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1. Krasna MJ, Tepper J: The role of multimodality therapy for esophageal cancer. Chest Surg Clin N Am; 2000 Aug;10(3):591-603
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of multimodality therapy for esophageal cancer.
  • One trial has suggested improved survival with preoperative chemotherapy and radiation therapy with acceptable morbidity and mortality.
  • These studies should compare identical CRT and surgery regimens and identify a group of esophageal patients that might benefit from preoperative chemotherapy or radiation therapy.
  • In order to evaluate the results of future trials without bias and to determine which group of esophageal patients will benefit from preoperative CRT, pretreatment, accurate TNM staging by CT and EUS combined with pathologic LN staging when possible will be crucial in future trimodality therapy trials for esophageal cancer.
  • Unfortunately, those patients without a response do not benefit from the preoperative chemotherapy but still may suffer the associated toxicity.
  • It has been shown that CR patients in the chemotherapy/surgery group survive longer than nonresponders; it would be helpful to find useful molecular biomarkers to identify chemotherapy-sensitive patients before the preoperative chemotherapy is employed.
  • Several pilot trials are underway using chemotherapy sensitivity testing on the endoscopic biopsy specimen before the chemotherapy is applied.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Lymphatic Metastasis. Neoplasm Staging. Prognosis. Radiotherapy, Adjuvant. Survival Rate. Treatment Outcome


2. Igaki H, Kato H, Tachimori Y, Sato H, Daiko H, Nakanishi Y: Prognostic evaluation for squamous cell carcinomas of the lower thoracic esophagus treated with three-field lymph node dissection. Eur J Cardiothorac Surg; 2001 Jun;19(6):887-93
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  • [Title] Prognostic evaluation for squamous cell carcinomas of the lower thoracic esophagus treated with three-field lymph node dissection.
  • OBJECTIVE: The efficacy of esophagectomy with three-field lymph node dissection in surgical treatment for patients with squamous cell carcinomas of the lower thoracic esophagus remains controversial.
  • This report documents the outcomes of this surgical procedure for a large series.
  • METHODS: From February 1986 to November 1998, 437 patients with squamous cell carcinomas of the thoracic esophagus underwent transthoracic esophagectomy with three-field lymph node dissection.
  • One hundred and sixteen of these had cancer of the lower thoracic esophagus.
  • To avoid the influence of adjuvant therapy on survival, 20 who also received radiation and/or chemotherapy were excluded, leaving 96 patients who were retrospectively analyzed.
  • Factors significantly influencing the overall survival rates were patient age (> or = 65 vs. <65), clinical N status (cN1 vs. cN0), clinical M status (cM1 vs. cM0), longitudinal tumor length of resected specimen (> or =5 vs. <5 cm), pathologic T status (pT3 vs. pT1, 2), pathologic N status (pN1 vs. pN0), lymphatic invasion (positive vs. negative), vascular invasion (positive vs. negative) and intramural metastasis (present vs. absent).
  • CONCLUSIONS: Patients with pathologic T3 tumors with both pathologic N1 status and the presence of intramural metastasis in the lower thoracic esophagus had a poor prognosis.
  • Cervical or celiac lymph node metastasis in patients with carcinomas of the lower thoracic esophagus should be distinguished from pathologic M1 status in the UICC-TNM staging system.
  • [MeSH-major] Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / surgery. Lymph Node Excision / methods

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  • (PMID = 11404147.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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3. Zenda S, Hironaka S, Boku N, Yamazaki K, Yasui H, Fukutomi A, Yoshino T, Onozawa Y, Nishimura T: Impact of hemoglobin level on survival in definitive chemoradiotherapy for T4/M1 lymph node esophageal cancer. Dis Esophagus; 2008;21(3):195-200
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  • [Title] Impact of hemoglobin level on survival in definitive chemoradiotherapy for T4/M1 lymph node esophageal cancer.
