crossing96/oncoscreening huggingface dataset:
Anaplastic lymphoma of the cervical esophagus presenting as a tracheoesophageal fistula.	BACKGROUND: Anaplastic kinase-1 positive lymphoma (ALK-1) is a very rare but distinct pathologic entity. ALK-1 lymphoma tends to affect the bone marrow, skin, lungs, soft tissue, but very rarely the gastrointestinal tract. METHODS: We report a case of ALK-1 positive lymphoma presenting as a tracheoesophageal fistula. The clinical presentation, histopathology, and management outcome are all discussed. CONCLUSION: ALK-1 positive lymphoma of the upper aerodigestive involvement is extremely rare. An unusual presentation such as pharyngeal pouch with vocal cord palsy should suggest pathology. Histopathologic analysis can be difficult and immunohistochemical studies will aid are of paramount importance in the diagnosis and help in subsequent management and also act as prognostic indicators.	esophagus
Clinical impact of endoscopic submucosal dissection for superficial adenocarcinoma located at the esophagogastric junction.	"BACKGROUND: Surgery is the standard treatment for neoplasms located at the esophagogastric junction (EGJ), and, recently, EMR, photodynamic therapy (PDT), or both have also been used for early stage neoplasms located at the EGJ. Endoscopic submucosal dissection (ESD) is a newly developed technique in the field of endoscopic treatments for GI neoplasms because of its high rate of en bloc resection. OBJECTIVE: We used ESD for superficial adenocarcinoma located at the EGJ and evaluated its clinical impact. PATIENTS: Twenty-five lesions of superficial adenocarcinomas located at the EGJ from 24 patients were treated with ESD between June 2001 and January 2006. An adenocarcinoma located at the EGJ was defined as a ""junctional carcinoma (type II)"" according to Siewert's classification. MAIN OUTCOME MEASUREMENT: Complications, en bloc resection rate, curative resection rate, local recurrence, and distant metastasis were evaluated. RESULTS: No complications except stenosis occurred. The en bloc resection rate was 100%. Seventeen lesions (72.0%) were judged as ""curative resection"" and showed no local or distant recurrence during a median follow-up period of 30.1 months. Seven lesions were diagnosed as ""noncurative resection."" Two patients underwent additional surgical resections. In 1 of 2 of the surgical resections, however, we could not identify a residual cancer. In 1 patient, who refused additional surgical resection, lung metastases were found after 3 years. LIMITATIONS: The limitation of the study was its retrospective design. CONCLUSIONS: After long-term follow-up, although surgery for a noncurative resection remains a standard treatment, ESD can be adequately adopted as an effective treatment for superficial adenocarcinomas at the EGJ."	esophagus
Oesphageal stenting for palliation of malignant mesothelioma.	Dyspahgia in patients with malignant mesothelioma is usually due to direct infiltration of the eosophagus by the tumour. It can be distressing for the patient and challenging for the physician to treat. We describe three cases in which this condition has been successfully palliated with self expanding esophageal stents.	esophagus
[A case of squamous cell carcinoma of esophagus with mediastinal lymph node recurrence after surgical resection treated with systemic chemotherapy and chemoradiotherapy].	The patient was a 58-year-old man with a mediastinal lymph node recurrence 26 months after surgical resection of squamous cell carcinoma of esophagus. We started a treatment with systemic chemotherapy (FAP chemotherapy) on the supposition of systemic recurrence. Next, chemoradiotherapy with docetaxel (DOC) was chosen for the expectation of powerful local control. Then bi-weekly DOC chemotherapy was chosen for the third-line therapy at an outpatient clinic. A complete response (CR) was observed after the sixth course and the treatment was finished at the twelfth course. CT showed CR after the treatment for six months. The prognosis of the cases with post-operative recurrences was poor, and its formation of recurrence varied. The strategy of the treatment should be considered a case-by-case.	esophagus
[A case report of local recurrence of esophageal cancer after chemoradiation successfully treated by placement of tracheal stent].	We have experienced a case of esophageal cancer demonstrating a progressive stricture, due to local recurrence after chemo-radiotherapy, successfully treated by placing a tracheal stent into the esophageal lumen. After placing the stent, the patient's quality of life has improved. For the patient who received radiation for esophageal cancer, esophageal stenting often caused a serious complication such as perforation due to tissue stiffness. Tracheal stent with a smaller diameter successfully improved a food passage without any adverse complications. Development of the covered esophageal stent with a smaller diameter to prevent a perforation after radiation is desired.	esophagus
