crossing96/oncoscreening huggingface dataset:
Impact of preoperative diastolic dysfunction on short-term outcomes following robotic-assisted minimally invasive esophagectomy (RAMIE).	Diastolic dysfunction is a common echocardiographic finding in patients undergoing major surgery and has been associated with adverse perioperative outcomes, particularly in high-risk procedures. However, its prognostic relevance in robotic-assisted minimally invasive esophagectomy (RAMIE) remains unclear. This study investigates the impact of preoperative diastolic dysfunction on short-term postoperative outcomes and intensive care unit (ICU) course in patients undergoing RAMIE. A retrospective, monocentric cohort of 256 adult patients, who underwent robotic-assisted Ivor-Lewis esophagectomy for esophageal carcinoma at the Medical Faculty of the University of Cologne and University Hospital of Cologne (2019-2024), was screened. Of these, 181 cases with available preoperative transthoracic echocardiography (TTE) data were included in this study. Included patients were stratified based on the presence and grade of diastolic dysfunction in preoperative echocardiography. Postoperative outcomes including new-onset atrial fibrillation (POAF), pulmonary complications, anastomotic leakage, length of ICU stay, and mortality, were analyzed using χ2 and Kruskal-Wallis tests, with *p < 0.05 considered significant. 181 of 256 screened patients could be included in our study. Preoperative diastolic dysfunction was identified in 67 of 181 screened patients: 63 patients with grade I and 4 patients with grade II diastolic dysfunction. Patients with diastolic dysfunction were more likely to present with coronary artery disease (13 vs. 7, 19 vs. 6%; p = 0.01), diabetes mellitus (16 vs. 10, 24 vs. 9%; p = 0.01), and hypertension (37 vs. 43, 55 vs. 38%; p = 0.02) compared to those without. However, no differences were observed in postoperative outcomes, including postoperative atrial fibrillation (21 vs. 18%; p > 0.05), pulmonary complications (22% in both groups; χ(2) = 0.045; p > 0.05), anastomotic leakage (16 vs. 18%; χ(2) = 0.048, p > 0.05), ICU stay (median 2 days for both groups), or in-hospital mortality (4 vs. 2%; p > 0.05). The severity of complications, as classified by the Clavien-Dindo system, was also not associated with diastolic dysfunction (Pearson chi-square: χ(2) = 1.094; p > 0.05). Mild diastolic dysfunction (predominantly grade I) was not associated with worse short-term outcomes in patients undergoing RAMIE. Despite a higher burden of cardiovascular comorbidities, ICU stay, postoperative complication rates, and mortality were comparable to patients with normal diastolic function. These findings suggest that mild diastolic dysfunction should not be considered a contraindication for RAMIE and highlight the need for refined risk stratification tools integrating echocardiographic and clinical parameter.	esophagus
Clinical Evaluation of Immune Cell Therapy in Esophageal Cancer Resistant to Immunochemotherapy.	BACKGROUND/AIM: Immune checkpoint inhibitors (ICIs) have improved cancer therapy outcomes, but effective treatments for ICI-refractory patients remain limited. Our group has investigated αβT cell therapy, which is adoptive immunotherapy, to enhance ICI efficacy. A safety evaluation study conducted in 2017 (UMIN: 000028756) confirmed that αβT cell therapy combined with low-dose ICIs can be administered safely without immune-related adverse events (irAEs). Encouraged by these findings, we launched a clinical trial (jRCTc031190098~031190101) to assess its efficacy. Additionally, a case of renal pelvis cancer achieved complete remission after αβT cell therapy following ICI failure. Given reports showing prolonged PD-1 occupancy post-ICI administration, we hypothesized a similar synergistic effect in ICI-refractory cases. CASE REPORT: Esophageal cancer in a 64-year-old woman progressed despite chemoradiation, chemotherapy, and nivolumab, metastasizing to the lymph nodes, lung, and liver. After standard treatment completion, she was referred to our hospital. She developed uveitis as an irAE, which was controlled with steroid drops. In February 2024, three months after nivolumab therapy, αβT cell therapy was initiated (six biweekly doses). No irAEs occurred, and computed tomography (CT) scans showed slight liver metastasis reduction. Flow cytometry revealed increased CD3(+) and αβT cells, suggesting an enhanced immune response. The MUSCAT assay revealed increased levels of autoantibodies against DDX53, a tumor-associated antigen. CONCLUSION: αβT cell therapy may enhance the immune response even in ICI-refractory cases. Its safety and potential efficacy warrant further investigation, and a clinical trial (jRCTc030220287) is ongoing to evaluate its role in ICI-refractory cancer.	esophagus
