crossing96/oncoscreening huggingface dataset:
Long-term results of neoadjuvant chemotherapy and combined chemoradiotherapy before surgery in the management of locally advanced oesophageal cancer: a single-centre experience.	INTRODUCTION: Neoadjuvant chemoradiotherapy before surgery is an option in the treatment of locally advanced resectable oesophageal cancer (EC). However toxicity is substantial and the improvement in overall survival (OS) with this approach is controversial. METHODS: This was a prospective, single-centre study of neoadjuvant chemotherapy and concomitant chemoradiotherapy with CDDP and 5-FU and 50.4 Gy of external radiotherapy before possible radical surgery in patients with locally advanced resectable EC. If surgery was not possible, a second-phase radiotherapy boost of 10 Gy and one cycle of modified dose chemotherapy were used. RESULTS: Seventy-three patients included between 1998 and 2007: 96% males, median age 61, 83% squamous cell carcinomas, 23% lower third tumours, 36% stage II and 54% stage III and 47% local lymph node involvement. Eighty-six percent completed the combined protocol. Main grade 3-4 toxicities: mucositis (19%) and infections (8%); 4 toxic deaths. Clinical response rates: complete response 54%, partial response 27%, stable disease 8%. Twenty-five patients proceeded to surgery, with radical resection in 24. Pathological response rate: complete response 32%, partial response 52%, progression 16%. There were 7 postoperative deaths and 16 of 34 patients that did not have surgery received the second-phase RT boost. Survival analysis: Median follow-up of 64 months (range 6-134 months). Median OS of 10.33 months. 2-year and 5-year OS of 22 and 16%. The only significant prognostic factor in OS is the clinical complete response rate: 13.9 vs. 7.7 months (p=0.0049). CONCLUSIONS: Our protocol offers a high rate of clinical activity although it is relatively toxic and seems to increase the postoperative mortality, which would blunt any small improvement in survival. The achievement of a complete response is a powerful prognostic factor.	esophagus
[Endosonography in the diagnostics of non-epithelial tumors of the esophagus, stomach and duodenum].	Non-epithelial tumors account for 5% of all neoplasms of the gastrointestinal (GI) tract, most often have no clinical manifestations and they are finding during the endoscopy. Visual inspection and standard method for gable biopsy doesn't let to verify the kind of education. Endoscopic ultrasonography (EUS) significantly expands the possible differential diagnosis of submucosal formations on the basis of their ultrasound characteristics. The article presents the literature and personal experience of differential diagnosis of non-epithelial tumors, and benign formations of the esophagus, stomach and duodenum wall.	esophagus
[Diffusion-weighted MR imaging for postoperative nodal recurrence of esophageal squamous cell cancer in comparison with FDG-PET].	We evaluated the power of DWIBS in patients with postoperative lymph node recurrence of esophageal cancer and compared with FDG-PET findings. Forty-seven suspected lesions by MDCT were enrolled. No significant difference between DWIBS and PET was observed in sensitivity (95% vs 97%), PPV (83% vs 90%) and overall accuracy rate (81% vs 87%). The ADCs (x10(-3) mm2/s) of recurrent nodes, primary cancer and normal esophagus were 1.124, 1.058 and 2.079, respectively. ADCs of recurrent nodes were significantly lower than those of normal esophagus (p<0.0001). The cut-off ADC line of 1.5 revealed 100% overall accuracy for separating the recurrent lesion from normal esophagus. Noninvasive DWIBS may become a valid modality to discriminate nodal recurrence of esophageal cancer by no means inferior to PET.	esophagus
[Radiofrequency ablation for postoperative recurrent of metastatic lesions of esophageal cancer].	Radiofrequency ablation (RFA) was performed for the postoperative recurrent of metastatic lesions of esophageal cancer in 6 patients. All patients were males, and the median age was 59. Surgical curativities were A (3 cases), B (2) and C (1). The recurrent sites were intramediastinal omentum of gastric tube (2 cases), rt lung (2), rt adrenal grand (1) and liver (1). Four cases had a single recurrent lesion and the two had multiple lesions consisted of a single lesion as RFA target, and the lesions in a different site that were simultaneously treated by other therapeutic modalities. The median time of recurrence was 12 months after esophagectomy. RFA was performed once in the 3 cases, and twice in the other 3 cases. Therapeutic effect evaluated by CT was CR (2 cases), PR (3) and SD (1). No serious complications associated with RFA procedure were observed. Three patients died due to cancer recurrence within 7 months after RFA. However, RFA-treated lesions were well controlled to the end. RFA are safe and minimally invasive, thus, can be repeatedly performed technique that can induce a good local control of the target lesion equivalent to surgical resection. RFA is applicable as an effective local therapy for the recurrent or metastatic lesions of esophageal cancer.	esophagus
