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Chen KY, Huang YQ, Zhang LL. Clinical characteristics of early esophageal cancer and squamous intraepithelial neoplasia in patients of different ages. Shijie Huaren Xiaohua Zazhi 2023; 31:238-243. [DOI: 10.11569/wcjd.v31.i6.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open
Abstract
BACKGROUND In recent years, with the development of endoscopic technology, endoscopic submucosal dissection (ESD) has been widely used in the treatment of early esophageal cancer (EEC) and squamous intraepithelial neoplasia (SIN) because of its low risk of complications and faster recovery. This study focused on evaluating the clinical features of EEC and SIN in elderly patients and the safety of ESD treatment.
AIM To analyze the clinical characteristics of EEC and SIN in patients of different ages.
METHODS A total of 349 patients with EEC or SIN (including high- and low-grade intraepithelial neoplasia) treated by endoscopic submucosal dissection (ESD) at the First Affiliated Hospital of Zhengzhou University from January 2019 to October 2022 were included. According to the age at the time of surgery, the patients were divided into either an elderly group (≥ 65 years old) or a young and middle-aged group (< 65 years old), and the general clinical data (gender, smoking status, alcohol consumption, hypertension, diabetes, coronary heart disease, history of other tumors, abdominal surgery history, family history of digestive tract tumor, etc.) and pathological data (lesion location, pathological type, depth of invasion, endoscopic classification, lesion length and diameter, presence of multiple lesions or not, combination with chronic esophagitis, gastric polyps, or atrophic gastritis or not, etc.) were compared between the two groups, and the postoperative related indicators (postoperative hospital stay, postoperative bleeding, esophageal stricture, and resection margin) of the two groups were compared.
RESULTS The number of patients with hypertension was significantly higher in the elderly group (P = 0.034), while the proportion of patients with smoking history was significantly higher in the middle-aged and young group (P = 0.017). In terms of lesion location, the lesions in the young and middle-aged group were mostly located in the lower thoracic segment, while the lesions in the elderly group were mostly located in the middle thoracic segment (P = 0.005); the lesions in the elderly group were more serious than those in the young and middle-aged group (P = 0.005); and the elderly group had a higher proportion of patients with combined gastric polyps (P = 0.026). In terms of complications and length of hospital stay after ESD, there was no significant difference between the two groups.
CONCLUSION Elderly patients with ESC or SIN have more comorbidities and relatively serious lesions. According to the location of the lesion, more detailed endoscopic observation and close follow-up should be carried out to improve the prognosis of such elderly patients.
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Hu JF, Song X, Zhong K, Zhao XK, Zhou FY, Xu RH, Li JL, Wang XZ, Li XM, Wang PP, Lei LL, Wei MX, Wang R, Fan ZM, Han XN, Chen Y, Li LY, Ji JJ, Yang YZ, Li B, Yang MM, Yang HJ, Chang FB, Ren JL, Zhou SL, Wang LD. Increases prognostic value of clinical-pathological nomogram in patients with esophageal squamous cell carcinoma. Front Oncol 2023; 13:997776. [PMID: 36865805 PMCID: PMC9973522 DOI: 10.3389/fonc.2023.997776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 01/04/2023] [Indexed: 02/16/2023] Open
Abstract
Background This study was intended to construct a brand new prognostic nomogram after combine clinical and pathological characteristics to increases prognostic value in patients with esophageal squamous cell carcinoma. Methods A total of 1,634 patients were included. Subsequently, the tumor tissues of all patients were prepared into tissue microarrays. AIPATHWELL software was employed to explore tissue microarrays and calculate the tumor-stroma ratio. X-tile was adopted to find the optimal cut-off value. Univariate and multivariate Cox analyses were used to screen out remarkable characteristics for constructing the nomogram in the total populations. A novel prognostic nomogram with clinical and pathological characteristics was constructed on the basis of the training cohort (n=1,144). What's more performance was validated in the validation cohort (n=490). Clinical-pathological nomogram were assessed by concordance index, time-dependent receiver operating characteristic, calibration curve and decision curve analysis. Results The patients can divide into two groups with cut-off value of 69.78 for the tumor-stroma ratio. It is noteworthy that the survival difference was noticeable (P<0.001). A clinical-pathological nomogram was constructed by combining clinical and pathological characteristics to predict the overall survival. In comparison with TNM stage, the concordance index and time-dependent receiver operating characteristic of the clinical-pathological nomogram showed better predictive value (P<0.001). High quality of calibration plots in overall survival was noticed. As demonstrated by the decision curve analysis, the nomogram has better value than the TNM stage. Conclusions As evidently revealed by the research findings, tumor-stroma ratio is an independent prognostic factor in patients with esophageal squamous cell carcinoma. The clinical-pathological nomogram has an incremental value compared TNM stage in predicting overall survival.
