crossing96/oncoscreening huggingface dataset:
[Consensus and controversies of surgical approach selection in the treatment for thoracic esophageal cancers].	Esophageal cancer is one of the most prevalent carcinoma with an incidence ranking at the fifth and the mortality at the fourth among all the carcinomas in China. Up to now, surgery-based multi-modality treatment is still the most effective treatment for esophageal carcinoma. The surgical approaches for esophageal cancer include left and right thoracic approaches. Esophagectomy through left thoracotomy is the earliest approach applied for esophageal cancer in China, and now is still used frequently for esophageal cancer in northern China. However, left thoracic approach is insufficient in the lymph node dissection for superior mediastinum and abdomen, especially for the tracheoesophageal groove and para-recurrent laryngeal nerve nodes. On the contrary, right thoracic approach can achieve complete thoracic and abdominal field(two-field) lymph node dissection, especially the tracheoesophageal groove and para-recurrent laryngeal nerve nodes, which may eventually improve the survival of the patients with esophageal cancer. This article summarizes the results of lymph node dissection and prognosis based on published literatures through left thoracic approach versus through right thoracic approach for esophageal cancer, comments on recent controversies and consensus: for resectable thoracic esophageal carcinoma, resection of thoracic esophageal carcinoma with 2-field or 3-field lymph node dissection through right thoracic approach should be recommended as the major treatment mode, but this consensus was made based on retrospective studies, and the evidence is only level III(, therefore, prospective randomized studies with larger sample size are warranted. The selection of surgical approach for the lower thoracic esophageal cancer patients without upper mediastinal lymph node enlargement is also the direction of future clinical trials.	esophagus
HER2 aberrations and heterogeneity in cancers of the digestive system: Implications for pathologists and gastroenterologists.	Management of cancers of the digestive system has progressed rapidly into the molecular era. Despite the significant recent achievements in the diagnosis and treatment of these patients, the number of deaths for these tumors has currently plateaued. Many investigations have assessed the role of HER2 in tumors of the digestive system in both prognostic and therapeutic settings, with heterogeneous results. Novel testing and treatment guidelines are emerging, in particular in gastric and colorectal cancers. However, further advances are needed. In this review we provide a comprehensive overview of the current state-of-knowledge of HER2 alterations in the most common tumors of the digestive system and discuss the operational implications of HER2 testing.	esophagus
Human papillomavirus and gastrointestinal cancer: A review.	Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. Exposure to HPV is very common, and an estimated 65%-100% of sexually active adults are exposed to HPV in their lifetime. The majority of HPV infections are asymptomatic, but there is a 10% chance that individuals will develop a persistent infection and have an increased risk of developing a carcinoma. The International Agency for Research on Cancer has found that the following cancer sites have a strong causal relationship with HPV: cervix uteri, penis, vulva, vagina, anus and oropharynx, including the base of the tongue and the tonsils. However, studies of the aetiological role of HPV in colorectal and esophageal malignancies have conflicting results. The aim of this review was to organize recent evidence and issues about the association between HPV infection and gastrointestinal tumours with a focus on esophageal, colorectal and anal cancers. The ultimate goal was to highlight possible implications for prognosis and prevention.	esophagus
