crossing96/oncoscreening huggingface dataset:
[Feasibility of appropriately extending the surgical interval after neoadjuvant immunotherapy combined with chemotherapy for esophageal squamous cell carcinoma].	Objective: To investigate the impact of the interval between neoadjuvant immunotherapy combined with chemotherapy(nICT) and surgery on pathological outcomes and prognosis in patients. Methods: This is a retrospective cohort study. A total of 115 patients with locally advanced esophageal squamous cell carcinoma who underwent nICT followed by sequential surgery at Department of Thoracic Surgery, Peking University People's Hospital or Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University from January 2020 to April 2024 were included. Among them, 99 were male and 16 were female, with an age of (M(IQR)) 65 (11) years (range:45 to 81 years). All patients received 2 to 6 cycles of paclitaxel plus platinum-based doublet chemotherapy combined with PD-1 immune checkpoint inhibitors. The resectability of tumors was assessed based on CT scans of the chest and abdomen, and surgical approaches included Sweet surgery, Mckeown surgery, and Ivor-Lewis surgery. Patients were divided into a short-interval group (4 to <6 weeks) and a long-interval group (6 to 12 weeks) based on the interval between neoadjuvant immunochemotherapy and surgery. General patient data, surgical details, pathological response, and prognosis were collected and analyzed. Data comparisons were performed using independent sample t-test, Mann-Whitney U test, χ(2) test, or Fisher's exact test. Multivariate logistic regression analysis was used to identify independent factors influencing pathological complete response (pCR). Survival analysis was conducted using the Kaplan-Meier method and Log-rank test. Results: There were no significant differences in baseline characteristics, neoadjuvant treatment details, surgical outcomes, or postoperative complications between the long-interval group and the short-interval group (all P>0.05). Multivariate Logistic regression analysis revealed that, among clinical factors, interval between neoadjuvant immunochemotherapy and surgery was significantly associated with pCR (long-interval group vs. short-interval group: OR=4.14, 95%CI:1.63 to 10.50, P=0.003). The pCR rate was higher in the long-interval group (43.6% vs. 17.1%, χ(2)=6.48,P=0.011). Survival analysis showed no significant differences in overall survival (P=0.094) or disease-free survival (P=0.840) between the two groups. Conclusion: Appropriately extending the surgical interval after neoadjuvant immunochemotherapy maybe lead to a higher pCR rate, without increasing surgical difficulty or damaging prognosis.	esophagus
Neoadjuvant chemotherapy with or without PD-1/PD-L1 inhibitors in resectable esophageal squamous cell carcinoma: a meta-analysis based on randomized controlled trials.	BACKGROUND: Neoadjuvant chemotherapy (NC) is a cornerstone in the management of resectable esophageal squamous cell carcinoma (ESCC). The integration of PD-1/PD-L1 inhibitors into NC (NIC) regimens has shown promise; however, its efficacy and safety remain uncertain. This meta-analysis aims to compare the potential risks and clinical benefits of NIC versus NC in patients with resectable ESCC based on randomized controlled trials (RCTs). METHODS: A thorough search of six databases was performed to identify RCTs evaluating NIC and NC in resectable ESCC. Key outcomes analyzed included the pathological complete response (pCR) rate and the major pathological response (MPR) rate. Other outcomes analyzed included overall survival (OS), event-free survival (EFS), surgery rate, R0 resection rate, and adverse events (AEs). RESULTS: Four RCTs encompassing 605 patients were included. NIC significantly improved pCR rate (risk ratio [RR]: 2.66 [1.63, 4.34], P < 0.0001) and MPR rate (RR: 1.74 [1.02, 2.95], P = 0.04) compared to the NC group. Only one phase III RCT reported survival outcomes, showing that the NIC group demonstrated improved OS (HR: 0.48 [0.24, 0.96], P = 0.04) and EFS (HR: 0.62 [0.39, 0.99], P = 0.05). Additionally, surgery rate (RR: 1.11 [1.03, 1.20], P = 0.008) and the number of resected lymph nodes (mean difference [MD]: 3.91 [0.60, 7.21], P = 0.02) were also higher in the NIC group. The R0 resection rate, duration of surgery, and intraoperative blood loss were comparable between the groups. However, the rate of immune-related AEs (irAEs) (RR: 40.80 [5.67, 293.37], P = 0.0002) was significantly higher in the NIC group. Similar surgical complications were observed between the two groups. CONCLUSIONS: NIC demonstrates superior efficacy in improving pCR and MPR in resectable ESCC compared to NC alone, and may potentially provide survival benefits, although it is associated with a higher risk of irAEs.	esophagus