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Affiliation(s)
- Jing Feng Hu
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xin Song
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Kan Zhong
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xue Ke Zhao
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Fu You Zhou
- Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang, Henan, China
| | - Rui Hua Xu
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Ji Lin Li
- Department of Pathology, Linzhou Esophageal Cancer Hospital, Linzhou, Henan, China
| | - Xian Zeng Wang
- Department of Thoracic Surgery, Linzhou People’s Hospital, Linzhou, Henan, China
| | - Xue Min Li
- Department of Pathology, Hebei Provincial Cixian People’s Hospital, Cixian, Hebei, China
| | - Pan Pan Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Ling Ling Lei
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Meng Xia Wei
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Ran Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Zong Min Fan
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Xue Na Han
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Yao Chen
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Liu Yu Li
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Jia Jia Ji
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Yuan Ze Yang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Bei Li
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Miao Miao Yang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
| | - Hai Jun Yang
- Department of Thoracic Surgery, Anyang Tumor Hospital, Anyang, Henan, China
| | - Fu Bao Chang
- Department of Surgery, Central Hospital of Linzhou City, Linzhou, Henan, China
| | - Jing Li Ren
- Department of Pathology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Sheng Li Zhou
- Department of Pathology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, People’s Hospital of Henan University, Zhengzhou, Henan, China
| | - Li Dong Wang
- State Key Laboratory of Esophageal Cancer Prevention & Treatment of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,Henan Key Laboratory for Esophageal Cancer Research of The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China,*Correspondence: Li Dong Wang,
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Zhang S, Chen J, Li B, Cai X, Wang K, Tan Z, Zheng Y, Liu Q. Family history of cancer is a prognostic factor for better survival in operable esophageal squamous cell carcinoma: A propensity score matching analysis. Front Oncol 2022; 12:945937. [PMID: 36591498 PMCID: PMC9796554 DOI: 10.3389/fonc.2022.945937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/24/2022] [Indexed: 12/15/2022] Open
Abstract
Lay summary Patients with a family history of cancer, especially digestive tract cancer and esophageal cancer, a family history of cancer in the first degree, and more than one relative affected by cancer were associated with favorable survival when compared to those without a family history of cancer. Precis for use in the Table of Contents A family history of cancer is a favorable independent prognostic factor in ESCC. Patients with a family history of cancer, especially digestive tract cancer and esophageal cancer, a family history of cancer in the first degree, and more than one relative affected by cancer were associated with favorable survival when compared to those without a family history of cancer. Background A family history of cancer (FH) is closely associated with the risk and survival of many cancers. However, the effect of FH on the prognosis of patients with esophageal squamous cell carcinoma (ESCC) remains unclear. We performed a large cohort study in the Chinese population to obtain insight into the prognostic value of FH in patients with operable ESCC. Methods A total of 1,322 consecutive patients with thoracic ESCC who had undergone esophagectomy between January 1997 and December 2013 were included. The FH group included patients with any degree of FH, while the non-FH group included patients without any degree of FH. In total, 215 patients with FH and 215 without FH were matched using the propensity score matching analysis method to adjust for differences in baseline variables between the two groups. The impact of FH on disease-free survival (DFS) and overall survival (OS) was estimated using the Kaplan-Meier method and Cox's proportional hazards models. Results Before matching, 280 (21.2%) patients were included in the FH group and 1,042 (78.8%) in the non-FH group. FH was associated with early pathological T stage (p = 0.001), lymph node-negative status (p = 0.022), and early pathological stage (p = 0.006). After matching, FH was an independent prognostic factor for DFS and OS in ESCC patients. Patients with FH had 35% lower risk of disease progression (hazard ratio [HR] = 0.65, 95% CI: 0.51-0.84, p = 0.001) and 34% lower risk of death (HR = 0.66, 95% CI: 0.51-0.86, p = 0.002) than those without FH. Patients with a family history of digestive tract cancer (FH-DC), a family history of esophageal cancer (FH-EC), FH in first-degree relatives (FH-FD), and more than one relative affected by cancer were associated with favorable DFS and OS as compared to those without FH. Conclusion FH is a favorable independent prognostic factor in ESCC. Patients with FH, especially those with FH-DC, FH-EC, FH-FD, and more than one relative affected by cancer, had improved survival.