A six-CpG panel with DNA methylation biomarkers predicting treatment response of chemoradiation in esophageal squamous cell carcinoma.	BACKGROUND: Prognosis of esophageal squamous cell carcinoma (ESCC) patients remains poor, and the chemoradiotherapy (CRT) applied to ESCC patients often failed. Therefore, development of biomarkers to predict CRT response is immensely important for choosing the best treatment strategy of an individual patient. METHODS: The methylation array and pyrosequencing methylation assay were performed in pre-treatment endoscopic biopsies to identify probes with differential CpG methylation levels between good and poor CRT responders in a cohort of 12 ESCC patients. Receiver operating characteristic curves and multivariate logistic regressions were conducted to build the risk score equation of selected CpG probes in another cohort of 91 ESCC patients to predict CRT response. Kaplan-Meier analysis was used to estimate progression-free survival or time-to-progression of patients predicted with good and poor CRT responses. RESULTS: Nine differentially methylated CpG probes were identified to be associated with CRT response. A risk score equation comprising six CpG probes located in IFNGR2, KCNK4, NOTCH4, NPY, PAX6, and SOX17 genes were built. The risk score was derived from the sum of each probe multiplied by its corresponding coefficient. Such a risk score has a good prediction performance in discriminating poor CRT responders from good responders (AUC: 0.930). Moreover, poor CRT responders predicted by risk score significantly had poorer prognosis in terms of shorter progression-free survival and time-to-progression (p = 0.004-0.008). CONCLUSION: We established a proof-of-concept CRT response prediction panel consisting of six-CpG methylation biomarkers in identifying ESCC patients who are at high risk of CRT failure and need intensive care.	esophagus
Endoscopic resection for patients with mucosal adenocarcinoma of the esophagus.	Due to its rapidly increasing incidence in the last decade, esophageal adenocarcinoma has been attracting widespread interest among gastroenterologists all over the world. Advanced adenocarcinomas arising from intestinal metaplasia in the esophagus (Barrett's esophagus, BE) are associated with a poor prognosis when esophagectomy is required. In addition to high mortality rates, there is a significant morbidity rate among patients who undergo surgery. However, if cancer can be diagnosed at an early stage, the endoscopic treatment options that are available significantly reduce the mortality rates. International guidelines recommend that endoscopic treatment should be carried out in all patients with mucosal cancer and low-risk criteria, but the method of choice for resection has been a matter of continuing debate. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection are the main techniques competing in this field. Endoscopists also have to be able to manage potential complications and need to know how to deal with recurrences. Finally, it is essential to treat nondysplastic BE as an important part of the treatment, in order to avoid metachronous neoplasia. Different methods of ablative treatment, such as argon plasma coagulation and radiofrequency ablation (RFA), have been included in the subsequent treatment after resection. This review introduces and evaluates the different resection methods and discusses ablative therapy and surveillance protocols. The major scientific databases (Medline / PubMed) were searched for diagnoses and treatment in early esophageal adenocarcinoma. The current literature and the latest national and international guidelines were also included in order to obtain a good overview of the field. In areas in which there is a low quality of evidence, such as poor healing after endoscopic treatment, the authors offer recommendations based on their own experience in this field.	esophagus
[Mortality and survival analysis of esophageal cancer in China].	OBJECTIVE: To estimate the nationwide mortality of esophageal cancer in China in 2012, to investigate the trends of the disease, and to provide support data for esophageal cancer prevention and control in China. METHODS: Data of population-based cancer registry of China were extracted by sex and geographical area. Joinpoint software was used to analyze the trends of esophageal cancer from 2000 to 2011 using the continuous data of 22 cancer registries. Average annual percentage change rates (AAPC) were calculated, and 17 cancer registries data during 2003-2005 were analyzed. RESULTS: In 2012, there were estimated 210.9 thousand new cases of esophageal cancer death in China, with 149 thousand in males and 61.9 thousand in females, accounting for 9.65% of overall cancer death. The crude mortality rate of esophageal cancer in 2012 was 15.58 per 100 000, accounting for the fourth-leading cause of overall cancer deaths. The age-standardized mortality rates by world population and China population were 10.67 per 100 000 and 10.62 per 