crossing96/oncoscreening huggingface dataset:
Asbestos exposure, pleural plaques and digestive cancers.	BACKGROUND: The aim of this study was to analyse the incidence and mortality from various digestive cancer sites and their potential link with pleural plaques, in a French cohort of workers previously occupationally exposed to asbestos. METHODS: We conducted a 10-year follow-up study in 13,481 male subjects, included in the cohort between October 2003 and December 2005, for whom asbestos exposure was assessed by calculation of a cumulative exposure index (CEI) in equivalent fibres.years/mL for each subject. We conducted an incidence study and a mortality study. Complementary analysis was restricted to men who had performed at least one chest CT-scan (N = 4,794). We used a Cox model with age as the time axis variable, adjusted for smoking, time since first exposure (TSFE), CEI to asbestos and the existence of pleural plaques on CT-scan. RESULTS: In the incidence study, a significant dose-response relationship was observed between CEI to asbestos and oesophageal cancer (HR 1.03, 95% CI [1.01-1.06]) in the entire cohort after adjustment for TSFE and smoking status. In subjects undergoing CT-scan, a significant association between pleural plaques was observed for oesophageal cancer incidence (HR 2.80, 95% CI [1.09-7.20]) and in the mortality study, multivariate analyses showed a significant dose-effect response between CEI to asbestos and death from oesophageal cancer (HR 1.03, 95% CI [1.00-1.05]) in the entire cohort. CONCLUSIONS: This large-scale study confirms results concerning a likely relationship between asbestos exposure and oesophageal cancer, and the association between this cancer and pleural plaques after adjustment on CEI to asbestos.	esophagus
Hot beverage intake and oesophageal cancer in the UK Biobank: prospective cohort study.	BACKGROUND: Drinking maté, a type of tea consumed at a very hot temperature in South America has been considered as a risk factor for oesophageal squamous cell carcinoma (ESCC). METHODS: We assessed daily intake and preferred temperature of hot beverages (tea and coffee) in relation to incident ESCC (n = 242) and adenocarcinoma (EAC; n = 710) among 454,796 adults in the UK Biobank. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportional hazards regression. RESULTS: Relative to non-drinkers and warm temperature drinkers (referent group), drinking 4-6 cups/d (HR, 1.97; 95% CI, 1.14-3.38) or more of hot temperature beverages was associated with higher risk of ESCC; HRs increased with increasing daily intake of hot temperature beverages (P-trend < 0.01). ESCC risk was still higher for those who drank very hot beverages; drinking ≤ 4 cups/d was associated with a 2.5-fold higher risk (HR, 2.52; 95% CI, 1.27-5.03), and risk increased with increasing daily intake of very hot temperature beverages (P-trend < 0.01). There was no clear association for EAC. CONCLUSIONS: Our findings provide new evidence that drinking hot or very hot beverages is a risk factor for ESCC in the UK where drinking hot tea and coffee is common.	esophagus
Atezolizumab following definitive chemoradiotherapy in patients with unresectable locally advanced esophageal squamous cell carcinoma - a multicenter phase 2 trial (EPOC1802).	Platinum-based definitive chemoradiotherapy (dCRT) is the standard treatment for patients with unresectable locally advanced esophageal squamous cell carcinoma (ESCC) that invades the aorta, vertebral body or trachea; however, complete response rates remain low (11-25%), leading to poor survival. To evaluate the additive efficacy of the anti-PD-L1 antibody drug atezolizumab, we conducted a phase 2, multicenter, single-arm trial of 1 year of atezolizumab treatment following dCRT in 40 patients with unresectable locally advanced ESCC recruited from seven Japanese centers (UMIN000034373). The confirmed complete response (cCR) rate (primary end point) of the first consecutive 38 patients was 42.1% (90% CI 28.5-56.7%). Regarding the secondary end points, the median progression-free survival and 12-month progression-free survival rates of all 40 patients were 3.2 months and 29.6%, respectively, and the preliminary median overall survival with short-term follow-up and 12-month overall survival rate were 31.0 months and 65.8%, respectively. Other secondary end points evaluated included the cCR rate determined by an investigator's assessment in the locoregionally recurrent ESCC cohort, cCR rate determined by central assessment, overall response rate and incidence of adverse events. No treatment-related death occurred during the study. Atezolizumab monotherapy after dCRT resulted in a promising cCR rate, although long-term survival data are required.	esophagus