[A case of advanced esophageal cancer with para-aortic lymph node metastasis with complete response (CR) to combination chemotherapy including nedaplatin].	The patient was a 55-year-old male, who was diagnosed to have a middle thoracic esophageal squamous cell carcinoma with para-aortic lymph node metastasis. The clinical stage diagnosis was T3N4M1, stage IVb, non-resectable esophageal SCC. Systemic chemotherapy with low-dose nedaplatin/5-FU treatment was started as the initial treatment. After three courses, para-aortic lymph node metastasis was not found by CT scan, and we added radiation therapy. After radiation therapy by 45 Gy, primary lesion and mediasternal lymph node metastasis were not shown by endoscopy and CT scan. We detected an increase of tumor marker after the observation for six months without any treatment, and then we started docetaxel/nedaplatin treatment as secondary chemotherapy. After ten courses, the tumor marker was decreased, and the patient is still in a stable disease state. We concluded that FGP therapy and DGP therapy were a very effective treatment for advanced esophageal SCC.	esophagus
[A case of mediastinoscope-assisted transhiatal esophagectomy for thoracic esophageal cancer after radical operation for lung cancer].	We herein report a case of thoracic esophageal cancer operated on by mediastinoscope-assisted transhiatal esophagectomy after a right upper lobectomy for primary lung cancer. A 70-year-old male with non-small-cell lung cancer (T4N2M0, cStage III B) underwent chemo-radiation therapy followed by an upper lobectomy of the right lung with mediastinal lymph node dissection. The lung cancer histologically showed complete remission (CR), and no recurrence has been shown. Five years after the operation of lung cancer, esophageal cancer (T3N0M0, cStage II) was endoscopically detected in this patient. Partial remission was obtained after neoadjuvant FP chemotherapy for esophageal cancer. Therefore, mediastinoscope-assisted transhiatal esophagectomy was performed in consideration of a history of a right thoracotomy and of pulmonary dysfunction. Preventive tracheostomy was performed because of recurrent nerve paralysis, but no other severe postoperative complication has developed in this case. Histopathological findings showed a well differentiated squamous cell carcinoma (pT3 (Ad), pN0, M0, pStage II), with involvement at resection margin. He was alive for 11 months after the operation for esophageal cancer, although a local recurrence was observed. There are still many problems remained of the treatment for esophageal cancer patients who had previously undergone a radical operation for lung cancer. However, mediastinoscope-assisted transhiatal esophagectomy may become a procedure for surgical approach if it seems to be difficult to approach the esophageal cancer by thoracotomy again.	esophagus
[A case of esophageal cancer associated with colon cancer successfully treated with combination chemotherapy of FOLFOX and concurrent radiotherapy].	The standard chemotherapy regimen for esophageal cancer is cisplatin and 5-fluorouracil (5-FU). We herein report a case of esophageal cancer associated with colon cancer, which was treated with combination chemotherapy of FOLFOX. The patient received chemotherapy of modified FOLFOX6 (mFOLFOX6) at dosages of 80% of standard regimen (oxaliplatin 68 mg/m2, levofolinate calcium 160 mg/m2, bolus 5-FU 320 mg/m2, and followed by continuous 5-FU 1,920 mg/m2/ 46 hr) in combination with radiotherapy (total 61.6 Gy). He developed grade 3 leukopenia after 2 courses of mFOLFOX6 and the 3rd course was started at dosages of 70% of standard regimen with 1 week delay. After that, no other adverse event without grade 2 esophagitis was appeared. Esophagogram revealed a partial response in primary tumor of the esophagus after 3 courses of chemotherapy with radiotherapy and blood chemistry examination showed negative squamous cell carcinoma antigen. One month after chemoradiotherapy, esophagogram revealed tracheoesophageal fistula, but tumor of the esophagus was well controlled. FOLFOX regimen combined with radiotherapy is well tolerated and effective for inoperable esophageal cancer. FOLFOX cannot be used for esophageal cancer in Japan, so clinical trial of FOLFOX for esophageal cancer should be conducted in the near future in Japan.	esophagus