100 000, respectively. The cumulative mortality rate for age 0-74 was 1.28%. The age-specific mortality rates were increasing with age, and there was a sharp increase after 50 years of age. From 2000 to 2011, there was a slight decreasing trend for crude mortality rate, with the AAPC of -1.1% (95% CI: -1.8% to -0.5%). However, the age standardized mortality rates were decreasing significantly with the AAPC of -4.6% (95% CI: -5.7% to -3.6%). The AAPCs for age-standardized esophageal cancer mortality were -3.8% in urban areas and -2.4% in rural areas. For combined 5-year age standardized relative survival was 20.9% (95%CI: 20.2% to 21.7%) and the 1-, 3- and 5-year observed survival rates were 54.0%, 25.5%, 18.4%, respectively. CONCLUSION: There is still a heavy burden of esophageal cancer in China. Prevention and early diagnosis of the disease in esophageal cancer high-risk areas is very essential.	esophagus
Review of the Burden of Esophageal Cancer in Malaysia.	Esophageal cancer is one of the top leading causes of cancer-related deaths in Malaysia. To date, neither the prevalence nor incidence of esophageal cancer nationally have been recorded. Esophageal cancer remains a major and lethal health problem even if it is not common in Malaysia. The late presentation of esophageal cancer makes it a difficult and challenging medical problem. Therefore, more governmental and non-governmental organizations of Malaysia should emphasize primary and secondary prevention strategies.	esophagus
Clinical pathway for esophagectomy improves perioperative nutrition.	BACKGROUND: Clinical pathways reduce hospitalization and costs in colorectal and pancreatic cancer. We describe creating an esophagectomy pathway and analyze its implementation and effects. METHODS: We documented the process of developing an esophagectomy clinical pathway. We performed a retrospective review of prospectively collected data on 12 patients before pathway implementation and 12 patients after. RESULTS: Pathway Implementation: more patients were presented at tumor board (9 pathway vs. 2 pre-pathway; p=0.012) and chose their postoperative care facility before surgery (8 vs. 0; p=0.0013) OUTCOMES: There were no changes in mortality (0 vs. 0), major complications (5 vs. 5), hospitalization (median 9.5 vs. 12 days; p=0.82), and total charges ($ 98,395 vs. $ 96,946; p=0.96). Pathway patients lost significantly less weight preoperatively (2.3% vs. 7.6%; p=0.01) and perioperatively (6.3% vs. 12%; p=0.02). CONCLUSIONS: This is the first study to report the process of designing and implementing an esophagectomy pathway. While there was no significant decrease in mortality, complications, hospitalization, or charges, our pathway significantly decreased pre- and perioperative weight loss, which we attribute to coordinated patient education and care.	esophagus
Predicting Pathologic Response of Esophageal Cancer to Neoadjuvant Chemotherapy: The Implications of Metabolic Nodal Response for Personalized Therapy.	Only a minority of esophageal cancers demonstrates a pathologic tumor response (pTR) to neoadjuvant chemotherapy (NAC). (18)F-FDG PET/CT is often used for restaging after NAC and to assess response. Increasingly, it is used during therapy to identify unresponsive tumors and predict pTR, using avidity of the primary tumor alone. However, definitions of such metabolic tumor response (mTR) vary. We aimed to comprehensively reevaluate metabolic response assessment using accepted parameters, as well as novel concepts of metabolic nodal stage (mN) and metabolic nodal response (mNR). METHODS: This was a single-center retrospective U.K. cohort study. All patients with esophageal cancer staged before NAC with PET/CT and after with CT or PET/CT and undergoing resection from 2006 to 2014 were identified. pTR was defined as Mandard tumor regression grade 1-3; imaging parameters included metrics of tumor avidity (SUV(max/mean/peak)), composites of avidity and volume (including metabolic tumor volume), nodal SUV(max), and our new concepts of mN stage and mNR. RESULTS: Eighty-two (27.2%) of 301 patients demonstrated pTR. No pre-NAC PET parameters predicted pTR. In 220 patients restaged by PET/CT, the optimal tumor ΔSUV(max) threshold was a 77.8% reduction. This was as sensitive as the current PERCIST 30% reduction, but more specific with a higher negative predictive value (P < 0.001). ΔSUV(max) and Δlength independently predicted pTR, and composite avidity/spatial metrics outperformed avidity alone. Although both mTR and mNR were associated with pTR, in 82 patients with (18)F-FDG-avid nodes before NAC we observed mNR in 10 (12.2%) not demonstrating mTR. CONCLUSION: Current definitions of metabolic response are suboptimal and too simplistic. Composite avidity/volume measures improve prediction. mNR may further improve response assessment, by specifically assessing metastatic tumor subpopulations, likely responsible for disease relapse, and should be urgently assessed when considering aborting therapy on the basis of mTR alone.	esophagus