  • We retrospectively investigated the impact of the pre-chemoradiotherapy hemoglobin level (pre-CRT Hb level) for T4 and/or M1 lymph node (LYM) squamous cell carcinoma of the esophagus.
  • Chemotherapy consisted of protracted infusion with 5-fluorouracil (5-FU) at 400 mg/m(2)/day on days 1-5 and 8-12, combined with cisplatin at 40 mg/m(2)/day on days 1 and 8, repeated twice at a 5-week interval.
  • Concurrent radiation therapy was started on day 1 and delivered at 2 Gy/day for five days a week for a total radiation dose of 60 Gy, with a two-week break after a cumulative dose of 30 Gy.
  • Several factors considered to be related with treatment outcome were evaluated by univariate and multivariate analysis.
  • A total of 48 patients with T4/M1 LYM (lymphocyte) esophageal cancer treated with chemoradiotherapy (CRT) between September 2002 and April 2005 were enrolled.
  • The complete response rate to this regimen was 44% and median survival time was 13.6 months, with a median follow-up period of 26.8 months.
  • As for survival, anovarevealed that a pre-CRT Hb of 13 g/dL or less was a significant prognostic factor with a hazard ratio of 0.45 (95% confidence interval [CI]); 0.21-0.97, P=0.04), while on manova, including performance status, tumor size, TNM stage and pre-CRT Hb level, a pre-CRT Hb level of 13 g/dL or less was the only significant prognostic factor, with a hazard ratio of 0.35 (95% CI; 0.13-0.90, P=0.03).
  • In conclusion, the pre-CRT Hb level may be an important determinant of outcome in patients with T4/M1 LYM squamous cell carcinoma of the esophagus.

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  • (PMID = 18430098.001).
  • [ISSN] 1442-2050
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hemoglobins
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4. McClave SA, Jones WF, Evans WB: Do physician attitudes and practices limit use of EUS in the staging and the treatment of esophageal carcinoma? Gastrointest Endosc; 2005 Jun;61(7):840-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Do physician attitudes and practices limit use of EUS in the staging and the treatment of esophageal carcinoma?
  • BACKGROUND: Although EUS provides superior local staging of esophageal carcinoma when compared with other tests, EUS seems to be underused by physicians.
  • We designed this prospective study to determine whether EUS is ordered in the evaluation of esophageal cancer and whether staging information obtained would change management.
  • METHODS: A total of 114 physicians were mailed a questionnaire that surveyed which tests are used in evaluating patients with esophageal cancer, the order in which they are requested, and their estimated cost.
  • Physicians were asked to estimate prognosis and to indicate which therapy would be used for each specific TNM cancer stage.
  • Only 47.3% of physicians would use EUS in the patient workup for esophageal cancer.
  • A significantly greater number of internists (78.9%, p = 0.055) would not order EUS, and 31.6% of internists would not use any staging data before referral to another physician for definitive management.
  • Physicians were accurate in their assessment of the prognosis for each cancer stage and the cost of each test.
  • Except for significantly greater use of chemotherapy by surgeons and oncologists for stage IIA than internists and gastroenterologists (36.6% vs. 3.1%, p = 0.0006), there were no differences between subspecialties with use of chemotherapy for all other stages or use of radiation therapy for any stage.
  • CONCLUSIONS: Clinicians have an adequate understanding of patient survival based on cancer stage and a reasonable appreciation of cost for diagnostic tests regarding esophageal carcinoma.
  • Specific data on cancer staging does impact treatment choices and management decisions.
  • EUS is grossly underused by clinicians for staging esophageal cancer.
  • Although internists may serve as gatekeepers, they fail to order EUS, order EUS only after less accurate tests, or fail to use staging data in management (especially referral) decisions.
  • The ultimate modality of treatment may be more related to the type of physician that the patient is referred to, instead of the specific cancer stage.