Vagus nerve/recurrent laryngeal nerve ratio: proposal of a new parameter predicting left vocal cord palsy using intraoperative nerve monitoring during esophagectomy.	AIM: Intraoperative nerve monitoring (IONM) during esophageal cancer surgery can help to identify and preserve the recurrent laryngeal nerve (RLN). To devise a useful parameter for prediction of left vocal cord palsy (VCP), we measured the electromyographic (EMG) amplitude of the left RLN and vagus nerve (VN) using intermittent IONM. METHODS: We studied 35 consecutive patients who underwent esophagectomy with lymph node dissection around the left RLN. After lymph node dissection, the left RLN and left VN were stimulated, and the EMG amplitude was measured using IONM. The VN/RLN ratio (V/R ratio) was calculated, and the presence of left VCP, diagnosed by laryngoscopy on the first postoperative day, was compared among the patients. RESULTS: Ten of the 35 patients (28.6%) had left VCP. In the VCP and non-VCP groups, the left VN amplitude was 190.0 (0-1111) µV and 520.0 (120-1200) µV (P = 0.006), and the VR ratio was 0.26 (0-0.75) and 0.71 (0.24-1.0) (P < 0.001), respectively. Receiver operating characteristic curve analysis using the left VN amplitude and V/R ratio showed an area under the curve (AUC) of 0.80 with a cutoff of 354 µV, and an AUC 0.90 with a cutoff of 0.50, respectively(P = 0.05). When left VN amplitudes of < 100 μV, < 354 μV, and a V/R ratio of ≤ 0.50 were defined as left VCP, the accuracy was 80.0%, 74.2%, and 88.6%, respectively. CONCLUSIONS: Using intermittent IONM, the V/R ratio with a cutoff value of 0.50 has the potential to be a more useful parameter for prediction of VCP after esophagectomy than EMG amplitude during VN stimulation.	esophagus
lncRNA FENDRR Predicts Adverse Prognosis and Regulates the Development of Esophageal Squamous Cell Carcinoma Through Negatively Modulating miR-495-3p.	Background/Aims: Esophageal squamous cell carcinoma (ESCC) is a major subtype of esophageal carcinoma and is highly prevalent in China. Identification of effective biomarkers could benefit ESCC management and therefore improve clinical outcomes. Evaluating the expression and significance of long non-coding RNA Fetal-lethal non-coding developmental regulatory RNA (FENDRR) in ESCC aims to provide a biomarker candidate for ESCC. Materials and Methods: This study enrolled 117 ESCC patients and collected tissue samples. The expression of FENDRR in collected samples was analyzed by polymerase chain reaction. The Chi-square, Kaplan-Meier, and Cox analyses were performed to reveal its clinical value. In ESCC cells, FENDRR was regulated by cell transfection, and its effect on cell growth and motility was evaluated. Results: FENDRR was downregulated in ESCC and was associated with large tumor size, poor differentiation, late TNM stage, positive lymph node metastasis, and adverse development-free survival of ESCC patients. FENDRR acted as an adverse indicator for the prognosis of ESCC patients. miR-495-3p was negatively regulated by FENDRR. Overexpressing FENDRR significantly suppressed ESCC cell growth and metastasis, while miR-495-3p reversed these effects. Conclusion: Downregulated FENDRR in ESCC predicted the malignant development and adverse prognosis of ESCC patients. FENDRR served as a tumor suppressor of ESCC by modulating miR-495-3p.	esophagus
Comparative Outcomes of Ileocolon Graft Versus Gastric Conduit Reconstruction in Esophageal Cancer: A Propensity-Matched Analysis of Survival, Quality of Life, and Perioperative Risks.	BACKGROUND: Esophagectomy with ileocolon graft (ICG) reconstruction serves as the standard surgical approach for esophageal cancer when gastric conduit (GC) is unavailable, yet comparative outcome data between these techniques remain scarce. This study evaluates survival, quality of life (QoL), and surgical risks between these approaches. PATIENTS AND METHODS: A single-center cohort compared ICG (n = 95 after propensity score matching) and GC (n = 95) in patients with esophageal cancer. Operative outcomes, complications, survival, and QoL (assessed via EORTC QLQ-C30/OES18) were analyzed. RESULTS: The 3-year overall survival [hazard ratio (HR):1.26, 95% confidence interval (CI) 0.81-1.96; p = 0.47] and recurrence-free survival (HR: 1.29, 95% CI 0.85-1.95; p = 0.09) were comparable. ICG patients exhibited significantly fewer reflux symptoms (p < 0.001) and less nausea/vomiting (p = 0.017), with better QoL scores. However, ICG required longer operative times (398.2 vs. 259.3 min; p < 0.001), greater blood loss (178.9 vs. 149.5 mL; p = 0.038), and higher reoperation rates (12 vs. 2; p = 0.005). Postoperatively, ICG was associated with extended hospital stays (15.9 vs. 11.8 days; p < 0.001), increased graft necrosis (4 vs. 0; p = 0.043), and a trend toward thromboembolism (3 vs. 0; p = 0.081). The 30-day mortality (2 vs. 0; p = 0.115) and long-term complications were similar between groups. CONCLUSIONS: ICG and GC offer equivalent long-term survival, but ICG reduces reflux and improves QoL despite higher perioperative complexity. ICG represents a viable alternative for esophageal reconstruction when symptom control and QoL are prioritized.	esophagus