Identifying compassionate oesophago-gastric cancer service care: a qualitative exploratory study of patient experiences and expectations in England.	OBJECTIVES: Oesophago-gastric cancer is one of the most common causes of cancer death worldwide. Care pathways are highly variable and complex to organise;however,there is limited evidence from a service user perspective to inform service design for best experience of care. This study explored the experiences of people living with incurable oesophago-gastric cancer to determine how services can be delivered to best support their needs. DESIGN: Based on interpretivism, this qualitative study used single, face-to-facesemistructured interviews. Interviews were audiorecorded and transcribed verbatim by a professional transcription serviceandinterrogated throughframework analysis. SETTING AND PARTICIPANTS: The study was based in a large UKNational Health ServiceTrust and designated regional specialist cancer centre. A total of27 patientsliving with incurable oesophago-gastric cancer took part in the study. RESULTS: The analysis revealed a central theme of'integrated relationship-centred care'and three subthemes: compassionate care interactions, integrated processes and systems and compassionate care environments. Positive experiences were marked by high-quality relationships with healthcare professionals, further strengthened by care process and environments that responded to their individual symptoms and healthcare needs, effectively spanning multiple agencies and professions. CONCLUSIONS: High quality services require enhanced clinical awareness and integrated service design to address a range of physical and psychosocial challenges which are often overlooked in thispatientpopulation. These essential components of positive care experiences must be driven at policy level to ensure a pathway approach to quality relationship-centred care, which crucially is not interrupted aspatientsmove across organisations and systems.	esophagus
Prognostic Indicators of Preoperative Fluorouracil, Leucovorin, Oxaliplatin, and Docetaxel Efficacy in Locally Advanced Gastroesophageal and Gastric Cancer: Integrating Biomarker Analysis and Clinicopathological Factors.	PURPOSE: Perioperative fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) is a standard treatment for locally advanced gastric/gastroesophageal junction cancer (GC/GEJC). The impact of biomarker status on the efficacy of perioperative FLOT remains unclear. This study evaluated the association between clinicopathological features, including biomarker status, and the efficacy of perioperative FLOT in patients with resectable GC/GEJC. PATIENTS AND METHODS: A retrospective observational study was conducted by reviewing medical records of patients treated with perioperative FLOT between February 2020 and March 2024. Eligible patients had histologically confirmed adenocarcinoma, resectable disease at stages cT2-4a and/or N0-3, M0, and underwent biomarker testing. RESULTS: Among 116 eligible patients, human epidermal growth factor receptor 2 (HER2) positivity was observed in 7.8%, whereas PD-L1 combined positive score (CPS) of ≥1, ≥5, and ≥10 was detected in 90.5%, 44.0%, and 15.5% of patients, respectively. Claudin-18 isoform 2 (CLDN18.2) positivity (2+/3+ in ≥75% of tumor cells) was observed in 30.2% of patients. Major pathological response (MPR) and pathological complete response (pCR) rates were 22.4% (95% CI, 15.3 to 31.0) and 8.6% (95% CI, 4.2 to 15.3), respectively. Diffuse-type histology was a negative indicator for pathological response. CLDN18.2 expression decreased significantly after preoperative FLOT, with the median H-score declining from 285.0 to 187.5 (P < .001) in patients with CLDN18.2 positivity at initiation. Maintained CLDN18.2 positivity was more frequently observed in patients without MPR compared with those with MPR (53.8% v 12.5%, P = .05). CONCLUSION: HER2, PD-L1, and CLDN18.2 statuses were not linked to pathological response to FLOT in resectable GC/GEJC. CLDN18.2 expression significantly decreased after preoperative FLOT but remained higher in patients without MPR, suggesting that CLDN18.2-targeted therapy may warrant investigation in the perioperative setting.	esophagus
