crossing96/oncoscreening huggingface dataset:
Esophagectomy may have a role in stage IV esophageal adenocarcinoma.	OBJECTIVE: We sought to determine whether aggressive local treatment provides a benefit in patients with stage IV esophageal adenocarcinoma and to determine factors associated with survival. METHODS: Patients with clinical stage IV esophageal adenocarcinoma at diagnosis who underwent esophagectomy from 2010 to 2023 were identified from our prospectively maintained database. Clinicopathologic and demographic characteristics were compared among patients by stage. Overall survival was estimated using the Kaplan-Meier approach. RESULTS: In total, 66 patients met the inclusion criteria. Of these, 30 (45%) had stage IVA disease, and 36 (55%) had stage IVB disease. Of the 36 patients with stage IVB disease, 26 had oligometastatic disease, and 10 had disseminated disease. All patients with stage IVA disease received standard neoadjuvant therapy followed by curative-intent surgery; 26 of these patients (87%) received chemoradiation. Patients with oligometastatic stage IVB disease underwent systemic therapy with the goal of surgical resection. Patients with disseminated stage IVB disease underwent palliative chemotherapy, which led to improvement in disease burden and performance of esophagectomy. Median time from the start of therapy to surgery was shorter for patients with stage IVA disease than patients with stage IVB disease (P < .001). Three-year progression-free survival was lower for patients with stage IVA disease (40% vs 56%), as was 3-year overall survival (57% vs 85%). Adjusted overall survival, from the start of therapy to most recent follow-up, was higher for patients with stage IVB disease. CONCLUSIONS: Aggressive local treatment may provide a benefit for highly selected patients with advanced or metastatic esophageal adenocarcinoma.	esophagus
The Impact of Economic Status on Cause-Specific Survival in Patients with Esophageal Adenocarcinoma in the United States: A Retrospective Analysis.	OBJECTIVE: This study aims to evaluate the impact of economic status on the cause-specific survival (CSS) of patients with esophageal adenocarcinoma (EAC). METHODS: Using propensity score matching (PSM), we analyzed data from 4676 patients with EAC, categorized into low household income (LHI) and high household income (HHI), sourced from the Surveillance, Epidemiology, and End Results database. Significant pre-PSM differences in age, gender, race, and tumor stage (T stage) were observed, necessitating PSM adjustment. The PSM incorporated these variables along with radiotherapy to balance the groups effectively. Kaplan-Meier curves and accelerated failure time (AFT) and random survival forest (RSF) models were used to assess the prognostic impacts. RESULTS: According to the pre-PSM data, a significant difference in CSS was observed between the LHI and HHI groups (median CSS = 1.25 years vs 1.50 years, P < .05). Post-PSM analysis maintained the result (P < .05). Using the AFT model, HHI was found to significantly enhance CSS (pre-PSM time ratio [TR] = 1.145, post-PSM TR = 1.146). Male gender (pre-PSM TR = 0.762, post-PSM TR = 0.819) and certain non-single marital statuses (such as divorced, pre- and post-TRs <1.000) are also prognostic risk factors for EAC (P values <.05). Additional significant prognostic risk factors for EAC included advanced American Joint Committee on Cancer stages (III and IV), higher tumor stages (T3 and T4), higher node stages (N1-N3), without surgery, and without chemotherapy, as identified using the AFT and/or RSF mothods. The results derived from the RSF model are consistent with those of the AFT model. CONCLUSION: Higher economic status is positively related to EAC CSS. Beyond standard clinical treatments, interventions such as enhancing socioeconomic support and preventive aspects, including intensive health education and EAC screening, could play a crucial role in improving EAC prognosis.	esophagus