FBXL18 increases cell proliferation and reduces cell radiosensitivity in esophageal squamous cell carcinoma.	BACKGROUND: Esophageal squamous cell carcinoma (ESCC) is one of the most common malignant tumors worldwide. In this study, we aimed to investigate the pathophysiological mechanism through which F‑box and leucine-rich repeat protein 18 (FBXL18) promotes the progression of ESCC. METHODS: ESCC cell lines KYSE150 and TE‑1 were infected with PLVX-FBXL18 or shFBXL18-derived lentivirus to overexpress or knock down FBXL18. A Cell-Counting Kit 8 and colony-forming assay were used to assess cell viability and proliferation. Cells were irradiated with varying doses of X‑ray (IR) to determine whether FBXL18 influenced the radiosensitivity of ESCC cells. KYSE450 cells, stably transduced with shNC or shFBXL18-derived lentivirus, were injected into nude mice to assess whether FBXL18 affected ESCC tumor growth. KYSE150 and TE-1 cells overexpressing FBXL18 were lysed for Western blot analysis to evaluate protein expression. RESULTS: FBXL18 overexpression enhanced cell viability and colony formation, and proliferation of ESCC cells. In contrast, FBXL18 knockdown inhibited tumor growth in vivo. Additionally, FBXL18 overexpression reduced the radiosensitivity of ESCC cells. Mechanistically, FBXL18 was found to exert its effects by suppressing the expression of FBXL7 in ESCC cells. CONCLUSION: FBXL18 promotes cell proliferation and diminishes radiosensitivity in ESCC cells. Most likely, it exerts its pro-tumorigenic effects by downregulating FBXL7.	esophagus
[Feasibility and safety of surgery in patients with stageⅣ esophageal cancer following first-line therapies].	Objective: This study aimed to evaluate the feasibility and safety of surgical intervention for patients with stage Ⅳ esophageal cancer who demonstrated tumor regression following first-line treatment. Methods: This was a descriptive case series. The inclusion criteria for surgery were as follows: (1) an initial diagnosis of stage Ⅳ esophageal cancer, i.e. cT4b or cM1; (2) the presence of residual tumor following first-line therapy deemed potentially resectable upon reassessment; and (3) sufficient organ function to tolerate surgical procedures. Clinical data were retrospectively collected for 63 patients with stage Ⅳ esophageal cancer who underwent surgery following first-line therapy at Sun Yat-sen University Cancer Center between January 2014 and December 2023. Of these patients, 12 were initially staged as IVA, and 51 as IVB. Post-treatment restaging revealed that 9 patients achieved a clinical complete response, while 3 were downstaged to stage Ⅰ, 14 to stage Ⅱ, 24 to stage Ⅲ, and 13 to stage ⅣB (with regression of distant metastatic lesions enabling curative resection). Surgical approaches included right thoracic esophagectomy (n=55), left thoracic esophagectomy (n=4), and transmediastinal esophagectomy (n=4). Additionally, 7 patients required extended organ resection. Two-field lymph node dissection was performed in 49 patients, while 14 underwent three-field lymph node dissection. Postoperative management varied: 31 patients received no adjuvant therapy, 11 underwent immunochemotherapy, 8 received immunotherapy alone, 8 underwent chemotherapy, 4 received chemoradiotherapy, and 1 received combined radiotherapy and immunotherapy. The primary endpoints were overall survival (OS) and progression-free survival (PFS), with secondary endpoints including surgical outcomes and postoperative complications. Results: All 63 patients successfully underwent surgery without intraoperative mortality. R0 resection was achieved in 58 cases (92.1%), while R1 and R2 resections were performed in 1 case (1.6%) and 4 cases (6.3%), respectively. The mean operative time was 357±135 minutes. Postoperative complications were observed in 27 cases (42.9%), with 9 cases (14.3%) classified as Clavien-Dindo grade Ⅲ or Ⅴ. One patient (1.6%) died perioperatively. The median follow-up duration was 21 months (range: 4-107 months). The median OS was 64.8 months (95% CI: 50.9-78.6 months), and the median PFS was 68.0 months (95% CI: 53.9-82.3 months). Among 24 patients with supraclavicular lymph node metastases, 6 experienced recurrence and 8 died. Of 25 patients with abdominal metastases, 3 had recurrence and subsequently died. All 4 patients with lung metastases and both patients with bone metastases experienced recurrence and death. Conclusions: Surgical intervention is a feasible and safe treatment option for selected patients with stage Ⅳ esophageal cancer who demonstrate the potential for curative resection following first-line therapy.	esophagus