[Clinical features of endotracheal/endobronchial metastases: analysis of 62 cases].	OBJECTIVE: To describe the clinical presentations, diagnosis and treatment of endotracheal/endobronchial metastases (EEM). METHODS: Retrospective and follow-up analyses were conducted for 62 cases of bronchoscopically confirmed EEM. Clinical staging, location in the tracheobronchial tree, the number of lesions, treatment and prognosis were analyzed. RESULTS: The most common neoplasms associated with EEM were breast cancer (17.7%), coronal cancer (17.7%), and esophageal carcinoma (14.5%). Most EEM patients presented with cough, hemoptysis, dyspnea, chest pain and fever. Abnormal changes on chest X-ray were found in 87.1% cases, and CT changes were found in all patients. A total of 76 intraluminal lesions were recorded, of which 19 in the trachea and 57 in the bronchus, including 31 in the right bronchus and 26 in the left bronchus. Type I EEM accounted for 28.9%; Type II, 23.7%; Type III, 14.5%, and Type IV, 32.9%. The median survival time was 9.8 months. There was significant difference in survival time between Type IV EEM and the other three types (P < 0.05). CONCLUSIONS: EEM may occur in the trachea or in the bronchus. Flexible bronchoscopy is a valuable tool for the diagnosis of EEM. Although there are cases of long survival, the prognosis of EEM is generally poor.	esophagus
Systematic review of the impact of endoscopic ultrasound on the management of patients with esophageal cancer.	OBJECTIVES: Although endoscopic ultrasound (EUS) staging of esophageal cancer is established in clinical practice, high-quality evidence about its impact on patient outcomes is not available. This study aims to determine the impact of EUS for esophageal cancer staging on patient management and survival. METHODS: A systematic review was conducted using Medline, PreMedline, Embase, and The Cochrane Library. Included studies were (i) comparative studies reporting survival following EUS esophageal cancer staging, (ii) therapeutic impact studies reporting change in patient management following EUS. The quality of included studies was critically appraised. RESULTS: One systematic review, five studies reporting therapeutic impact, and two studies reporting patient survival were identified. The design and quality of the therapeutic impact studies varied widely. Management changed in 24-29 percent of patients following EUS staging of esophageal cancer (two studies). No studies provided data on the avoidance of surgery for this indication. One retrospective cohort study with historical control found EUS staging of esophageal cancer improved patient survival; a second study with similar design limitations did not find a survival benefit for EUS staging in patients undergoing resection. These studies had a high potential for bias, limiting the value of these findings. CONCLUSIONS: Two studies provided evidence of a change in patient management following EUS for staging esophageal cancer, a higher level of evidence for a clinical benefit than can be obtained from accuracy studies alone. This evidence contributed to a recommendation for public funding of EUS in staging esophageal cancer in Australia.	esophagus
Surgical treatment of intractable cutaneous fistula with osteomyelitis in the neck developed after esophagectomy.	A case of intractable cutaneous fistula in an esophagogastrostomized region complicated by osteomyelitis is reported. A three-stage operation was performed, and gratifying results were obtained. The patient was a 74-year-old man who received a subtotal esophagectomy and a cervical esophagogastrostomy through a retrosternal approach for advanced esophageal cancer. Following subsequent radiotherapy, the anastomosed region in the neck was found to have been stenosed. Endoscopic balloon dilatation was then performed and perforation of the stenosed region occurred to form an intractable fistula. A chest computed tomography scan revealed osteolysis of the sternum, clavicular head and left first rib. Treatment comprised an initial control of the infective foci including osteomyelitis and, after achieving stabilization of the wounds, the subsequent step of reconstruction. The patient's postoperative course was satisfactory without involvement of any leakage or stenosis of the anastomosed regions, or wound infection. It is considered feasible to cure even a cutaneous fistula in the neck complicated by osteomyelitis, as in the present case, by sufficient control of infection and procedural contrivance.	esophagus