Omission of lymph node dissection along the recurrent laryngeal nerve for lower thoracic esophageal squamous cell carcinoma with short esophageal invasion.	BACKGROUND: Esophagectomy with lymphadenectomy is the primary treatment for esophageal squamous cell carcinoma (ESCC). However, intensive dissection of lymph nodes (LNs) along the recurrent laryngeal nerve (RLN) is associated with RLN palsy and pulmonary complications leading to poor survival. Therefore, this study aimed identify the risk factors for LNs metastasis along the RLN in patients with ESCC. METHODS: The present study included 168 patients with lower thoracic esophageal and esophagogastric junction (EGJ) squamous cell carcinoma who underwent esophagectomy with total mediastinal lymphadenectomy at Kobe University Hospital. Left/Right cervical paraesophageal (101 L/R), left/right recurrent nerve (106 recL/R), and left tracheobronchial LNs (106 tbL) were defined as LNs along the RLN. We evaluated the pathological distance between the proximal tumor boundary and the EGJ using images of the fixed specimen (PB-EGJ length). RESULTS: LN metastasis along the RLN was observed in 19 (11%) patients. The percentage of patients with a longer PB-EGJ length and cLNs metastasis was higher in the LNs metastasis along the RLN positive-group than in the RLN-negative group (p = 0.0075 and p = 0.013, respectively). The incidence of LNs metastasis along the RLN was 0% (95% confidence interval [CI] = 0-7.7%) when the PB-EGJ length was <4 cm. Univariate analysis showed that patients with cLNs metastasis negative had a low risk for LNs metastasis along the RLN (odds ratio = 0.26 and 95% CI = 0.083-0.82). CONCLUSIONS: Patients with a PB-EGJ length <4 cm and negative for cLNs metastasis may be candidates for the omission of lymphadenectomy along the RLN.	esophagus
Efficacy and safety of Nivolumab in advanced gastric and gastroesophageal junction cancer: a meta-analysis of randomized controlled trials.	BACKGROUND: *CoNivolumab, an immune checkpoint inhibitor, has shown promise in treating advanced unresectable gastric and gastroesophageal junction cancer. This meta-analysis aims to evaluate the efficacy and safety of Nivolumab, alone and in combination with chemotherapy, in this patient population. METHODS: A systematic review and meta-analysis were conducted according to PRISMA guidelines, using data from PubMed, Embase, CENTRAL, Web of Science, and CNKI up to June 3, 2024. Eight randomized controlled trials (RCTs) involving 3729 patients were included. The primary outcomes were overall survival (OS) and progression-free survival (PFS), while safety was assessed through adverse events (AEs) and grade ≥ 3 AEs. Effect sizes were measured using mean differences (MD) and relative risks (RR), with 95% confidence intervals (CIs). RESULTS: Nivolumab significantly extended OS (MD = 2.29, 95% CI: 1.48, 3.09) and PFS (MD = 0.69, 95% CI: 0.32, 1.06) compared to controls. Subgroup analysis showed that both Nivolumab monotherapy (OS: MD = 2.52, 95% CI: 0.81, 4.23; PFS: MD = 0.16, 95% CI: 0.11, 0.22) and Nivolumab combined with chemotherapy (OS: MD = 2.06, 95% CI: 0.56, 3.57; PFS: MD = 1.53, 95% CI: 0.32, 1.06) improved OS and PFS. While the overall risk of AEs was not significantly increased, Nivolumab monotherapy significantly increased the risk of AEs (RR = 1.47, 95% CI: 1.16, 1.87), whereas Nivolumab combined with chemotherapy did not (RR = 1.03, 95% CI: 0.97, 1.09). Both treatments increased the risk of grade ≥ 3 AEs (RR = 1.24, 95% CI: 1.12, 1.36). CONCLUSION: Nivolumab, both alone and in combination with chemotherapy, improves OS and PFS in patients with advanced gastric and gastroesophageal junction cancer. However, careful patient monitoring is necessary due to the increased risk of severe AEs, particularly with monotherapy.	esophagus