Esophageal insufflation computed tomography for the diagnosis and management of esophageal submucosal tumors.	BACKGROUND: The selection of therapy for benign esophageal lesions depends in part on whether the lesion extends to or through the esophageal muscle wall. The advent of endoscopic dissection of deep lesions has made this distinction important in the choice between different forms of advanced endoscopic therapy. The goal of this study was to evaluate esophageal insufflation computed tomography (EICT) for the diagnosis and management of esophageal submucosal tumors (SMTs). METHODS: Between April 2011 and May 2013 at the Second Affiliated Hospital of Harbin Medical University, 27 patients with esophageal SMTs diagnosed by gastroscopy were studied observationally. Entry criteria included tumors larger than 0.5 cm. We compared endoscopic ultrasound (EUS) and EICT to assess lesion depth and the relationship between the submucosal lesion and the esophageal wall using the resected lesion as the gold standard. RESULTS: Twenty-seven esophageal SMTs were evaluated. EUS and EICT accurately identified nine as superficial to the muscularis propria. EICT correctly identified the relation of the tumor extension and the outer esophageal wall in all 18 lesions that originated from the muscularis propria; only nine were correctly assessed by EUS (P < 0.001). CONCLUSIONS: EICT enables improved judgment of the relation of esophageal lesions and the esophageal-mediastinal border. We propose EICT as a new, safe, effective, useful, simple and high-tolerance method for assessing the depth and relationships of esophageal submucosal lesions.	esophagus
Significance of Expression of Complement C4d in Esophageal Squamous Cell Carcinoma.	BACKGROUND/AIM: Esophageal squamous cell carcinoma (ESCC) is one of the most difficult malignancies to cure. C4d is a degradation product of the classical complement pathway and is suggested as an early diagnostic marker for other SCCs. The purpose of this study was to clarify the association of complement C4d with ESCC. PATIENTS AND METHODS: Immunohistochemical staining for C4d was performed on surgical specimens obtained from 114 patients with ESCC. RESULTS: Positive C4d expression was observed in 70 (61.4%) cases and negative expression in 44 (38.6%) cases. There was a significant inverse correlation between C4d expression and depth of tumor invasion (p=0.0001), lymph node metastasis (p=0.011), lymphatic invasion (p=0.033), and TNM stage (p=0.0021). Kaplan-Meier analysis showed that negative C4d expression tended to lead to shorter overall survival (p=0.232). CONCLUSION: C4d expression in ESCC might be useful in developing treatment strategies or suppression of ESCC.	esophagus
Promoter DNA methylation of CDO1 gene and its clinical significance in esophageal squamous cell carcinoma.	We have demonstrated that CDO1 methylation is frequently found in various cancers, including esophageal squamous cell carcinoma (ESCC), but its clinical relevance has remained elusive. CDO1 methylation was investigated in 169 ESCC patients who underwent esophagectomy between 1996 and 2007. CDO1 methylation was assessed by Q-MSP (quantitative methylation specific PCR), and its clinical significance, including its relationship to prognosis, was analyzed. (i) The median TaqMeth value of CDO1 methylation was 9.4, ranging from 0 to 279.5. CDO1 methylation was significantly different between cStage I and cStage II/III (P = 0.02). (ii) On the log-rank plot, the optimal cut-off value was determined to be 8.9; ESCC patients with high CDO1 methylation showed a significantly worse prognosis than those with low CDO1 methylation (P = 0.02). (iii) A multivariate Cox proportional hazards model identified only CDO1 hypermethylation as an independent prognostic factor (HR 2.00, CI 1.09-3.78, P = 0.03). (iv) CDO1 hypermethylation stratified ESCC patients' prognosis in cStage II/III for both neoadjuvant chemo(radio)therapy (NAC)-positive and NAC-negative cases. Moreover, the CDO1 methylation level was significantly lower in cases with Grade 2/3 than in those with Grade 0/1 (P = 0.02) among cStage II/III ESCC patients with NAC. Promoter DNA hypermethylation of CDO1 could be an independent prognostic factor in ESCC; it may also reflect NAC eradication of tumor cells in the primary tumors.	esophagus