[An abscess gone astray].	A 69-year-old female patient with known recurrence of esophageal cancer presented with fever and elevated inflammatory markers. In the recent past, a suspicious mediastinal lymph node had been biopsied via bronchoscopy. Consequently, a lymph node abscess developed, leading to blood stream infection (pathogen: Streptococcus anginosus) via a fistula into the superior vena cava. Through a preexisting atrial septal defect, the infection also spread to the brain, causing multiple brain abscesses.	esophagus
Is prophylactic lymph node dissection efficacious in salvage esophagectomy after definitive chemoradiotherapy?	BACKGROUND: Salvage esophagectomy for esophageal cancer after definitive chemoradiotherapy (dCRT) is a high-risk surgery, and radical lymph node dissection (RLND) can cause severe complications. However, the significance of RLND in salvage surgery remains unclear. METHODS: This study included 55 patients who underwent curative-intent salvage esophagectomy after dCRT for esophageal squamous cell carcinoma. We evaluated the prognostic impact of lymph node dissection of each station using efficacy indexes (EIs) and compared the outcomes between RLND and limited lymph node dissection (LLND). RESULTS: Nine (16.4%) patients underwent RLND and 46 (83.6%) underwent LLND. Patients who underwent RLND had greater operative blood loss and a greater number of resected lymph nodes compared to patients who underwent LLND (P = 0.053 and 0.002, respectively). However, the incidence of postoperative complications was not significantly different between the groups. The EIs of the cervical and mediastinal lymph nodes were zero because no patients with involved nodes at these stations remained alive at 5 years. In contrast, perigastric lymph nodes had relatively high EIs. Overall and cancer-specific survival did not differ significantly between patients who underwent RLND and those who underwent LLND (P = 0.475 and 0.808, respectively). CONCLUSIONS: The EIs of the cervical and mediastinal lymph nodes were zero, and RLND did not improve survival. Depending on tumor status, LLND may be sufficient for salvage esophagectomy.	esophagus
A comprehensive operative risk assessment driving the application of major and emergency surgery in octogenarians.	Medical decisions driving the clinical management of octogenarians who require either major or urgent surgery still depend on the patient's age rather than individual functions. This report created the privileged opportunity to illustrate the clinical effectiveness of a comprehensive function-based assessment. This was the case of an 83-year-old gentleman presenting with severe malnutrition and debility due to esophageal cancer. Multidimensional assessments were systematically performed to design the best-tailored therapeutic strategy, including prehabilitation, elective esophagectomy, and emergency laparotomy with ileocolic resection for postoperative hemorrhagic shock due to an occult colonic tumor. This clinical case highlights the need for a systematic and comprehensive assessment of fragile octogenarians, allowing accurate patient evaluation, identification of areas of functional optimization, and establishment of the most appropriate therapeutic decisions.	esophagus
Integrative analysis of T cell-mediated tumor killing-related genes reveals KIF11 as a novel therapeutic target in esophageal squamous cell carcinoma.	