Targeting TSPEAR-AS2 suppresses tumor growth and interferon signaling in esophageal cancer.	Dysregulation of long non-coding RNAs (lncRNAs) and interferon signaling contributes to tumorigenesis and progression; however, their crosstalk in tumor biology remains poorly understood. Here, we showed that TSPEAR-AS2, an lncRNA mediated by METTL1, activates the interferon signaling pathway in esophageal cancer (ESCA). Clinically, we conducted a pan-cancer investigation and identified TSPEAR-AS2 as a novel ESCA-related lncRNA that predicts a worse patient prognosis. The high expression of TSPEAR-AS2 was validated in multiple ESCA cohorts, demonstrating that this lncRNA had good diagnostic performance. METTL1, an RNA N7-methylguanosine (m7G) methyltransferase, was positively correlated with TSPEAR-AS2 expression in ESCA tissues, and METTL1 was found to induce TSPEAR-AS2 expression in ESCA cells. Functionally, the up-regulation of TSPEAR-AS2 promoted proliferation, cell cycle progression, migration, and stemness in ESCA cells, whereas its knockdown attenuated these malignant phenotypes. Furthermore, both TSPEAR-AS2 deficiency and antisense oligonucleotide (ASO)-based intratumoral intervention could significantly suppress tumor growth in vivo. Mechanistically, quantitative proteomic analysis revealed that TSPEAR-AS2 ablation altered the expression of functional proteins related to interferon signaling pathways, such as HLA-E, IRF3, and IFITs. These findings identify a previously unrecognized role of the METTL1/TSPEAR-AS2/interferon signaling axis in ESCA development and suggest that TSPEAR-AS2 is a potential prognostic indicator and therapeutic vulnerability for this malignancy.	esophagus
Esophageal melanosis: Two case reports and review of literature.	BACKGROUND: Esophageal melanosis (EM) is a rare condition characterized by melanin pigmentation in the esophageal mucosa. It is not well understood and has been documented in less than 100 cases worldwide. CASE SUMMARY: We report two cases of African American patients who complained of significant weight loss (over 20 pounds in approximately six months) and abdominal pain during their first visit. The first case involves a 54-year female with a history of hepatic steatosis and polysubstance abuse, who also experiences nausea and vomiting. The second case is a 59-year-old male with hypertension and gastroesophageal reflux disease (GERD), who was diagnosed with esophageal squamous cell carcinoma. Both cases show benign melanocytes in the basal layer on the esophagus biopsy and are diagnosed as EM. CONCLUSION: It is important to note that EM has been associated with malignancies such as carcinoma and melanoma. Therefore, accurate diagnosis and appropriate management are crucial. Patients with EM, especially those with concurrent risk factors (e.g., GERD, smoking), should be carefully monitored for any signs of malignancy.	esophagus
Optimizing neoadjuvant radiotherapy for locally advanced esophageal squamous cell carcinoma: a comprehensive review on the role of concomitant or sequential immune checkpoint inhibitors.	Esophageal squamous cell carcinoma (ESCC) is a prevalent form of esophageal cancer with a poor prognosis despite advances in treatment. Combining immune checkpoint inhibitors (ICIs) with radiotherapy (RT) or chemoradiotherapy (CRT) has shown potential in enhancing treatment efficacy. We conducted a comprehensive review of clinical trials published between 2019 and 2024, sourced from PubMed, Scopus, and Embase databases. Studies included were prospective phase II trials that evaluated the combination of ICIs with neoadjuvant chemoradiotherapy (nCRT) in resectable locally advanced ESCC. Ten trials met the inclusion criteria. The review highlights various approaches in combining ICIs with CRT, including concurrent, induction, and consolidation therapy. Among the included trials, a significant proportion focused on concurrently administering ICIs with CRT, showing promising outcomes with high pathological complete response rates (pCR) and manageable toxicities. However, further research is needed to validate the efficacy of induction and consolidation therapies and determine optimal treatment protocols. The combination of ICIs and nCRT can potentially improve treatment responses and outcomes for patients with locally advanced ESCC. Despite recent encouraging findings, most trials were single-arm with small sample sizes, indicating the need for larger studies with longer follow-ups to assess survival outcomes comprehensively.	esophagus