[Two case reports of metastatic liver carcinoma with the effective treatment of radiofrequency ablation and intraarterial chemotherapy].	We report two cases of metastatic liver carcinoma with the treatment of radiofrequency ablation (RFA) and intraarterial chemotherapy. The 57-year-old man of Case 1 had resectable multiple liver metastases of rectal carcinoma in November 2007. He refused a liver resection, but accepted a low anterior resection of the rectum and RFA and intraarterial chemotherapy (5-FU 1,000 mg WHD). After this treatment, he had accepted systemic chemotherapy and found no liver recurrence within a year. The 66-year-old man of Case 2 had unresectable multiple liver metastases of locally-advanced esophageal carcinoma in July 2006. He had accepted radiochemotherapy (FP+65 Gy), and then RFA and intraarterial chemotherapy (5-FU 1,000 mg WHD). After this treatment, solitary brain metastasis and lymph node metastasis of mediastinum were found and treated, and now he has been alive with systemic chemotherapy.	esophagus
[A case of a 14-month survival patient on advanced esophageal cancer with uncontrolled brain metastasis completely responding to nedaplatin, adriamycin, plus 5-FU (NAF) therapy].	This case was a male patient, about 50 years old. He received a curative operation for advanced esophageal carcinoma [poorly differentiated squamous cell carcinoma type, Lt, pT3 (pAd) pN3, pstage III] in March 2005. He also received adjuvant chemotherapy of 5-FU plus cisplatin (CDDP). Fourteen months later (May 2006) from surgery, metastases to the left lung and left subclavian lymph nodes were diagnosed, so he received first-line triplet combination chemotherapy (NAF regimen; nedaplatin 60 mg/m2: day 1, adriamycin 50 mg/m2: day 1, 5-FU 700 mg/m2: day 1-5). According to the 9 courses of treatment of this regimen, complete response for these metastases was observed and first-line chemotherapy was finished. However, a severe headache appeared 3 months later, and he had a diagnosis of solitary 5 cm brain metastasis by MRI. Excision of the metastasis was performed with sequential whole-brain radiation therapy (30 Gy). Five months later, diffuse and multiple brain metastases relapsed, and second-line chemotherapy did not respond well, and finally he was died 3 months after palliative care. But, completely controlled metastases (lung and lymph node) by first-line chemotherapy did not relapse again in all his clinical period. If an anticancer therapy goes in complete response in an advanced esophageal carcinoma patient, we should consider about a rare brain metastasis in order to find out as small and solitary state.	esophagus
[A study of nutrition screening for patients with surgically treated esophageal cancer].	PURPOSE: The present study was performed to investigate the effects of the nutrition screening index and pulmonary function test data for patients who underwent surgery for esophageal cancer, based on the incidence of postoperative complications and the duration of postoperative hospitalization. SUBJECTS AND METHODS: A total of 69 patients who received esophageal cancer resection were included in the study. It was determined how the parameters studied (ie, between ages, concomitant diabetes mellitus, body mass index( BMI), serum albumin level, Onodera's prognostic nutritional index, percentage of vital capacity(%VC), and forced expiratory volume[ FEV]1.0%) were related to the incidence of complications and the duration of postoperative hospital days, as expressed by the median days for all patients and the frequency of long-term hospitalization. RESULTS: The incidence of postoperative complications was significantly higher in patients aged 65 and above and those with a %VC value of less than 80%. The median duration of postoperative hospitalization was longer in those aged 65 and above and those with a FEV1.0% value of less than 70%, which was related to BMI. In addition, the frequency of long-term hospitalization was higher in those aged 65 and above, which was also related to BMI. CONCLUSIONS: The results of the present study confirm that postoperative complications and length of postoperative hospital stay in patients with surgically treated esophageal cancer were largely dependent on their pulmonary function as well as age and BMI used for the nutrition screening index. Nutrition screening combined with pulmonary function tests, using age, BMI, %VC, and FEV1.0%, is considered desirable to avoid postoperative complications associated with esophageal cancer.	esophagus