Staging investigations for oesophageal cancer: a meta-analysis.	The aim of the study was to compare the diagnostic performance of endoscopic ultrasonography (EUS), computed tomography (CT), and 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in staging of oesophageal cancer. PubMed was searched to identify English-language articles published before January 2006 and reporting on diagnostic performance of EUS, CT, and/or FDG-PET in oesophageal cancer patients. Articles were included if absolute numbers of true-positive, false-negative, false-positive, and true-negative test results were available or derivable for regional, celiac, and abdominal lymph node metastases and/or distant metastases. Sensitivities and specificities were pooled using a random effects model. Summary receiver operating characteristic analysis was performed to study potential effects of study and patient characteristics. Random effects pooled sensitivities of EUS, CT, and FDG-PET for regional lymph node metastases were 0.80 (95% confidence interval 0.75-0.84), 0.50 (0.41-0.60), and 0.57 (0.43-0.70), respectively, and specificities were 0.70 (0.65-0.75), 0.83 (0.77-0.89), and 0.85 (0.76-0.95), respectively. Diagnostic performance did not differ significantly across these tests. For detection of celiac lymph node metastases by EUS, sensitivity and specificity were 0.85 (0.72-0.99) and 0.96 (0.92-1.00), respectively. For abdominal lymph node metastases by CT, these values were 0.42 (0.29-0.54) and 0.93 (0.86-1.00), respectively. For distant metastases, sensitivity and specificity were 0.71 (0.62-0.79) and 0.93 (0.89-0.97) for FDG-PET and 0.52 (0.33-0.71) and 0.91 (0.86-0.96) for CT, respectively. Diagnostic performance of FDG-PET for distant metastases was significantly higher than that of CT, which was not significantly affected by study and patient characteristics. The results suggest that EUS, CT, and FDG-PET each play a distinctive role in the detection of metastases in oesophageal cancer patients. For the detection of regional lymph node metastases, EUS is most sensitive, whereas CT and FDG-PET are more specific tests. For the evaluation of distant metastases, FDG-PET has probably a higher sensitivity than CT. Its combined use could however be of clinical value, with FDG-PET detecting possible metastases and CT confirming or excluding their presence and precisely determining the location(s).	esophagus
Interplay between oncoproteins and antioxidant enzymes in esophageal carcinoma treated without and with chemoradiotherapy: a prospective study.	PURPOSE: To analyze p53, bcl-2, c-myc, and cyclooxygenase-2 protein expression changes and examine their relationship with various antioxidant enzymes in esophageal carcinoma patients. METHODS AND MATERIALS: Patients in Group 1 underwent transhiatal esophagectomy and those in Group 2 were administered chemoradiotherapy followed by surgery after 4 weeks of neoadjuvant therapy. RESULTS: The relationship analysis among the various protein markers and antioxidant enzymes showed an inverse correlation between bcl-2 and superoxide dismutase/catalase in tumor tissues, irrespective of the treatment arm followed. An important positive association was observed between bcl-2 and reduced glutathione levels in the tumor tissue of patients receiving neoadjuvant therapy. Another apoptosis-modulating marker, c-myc, in the tumor tissue of Group 2 patients showed similar pattern levels (high and low) as that of superoxide dismutase/catalase. The association of cyclooxygenase-2 and p53 with various antioxidant enzymes showed a significant positive correlation between cyclooxygenase-2 expression and catalase activity and an inverse trend between p53 expression and superoxide dismutase and catalase activity in the tumor tissue of patients given neoadjuvant therapy. In addition, patients with overexpressed p53 protein levels had lower glutathione peroxidase enzyme levels and vice versa in the tumor tissue of patients who had undergone surgery as their main mode of treatment. CONCLUSION: The results of this study broaden the insight into the relationships shared among oncoproteins and the antioxidant defense system, and this could be helpful in the clinical management of esophageal carcinoma.	esophagus
