crossing96/oncoscreening huggingface dataset:
[Analysis of the therapeutic effect of esophagectomy with extended 2-field lymph node dissection for esophageal carcinoma].	OBJECTIVE: To summarize the surgical effect and clinical application value of esophagectomy with extended 2-field lymph node dissection for patients with esophageal carcinoma. METHODS: From June 1987 to December 2008, 1690 patients with esophageal cancer underwent esophagectomy with extended 2-field (thoracic and abdominal) dissection of lymph nodes. Patients with the middle and lower thoracic esophageal cancer underwent Ivor-Lewis esophagectomy, and patients with upper thoracic esophageal cancer underwent Akiyama esophagectomy. 2-field (thoracic and abdominal) lymph node metastases information and the 1, 3, 5, 10-year survival rates were analyzed retrospectively. RESULTS: Lymph node metastases were found in 713 patients. The lymph node metastases rate was 42.2% (713/1690).Thoracic lymph node metastasis rate was 39.3% (665/1690), among which in the right pleural apical para-tracheal triangle was 20.7% (349/1690), in the posterior upper mediastinum was 26.3% (444/1690), in the lower mediastinum was 18.2% (307/1690). Abdominal lymph node metastasis rate was 20.1% (339/1690). THE Postoperative complication rate was 16.4% (278/1690), among which the pulmonary complication rate ranking the first, was 43.6% (136/312). The operative mortality rate was 0.2%. The 1-year, 3-year, 5-year and 10-year survival rates were 88.2% (1388/1574), 63.5% (868/1367), 54.8% (705/1287) and 30.8% (232/754), respectively. The 5-year survival rate in patients without lymph node metastasis was 76.2% (448/588), but that in patients with lymph node metastases was 36.8% (257/669). CONCLUSION: The results of this study demonstrated that Ivor-Lewis and Akiyama esophagectomy with two-field lymph node dissection exposes the operation fields clearly and make radical lymphadenectomy thoroughly, especially the lymph nodes in the posterior upper mediastinum around the recurrent laryngeal nerve and in the right pleural apical para-tracheal triangle. It is essential that patients with esophageal carcinoma with lymph node metastases should undergo esophagectomy with extended 2-field dissection of lymph nodes. This can elevate the postoperative 5-year survival rate remarkably.	esophagus
[Relationship between the level of RRM1 expression and the sensitivity to gemcitabine in the esophageal squamous cell carcinoma cell lines].	OBJECTIVE: Ribonucleotide reductase subunit M1 (RRM1) is the intracellular target of gemcitabine (GEM). The aim of this study is to explore the relationship between the level of RRM1 expression and the sensitivity to GEM in the esophageal squamous cell carcinoma cell lines. METHODS: Four esophageal squamous cell carcinoma cell lines (Kyse-150, Kyse-450, 9706 and Eca-109) were cultured in vitro. In the same period, RRM1 expression level was measured by RT-PCR and Western blot, and cell sensitivity to GEM was determined by CCK-8 assay. The relation between cell sensitivity and RRM1 expression was further analyzed. Kyse-450 cells were continuously cultured in the medium containing 50 nM GEM. RRM1 expression was measured at different time points to monitor the dynamic changes in the surviving cells. Inhibition of RRM1 expression by RNAi method was applied and the effect on GEM-sensitivity was further examined. RESULTS: The IC(50) of Eca-109, Kyse-150, Kyse-450 and 9706 cells were (0.92 +/- 0.17), (0.48 +/- 0.11), (0.29 +/- 0.06) and (0.02 +/- 0.01) mmol/L, respectively. The expressions of RRM1 protein and mRNA of Eca-109 cell line were the highest detected by Western blot and RT-PCR, followed by Kyse-150 and Kyse-450, and the lowest one was 9706 cell line. When Kyse-450 cells were continuously treated with 50 nmol/L GEM, the level of RRM1 protein was increasing in the surviving cells. RRM1 siRNA could effectively knock down the expression of RRM1 and significantly increase the cell sensitivity to GEM (P = 0.035). CONCLUSION: The level of RRM1 expression correlates with the cell sensitivity to gemcitabine. The cells with a lower level of RRM1 expression are more sensitive to gemcitabine.	esophagus