Clinical biomarkers in esophageal adenocarcinoma.	This review describes genetic and molecular changes related to adenocarcinoma of the esophagus and gastroesophageal junction (GEJ) with emphasis on prognostic value and possibilities for targeted therapy in clinical setting. The progression of Barrett's esophagus to adenocarcinoma has been the focus of particular scrutiny, and a number of potential tissue and serum-based disease biomarkers have emerged. Tissue biomarkers allowing risk stratification of Barrett's are reviewed as well as strategies currently being used to discover novel biomarkers that will facilitate the early detection of esophageal adenocarcinoma.	esophagus
Ivor Lewis esophagectomy with manual esogastric anastomosis by thoracoscopy in prone position and laparoscopy.	INTRODUCTION: Only a few authors have reported the technique of Ivor Lewis esophagectomy by minimally invasive means, and anastomosis was usually performed by a circular stapler. We report an Ivor Lewis esophagogastrectomy with manual esogastric anastomosis performed by thoracoscopy in the prone position. CASE REPORT: An adenocarcinoma of the distal esophagus without lymph nodes invasion was diagnosed in a 51-year-old man. General anesthesia and double-lumen endotracheal tube intubation were used. First the patient was placed in the supine position, and five abdominal trocars were placed. Celiac lymphadenectomy was performed with section of the left gastric vessels. A wide Kocher maneuver and pyloroplasty were performed. A wide gastric tube was performed and advanced through the hiatus into the right chest. Subsequently the patient was placed in the prone position. Three trocars (two 5-mm and one 11-mm) were placed on the posterior axillary line in the fifth, seventh, and ninth right intercostal space. The intrathoracic esophagus was dissected. Mediastinal lymphadenectomy with en bloc resection of the left inferior mediastinal pleura was performed. The azygos vein was sectioned, and the esophagus was transected by scissors 1-cm cranial to the azygos vein. A completely thoracoscopic manual double-layer anastomosis was performed by using running sutures with PDS 2/0 externally and Maxon 4/0 internally. Finally the patient was replaced in the supine position to retrieve the specimen through a suprapubic incision, and the gastric tube was fixed to the hiatus. RESULTS: Thoracoscopy lasted 157' (anastomosis 40'), laparoscopy 160', and second laparoscopy 20'. Blood loss was estimated at 170 ml. The gastrograffin swallow on postoperative day 4 showed absence of stenosis and leak. The patient was discharged on postoperative day 6. CONCLUSIONS: Thoracoscopy in the prone position allows the surgeon to perform a thoracoscopic esogastric anastomosis completely handsewn without selective lung desufflation, and using only three trocars.	esophagus
Effects of carbon-ion radiotherapy combined with a novel histone deacetylase inhibitor, cyclic hydroxamic-acid-containing peptide 31 in human esophageal squamous cell carcinoma.	BACKGROUND: Carbon-ion radiotherapy has several potential advantages over X-rays. This therapy has been applied for various solid tumors including esophageal squamous cell carcinoma (SCC). However, some patients have shown resistance to this treatment. A new effective combined treatment strategy is required for improving the therapeutic effects. Histone deacetylase inhibitors (HDACIs) are new therapeutic candidates for cancer treatment. Several studies have evaluated the combination of X-rays and HDACIs, but, to date, no study has evaluated carbon-ion radiotherapy combined with HDACIs. MATERIALS AND METHODS: Radio-sensitization to carbon-ion radiotherapy when combined with a novel HDACI cyclic hydroxamic-acid-containing peptide 31(CHAP31) was assessed in human esophageal SCC both in vitro and in vivo. Changes of expression of genes related to DNA repair, by CHAP31 were assessed by quantitative real-time reverse transcriptional PCR analysis. RESULTS: CHAP31 induced sensitization to carbon-ion radiotherapy in vitro and tumor growth was significantly suppressed by the combination of carbon-ion radiotherapy with CHAP31 in comparison to either agent alone in in vivo experiments. CHAP31 inhibited the expression of genes related to DNA repair. CONCLUSION: CHAP31 sensitizes SCC cells to carbon-ion radiotherapy and this combinatory treatment may be a potentially useful therapeutic strategy for esophageal SCC.	esophagus