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Affiliation(s)
- Shuishen Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Junying Chen
- Guangdong Esophageal Cancer Institute, Guangzhou, China,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China,State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Bin Li
- Biostatistics Team, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoli Cai
- Department of Medical Ultrasonics, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Kexi Wang
- Department of Thoracic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zihui Tan
- Guangdong Esophageal Cancer Institute, Guangzhou, China,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China,State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China,*Correspondence: Qianwen Liu, ; Zihui Tan, ; Yuzhen Zheng,
| | - Yuzhen Zheng
- Department of Thoracic Surgery, The Six Affiliated Hospital, Sun Yat-sen University, Guangzhou, China,*Correspondence: Qianwen Liu, ; Zihui Tan, ; Yuzhen Zheng,
| | - Qianwen Liu
- Guangdong Esophageal Cancer Institute, Guangzhou, China,Department of Thoracic Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China,State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China,*Correspondence: Qianwen Liu, ; Zihui Tan, ; Yuzhen Zheng,
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Development and External Validation of an Improved Version of the Diagnostic Model for Opportunistic Screening of Malignant Esophageal Lesions. Cancers (Basel) 2022; 14:cancers14235945. [PMID: 36497427 PMCID: PMC9737355 DOI: 10.3390/cancers14235945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/03/2022] Open
Abstract
We aimed to develop an improved version of the diagnostic model predicting the risk of malignant esophageal lesions in opportunistic screening and validate it in external populations. The development set involved 10,595 outpatients receiving endoscopy from a hospital in Hua County, a high-risk region for esophageal squamous cell carcinoma in northern China. Validation set A enrolled 9453 outpatients receiving endoscopy in a non-high-risk region in southern China. Validation set B involved 17,511 residents in Hua County. The improved diagnostic model consisted of seven predictors including age, gender, family history of esophageal squamous cell carcinoma, smoking, body mass index, dysphagia, and retrosternal pain, with an area under the receiver operating characteristic curve (AUC) of 0.860 (95% confidence interval: 0.835-0.886) in the development set. Ideal discrimination ability was achieved in external validations (AUC validation set A: 0.892, 95% confidence interval: 0.858-0.926; AUC validation set B: 0.799, 95% confidence interval: 0.705-0.894). This improved model also markedly increased the detection rate of malignant esophageal lesions compared with universal screening, demonstrating great potential for use in opportunistic screening of malignant esophageal lesions in heterogeneous populations.
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Kuo YC, Yu LY, Wang HY, Chen MJ, Wu MS, Liu CJ, Lin YC, Shih SC, Hu KC. Effects of Helicobacter pylori infection in gastrointestinal tract malignant diseases: From the oral cavity to rectum. World J Gastrointest Oncol 2022; 14:55-74. [PMID: 35116103 PMCID: PMC8790410 DOI: 10.4251/wjgo.v14.i1.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/03/2021] [Accepted: 12/10/2021] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) has infected approximately fifty percent of humans for a long period of time. However, improvements in the public health environment have led to a decreased chance of H. pylori infection. However, a high infection rate is noted in populations with a high incidence rate of gastric cancer (GC). The worldwide fraction of GC attributable to H. pylori is greater than 85%, and a high H. pylori prevalence is noted in gastric mucosa-associated lymphoid tissue lymphoma patients. These results indicate that the majority of GC cases can be prevented if H. pylori infection is eliminated. Because H. pylori exhibits oral-oral or fecal-oral transmission, the relationship between this microorganism and other digestive tract malignant diseases has also attracted attention. This review article provides an overview of H. pylori and the condition of the whole gastrointestinal tract environment to further understand the correlation between the pathogen and the host, thus allowing improved realization of disease presentation.