Predicting pathological response of resectable esophageal squamous cell carcinoma to neoadjuvant anti-PD-1 with chemotherapy using serum inflammation indexes.	BACKGROUND: Inflammatory indexes are increasingly being considered to predict treatment response in tumors. This study aimed to investigate the efficacy of serum inflammatory indexes in predicting pathological response in patients with esophageal squamous cell carcinoma (ESCC) receiving anti-PD-1 neoadjuvant immunochemotherapy (NICT). METHODS: We retrospectively collected clinical and laboratory data from 116 ESCC patients who received NICT. We set three outcome variables: pathologic complete response (PCR), good response (GR), and response (R). We assessed between-group differences in inflammation indexes and their diagnostic efficacy. Independent diagnostic markers were filtered using least absolute shrinkage and selection operator (LASSO) logistic regression and multivariable analysis, and the corresponding nomograms for PCR and GR were constructed, respectively. Receiver operating characteristic curves (ROC) and calibration curves assessed the efficiency and accuracy of the models. Decision curve analysis (DCA) and clinical impact curves (CIC) evaluated the clinical value. Moreover, we internally validated the predictive model with a random sample of 30% of patients. RESULTS: The prognostic nutritional index (PNI) predicted a cutoff value of 53.585 for PCR with an area under curve (AUC) value of 0.720, a cutoff value of 47.85 for GR with an AUC of 0.723, a cutoff value of 47.85 for R with an AUC of 0.629. Smoking and PNI were independent predictors of PCR, platelet-to-lymphocyte ratio (PLR) and PNI were independent predictors of GR, and PNI was an independent predictor of R. We built PNI-based nomograms to predict PCR and GR with AUC values of 0.795 and 0.763 for the training cohort and 0.907 and 0.757 for the validation cohort, respectively. The predicted and actual results of the calibration curves for both the training and validation groups showed good agreement, with Brier scores below 0.25. CONCLUSION: High PNI value is a shared independent predictor of achieving PCR, GR, and R in ESCC patients receiving anti-PD1 NICT. PNI-based diagnostic models can be used as a practical tool to identify ideal patients for personalized clinical decisions.	esophagus
Identifying risk factors and evaluating therapeutic interventions for anastomotic recurrence in postoperative esophageal squamous cell carcinoma.	PURPOSE: This investigation delineates the differential impact of recurrence patterns-specifically, anastomotic recurrence (AR) and lymph node recurrence (LNR)-on the survival outcomes of patients with esophageal squamous cell carcinoma (ESCC). Additionally, it assesses the therapeutic efficacy of adjuvant radiotherapy in modifying these postoperative recurrence dynamics to inform optimized clinical management. METHODS AND MATERIALS: A retrospective cohort analysis was conducted on 434 patients who developed recurrent ESCC following radical surgery at Shandong Cancer Hospital, from July 2018 through December 2022. Comprehensive clinical data were analyzed using logistic and Cox proportional hazards regression models to elucidate the risk factors associated with AR and LNR. RESULTS: Of the patients analyzed, 118 exhibited AR post-surgery. Multivariate logistic regression identified advanced N stage and the presence of LNR as predominant risk factors influencing recurrence. Survival analysis, employing Kaplan-Meier estimates, demonstrated a median survival time (MST) of 21 months (range: 1.6-146.1 months) for patients with AR. In patients experiencing LNR, Cox regression analyses revealed tumor location and the application of adjuvant radiotherapy as critical determinants of survival outcomes. Significantly, adjuvant radiotherapy markedly reduced the incidence of LNR, thereby attenuating overall recurrence rates. CONCLUSIONS: Postoperative recurrence significantly compromises survival in ESCC, underscoring the critical need for precise risk stratification and proactive management. This study substantiates the prognostic significance of adjuvant radiotherapy in reducing recurrence, providing pivotal insights for tailoring treatment protocols to enhance patient prognoses in ESCC.	esophagus