FGFR3 amplification is predictive of poor prognosis in esophageal squamous cell carcinoma patients.	Identification and verification of clinically actionable molecular variations to refine currently adopted risk-stratified treatment strategy for esophageal squamous cell carcinoma (ESCC) is urgently needed. Here, we evaluated FGFR3 amplification status by fluorescence in situ hybridization (FISH) performed on tissue microarrays and its prognostic value in 526 ESCC patients. FGFR3 amplification was found in 3.0% (16/526) of ESCC patients enrolled in this study cohort. Intratumor heterogeneity and metastatic heterogeneity of FGFR3 amplification were found in 10% (2/20) and 40% (2/5) FGFR3 amplified ESCC cases, respectively. No statistically significant associations were found between FGFR3 amplification status and common clinicopathological features. Survival analyses demonstrated that FGFR3 amplification was associated with a worse disease-free survival (DFS) and overall survival (OS) (DFS, P = 0.008; OS, P = 0.027). Univariate and multivariate analyses revealed that invasive depth was significantly associated with DFS (P = 0.001, HR: 1.498, 95% CI: 1.172-1.914) and OS (P = 0.002, HR: 1.482, 95% CI: 1.159-1.894), and FGFR3 amplification was significantly associated with DFS (P = 0.020, HR: 2.065, 95% CI: 1.120-3.808) and tend to associate with OS (P = 0.070, HR: 1.756, 95% CI: 0.954-3.233). Furthermore, when patients were stratified into stage I-II group and stage III-IV group, the adverse effect of FGFR3 amplification on prognosis was presented in stage III-IV patients (DFS, P = 0.0047; OS, P = 0.029) rather than stage I-II patients (DFS, P = 0.46; OS, P = 0.53), indicating that the prognostic value of FGFR3 amplification may relying on clinical stage. Our findings might provide a better understanding of the FGFR3 amplification status in ESCC patients and add further insights into its potential prognostic value.	esophagus
High Quality Barrett's Esophagus Examination and Endoscopic Eradication Therapy.	A high-quality examination (HQE) for Barrett's esophagus (BE) involves a 10-step approach including advanced imaging with virtual chromoendoscopy, adherence to biopsy protocols, documentation of landmarks, and use of high-definition white light in order to maximize diagnostic yield. For dysplastic BE and BE-related neoplasia, multimodal endoscopic eradication therapy (EET) has become the cornerstone of treatment, proving to be both efficacious and safe in numerous studies. By implementing principles of an HQE and utilizing EET as indicated, clinicians can improve outcomes in BE and reduce progression of disease to esophageal adenocarcinoma.	esophagus
Recurrent laryngeal nerve paralysis as a potential mediator of complications in esophagectomy following lymph node dissection.	Complications from esophagectomy often interact with each other, with those related to recurrent laryngeal nerve (RLN) paralysis (RLNP) being particularly significant. Aggressive dissection of RLN lymph nodes (RLN-LNs) is considered a major contributing factor to RLNP. This study seeks to validate the hypothesis that RLNP acts as a mediator, not only resulting from RLN-LN dissection but also amplifying the likelihood of other postoperative complications. Data were retrospectively extracted from the Chinese 12th Five-Year Major Science and Technology Project on esophageal diseases, including a cohort of 1684 patients enrolled between 2015 and 2018. Both univariate and multivariate structural equation models were employed to validate the mediating role of RLNP in postoperative complications. Without causing RLNP, RLN-LN dissection directly increased the risk of chylothorax (odds ratio [OR] = 1.179, 95% confidence interval [CI] = 1.003-1.385) and decreased the risk of cardiac arrhythmia (OR = 0.919, 95% CI = 0.838-0.993). Meanwhile, through the mediating effect of RLNP, RLN-LN dissection indirectly led to complications requiring intensive care (OR = 1.043, 95% CI = 1.004-1.083) and conservative therapy (OR = 1.043, 95% CI = 0.996-1.092). RLNP serves as a critical mediator between RLN-LN dissection and subsequent postoperative complications requiring intensive care and conservative therapy. Recognizing that many of these complications are mediated by RLNP could help thoracic surgeons prioritize neural protection during RLN-LN dissection, potentially reducing the overall risk of multiple complications and alleviating the associated concerns.	esophagus