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Affiliation(s)
- Yang-Che Kuo
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Lo-Yip Yu
- Department of Internal Medicine, Healthy Evaluation Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Horng-Yuan Wang
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Ming-Jen Chen
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei 10051, Taiwan
| | - Chun-Jen Liu
- Department of Internal Medicine, Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
| | - Ying-Chun Lin
- Department of Anesthesia, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Shou-Chuan Shih
- Division of Gastroenterology, Department of Internal Medicine, Health Evaluate Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
| | - Kuang-Chun Hu
- Department of Internal Medicine, Healthy Evaluation Center, Mackay Memorial Hospital, MacKay Junior College of Medicine, Nursing, and Management, Taipei 10038, Taiwan
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Liu X, Shi X, Guo W, Ke Y, Li Y, Pan S, Li X, Liu M, Liu M, Wang Y, Ruan Q, Ma H. A Promising Esophageal Cancer Prognostic Signature of Ferroptosis-Related LncRNA to Predict Immune Scenery and Immunotherapy Response. Int J Gen Med 2021; 14:5845-5862. [PMID: 34566425 PMCID: PMC8457888 DOI: 10.2147/ijgm.s327555] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/23/2021] [Indexed: 12/28/2022] Open
Abstract
Purpose Ferroptosis and long non-coding RNA (lncRNA) expression signatures have been associated with the clinical progression and immune-contexture of different solid tumors. The study aimed to identify a prognostic signature of ferroptosis-related lncRNAs (falncRNAs) to forecast the immune scenery and immunotherapy response in esophageal cancer (EC). Patients and Methods Gene expression profiles of EC were extracted from The Cancer Genome Atlas (TCGA) database, and ferroptosis-related genes were downloaded from the FerrDb database, which identified differentially expressed falncRNAs (DEfalncRNAs) via differential analysis. DEfalncRNA pairs associated with prognosis were identified by constructing a matrix, univariate and least absolute shrinkage and selection operator (LASSO) analysis. The prognostic signature was constructed by multivariate analysis. We appraised the forecasting capability of prognostic signature in survival, clinicopathological features, immune landscape, efficacy of immunotherapy, and drug sensitivity. The potential molecular mechanism of signature was investigated by gene set enrichment analysis (GSEA). Results We obtained 18 DEfalncRNA pairs to define a novel prognostic signature that was determined on a discovery cohort of 158 tumor samples and 11 adjacent normal tissues from TCGA and internally validated, with the definition of high- vs low-risk groups based on 3 years overall survival. We demonstrated that the high- vs low-risk groups differed for clinical parameters and computationally predicted drug sensitivity and tumor immune contexture, with the high-risk group having worse survival, more aggressive disease (node involvement, metastasis), reduced drug sensitivity, higher tumor mutation load, and gene signatures of infiltration of pro-tumoral immune cell subsets. The GSEA results revealed that ferroptosis and immunoregulatory pathways were significantly enriched in the high-risk group. Conclusion The prognostic signature based on falncRNAs has the potential to forecast the survival, immune scenery, efficacy of immunotherapy, and drug sensitivity of EC, which is helpful for clinical prediction and individualized treatment.
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Affiliation(s)
- Xiaoxiao Liu
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Xiaobo Shi
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Wei Guo
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Yue Ke
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Yuxing Li
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Shupei Pan
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Xiaona Li
- Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Mei Liu
- Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Mingzhu Liu
- Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Yuchen Wang
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Qinli Ruan
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
| | - Hongbing Ma
- Department of Radiation Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, People's Republic of China
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Schizas D, Vailas M, Sotiropoulou M, A Ziogas I, S Mylonas K, Katsaros I, Kapelouzou A, Liakakos T. Surgery for metachronous oligometastatic esophageal cancer: Is there enough evidence? Cir Esp 2021; 99:490-499. [PMID: 34353590 DOI: 10.1016/j.cireng.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/05/2021] [Indexed: 02/07/2023]
Abstract
Esophageal cancer is the sixth most common cause of cancer-related mortality worldwide. Despite advances in diagnostic modalities and treatment options, five-year survival rates are below 20%. Esophagectomy with extended lymph node dissection is the mainstay of treatment. More than 50% of patients experience recurrence within 1-3 years postoperatively. Recurrent disease may present locoregionally at the site of anastomosis or as recurrence through lymphatic spread in lymph node basins, as hematogenic metastasis, or as a combination of these. The standard treatment of recurrence is currently predicated on systemic chemotherapy and/or radiotherapy. Recent evidence suggests that surgical treatment of metachronous oligometastatic disease may be prognostically advantageous over medical management alone. Given the considerably low response rates to chemoradiotherapy, many institutions have adopted surgical treatment strategies for oligo-recurrent disease on a case-by-case basis. The aim of this article is to review the current evidence on the role of surgical treatment for metachronous oligometastases from esophageal cancer.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Michail Vailas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece.