Study on the mechanism of hyperoside in affecting the biological progression and radiosensitivity of esophageal carcinoma by modulating the STAT3/AKT/ERK pathway.	Hyperoside (HYP) exhibits diverse pharmacological effects and holds potential for enhancing chemotherapy sensitivity. However, few studies have reported the impact of HYP on the malignant progression of esophageal carcinoma (EC) and its sensitivity to radiotherapy. The impact of HYP on the viability of EC cells (TE-1 and KYSE-150) was assessed using Cell Counting Kit-8 (CCK-8) assays. The biological characteristics and radiosensitivity of EC cells following HYP treatment were evaluated through clone formation experiments, flow cytometry, scratch wound-healing assays, and transwell migration and invasion assays. Western blot analysis was performed to determine the levels of proteins associated with cell death and epithelial-mesenchymal transition (EMT), as well as to explore whether HYP interferes with the radiosensitivity of EC cells via the  STAT3/AKT/ERK pathways. Finally, a subcutaneous graft tumor model was constructed to investigate the effects of HYP and X-ray treatments on in vivo tumor growth. The findings indicated a dose-dependent decrease in the survival rate of KYSE-150 and TE-1 cells following HYP treatment. HYP treatment also inhibited cell proliferation, invasion, migration, and EMT, while increasing the apoptotic rate and radiosensitivity of the cells. Notably, HYP suppressed the malignant progression of EC and enhanced radiosensitivity via the STAT3/AKT/ERK pathway. Moreover, HYP impaired the growth of EC tumors in mice, with the combined HYP and X-ray treatment exerting a stronger inhibitory effect. In conclusion, HYP increases the radiosensitivity of esophageal carcinoma cells, offering considerable promise for application in the clinical treatment of EC.	esophagus
Prospective multicenter study of camrelizumab in real-world settings for asian patients with esophageal squamous cell carcinoma.	BACKGROUND: In this study, we aimed to evaluate the real-world efficacy and safety of camrelizumab and identify clinicolaboratory factors that predict treatment outcomes in patients with unresectable advanced, recurrent, or metastatic esophageal squamous cell carcinoma (ESCC) receiving camrelizumab. METHODS: Herein, 174 patients with unresectable advanced, recurrent, or metastatic ESCC treated with camrelizumab monotherapy (n = 30), camrelizumab + chemotherapy (CT; n = 91), and camrelizumab + radiotherapy (RT; n = 53) between October 1, 2019 and October 1, 2022 were included. RESULTS: The median follow-up time was 20 months (range, 1-34 months). The median progression-free survival (PFS) and overall survival (OS) of the whole cohort were 8 months [95% confidence interval (CI), 6.5-9.5 months] and 14 months (95% CI, 11.2-16.8 months), respectively. After multivariate analysis, receiving > 4 cycles of camrelizumab was identified as an independent predictor of better PFS [hazard ratio (HR), 0.56; 95% CI, 0.38-0.827; P = 0.004] and OS (HR, 0.532; 95% CI, 0.341-0.83; P = 0.005). An intermediate-to-poor lung immune prognostic index (LIPI) was identified as an independent predictor of worse PFS (HR, 1.505; 95% CI, 1.032-2.196; P = 0.034) and OS (HR, 1.657; 95% CI, 1.094-2.51; P = 0.017). The disease control rate of patients in the camrelizumab monotherapy group, camrelizumab + CT group, and camrelizumab + RT group was 92.3% (95% CI, 74.9-99.1%), 90.6% (95% CI, 82.3-95.9%), and 96.1% (95% CI, 