In vitro antigen-specific cytotoxic T cell response against esophageal carcinoma cells induced by HPV18E7-transfected dendritic cells.	Human Papillomavirus (HPV)-associated esophageal carcinoma (EC) is a high incidence tumor worldwide. Dendritic cell (DC)-based tumor vaccine is considered an alternative therapy to treat EC. Here we developed a DC-based vaccine by transfecting cord blood CD34+ stem cell-derived DC with HPV18E7 gene, observed its biological characteristics and the antigen-specific T-cell cytotoxicity on EC cells induced by HPV18E7-DC in vitro. Our results showed that 1) HPV18E7 gene transfer did not change the typical morphology of mature DC, 2) the representative phenotypes of mature DC (CD80, CD86, and CD83) were highly expressed in HPV18E7- DC (81.6%, 80.5%, and 86.6%, respectively), 3) the expression level of 18E7 protein in HPV18E7-DC was 47.5%, and 4) the specific cytotoxicity against EC cells was significantly higher than that in controls (p<0.01). This study indicates the possibility of a DC-based immunotherapy in HPV-associated EC.	esophagus
Neoadjuvant chemoradiotherapy for resectable esophageal carcinoma: a meta-analysis.	AIM: To compare neoadjuvant chemoradiotherapy and surgery with surgery alone for resectable esophageal carcinoma. METHODS: We used MEDLINE and EMBASE databases to identify eligible studies and manual searches were done to ensure no studies were missed. Trial validity assessment was performed and a trial quality score was assigned. RESULTS: Eleven randomized controlled trials (RCTs) including 1308 patients were selected. Neoadjuvant chemoradiotherapy significantly improved the overall survival compared with surgery alone. Odds ratio (OR) [95% confidence interval (CI), P value], expressed as neoadjuvant chemoradiotherapy and surgery vs surgery alone, was 1.28 (1.01-1.64, P = 0.05) for 1-year survival, 1.78 (1.20-2.66, P = 0.004) for 3-year survival, and 1.46 (1.07-1.99, P = 0.02) for 5-year survival. Postoperative mortality increased in patients treated by neoadjuvant chemoradiotherapy (OR: 1.68, 95% CI: 1.03-2.73, P = 0.04), but incidence of postoperative complications was similar in two groups (OR: 1.14, 95% CI: 0.88-1.49, P = 0.32). Neoadjuvant chemoradiotherapy lowered the local-regional cancer recurrence (OR: 0.64, 95% CI: 0.41-0.99, P = 0.04), but incidence of distant cancer recurrence was similar (OR: 0.94, 95% CI: 0.68-1.31, P = 0.73). Histological subgroup analysis indicated that esophageal squamous cell carcinoma did not benefit from neoadjuvant chemoradiotherapy, OR (95% CI, P value) was 1.16 (0.85-1.57, P = 0.34) for 1-year survival, 1.34 (0.98-1.82, P = 0.07) for 3-year survival and 1.41 (0.98-2.02, P = 0.06) for 5-year survival. CONCLUSION: Neoadjuvant chemoradiotherapy can raise the survival rate of patients with esophageal adenocarcinoma.	esophagus
[Clinical utility of PET-CT for esophageal cancer].	It is important to diagnose the exact clinical staging according to the improvement of treatment for esophageal cancer. PET examinations for esophageal cancer are now covered by Japanese government health insurance, so the number of PET scans is now gradually increased in many institutions and their utility has been reported. In this report, we reviewed the conventional diagnostic tools for esophageal cancer and evaluated the clinical significance of PET-scans conventionally associated with it. The depth of tumor invasion of a primary tumor is detectable in more than 80% of cases of SM2 or deeper invasion. With lymph node metastasis, the sensitivity was 66. 7% and specificity 93. 5%. With distant metastasis, there is reportedly a high detection rate in bone metastasis and liver metastasis. However, with lung metastasis, reference to CT scans rather than PETscans is important in making a carefull diagnosis. In judging the effect of preoperative chemoradiotherapy, PET-CT was suggested to be an effective diagnostic tool. In addition, PET may be a useful diagnostic tool for postoperative follow-up patients. Finally, further investigation may well be necessary in the future.	esophagus
[Inflammatory fibroid polyp: a report of three cases including an oesophageal tumor].	We report three different cases in location with an original occurrence in the oesophagus. The gross appearance showed polypoid pedonculated masses with a whitish cut surface, arising from the submucosa. On microscopic examination, the tumor consisted of spindle cell dispersed in a loose fibromyxoid stroma containing numerous blood vessels and inflammatory cells with abundant eosinophils. At immunohistochemistry, the cells were strongly positive for CD34. Inflammatory fibroid polyp is a rare benign lesion of the gastro-intestinal tract. The pathogenesis of this lesion remains throat and unclear. Diagnosis on biopsy is difficult with various histologic pattern and because the inflammatory fibroid polyp share common pathologic features with digestive spindle cells tumor.	esophagus