Barrett's esophagus: a retrospective analysis of 13 years surveillance.	BACKGROUND AND AIMS: The incidence of esophageal adenocarcinoma has increased significantly. Barrett's esophagus (BE), a known precursor, has a high prevalence but only few patients with this condition progress to malignancy--surveillance and screening programs are controversial and lack proven efficacy. This retrospective analysis reviews the 13-year outcome for patients entered into a surveillance program. METHODS: Data from patients with histologically proven Barrett's esophagus (1992-2003) that participated in a surveillance program were identified and analyzed retrospectively until 2005. RESULTS: 404/536 patients had Barrett's esophagus confirmed histologically of which 212 (53%) were followed in a surveillance program (mean 3.95 years per patient). This resulted in 749 gastroscopies (3.5/patient). Histologically, Barrett's mucosa was seen in 54%, low-grade dysplasia in 18%, ulcerations in 9%, high-grade dysplasia in 2%. No metaplasia was seen in 13%, no biopsy was obtained in 3%. Nine of 212 patients (4.3%) under surveillance developed esophageal cancer; two presented with symptoms, requiring gastroscopy outside the surveillance program (1/2 was operated successfully, one had advanced disease). In seven asymptomatic patients, cancer was detected on routine endoscopy; curative esophagectomy was performed in six. All patients who developed cancer were male and all but one patient had dysplasia or ulcerations on index endoscopy. CONCLUSION: During 13 years of Barrett's surveillance, 88% of all adenocarcinoma occurred in a subset of only 11% patients. To stratify surveillance for Barrett's esophagus, programs could focus on male patients with dysplasia or ulcerations on index endoscopy. However, the cost-effectiveness of this remains unproven.	esophagus
Lymphovascular invasion as a tool to further subclassify T1b esophageal adenocarcinoma.	BACKGROUND: Lymphovascular invasion (LVI) and/or lymph node metastases (LNM) adversely influence the overall survival (OS) of patients with T1 esophageal adenocarcinoma. Although endoscopic therapy may be adequate for patients with T1a cancer, patients with T1b cancer require esophagectomy/lymphadenectomy. The authors hypothesized that LVI status would subclassify T1b cancers and facilitate new therapeutic strategies. METHODS: Ninety-nine consecutive patients with T1 adenocarcinoma were analyzed after they underwent esophagectomy/lymphadenectomy. LNM was assessed in all patients, and LVI was assessed in 89 patients. OS was correlated with pathologic cancer stage in association with LVI and LNM. RESULTS: The 5-year OS rate for patients with T1a tumors (88%) was superior to that for patients with T1b tumors (62%; P = .001). The 5-year OS rate for patients who had cancers without LVI (85%) was superior to the rate for patients who had cancers with LVI (36%; P = .0001). It is noteworthy that, for cancers without LVI, the 5-year OS rate for patients with T1b tumors (77%) was similar to the rate for patients with T1a tumors (90%; P = .08), but it was superior to the rate for patients with T1b tumors that had LVI (27%; P = .006). The presence of LVI and/or LNM resulted in worse 5-year OS (< or =37%) compared with the lack of LVI and/or LNM (88%; P < .001). The rate of LNM for patients who had T1b tumors without LVI still was 19%, and the relapse rate was 16%. CONCLUSIONS: The current results demonstrated that LVI distinguishes the biologic behavior of early esophageal cancer, and patients who have T1b cancer without LVI have a clinical biology similar to that of patients with T1a cancer. If LNM before surgery can be diagnosed with high sensitivity by better endoscopic techniques and/or molecular biomarkers, then a new therapeutic paradigm for T1b cancers could emerge. Further research is needed on patients with T1b esophageal adenocarcinoma.	esophagus
The adenocarcinoma-associated antigen, AGR2, promotes tumor growth, cell migration, and cellular transformation.	The AGR2 gene encodes a secretory protein that is highly expressed in adenocarcinomas of the esophagus, pancreas, breast, and prostate. This study explores the effect of AGR2 expression with well-established in vitro and in vivo assays that screen for cellular transformation and tumor growth. AGR2 expression in SEG-1 esophageal adenocarcinoma cells was reduced with RNA interference. Cellular transformation was examined using NIH3T3 cells that express AGR2 after stable transfection. The cell lines were studied in vitro with assays for density-dependent and anchorage-independent growth, and in vivo as tumor xenografts in nude mice. SEG-1 cells with reduced AGR2 expression showed an 82% decrease in anchorage-independent colony growth and a 60% reduction in tumor xenograft size. In vitro assays of AGR2-expressing NIH3T3 cells displayed enhanced foci formation and anchorage-independent growth. In vivo, AGR2-expressing NIH3T3 cells established tumors in nude mice. Thus, AGR2 expression promotes tumor growth in esophageal adenocarcinoma cells and is able to transform NIH3T3 cells. Immunohistochemistry of the normal mouse intestine detected AGR2 expression in proliferating and differentiated intestinal cells of secretory lineage. AGR2 may be important for the growth and development of the intestine as well as esophageal adenocarcinomas.	esophagus