Patterns of toxic side effects and prognostic factors in concurrent chemoradiotherapy for esophageal cancer.	Esophageal cancer is a leading cause of cancer-related mortality globally, characterized by poor prognosis and high recurrence rates. This study aimed to systematically evaluate the causes of death and treatment-related toxicities in esophageal cancer patients undergoing concurrent chemoradiotherapy (CCRT), to identify key prognostic factors. Clinical data from 79 patients were analyzed retrospectively, assessing survival outcomes, toxic side effects, and primary causes of death. Results revealed that local control failure and recurrence were the predominant causes of mortality, followed by distant metastasis and lymph node involvement. The overall survival rates at 1, 2, 3, and 4 years were 82.3%, 50.9%, 42.3%, and 40.0%, respectively, with a median survival time of 13 months. Radiation esophagitis and nausea/vomiting were the most common toxicities, though the majority of cases were mild. Tumor length and clinical stage were identified as significant independent prognostic factors, with shorter tumors and early-stage disease correlating with better survival. These findings emphasize the importance of early diagnosis, precise local control, and effective toxicity management in improving patient outcomes. This study provides critical insights into optimizing CCRT strategies, offering practical guidance for enhancing survival and quality of life in esophageal cancer patients.	esophagus
Association of anthropometric indicators with oesophageal squamous carcinoma and precancerous lesions in people aged 40-69 years from high-risk setting in China: a population-based study.	OBJECTIVES: This study aimed to explore the relationship between multiple anthropometric indicators (AIs), oesophageal squamous cell carcinoma (ESCC) and precancerous lesions. DESIGN: Cross-sectional study. PARTICIPANTS: A total of 10 115 participants aged 40-69 years, recruited between 2017 and 2022 from Yangzhong City, Jiangsu Province, Southeast China, were included in the analysis. MAIN OUTCOME MEASURES: The association of 11 AIs with ESCC and precancerous lesions was analysed using multivariate logistic regression and restricted cubic splines (RCS). RESULTS: The prevalence of ESCC and precancerous lesions was 4.52%. Multivariate logistic regression analyses revealed that AIs were not significantly associated with ESCC or precancerous lesions in the total population (all p>0.05). Among men, only the fourth quartile (Q4) level of A Body Shape Index (ABSI) was protective against ESCC and precancerous lesions compared with the first quartile (Q1) (OR = 0.648, 95% CI = 0.440 to 0.955). Among women, the Q4 level of waist circumference (OR=1.612, 95% CI=1.066 to 2.438), third quartile (Q3) level of waist-to-hip ratio (WHR) (OR=1.890, 95% CI=1.252 to 2.854), Q4 level of Conicity Index (CI) (OR=1.869, 95% CI=1.227 to 2.848), and Q3 (OR=1.993, 95% CI=1.266 to 3.136) and Q4 (OR=2.137, 95% CI=1.380 to 3.310) ABSI levels were associated with an increased risk of ESCC and precancerous lesions compared with Q1 (all p<0.05). The risk of ESCC and precancerous lesions increased by 28.5% (OR=1.285, 95% CI=1.117 to 1.480) and 30.6% (OR=1.306, 95% CI=1.139 to 1.496), respectively, for each SD increase in the CI and ABSI among women (all p<0.05). RCS analyses demonstrated a non-linear association between Body Mass Index (BMI) in men and WHR in women with ESCC and precancerous lesions (all p for overall/non-linear <0.05). There was a positive linear association between CI and ABSI for ESCC and precancerous lesions in women (all p for overall <0.05; p for non-linear >0.05). CONCLUSIONS: Abdominal obesity and moderately overweight in men appeared to reduce the risk of ESCC and precancerous lesions. However, increasing levels of abdominal obesity in women are associated with a higher risk of ESCC and precancerous lesions. The heterogeneity in the role of adiposity, especially abdominal obesity, on ESCC and precancerous lesions between genders emphasises the importance of maintaining an appropriate body weight.	esophagus
Organ-Sparing Approach after Neoadjuvant Treatment in Oesophageal Cancer.	<p>Background: Neoadjuvant chemoradiotherapy (nCRT) or perioperative chemotherapy followed by surgical resection is the standard of care for oesophageal and gastroesophageal junction cancer. Up to a third of patients will have a pathological complete response to neoadjuvant treatment. Given the significant morbidity associated with surgery, active surveillance is considered as a potential alternative for patients with clinical complete response post-nCRT. Summary: The preSANO and preSINO trials have validated a multimodal diagnostic strategy combining oesophagogastroduodenoscopy with bite-on-bite biopsies, endoscopic ultrasonography with fine-needle aspiration of suspicious lymph nodes, and PET-CT to detect residual disease. The SANO trial is assessing whether active surveillance leads to non-inferior overall survival compared to planned surgery. Early results of randomized studies support previous retrospective reports of comparable oncological outcomes, with improved quality of life in