86.8-99.5%), respectively. The treatment-related adverse events (AEs) of grade 3 or higher were reported in 67 patients (38.5%). The most common treatment-related AEs were decreased neutrophil count (23.0%), decreased white blood cell count (19.5%), anemia (7.5%), and pneumonitis (4.6%). One patient (0.6%) died from a treatment-related AE of immune checkpoint inhibitor-induced myocarditis. CONCLUSION: Camrelizumab was safe and effective as both monotherapy and part of a combination therapy. Longer PFS and OS were associated with receiving > 4 cycles of camrelizumab and having a good LIPI. LIPI can be used as a prognostic biomarker for ESCC patients receiving camrelizumab + RT. TRIAL REGISTRATION: ClinicalTrial.gov Identifier: CHICTR2000039499. Registered: 19th October 2020.	esophagus
Multimodality Therapy and Survival Outcomes in Resectable Primary Small Cell Carcinoma of the Esophagus: A Multicenter Retrospective Study.	BACKGROUND: Currently, optimal treatment strategy for resectable primary small cell carcinoma of the esophagus (PSmCCE) remains controversial. To address this, we conducted a multicenter study to evaluate treatment patterns and long-term survival of PSmCCE patients who underwent radical resection. METHODS: This retrospective multicenter study included resected PSmCCE patients who received radical resection at seven high-volume cancer centers. Overall survival (OS) and median survival time (MST) were calculated by using a Kaplan-Meier method and the log-rank test was utilized to assess differences. Multivariable Cox analysis was performed to identify independent prognostic factors. RESULTS: A total of 352 patients with resected PSmCCE were included. For PSmCCE with stage cT1-2N0M0, patients who received surgery plus adjuvant therapy showed better survival than those who received surgery alone (5-year OS rate: 32.8% vs. 19.2%, MST: 44.0 vs. 33.0 months, P = 0.035). Multivariable Cox survival analysis revealed an independent correlation between receiving surgery plus adjuvant therapy and improved OS (hazard ratio [HR] 0.529; 95% confidence interval [CI] 0.280-0.997; P = 0.049). For stage cT3N0M0/T1-3N1M0 PSmCCE, patients who received neoadjuvant therapy followed by surgery had superior long-term survival compared with those who received surgery combined with adjuvant therapy and those who received surgery alone (5-year OS rate: 27.2% vs. 9.5% vs. 0%, MST: 36.0 vs. 24.0 vs. 20.0 months, P = 0.014). Multivariable Cox survival analysis showed that neoadjuvant therapy was independently associated with improved OS (HR 0.384, 95% CI 0.203-0.728; HR 0.550, 95% CI 0.312-0.968; P = 0.013). CONCLUSIONS: Adjuvant therapy was associated with improved survival in stage cT1-2N0M0 PSmCCE, but this should be confirmed in prospective studies. For stage cT3N0M0/T1-3N1M0 cases, neoadjuvant therapy followed by surgery should be considered.	esophagus
Synthesis, characterisation, and anti-tumour activity of nano-immuno-conjugates for enhanced photodynamic therapy of oesophageal cancer stem cells.	In recent times, oesophageal cancer has been listed as the eleventh most prevalent type of cancer. It is a lethal disease attributed to a high mortality rate, tumour metastasis and poor treatment outcome. A subset of oesophageal cancer referred to as stem cells (CSCs) has been revealed to drive carcinogenesis, metastasis, and treatment failure. Therefore, it is essential to target these CSCs to improve the efficacy of treatment for oesophageal cancer. In this present study, we employed a strategy to target oesophageal CSCs with a nano-immuno-conjugate (NIC) consisting of AlPcS(4)Cl, gold nanoparticle (AuNPs) and anti-CD271 antibody synthesised using a chemical reaction. The synthesised NIC was characterised using ultraviolet-visible spectroscopy, transmission electron microscope (TEM), Fourier transform infra-red (FTIR) spectroscopy, dynamic light scattering (DLS), and zeta potential (ZP). The in vitro anti-tumour