  • [MeSH-major] Attitude of Health Personnel. Carcinoma / diagnostic imaging. Endosonography / utilization. Esophageal Neoplasms / diagnostic imaging. Physicians. Practice Patterns, Physicians'
  • [MeSH-minor] Adenocarcinoma / pathology. Adenocarcinoma / therapy. Antineoplastic Agents / therapeutic use. Barium Sulfate. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / therapy. Contrast Media. Esophagoscopy. Gastroenterology. General Surgery. Humans. Internal Medicine. Medical Oncology. Neoplasm Staging. Patient Care Planning. Prognosis. Prospective Studies. Radiopharmaceuticals / therapeutic use. Tomography, X-Ray Computed

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  • (PMID = 15933685.001).
  • [ISSN] 0016-5107
  • [Journal-full-title] Gastrointestinal endoscopy
  • [ISO-abbreviation] Gastrointest. Endosc.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Contrast Media; 0 / Radiopharmaceuticals; 25BB7EKE2E / Barium Sulfate
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5. Bradley J, Thorstad WL, Mutic S, Miller TR, Dehdashti F, Siegel BA, Bosch W, Bertrand RJ: Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer. Int J Radiat Oncol Biol Phys; 2004 May 1;59(1):78-86
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  • [Title] Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer.
  • PURPOSE: Locoregional failure remains a significant problem for patients receiving definitive radiation therapy alone or combined with chemotherapy for non-small-cell lung cancer (NSCLC).
  • Positron emission tomography (PET) with [(18)F]fluoro-2-deoxy-d-glucose (FDG) has proven to be a valuable diagnostic and staging tool for NSCLC.
  • This prospective study was performed to determine the impact of treatment simulation with FDG-PET and CT on radiation therapy target volume definition and toxicity profiles by comparison to simulation with computed tomography (CT) scanning alone.
  • A radiation therapist participated in both simulations to reproduce the treatment setup.
  • Both the CT and fused PET/CT image data sets were transferred to the radiation treatment planning workstation for contouring.
  • Each FDG-PET study was reviewed with the interpreting nuclear radiologist before tumor volumes were contoured.
  • The fused PET/CT images were used to develop the three-dimensional conformal radiation therapy (3DCRT) plan.
  • A second physician, blinded to the results of PET, contoured the gross tumor volumes (GTV) and planning target volumes (PTV) from the CT data sets, and these volumes were used to generate mock 3DCRT plans.
  • The two 3DCRT plans for each patient were compared with respect to the GTV, PTV, mean lung dose, volume of normal lung receiving > or =20 Gy (V20), and mean esophageal dose.
  • RESULTS: The FDG-PET findings altered the AJCC TNM stage in 8 of 26 (31%) patients; 2 patients were diagnosed with metastatic disease based on FDG-PET and received palliative radiation therapy.
  • Of the 24 patients who were planned with 3DCRT, PET clearly altered the radiation therapy volume in 14 (58%), as follows.
  • PET helped to distinguish tumor from atelectasis in all 3 patients with atelectasis.
  • Unsuspected nodal disease was detected by PET in 10 patients, and 1 patient had a separate tumor focus detected within the same lobe of the lung.
  • Increases in the target volumes led to increases in the mean lung dose, V20, and mean esophageal dose.
  • Decreases in the target volumes in the patients with atelectasis led to decreases in these normal-tissue toxicity parameters.
  • CONCLUSIONS: Radiation targeting with fused FDG-PET and CT images resulted in alterations in radiation therapy planning in over 50% of patients by comparison with CT targeting.
  • The increasing availability of integrated PET/CT units will facilitate the use of this technology for radiation treatment planning.