the surveillance group. Despite concerns of increased morbidity of postponed surgery upon recurrence, recent data indicate comparable surgical outcomes of delayed oesophagectomy. Ongoing trials, including SANO-2, CELEAC, and NEEDS, aim to rationalize surveillance protocols, while SANO-3 is investigating the role of adding immunotherapy in improving response durability. Key Messages: Active surveillance represents a promising alternative to surgery for oesophageal cancer patients achieving complete clinical response after neoadjuvant therapy. While it can spare patients the morbidity of oesophagectomy and significantly improve quality of life, it requires accurate response assessment and structured follow-up. Future developments, including immunotherapy and non-invasive diagnostics, may further refine this approach and expand its safe applicability. </p>.	esophagus
Low levels of tumor suppressor miR-3619 in plasma contribute to malignant outcomes and a target for nucleic acid therapy in esophageal cancer.	Recent studies indicate that reduced levels of certain tumor-suppressing microRNAs (miRNAs) circulating in the blood are linked to tumor progression and poor prognosis across various types of malignancies. Identified from a comprehensive analysis of the NCBI and miRNA databases, we tested tumor suppressor miR-3619-5p in esophageal squamous cell carcinoma (ESCC). Both test-scale and large-scale analyses demonstrated that plasma levels of miR-3619-5p were markedly lower in ESCC patients than in healthy volunteers. Lower plasma levels of miR-3619-5p showed a strong association with advanced pathological stages and were recognized as an independent prognostic marker. Overexpression of miR-3619-5p in ESCC cells inhibited cell proliferation, migration and invasion through the direct suppression of novel target protein, proviral insertion site in Moloney murine leukemia virus 1 (PIM1). PIM1 is overexpressed in various solid and hematological cancers including ESCC, and has proven to be a promising target of inhibitors in recent clinical trials. In vivo, increased plasma 3619-5p levels following subcutaneous injection in mice bearing ESCC tumors significantly inhibited tumor growth, with low expression of PIM1 in tumor. Until now, no study has demonstrated that the secretory-type miRNA such as miR- 3619-5p could contribute to nucleic acid therapy to PIM1. Reduced blood levels of miR-3619-5p are linked to ESCC progression and poor prognosis, suggesting that miR-3619-5p could act as a novel therapeutic focus for nucleic acid-based treatment targeting PIM1 in ESCC patients.	esophagus
Risk Prediction Models of Esophageal Strictures After Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis.	BACKGROUND AND AIMS: The number of risk prediction models for esophageal stricture following endoscopic submucosal dissection (ESD) has been increasing steadily, yet their methodological quality and clinical applicability remain under-evaluated. This study systematically evaluates existing models to inform evidence-based selection and use in clinical practice and future research. METHODS: A systematic search was conducted across both international and Chinese databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, Wanfang Database, VIP, and SinoMed, covering the period from database inception to December 2024. The PROBAST checklist assessed the risk of bias and applicability of the models. Meta-analyses of predictive factors and were conducted using RevMan 5.4. RESULTS: A total of 13 studies were included, involving 13 risk prediction models. The area under the receiver operating characteristic curve (AUC) of the models ranged from 0.624 to 0.934, with 10 models having an AUC > 0.8. Quality assessment results indicated all 13 studies had a high risk of bias but demonstrated good applicability. Meta-analysis identified lesion location, lesion longitudinal diameter ≥ 4 cm, circumferential extent ≥ 1/2 or ≥ 3/4, histological invasion depth ≥ M2 or M3 ~ SM1, and damage to the muscularis propria as significant predictive factors for esophageal stricture after esophageal ESD (P < 0.05). Among them, muscularis propria injury was the most reliable predictor (OR = 5.53, 95% CI 3.67-8.34, I(2) = 0%, P = 0.88). CONCLUSIONS: This study systematically evaluated the methodological quality of risk prediction models for esophageal stricture after ESD and conducted the first meta-analysis of shared predictive factors. Future research should improve methodological rigor, perform external validation, and conduct prospective studies focusing on modifiable factors to facilitate precise prevention of stricture.	esophagus