Outcomes following oesophagectomy in patients with oesophageal cancer: a secondary analysis of the ICNARC Case Mix Programme Database.	INTRODUCTION: This report describes the case mix and outcomes of patients with oesophageal cancer admitted to adult critical care units following elective oesophageal surgery in England, Wales and Northern Ireland. METHODS: Admissions to critical care following elective oesophageal surgery for malignancy were identified using data from the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme Database. Information on admissions between December 1995 and September 2007 were extracted and the association between in-hospital mortality and patient characteristics on admission to critical care was assessed using multiple logistic regression analysis. The performance of three prognostic models (Simplified Acute Physiology Score (SAPS) II, Acute Physiology and Chronic Health Evaluation (APACHE) II and the ICNARC physiology score) was also evaluated. RESULTS: Between 1995 and 2007, there were 7227 admissions to 181 critical care units following oesophageal surgery for malignancy. Overall mortality in critical care was 4.4% and in-hospital mortality was 11%, although both declined steadily over time. Eight hundred and seventy-three (12.2%) patients were readmitted to critical care, most commonly for respiratory complications (49%) and surgical complications (25%). Readmitted patients had a critical care unit mortality of 24.7% and in-hospital mortality of 33.9%. Overall in-hospital mortality was associated with patient age, and various physiological measurements on admission to critical care (partial pressure of arterial oxygen (PaO2):fraction of inspired oxygen (FiO2) ratio, lowest arterial pH, mechanical ventilation, serum albumin, urea and creatinine). The three prognostic models evaluated performed poorly in measures of discrimination, calibration and goodness of fit. CONCLUSIONS: Surgery for oesophageal malignancy continues to be associated with significant morbidity and mortality. Age and organ dysfunction in the early postoperative period are associated with an increased risk of death. Postoperative serum albumin is confirmed as an additional prognostic factor. More work is required to determine how this knowledge may improve clinical management.	esophagus
[Cyclooxygenase inhibitors in chemoprevention and treatment of esophageal squamous cell carcinoma].	Cyclooxygenase inhibitors (COX) are a complex group of pharmacological compounds characterized by significant efficacy in chemoprevention of epithelial origin tumors, especially colorectal ones. It was found that inducible isoform of COX - COX-2 plays an important role in cancer growth and dissemination, e.g., by increase of cellular proliferation, reduction of apoptosis, promotion of local invasiveness and angiogenesis. COX inhibitors decrease prostaglandins' synthesis, but COX-independent mechanisms of their preventive and therapeutical activity were also proven. The influence of COX inhibitors on growth of esophageal squamous cell carcinoma and its precursor lesions was not completely clear. Most studies based on human cancer cell lines revealed antiproliferative and proapoptotic ability of both nonselective (previously called non-steroidal antiinflammatory drugs--NSAIDs) and selective COX-2 inhibitors (coxibs). In in vivo studies performed on animals exposed to chemical carcinogens, the chemopreventive effect was achieved exclusively after administration of experimental selective COX-2 inhibitors, but in the only human trial, supplementation of selective COX-2 inhibitor--celecoxib turned out ineffective. However, many epidemiological data proved effect of prolonged administration of nonselective COX inhibitors, especially acetylsalicylic acid on decreased risk of esophageal squamous cell carcinoma. Few reports concerning application of selective COX-2 inhibitors in patients with invasive squamous cell carcinoma are insufficient for ultimate evaluation of this method of therapy.	esophagus