BACKGROUND: Immune checkpoint inhibitors (ICIs) are emerging promising agents for the treatment of patients with esophageal squamous cell carcinoma (ESCC), however, there are only a small proportion respond to ICI therapy. Therefore, selecting candidate patients who will benefit the most from these drugs is critical. However, validated biomarkers for predicting immunotherapy response and overall survival are lacking. As the fundamental principle of ICI therapy is T cell-mediated tumor killing (TTK), we aimed to develop a unique TTK-related gene prognostic index (TTKPI) for predicting survival outcomes and responses to immune-based therapy in ESCC patients. METHODS: Transcriptomic and clinical information of ESCC patients were from the GSE53625, GSE53624, GSE47404 and TCGA datasets. TTK-related genes were from the TISIDB database. The LASSO Cox regression model was employed to create the TTKPI. The prediction potential of the TTKPI was evaluated using the KM curve and time-dependent ROC curve analysis. Finally, the relationship between TTKPI and immunotherapy efficacy was investigated in clinical trials of ICIs (GSE91061, GSE135222, IMvigor210 cohort). The role of KIF11 in accelerating tumor progression was validated via a variety of functional experiments, including western blot, CCK-8, colony formation, wound healing scratch, and xenograft tumor model. The KIF11 expression was detected by multiplex fluorescent immunohistochemistry on tissue microarray from ESCC patients. RESULTS: We constructed the TTKPI based on 8 TTK-related genes. The TTKPI low-risk patients exhibited better overall survival. TTKPI was significantly and positively correlated with the main immune checkpoint molecules levels. Furthermore, the low-risk patients were more prone to reap the benefits of immunotherapy in the cohort undergoing anti-PD-L1 therapy. Moreover, we performed functional experiments on KIF11, which ranked as the most significant prognostic risk gene among the 8 TTK-related genes. Our findings identified that KIF11 knockdown significantly hindered cell proliferation and mobility in ESCC cells. The KIF11 expression was negatively related with CD8(+) T cell infiltration in ESCC patient samples. CONCLUSIONS: The TTKPI is a promising biomarker for accurately determining survival and predicting the effectiveness of immunotherapy in ESCC patients. This risk indicator can help patients receive timely and precise early intervention, thereby advancing personalized medicine and facilitating precise immuno-oncology research. KIF11 plays a crucial role in driving tumor proliferation and migration and may act as a potential tumor biomarker of ESCC.	esophagus
Exploring the Clinical Value of Perioperative ctDNA-Based Detection of Molecular Residual Disease in Patients With Esophageal Squamous Cell Carcinoma.	OBJECTIVE: To explore the clinical value of molecular residual disease detection based on circulating tumor DNA (ctDNA-MRD) in the perioperative period of esophageal squamous cell carcinoma (ESCC) and to analyze the tumor escape mechanisms in MRD-positive cases. METHODS: A total of 35 ESCC patients were prospectively enrolled. Preoperative and postoperative (1 month after surgery) blood and surgical tissue samples were analyzed. ctDNA variants were tracked in plasma to assess ctDNA-MRD, and whole-transcriptome sequencing was performed on MRD-positive and MRD-negative tissue samples. RESULTS: Preoperative blood ctDNA was positive in 54.3% of patients, with a 31.6% positive predictive value for recurrence. One month postsurgery, the positive rate of ctDNA was 17.1%, with an 83.3% predictive value for recurrence. Both preoperative and postoperative ctDNA positivity were significant prognostic indicators (HR = 2.78, p < 0.05; HR = 4.42, p < 0.001). Multivariate analysis confirmed ctDNA as an independent prognostic factor (HR = 303.75, p < 0.001). Transcriptomic analysis revealed increased macrophage (W = 15 848; p < 0.01) and follicular helper T (Tfh) cell (W = 10 935; p < 0.01) levels in MRD-positive patients, suggesting a potential link to immune escape in tumors. CONCLUSIONS: Plasma ctDNA measured 1 month postoperatively in ESCC patients can effectively detect MRD, and ctDNA-MRD serves as an independent risk factor for postoperative recurrence. The mechanism underlying MRD positivity may involve the polarization of Tfh cells and macrophages, aiding tumor cells in immune escape through the bloodstream.	esophagus
