referral centers. PATIENTS: This study involved 37 patients with cancer of the esophagus or gastric cardia. INTERVENTIONS: Stent placement. MAIN OUTCOME MEASUREMENTS: Data were collected regarding technical and clinical outcome, complications, recurrent dysphagia, and survival. RESULTS: A total of 37 patients (median age, 67 years; range, 48-84 years; 22 men [59%]) had a Wallflex stent placed. Stent placement was technically successful in all but 1 patient. Dysphagia improved from a median dysphagia score of 3 (ability to swallow liquids only) to 1 (ability to eat some solid foods) 4 weeks after stent placement. Major complications occurred in 3 patients (8%; pneumonia in 1, severe pain in 2), and 1 patient (3%) died from a complication (pneumonia). Minor complications included mild retrosternal pain in 10 patients (27%) and regurgitation in 7 patients (19%). In total, 8 patients (22%) developed recurrent dysphagia because of stent migration (n = 2 [6%]), food impaction (n = 2 [6%]), or tissue ingrowth or overgrowth (n = 4 [10%]). LIMITATIONS: Nonrandomized study design. CONCLUSIONS: Placement of a partially covered Wallflex stent is safe and effective for the palliation of malignant dysphagia, with migration and tissue in- and overgrowth rates comparable to those of similarly designed stents. Retrosternal pain may occur more often with this stent than with other stent designs.	esophagus
Adding external beam to intra-luminal brachytherapy improves palliation in obstructive squamous cell oesophageal cancer: a prospective multi-centre randomized trial of the International Atomic Energy Agency.	BACKGROUND: Whether the combination of high dose-rate brachytherapy (HDRBT) and External Beam Radiation Therapy (EBRT) is superior to HDRBT alone for the palliation of oesophageal cancer has only been explored in a previous IAEA pilot randomized trial. METHODS: Two hundred and nineteen patients were randomized to adding EBRT or not, after receiving two fractions of HDRBT within 1 week. Each HDRBT consisted of 8 Gy prescribed at 1cm from source centre. Patients randomized to EBRT received 30 Gy in 10 fractions. The primary outcome was dysphagia-relief experience (DRE). Additional outcomes included various scores, performance status, weight and adverse events. A majority of charts, imaging and radiotherapy plans were externally audited. RESULTS: Median follow-up was 197 days, with a median OS of 188 days and an 18% survival rate at 1 year. DRE was significantly improved with combined therapy, for an absolute benefit of +18% at 200 days from randomization (p=0.019). In longitudinal regression analyses, scores for dysphagia (p=0.00005), odynophagia (p=0.006), regurgitation (p=0.00005), chest pain (p=0.0038) and performance status (p=0.0015) were all significantly improved. In contrast, weight, toxicities and overall survival were not different between study arms. CONCLUSION: Symptom improvement occurs with the addition of EBRT to standard HDRBT. The combination is well tolerated and relatively safe.	esophagus
Past and current tendency for facial flushing after a small dose of alcohol is a marker for increased risk of upper aerodigestive tract cancer in Japanese drinkers.	(Cancer Sci 2010; 101: 2497–2498)	esophagus
Evaluation of Raman probe for oesophageal cancer diagnostics.	Early detection of (pre-)cancerous changes improves prognosis, therefore in the UK patients at high risk of developing gastrointestinal cancers are enrolled on endoscopic surveillance programmes or the Bowel Cancer Screening Programme. The current gold standard technique for the detection of pre-cancerous changes in the gastrointestinal tract is histopathological analysis of biopsy tissue collected at endoscopy. This relies upon subjective assessment of morphological changes within the excised tissue samples and poor targeting of pre-malignant lesions. Raman spectroscopy offers a number of potential advantages for in vivo assessment of tissue at endoscopy. The performance of a custom built Raman probe as a biopsy targeting tool has been evaluated using excised biopsy material. Multivariate classification models have been used to demonstrate the likely ability of a miniature, confocal, fibre optic Raman probe to be used as an optical biopsy tool at endoscopy to provide spectral information in clinically practicable timescales. This technique could facilitate improved targeting of excisional biopsy with associated clinical benefits.	esophagus