Intrathoracic versus cervical anastomosis after totally or hybrid minimally invasive transthoracic oesophagectomy for oesophageal cancer: cost-effectiveness analysis alongside the randomized ICAN trial.	BACKGROUND: There is a worldwide trend towards minimally invasive oesophagectomy with intrathoracic anastomosis in oesophageal cancer surgery. Minimally invasive oesophagectomy with intrathoracic anastomosis has been shown to result in fewer anastomotic leaks, but cost-effectiveness is yet to be established. The aim of this study was to determine the cost-effectiveness of transthoracic minimally invasive oesophagectomy with intrathoracic anastomosis compared with cervical anastomosis. METHODS: A prospective economic evaluation was performed alongside the ICAN trial, a randomized clinical superiority trial. Patients with mid/distal oesophageal or gastro-oesophageal junction cancer were randomly assigned to transthoracic minimally invasive oesophagectomy with either intrathoracic or cervical anastomosis. Quality-adjusted life-years, mean healthcare, and societal costs were assessed for both groups at 9 and 21 months after surgery. RESULTS: A total of 245 patients randomized for transthoracic minimally invasive oesophagectomy with either intrathoracic (122) or cervical (123) anastomosis were included in the cost-effectiveness analysis. After 9 months, the intrathoracic group yielded 0.58 (95% confidence interval (c.i.) 0.55 to 0.61) quality-adjusted life-years per patient, compared with 0.56 (0.52 to 0.58) quality-adjusted life-years for the cervical group. After 9 months, both mean healthcare costs (20 573 (95% c.i. 17 623 to 24 177) versus 28 039 (23 574 to 33 116) euros), and societal costs (24 590 (21 237 to 29 074) versus 33 383 (27 885 to 38 805) euros), per patient were lower in the intrathoracic anastomosis group. Similarly, at 21 months no statistically significant difference was found (mean difference 0.08 (-0.05 to 0.2) quality-adjusted life-years), whereas minimally invasive oesophagectomy with intrathoracic anastomosis was less costly than that with cervical anastomosis (mean difference -9930 (-16 301 to -2521) euros). The higher costs in the cervical anastomosis group were mainly due to longer lengths of stay owing to complications. CONCLUSION: Transthoracic minimally invasive oesophagectomy with intrathoracic anastomosis was found to be cost-effective compared with transthoracic minimally invasive oesophagectomy with cervical anastomosis.	esophagus
Single-cell RNA sequencing reveals adrb1 as a sympathetic nerve-regulated immune checkpoint driving T cell exhaustion and impacting immunotherapy in esophageal squamous cell carcinoma.	BACKGROUND: Esophageal squamous cell carcinoma (ESCC) presents significant health challenges due to its aggressive nature and poor prognosis from late-stage diagnosis. Despite these challenges, emerging therapies like immune checkpoint inhibitors offer hope. β1-adrenergic signaling has been implicated in T cell exhaustion, which weakens the immune response in ESCC. Blocking this pathway could restore T cell function. Recent advances in single-cell RNA sequencing (scRNA-seq) have enabled deeper insights into tumor heterogeneity and the immune landscape, opening the door for personalized treatment strategies that may improve survival and reduce resistance to therapy. METHODS: We combined scRNA-seq with bulk RNA analysis to explore adrenergic receptor signaling in ESCC, focusing on changes before and after neoadjuvant therapy. We identified ADRB1(+) T cells through data analysis and experimental validation. Copy number variation (CNV) analysis detected malignant cells within scRNA-seq data, while intercellular interaction analysis examined communication between cell populations. Deconvolution of TCGA data revealed key immune populations, which were integrated into a prognostic model based on the adrenergic receptor signaling pathway and differentially expressed genes. RESULTS: The adrenergic receptor signaling pathway was found in various immune cells, including T cells. scRNA-seq analysis revealed increased ADRB1 expression in T cells after neoadjuvant therapy. Immunofluorescence confirmed colocalization of ADRB1 with T