| | - Maria Sotiropoulou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis A Ziogas
- Department of Surgery, Vanderbilt University Medical Center, 1313 21st Avenue South, Nashville, TN, USA
| | - Konstantinos S Mylonas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis Katsaros
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Alkistis Kapelouzou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Theodore Liakakos
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
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Schizas D, Vailas M, Sotiropoulou M, A Ziogas I, S Mylonas K, Katsaros I, Kapelouzou A, Liakakos T. Surgery for metachronous oligometastatic esophageal cancer: Is there enough evidence? Cir Esp 2021. [PMID: 33894971 DOI: 10.1016/j.ciresp.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Esophageal cancer is the sixth most common cause of cancer-related mortality worldwide. Despite advances in diagnostic modalities and treatment options, five-year survival rates are below 20%. Esophagectomy with extended lymph node dissection is the mainstay of treatment. More than 50% of patients experience recurrence within 1-3 years postoperatively. Recurrent disease may present locoregionally at the site of anastomosis or as recurrence through lymphatic spread in lymph node basins, as hematogenic metastasis, or as a combination of these. The standard treatment of recurrence is currently predicated on systemic chemotherapy and/or radiotherapy. Recent evidence suggests that surgical treatment of metachronous oligometastatic disease may be prognostically advantageous over medical management alone. Given the considerably low response rates to chemoradiotherapy, many institutions have adopted surgical treatment strategies for oligo-recurrent disease on a case-by-case basis. The aim of this article is to review the current evidence on the role of surgical treatment for metachronous oligometastases from esophageal cancer.
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Affiliation(s)
- Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Michail Vailas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece.
| | - Maria Sotiropoulou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis A Ziogas
- Department of Surgery, Vanderbilt University Medical Center, 1313 21st Avenue South, Nashville, TN, USA
| | - Konstantinos S Mylonas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Ioannis Katsaros
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Alkistis Kapelouzou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
| | - Theodore Liakakos
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
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Epidemiology of esophageal cancer: update in global trends, etiology and risk factors. Clin J Gastroenterol 2020; 13:1010-1021. [PMID: 32965635 DOI: 10.1007/s12328-020-01237-x] [Citation(s) in RCA: 277] [Impact Index Per Article: 69.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/02/2020] [Indexed: 12/24/2022]
Abstract
Esophageal cancer is the eighth most common type of cancer worldwide and constitutes the sixth leading cause of cancer deaths. It is characterized by its high mortality rate, poor prognosis at time of diagnosis and variability based on geographic location. Present day, the prevalence of esophageal cancer is in transition. Although esophageal squamous cell carcinoma continues to be the most prevalent type worldwide, esophageal adenocarcinoma is quickly becoming the most prevalent type in developed countries. Risk factors for the development of esophageal squamous cell carcinoma include low socioeconomic status, consumption of tobacco, alcohol, hot beverages, and nitrosamines. Additionally, micronutrient deficiencies have also been linked to the development of esophageal squamous cell cancer. These include vitamin C, vitamin E, and folate. With respect to esophageal adenocarcinoma, risk factors include Barrett's esophagus, gastroesophageal reflux disease, obesity, and tobacco consumption. Screening for esophageal cancer will likely play an essential role in prevention, and consequently, mortality in the future. Present day, there are no established guidelines for esophageal squamous cell cancer screening. Guidelines for esophageal adenocarcinoma are more well established but lack concrete evidence in the form of randomized controlled trials. This review will discuss the epidemiology, risk factors, and current prevention strategies for esophageal cancer in depth. It is our aim to raise awareness on the aforementioned topics to increase public health efforts in eradicating this disease.
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