[A successful resected case of far-advanced cancer at the esophagogastric junction by chemoradiotherapy with docetaxel, nedaplatin and 5-fluorouracil].	The patient, a 73-year-old male, was admitted to our hospital because of dysphagia. A far-advanced cancer was diagnosed at the esophagogastric junction by upper gastrointestinal endoscopic examination. Pathological biopsy examinations revealed poorly-differentiated adenocarcinoma. Computed tomography (CT) of the chest and abdomen showed invasion to the diaphragm. Clinical Stage was IV in an unresectable far-advanced tumor. He received radiation therapy (40 Gy/total, 2 Gy/day×20 times) in combination with chemotherapy using docetaxel (40 mg/m², day 1), nedaplatin (10mg/body, days 1-5) and 5-fluorouracil (500 mg/body, days 1-5). After this combination chemoradiation therapy (CRT), macroscopic examinations showed significant reductions in the size of tumor, leading a partial response according to the RECIST guidelines. He underwent total gastrectomy, partial resection of the lower esophagus via left thoracotomy, and Roux-en Y reconstruction with jejunostomy. Pathological examination of the resected specimens revealed Stage IV (T3N2P1CY0). The postoperative course was uneventful. He was treated on an outpatient basis without adjuvant therapy, and died 6 months after the operation by liver, spleen and lymph node metastases.	esophagus
A case of esophageal cancer showing complete remission of nephrotic syndrome after esophagectomy.	Nephrotic syndrome associated with a malignant tumor may remit following resection of the tumor. This report documents a case of esophageal cancer with concurrent nephrotic syndrome in which a surgical resection of the tumor resulted in a complete remission of nephrotic syndrome. A 78-year-old male patient noticed edema of his lower legs in February 2009 and was diagnosed with nephrotic syndrome. An endoscopic examination revealed an indented lesion with a nearly semiannular low elevation on the posterior wall of the esophagus at 31 to 34 cm from the upper incisors, and a diagnosis of esophageal cancer was made. A two-stage operation was planned. In March 2009, a subtotal resection of the thoracic esophagus through a right thoracic approach and cervical external esophagostomy were performed, and in April 2009, antethoracic route esophagogastrostomy was performed. The urinary protein levels were negative by the 86th day of hospitalization, and the patient progressively improved and was discharged on the 91st hospital day. There has been no recurrence of esophageal cancer or relapse of nephrotic syndrome at 12 months following the operation. In esophageal cancer patients with nephrotic syndrome, surgical treatment should be undertaken because the remission of nephrotic syndrome may be expected following tumor resection. For this purpose, selecting the appropriate operative procedures and careful perioperative management, including nutritional management, are of profound importance.	esophagus
Expression profile of microRNAs in serum: a fingerprint for esophageal squamous cell carcinoma.	BACKGROUND: Sensitive and specific biomarkers for the early detection of esophageal squamous cell carcinoma (ESCC) are urgently needed to reduce the high morbidity and mortality of the disease. The discovery of serum microRNAs (miRNAs) and their unique concentration profiles in patients with various diseases makes them attractive, novel noninvasive biomarkers for tumor diagnosis. In this study, we investigated the serum miRNA profile in ESCC patients to develop a novel diagnostic ESCC biomarker. METHODS: Serum samples were taken from 290 ESCC patients and 140 age- and sex-matched controls. Solexa sequencing technology was used for an initial screen of miRNAs in serum samples from 141 patients and 40 controls. A hydrolysis probe-based stem-loop quantitative reverse-transcription PCR (RT-qPCR) assay was conducted in the training and verification phases to confirm the concentrations of selected miRNAs in serum samples from 149 patients and 100 controls. RESULTS: The Solexa sequencing results demonstrated marked upregulation of 25 serum miRNAs in ESCC patients compared with controls. RT-qPCR analysis identified a profile of 7 serum miRNAs (miR-10a, miR-22, miR-100, miR-148b, miR-223, miR-133a, and miR-127-3p) as ESCC biomarkers. The area under the ROC curve for the selected miRNAs ranged from 0.817 to 0.949, significantly higher than for carcinoembryonic antigen (0.549; P < 0.0005). More importantly, this panel of 7 miRNAs clearly distinguished stage I/II ESCC patients from controls. CONCLUSIONS: This panel of 7 serum miRNAs holds promise as a novel blood-based biomarker for the diagnosis of ESCC.	esophagus