action of NIC-mediated photodynamic therapy (PDT) was performed on oesophageal CSCs using cell viability/cytotoxicity assays and morphological examination via light microscopy. The characterisation analysis confirmed the successful synthesis of the NIC. The synthesised nano-immuno-conjugates showed significant cytotoxicity and reduction in cell viability in the HKESC-1 oesophageal CSCs. Fluorescence microscopy confirmed the rapid internalisation of the targeted NIC in key cellular organelles of the CSCs, resulting in enhanced effects. Interestingly, NIC exhibited cytocompatibility with non-tumour WS1 cells, thus supporting its clinical application as a safe anti-tumour agent for enhanced PDT. The study demonstrates the improved effects of NIC-mediated PDT as targeted therapeutics against oesophageal CSCs.	esophagus
Risk factors for readmission following esophagectomy and gastrectomy for cancer.	INTRODUCTION: Hospital readmission after surgery is a key quality indicator. This nationwide cohort study aimed to assess readmission rates following esophagectomy and gastrectomy for cancer and identify associated risk factors. METHODS: Data were extracted from the Dutch Upper GI Cancer Audit (DUCA) for patients with esophagogastric cancer who underwent esophagectomy or gastrectomy with curative intent between January 2011 and June 2016. Logistic regression analysis identified risk factors for 30-day readmission. RESULTS: In total, 5566 patients were included. Readmission within 30 days occurred in 483 of 3488 (13.8%) patients after esophagectomy and 243 of 2078 patients (11.7%) after gastrectomy. Both minor (Clavien Dindo 1-2) and major (Clavien Dindo ≥3) postoperative complications were independent predictors of readmission after esophagectomy (OR 2.99; 95%CI 2.23-4.02; p < 0.001 and OR 5.20; 95%CI 3.82-7.09; p < 0.001). Specific complications included pulmonary (OR 1.49; 95%CI 1.20-1.85; p < 0.001), gastrointestinal (OR 2.43; 95%CI 1.94-3.05; p < 0.001), and infectious (OR 2.27; 95%CI 1.60-3.22; p < 0.001). Prolonged length of stay (pLOS) was associated with higher readmission rates in patients without complications following esophagectomy (OR 1.91 95% CI 1.19-3.07; p = 0.008), but lower rates in those with complications (OR 0.65 95% CI 0.51-0.83; p < 0.001). For gastrectomy, postoperative complications were also linked to readmission (OR 3.18; 95%CI 2.30-4.40; p < 0.001), particularly gastrointestinal (OR 2.16; 95%CI 1.40-3.32; p < 0.001), and infectious (OR 3.80; 95%CI 2.53-5.71; p < 0.001). CONCLUSION: Readmission after esophagogastric resection is common, particularly among patients with both minor and major postoperative complications. Prolonged stay after esophagectomy impacts readmission risk differently based on the presence of complications.	esophagus
Oesophageal cancer.	Oesophageal cancer is the seventh leading cause of cancer mortality worldwide. Two major pathological subtypes exist: oesophageal squamous cell carcinoma and oesophageal adenocarcinoma. Epidemiological studies in the last decade have shown a gradual increase in the incidence of oesophageal adenocarcinoma worldwide. The prognosis of oesophageal cancer has greatly improved due to breakthroughs in screening, surgical procedures, and novel treatment modalities. The success achieved with combined modality therapies, including surgery, chemotherapy, and radiotherapy, to treat locally advanced oesophageal cancer is particularly notable. Immunotherapy has become a crucial treatment for oesophageal cancer, with immune checkpoint inhibitor-based therapies now established as the standard of care in adjuvant and metastatic first-line settings. This Seminar provides an overview of advances in the screening, diagnosis, and treatment of oesophageal squamous cell carcinoma and oesophageal adenocarcinoma, with a particular focus on neoadjuvant therapies for locally advanced oesophageal cancer and immune checkpoint inhibitor-based therapies.	esophagus