Ischemic conditioning shows a time-dependant influence on the fate of the gastric conduit after minimally invasive esophagectomy.	BACKGROUND: Minimally invasive esophagectomy (MIO) is now established as a valid alternative to open surgery for the management of esophagogastric cancers. However, a high incidence of ischemia-related gastric conduit failure (ICF) is observed, which is detrimental to any potential benefits of this approach. METHODS: Since April 2004, MIO has been the procedure of choice for esophagogastric resection in the authors' unit. Data relating to the surgical technique were collected, with a focus on ischemic conditioning by laparoscopic ligation of the left gastric artery (LIC) 2 weeks or 5 days before resection. RESULTS: A total of 97 patients underwent a planned MIO. Four in-patient deaths (4.1%) occurred, none of which were conduit related, and overall, 20 patients experienced ICF (20.6%). In four patients, ICF was recognized and dealt with at the initial surgery. The remaining 16 patients experienced this complication postoperatively, with 9 (9.3%) of them requiring further surgery. Of the 97 patients, 55 did not undergo ischemic conditioning, and conduit failure was observed in 11 (20%). Thirty-five patients had LIC at 2 weeks, and 2 (5.7%) experienced ICF. All seven patients (100%) who had LIC at 5 days experienced ICF. Timing of ischemic conditioning (p < 0.0001) had a definite impact on the conduit failure rate, and the benefit of ischemic conditioning at 2 weeks compared with no conditioning neared significance (p = 0.07). CONCLUSIONS: Ischemic failure of the gastric conduit significantly impairs recovery after MIO. Ischemic conditioning 2 weeks before surgery may reduce this complication and allow the benefits of this approach to be realized.	esophagus
Optimal timing of endoscopic evaluation of the primary site of esophageal cancer after chemoradiotherapy or radiotherapy: a retrospective analysis.	BACKGROUND: Although use of gastrointestinal endoscopy for response evaluation in patients with esophageal cancer undergoing chemoradiotherapy or radiotherapy (CRT/RT) treatment is widely accepted, optimal timing for evaluation has not been sufficiently investigated. Here, we investigated optimal timing of primary site response evaluation in esophageal cancer patients treated with CRT/RT. PATIENTS AND METHODS: This study examined esophageal cancer patients who underwent CRT/RT between September 2002 and December 2004. Time to complete response (CR) at the primary site was assessed in patients designated as CR at the primary site, while progression-free survival at the primary site (PFSp) was assessed in patients designated as incomplete response at the primary site. RESULTS: Eighty-three patients were enrolled in this study. Median total RT dose was 60 Gy (range, 50-60 Gy), and median RT duration was 53 days (range, 35-74 days). Mean time to CR at the primary site was 97 days (range, 52-201 days). In four patients, although initial examination of biopsy specimens found evidence of viable cancer cells within 75 days of treatment initiation, subsequent examination found no such evidence, and the patients were thus designated as CR. Median PFSp was 149 days (range, 67-399 days), and PFSp rate at 90 days was 97%. Median interval between the previous examination and initial primary progressive disease was 37 days. CONCLUSION: Recommended time of first response evaluation for esophageal cancer following initiation of CRT/RT was found to be between 75 and 90 days. Subsequent evaluation should be carried out approximately one month following non-CR/non-progressive disease declassification.	esophagus
"""NCCT scan""--an alternative technique for Gorge carcinoma."	"INTRODUCTION: Gorge carcinoma or carcinoma of esophagus is one of the most commonly occurring malignancies in developing countries. In these patients, dysphagia for liquids is one of the most common complaints, resulting in unwillingness of the patient to swallow contrast containing liquid. The objective of the study was to find an alternative technique to the currently existing techniques for evaluating esophageal carcinoma. MATERIALS AND METHODS: Twenty patients with endoscopically proved cases of esophageal cancer were examined with CT thorax using AIR (negative) as a contrast agent-negative contrast computed tomography scan. Only the mid- and lower third esophageal malignant cases were included in the study. Upper third esophageal malignancy and lesions causing complete obstruction were excluded from the study. All cases were scanned using single-slice Somatom-4 (Siemens). NECT scan was done after intravenous injection of Buscopan. A total of 450-600 ml of air is introduced through a 14G Ryle's tube, both manually and as a continuous flow. IV contrast is given simultaneously, and a CECT scan is done. Multiplanar reconstructions were done in all patients. RESULTS: Significant distension of the normal esophagus was noted. However, very minimal distension of the esophageal lumen was noted at the carcinomatous site--called the ""streak sign"" as air is seen as a thin streak within the narrowed lumen. In some cases, intraluminal polypoid growth could be seen. No significant complications were noted except for throat irritation. We conclude that usage of air as negative contrast in identifying carcinoma of mid- and lower third esophagus is safe, cost-effective, and feasible and can be used as an alternative technique in patients who are not readily willing to swallow liquid contrast."	esophagus