Outcome and risk factors assessment for adverse events in advanced esophageal cancer patients after self-expanding metal stents placement.	Self-expanding metal stents (SEMS) are the treatment of choice for advanced esophageal cancers. Literature is scarce on risk factors predictors for adverse events after SEMS placement. Assess risk factors for adverse events after SEMS placement in advanced esophageal cancer and evaluate survival after SEMS placement. Cross-sectional study of patients with advanced esophageal cancer referred for SEMS placement, during a period of 3 years. Ninety-seven patients with advanced esophageal cancer placed SEMS. Adverse events were more common when tumors were located at the level of the distal esophagus/cardia (47% vs 23%, P = 0.011, OR 3.1), with statistical significance being kept in the multivariate analysis (OR 3.1, P = 0.018). Time until adverse events was lower in the tumors located at the level of the distal esophagus/cardia (P = 0.036). Survival was higher in patients who placed SEMS with curative intent (327 days [126-528] vs. 119 days [91-147], P = 0.002) and in patients submitted subsequently to surgery compared with those who did just chemo/radiotherapy or who did not do further treatment (563 days [378-748] vs. 154 days [133-175] vs. 46 days [20-72], P < 0.001). Subsequent treatment kept statistical significance in the multivariate analysis (HR 3.4, P < 0.001). SEMS allow palliation of dysphagia in advanced esophageal cancer and are associated with an increased out-of-hospital survival, as long as there are conditions for further treatments. Tumors located at the level of the distal esophagus/cardia are associated with a greater number of adverse events, which also occur earlier.	esophagus
Expression of Wnt11 and Rock2 in esophageal squamous cell carcinoma by activation of the WNT/PCP pathway and its clinical significance.	The purpose of this study was to investigate the relation between expression of Wnt11, Rho-associated protein kinase 2 (Rock2), and its clinical characteristics in esophageal squamous cell carcinoma (ESCC). Expression of Wnt11 and Rock2 protein was examined by using immunohistochemistry that contained 260 paraffin-embedded specimens of ESCC and its adjacent normal tissues; expression of Wnt11 and Rock2 protein was verified by Western-blotting that contained 20 specimens of ESCC and its adjacent normal tissues. The positive rates of Wnt11 protein in normal esophageal epithelium tissue was 29.8% and in esophageal carcinomas tissue was 31.9%; there was no significant difference between the two groups(P>0.05); The positive rates of Rock2 protein in normal esophageal epithelium tissue was 12.3% and in esophageal carcinomas tissues was 56.5%, there was a significant difference between the two groups (p<0.05). The expression of Rock2 protein was significantly related with the invasion of vascular and there was no significantly difference between the expression of Rock2 protein and ESCC patients' tumor location, differentiation, T stage, and lymph node metastases. The abnormal expression of Rock2 protein may promote tumor cell invasion.	esophagus
[Potentiality of Immune Checkpoint Inhibitors for Advanced Esophageal and Gastric Cancer].	Immune checkpoint inhibitors which have been currently approved on malignant melanoma and non-small cell lung cancer in Japan, are having completely different mechanism from the conventional anti-neoplastic agents such as cytotoxic anticancer agents or molecular targeting agents. Therefore, although the response rate is not so high, the patterns of anti-tumor effect such as long-term survival or durable response and unique toxicity profiles to stimulate autoimmune response are quite distinguished. It has been found to be significantly different from conventional anti-neoplastic agents. The results of current clinical trials using immune checkpoint inhibitors for gastrointestinal tract cancers, promises to gain new promising treatment options near future. The clarification of the biomarkers and development of combination therapy is strongly warranted in the future.	esophagus