cells, and fluorescence-activated cell sorting (FACS) showed that ADRB1 expression was elevated alongside exhaustion markers, while immune function markers were reduced. CNV analysis highlighted malignant cells in the tumor microenvironment, and intercellular interaction analysis explored ADRB1(+) T cells' role in immune support. Deconvolution of TCGA data identified ADRB1(+) T cells, SPP1(+) macrophages, and CD44(+) malignant cells, all of which were prognostically significant. A prognostic model constructed from the intersection of the adrenergic receptor signaling pathway and differentially expressed genes following neoadjuvant therapy showed a significant prognostic effect. CONCLUSIONS: ADRB1 expression increases after neoadjuvant therapy in ESCC and correlates with poor prognosis. Our findings suggest ADRB1 as a potential prognostic biomarker and therapeutic target for post-neoadjuvant immunotherapy.	esophagus
Trop2, Nectin-4, and PD-L1 expression profiles in esophageal squamous cell carcinoma: Implications for combined immunotherapy and ADC targeted therapies.	AIM: Trop2, Nectin-4, and PD-L1 are targets of antibody-drug conjugate (ADC) drugs and immunological agents, respectively, closely related to the biological characteristics of malignant tumors. This study analyzed the expression and clinical significance of Trop2, Nectin-4, and PD-L1 and their association with esophageal squamous cell carcinoma (ESCC). METHODS: Clinicopathological data of 140 patients with ESCC undergoing radical resection at the Affiliated Hospital of Qingdao University were retrospectively collected. Immunohistochemistry (IHC) was conducted to assess the expression of Trop2, Nectin-4, and PD-L1 in the specimens, with quantification and categorization of expression levels by the histochemistry score (H-score). For PD-L1, the combined positive score (CPS) was also evaluated. RESULTS: Positivity rates for Trop2, Nectin-4, and PD-L1 were 99.3 %, 95.7 %, and 43.6 %, respectively. Trop2 correlated with lymphatic vessel invasion, lymph node invasion, and advanced tumor stage, while Nectin-4 was associated with lymphatic vessel invasion, peripheral nerve invasion, lymph node invasion, and advanced pathological T stage. Additionally, PD-L1-positive patients exhibited higher rates of elevated Trop2 and Nectin-4 expression, increased lymphatic vessel invasion, and advanced pathological T stage compared to PD-L1-negative patients. Furthermore, among individuals potentially eligible for immunotherapy (PD-L1 CPS >10), PD-L1 expression displayed a significantly weak correlation with Nectin-4 expression. Furthermore, Trop2 served as an independent poor prognostic indicator for ESCC patients. CONCLUSIONS: The expression landscape of Trop2, Nectin-4, and PD-L1 in ESCC indicated the feasibility of combining immunotherapy with ADC drug-targeted therapies.	esophagus
Sentinel Lymph Node Mapping in Esophageal Cancer: Current Status and Future Directions.	OBJECTIVE: This review provides a comprehensive discussion about the importance of adequate lymphadenectomy, its anatomic and oncologic significance, principles and rationale of sentinel lymph node mapping, current evidence stratified by tracer substrate, challenges, and future directions. Esophageal cancer has one of the worst cancer-related survival rates, and nodal status is the single most significant prognostic factor. Submucosal penetration generally demands esophagectomy, often following neoadjuvant therapy in the presence of deeper extension. Guidelines recommend resecting ≥15 lymph nodes. Variability in surgical approach and dissection in concert with aberrant esophageal lymphatic anatomy make adequate lymphadenectomy difficult. METHODS: A narrative review was conducted to explore existing literature regarding lymphadenectomy with its requisite anatomic and oncologic significance in esophageal cancer, as well as the rationale for and present state of sentinel lymph node mapping stratified by substrates. Tables and figures were constructed by the authors using Microsoft Office applications and Biorender software, respectively. RESULTS: Sentinel lymph node mapping exploits the tumoral lymphatic network to identify the nodes most prone to metastasis, directing further dissection. Targeting sentinel lymph nodes with dyes, radiotracers, or hybrid tracers can assist surgeons with lymphadenectomy, potentially improving staging accuracy and personalizing care to individual anatomy. CONCLUSIONS: While this approach would benefit from larger studies and long-term data, early evaluations suggest improved detection of metastases outside the en bloc field without significantly increasing morbidity.	esophagus