Side-to-side stapled intra-thoracic esophagogastric anastomosis reduces the incidence of leaks and stenosis.	Trans-hiatal esophagectomy with a hand-sewn anastomosis was for 2 decades the preferred approach in our institution for patients with esophageal cancer. In our experience, this anastomotic technique was associated with a 12% leak rate and a 48% rate of stricture requiring dilatation. We sought to determine if a side-to-side intra-thoracic anastomosis was associated with a lower rate of anastomotic stricture and leak. Thirty-three consecutive patients with distal esophageal cancer or Barrett's esophagus with high grade dysplasia underwent a trans-thoracic esophagectomy with a side-to-side stapled intra-thoracic anastomosis. The overall morbidity was 27%, with no anastomotic stricture or leaks. One patient died (3%). The median time to the resumption of an oral diet was 7 days (range 5-28), and the median length of stay in hospital was 9 days (range 6-45). Trans-thoracic esophagectomy with a side-to-side stapled anastomosis is safe and it is associated with a very low rate of anastomotic complications. We consider this to be the procedure of choice for patients with distal esophageal cancers.	esophagus
A large series, resection controlled study to assess the value of radial EUS in restaging gastroesophageal cancer following neoadjuvant chemotherapy.	The true value of endoscopic ultrasound (EUS) post-neoadjuvant chemotherapy for esophageal carcinoma is not established. Superior loco-regional detail may yield useful staging and prognostic information but information on its accuracy, as compared with computed tomography (CT), remains undefined and limited by small study size. We prospectively studied 109 patients with gastroesophageal cancer; 99 of whom were undergoing surgery. All had EUS and helical CT imaging before and after neoadjuvant chemotherapy and the results were compared with pathological staging of resected specimens. Tumor response was assessed by the reduction in maximal tumor depth at EUS and correlated with patient survival. There was no difference in T and N stage accuracies between EUS and CT following neoadjuvant chemotherapy. manova showed a reduction in maximal tumor depth by > 50% at EUS to be associated with longer survival (relative risk = 0.48, P < 0.05). EUS responders had a median survival of 38 months compared to 30 months for non-responders (P < 0.05). The identification of lymphadenopathy at radial EUS was not predictive of survival. This large series study demonstrates the staging accuracy of CT and non-biopsy EUS in the setting of neoadjuvant chemotherapy for gastroesophageal cancer to be equivalent and poor. An endosonography may contribute useful clinical information in respect of potential survival. It is questionable whether radial EUS should be included in protocols for restaging.	esophagus
[Effect of thoracic duct ligation during transthoracic esophagectomy on the prevention of post-operative chylothorax in different tumor locations].	OBJECTIVE: To investigate the effect of thoracic duct ligation during transthoracic esophagectomy on preventing post-operative chylothorax in different tumor locations. METHODS: Between March 2003 and June 2007, 243 patients with thoracic esophageal carcinoma underwent esophageal resection in our hospital. All the cases were divided into five groups according to tumor localization, including cervical, upper middle, middle, lower middle and lower sections. Each was then subdivided into 2 groups: with and without intraoperative thoracic duct ligation. Statistical analysis was carried out to evaluate the relevance between ligation and non-ligation of the thoracic duct during esophagectomy and the incidence of post-operative chylothorax. RESULTS: A total of 8 cases of post-operative chylothorax was recorded and the incidence was 3.3%. Incidence with respect to tumor location was as follows: cervical section: ligation subgroup 3 cases and non-ligation subgroup 5 cases; upper middle section: no one for both ligation and non-ligation subgroups; middle section: ligation subgroup 0/26 and non-ligation subgroup 1/28 (3.6%); lower middle section: ligation subgroup 1/39 (2.6%) and non-ligation subgroup 1/35 (2.9%); lower section: ligation subgroup 1/37 (2.7%) and non-ligation subgroup 2/44 (4.5%). Logistic regression analysis revealed no significant difference between ligation and non-ligation subgroup in the prevention of post-operative chylothorax (P>0.05). CONCLUSION: Thoracic duct ligation as preventive measure can not decrease the incidence of chylothorax secondary to esophagectomy.	esophagus