[Absorption and elimination of photofrin-II in human immortalization esophageal epithelial cell line SHEE and its malignant transformation cell line SHEEC].	BACKGROUND AND OBJECTIVE: The mechanism of tumor tissues selectively uptake the photosensitizer in photodynamic therapy (PDT) is still unclear. This study was to investigate the affinity of tumor cells to the photosensitizer photofrin-II. METHODS: Ultraviolet spectrophotometer was applied to measure the absorption spectra of various cell culture media. The fluorescence spectrum of photofrin-II was determined by spectrofluorometer. The absorption and elimination condition of photofrin-II were detected in immortalized human esophageal epithelial cell line SHEE and its malignant transformation cell line SHEEC. RESULTS: The maximum excitation wavelength of fluorescence for photofrin-II was (395.0+/-0.5) nm, and the maximum emission wavelength of that was (634.1+/-0.5) nm. The laser at the wavelength of 630 nm used in this experiment could permeate various types of cell culture media. There was no significant difference in the absorption and elimination of photofrin-II between SHEE and SHEEC at the same concentration and time. The absorption of photofrin-II in SHEE and SHEEC increased with the increase in photofrin-II concentration and duration, and reached the platform at the concentration of 30 microg/mL and a time point of 150 min, respectively. The photofrin-II contents of SHEE and SHEEC showed a slight change after 15-30 min, and diminished rapidly after 30 min. CONCLUSION: High photosensitizer concentration in tumor tissues may be not correlated with the affinity of tumor cells.	esophagus
A novel pharmacodynamic approach to assess and predict tumor response to the epidermal growth factor receptor inhibitor gefitinib in patients with esophageal cancer.	This study aimed to describe a short-term ex vivo assay to predict response to epidermal growth factor receptor (EGFR) targeted therapy (gefitinib) in adenocarcinoma patients. Four patients with locally advanced esophageal adenocarcinoma were treated with gefitinib (250 mg/day) for 14 days and pharmacokinetic (PK) studies were conducted to monitor plasma drug concentrations. Tumor cells were sampled by endoscopic biopsy prior to (baseline, day 0) and at the completion of (day 14) treatment. Cells obtained at baseline were exposed to gefitinib in short-term cell culture conditions (ex vivo assay). Western blot analyses with phospho-specific antibodies were performed to evaluate activation and biochemical response to therapy of EGFR and its downstream signaling components ERK and AKT ex vivo and in vivo. The in vivo profiles were correlated with the gefitinib-mediated alteration in proliferating cell nuclear antigen (PCNA) expression, a marker of cell proliferation. The correlation between EGFR expression and ERK activity was also investigated by immunohistochemical analysis in pretreatment biopsies. Mutational status of the genes encoding EGFR, K-RAS, and PI3KCA (the phosphoinositide 3-kinase catalytic subunit p110) as well as expression levels of PTEN protein were tested in order to investigate potential confounders of the gefitinib effect. All patients completed the gefitinib therapy. PK studies demonstrated constant gefitinib concentrations during the treatment, confirming persistent exposure of target tissue to the drug at sufficient levels to achieve EGFR blockade. Ex vivo culture with gefitinib resulted in distinct response patterns representing various states of activity of the ERK and AKT pathways. The results of the ex vivo studies correctly predicted the pharmacodynamic (PD) effects of the agents in tumor tissue in vivo. PCNA expression correlated with ERK pathway inhibition, but not with gefitinib-mediated inhibition of EGFR activity alone. Immunohistochemical analysis performed on pretreatment biopsies correlated with Western blot analysis of EGFR and phospho-ERK expression. No mutations were identified in exons 18-21 of EGFR, exons 2 and 3 of K-RAS or exons 9 and 22 of PI3KCA. Levels of PTEN were comparable across tumors. The novel pharmacodynamic approach described in this proof of principle study may be useful to refine the patient selection to maximize the potential benefits of drugs and design individualized rational therapies for cancer patients.	esophagus