Nine years experience in surgical approach of leiomyomatosis of esophagus.	BACKGROUND: Leiomyomas of esophagus, although rare, are the most frequent benign tumors of esophagus. Aim of this study is the presentation of 7 patients with esophageal leiomyomas who underwent surgical treatment during a 9-year period. METHODS: Epidemiological data (sex, age), the presenting symptoms, diagnostic examinations, tumor location, histopathological findings and the safety and efficacy of surgical resection are analyzed and assessed. RESULTS: 5 men and 2 women with mean age of 56.9 years were operated. In 3 cases the tumor was located at the lower esophagus, while in the other 4 cases, the leiomyoma was found at the median third of esophagus. 4 patients had severe symptoms related to the leiomyoma, such as dysphagia and epigastric pain. All patients underwent a right postolateral thoracotomy with enucleation of the lesion. None of them received resection of part of the esophagus. The mean diameter of the resected tumors was 4.3 cm. The dimensions of leiomyomas were immediately associated with the symptoms. In no case was detected malignancy or recurrence. All patients were relieved from their symptoms, while postoperative morbidity and mortality did not occur. CONCLUSIONS: Esophageal leiomyoma is a benign tumor, which causes symptoms only if its size becomes large. Surgical enucleation is considered to be safe and effective, without complications.	esophagus
Dietary folate and vitamin B6 are not associated with p53 mutations in esophageal adenocarcinoma.	Recent studies have suggested an association between dietary folate, and related B-vitamins, and risk for cancer, potentially mediated by the p53 tumor suppressor gene. The aim of this study was to explore the effect of dietary folate and vitamin B(6) intake on p53 in the molecular pathogenesis of esophageal adenocarcinoma (EADC). For each participant, a structured questionnaire was used to obtain detailed sociodemographic and lifestyle risk factors, including diet, from which folate and vitamin B(6) intake were calculated. Risks for p53 mutations, p53 mutations at CpG sites, and p53 protein overexpression among EADC cases (n = 54) were calculated using logistic regression with dietary folate and vitamin B(6) intake as predictive variables, adjusting for age, gender, smoking, and alcohol consumption. No significant differences were found for patients with EADC who had p53 mutations (n = 21) compared with patients with wild-type p53 (n = 33) with respect to selected clinicopathologic variables (age, gender, tumor grade, stage, alcohol, or tobacco consumption) and dietary intake of folate or vitamin B(6). No statistically significant associations were seen between dietary folate and vitamin B(6) intake (highest vs. lowest quartiles) and p53 mutations, p53 mutations at CpG sites (n = 12), and p53 protein overexpression (n = 17). We conclude that dietary intake of folate and vitamin B(6) do not appear to have an effect on p53, suggesting alternative molecular mechanisms underlying esophageal adenocarcinogenesis.	esophagus
Surgery within multimodal therapy concepts for esophageal squamous cell carcinoma (ESCC): the MRI approach and review of the literature.	BACKGROUND: Radical esophagectomy with lymphadenectomy remains the only curative therapy for patients with resectable esophageal squamous cell cancer (ESCC), however, combined treatment modalities may improve survival. Based upon more than 1300 consecutive esophageal resections, we present our current multidisciplinary ESCC approach with analysis in the context of recently published RCTs. METHODS: Subject to tumor staging, patients with resectable ESCC receive either a neoadjuvant radiochemotherapy (uT3N+) or are referred to primary surgery (uT1/2N0). By Medline searches (1997-2009), all published RCTs containing multimodal ESCC therapy concepts were identified and a systematic review was generated. RESULTS: From July 2007 to June 2009, 62 patients with ESCC were treated in our department (40 multimodal treatment concept, 21 primary surgery, 1 definite radiochemotherapy). The R0 resection rate was 78%, in hospital mortality 4.8%. 60% of patients showed a good response to neoadjuvant treatment. 18-month follow-up data revealed absence of tumor recurrence in 7 patients (18%). Our approach is aligned to the current published literature including 12 studies in this review. In line with our institutional experience, neodjuvant radiochemotherapy tends to improve overall survival and increases the likelihood of R0 resection. However, postoperative morbidity and mortality rates are increased. Adjuvant treatment failed to demonstrate any improvement in prognosis. For palliation, concurrent radiochemotherapy is the treatment of choice. CONCLUSION: The MRI approach can be aligned to the most recent published data. Surgical resection remains the principle treatment for patients with resectable ESCC. Although multimodal therapy concepts tend to improve survival rates, postoperative morbidity and mortality rates are increased.	esophagus