New trends for staging and therapy for localized gastroesophageal cancer: the role of PET.	Treatment options for localized gastroesophageal cancers reach from limited resection to multimodality treatment. Accurate clinical assessment, prognostic and predictive information are needed to select the most appropriate treatment approach. Positron emission tomography (PET) in combination with computed tomography (CT) in a hybrid imaging modality PET-CT may refine the staging accuracy and add prognostic information. Moreover, experiences from diverse centers indicate that PET also might improve significantly the assessment of response to preoperative chemotherapy and chemoradiotherapy. This article outlines the current value of PET in the staging and multidisciplinary care of gastroesophageal cancer. At this stage, it remains unclear whether the prognosis of patients can be improved by implementing PET in the management of localized disease. Prospective multicenter studies have to be carried out to validate metabolic cut-off values and to prove the benefit of PET-guided treatment decisions.	esophagus
Is there any role for surgery in the multidisciplinary treatment of esophageal cancer?	Due to the poor prognosis of patients after unimodal therapy like surgical resection or radiotherapy multidisciplinary treatment is regarded as standard of care in localized esophageal cancer. Within the last decade phase III trials investigating the curative potential of radiochemotherapy alone have challenged surgery to be an indispensible part of curative therapy. Nevertheless, surgical resection does play an important role in the multidisciplinary treatment. But its role is limited to subgroups of patients with a distinct clinical situation. Today it appears that particularly patients with adenocarcinomas of the lower esophagus and esophagogastric junction and those patients with squamous cell carcinomas not responding to induction chemo- or radiochemotherapy benefit from surgery. Patient selection according to their individual operative risk is most important to guide multidisciplinary therapy. Early molecular or diagnostic markers to predict response to chemo- or radiotherapy and also recurrence despite complete surgical resection are urgently needed.	esophagus
Iron intake and markers of iron status and risk of Barrett's esophagus and esophageal adenocarcinoma.	OBJECTIVE: To investigate the association between iron intake and iron status with Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC). METHODS: A total of 220 BE patients, 224 EAC patients, and 256 frequency-matched controls completed a lifestyle and food frequency questionnaire and provided serum and toenail samples between 2002 and 2005. Using multiple logistic regression, odds ratios (OR) and 95% confidence intervals (95% CI) were calculated within quartiles of intake/status. RESULTS: Comparing the fourth to the first quartile, ferritin (OR 0.47; 95% CI: 0.23, 0.97) and transferrin saturation (OR 0.41; 95% CI: 0.20, 0.82) were negatively associated with BE; while total iron binding capacity was positively associated per 50 μg/dl increment (OR 1.47; 95% CI: 1.12, 1.92). Comparing the fourth to the first quartile, iron intake (OR 0.50; 95% CI: 0.25, 0.98), non-heme iron intake per 10 mg/day increment (OR 0.29; 95% CI: 0.08, 0.99), and toenail iron (OR 0.40; 95% CI: 0.17, 0.93) were negatively associated with EAC; while heme iron intake was positively associated (OR 3.11 95% CI: 1.46, 6.61). PRINCIPAL CONCLUSION: In contrast to the hypothesis that increased iron intakes and higher iron stores are a risk factor for BE and EAC, this study suggests that higher iron intakes and stores may have a protective association with BE and EAC, with the exception of what was found for heme iron intake.	esophagus