FOXA3: A Novel Tumor Suppressor in Esophageal Squamous Cell Carcinoma.	BACKGROUND: The forkhead box A (FOXA) family has been extensively studied in cancer research; however, the role of FOXA3 in malignant tumors, particularly esophageal squamous cell carcinoma (ESCC), is not well understood. This study explores the expression and function of FOXA3 in ESCC, assessing its potential as a prognostic marker and therapeutic target. METHODS: This study analyzed FOXA3 expression in ESCC tissues and its correlation with patient prognosis. The effects of FOXA3 overexpression on ESCC cell proliferation, migration, and invasion were examined in ESCC cell lines in vitro. Additionally, an in vivo tumorigenesis assay was performed using subcutaneous injection to assess the impact of FOXA3 overexpression on tumor growth. Statistical analyses were conducted to determine the significance of the results. RESULTS: FOXA3 expression was significantly reduced in ESCC tissues compared with it in paired adjacent normal tissues, and low FOXA3 expression was significantly associated with poor prognosis in ESCC patients. FOXA3 overexpression markedly inhibited ESCC cell proliferation, migration, and invasion. In addition, overexpression of FOXA3 repressed tumor growth in mice. CONCLUSIONS: These findings indicate that FOXA3 acts as a tumor suppressor in ESCC, and its low expression is linked to poor outcomes. FOXA3 may serve as a potential diagnostic and therapeutic target for ESCC.	esophagus
Time Trends in Survival After Surgery for Esophageal Cancer in a National Population-Based Study in Sweden.	BACKGROUND: The long-term survival after surgery for esophageal cancer has improved over the past few decades, but studies that assess recent survival trends are lacking. METHODS: This population-based cohort study included 2291 patients who underwent esophagectomy for esophageal cancer in Sweden between 2000 and 2020, with follow-up until 2024. Data came from medical records and national registries. Calendar time was analyzed as a continuous and categorized variable. The main outcome was all-cause 5-year mortality. Secondary outcomes were disease-specific 5-year mortality and 1-year all-cause mortality. Multivariable Cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for age, sex, comorbidity, tumor histology, neoadjuvant therapy, hospital volume, and pathological tumor stage. RESULTS: The study period witnessed increasing resection rates, centralization to fewer hospitals, and improving postoperative 5-year survival. When analyzing calendar time as a continuous variable, the adjusted HR for all-cause 5-year mortality was 0.97 (95% CI 0.95-0.98). In categorized analyses, the HRs decreased for each later time period and was 0.57 (95% CI 0.47-0.69) comparing the surgery period 2015-2020 with 2000-2004. The trends were similar for disease-specific 5-year mortality and all-cause 1-year mortality. In stratified analyses, patients with Charlson comorbidity score ≥2 had the strongest improvement in all-cause 5-year mortality (HR 0.45, 95% CI 0.30-0.69 comparing surgery in 2015-2020 with 2000-2004). CONCLUSIONS: The recent 5-year survival has improved after surgery for esophageal cancer in Sweden. This improvement is not explained by lower surgery rates or selection of surgical candidates of younger age, fewer comorbidities, or earlier tumor stage.	esophagus
Esophageal mixed or collision small cell-squamous cell carcinoma: Report of 6 cases and review of the literature.	BACKGROUND: Esophageal mixed neuroendocrine-nonneuroendocrine neoplasms (MiNENs) are now known as a neuroendocrine component mixed with a nonneuroendocrine component in a single neoplasm, one of which is in the form of mixed small cell-squamous cell carcinoma. Collision tumors have been excluded from the category of MiNENs, but difference between mixed and collision small cell-squamous cell carcinoma has never been reported. METHODS: We collected six cases and reviewed 11 cases of mixed or collision small cell-squamous cell carcinoma (MCSSC); the data from 17 cases of MCSSC were analyzed to observe their clinicopathological features. RESULTS: Most of the MCSSC patients were middle-aged and elderly, with more men than women, and most of the tumors occurred in the middle and lower esophagus. We found that in mixed cancers, the metastases were a mixture of squamous cell carcinoma and small cell carcinoma, whereas metastatic foci in collisional tumors showed simple cancer components; this phenomenon has never been reported before. Mixed cancers account for a higher proportion of small cell carcinomas, a higher pathological stage, and a worse prognosis than collisional cancers. PD-L1 (22C3) was negative in both squamous cell carcinoma and small cell carcinoma regions (<1%). CONCLUSIONS: Mixed and collisional small cell-squamous cell carcinomas are essentially distinct tumors. In the clinical diagnostic of MCSSC, the tumor should be clearly identified as mixed or collisional carcinoma to guide the clinical treatment and prognosis more accurately.	esophagus