  • A confirmatory multicenter, cooperative group trial is planned within the Radiation Therapy Oncology Group.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / radionuclide imaging. Fluorodeoxyglucose F18. Lung Neoplasms / radionuclide imaging. Radiopharmaceuticals. Radiotherapy Planning, Computer-Assisted / methods. Tomography, Emission-Computed. Tomography, X-Ray Computed / methods
  • [MeSH-minor] Humans. Neoplasm Staging / methods. Pilot Projects. Prospective Studies. Pulmonary Atelectasis / radionuclide imaging. Radiographic Image Interpretation, Computer-Assisted

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  • [CommentIn] Int J Radiat Oncol Biol Phys. 2004 May 1;59(1):4-5 [15093892.001]
  • (PMID = 15093902.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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6. Chen EC, Liu MZ, Hu YH, Li QQ, Liu H, Cai L, Liu H, Lin HX, Huang Y, Wang HY, Cui NJ: [Multivariate prognostic analysis for patients with unresectable esophageal carcinoma after concurrent chemoradiotherapy]. Ai Zheng; 2005 Jun;24(6):731-4
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  • [Title] [Multivariate prognostic analysis for patients with unresectable esophageal carcinoma after concurrent chemoradiotherapy].
  • BACKGROUND & OBJECTIVE: Concurrent chemoradiotherapy is recommended as standard treatment for unresectable esophageal carcinoma now.
  • This study was to analyze the prognostic factors of unresectable esophageal carcinoma after concurrent chemoradiotherapy.
  • METHODS: A total of 132 unresectable esophageal carcinoma patients received concurrent chemoradiotherapy from Jan.
  • All patients received chemotherapy at the beginning of radiotherapy, and when the radiation dose escalated to 40 Gy.
  • Total dose of irradiation was 60-70 Gy.
  • Gender, age, disease course, focus location, swallow embarrassment, weight loss, Karnofsky's performance status (KPS) score, family history, hemoglobin (HB) before therapy, X-ray type, pathologic grade, focus length, TNM stage, irradiation method and technology, irradiation dose, radiotherapy interval, short-term effect, esophagus perforation, esophagus haemorrhage, and retreatment methods were used as analysis factors for Cox regression univariate and multivariate analyses.
  • RESULTS: Univariate analysis showed that diseases course, focus location, weight loss, M stage, short-term effect, esophagus perforation, esophagus haemorrhage, and retreatment methods were prognostic factors of these patients.
  • Multivariate analysis showed that M stage [P=0.014, odds ratio (OR)=2.515], short-term effect (P < 0.001, OR=2.181), esophagus perforation (P=0.022, OR=3.266), and retreatment methods (P=0.026, OR=1.142) were independent prognostic factors.
  • CONCLUSION: The main prognostic factors of the patients with unresectable esophageal carcinoma treated with concurrent chemoradiotherapy are M stage, short-term effect, esophagus perforation, and retreatment methods.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Humans. Lymphatic Metastasis. Male. Middle Aged. Multivariate Analysis. Neoplasm Recurrence, Local. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiotherapy, High-Energy

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  • (PMID = 15946490.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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7. Lü JM, Liang J, Wang JW, He J, Xiao ZF, Zhang HX, Chen DF, Feng QF, Wang LH: [Clinical analysis of 126 patients with primary small cell carcinoma of the esophagus]. Zhonghua Zhong Liu Za Zhi; 2009 Feb;31(2):121-5
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  • [Title] [Clinical analysis of 126 patients with primary small cell carcinoma of the esophagus].
  • OBJECTIVE: To investigate the prognostic factors and the principles of treatment of primary esophageal small cell carcinoma (SCEC) retrospectively.
  • 85 patients were in limited disease stage (LD) and 41 patients as extensive disease stage (ED) according to the Veterans Administration Lung Study Group staging system.
  • Among the 84 patients treated with esophagectomy, 8 cases were in stage I, 16 in stage IIa, 10 in stage IIb, 40 in stage III, 4 in stage IVa and 6 in stage IVb, according to the TNM system (6(th) edition, AJCC).
  • The 1-, 3-, and 5-year overall survival rates (OS) were 52.2%, 15.9%, and 12.2%, respectively, with a median survival time (MST) of 12.5 months.
  • The MST of the patients treated with chemotherapy was 14.5 months, significantly longer than the 5.2 months of the patients without (P = 0.0001).
  • Multivariate analysis showed that stage (HR 1.91, 95% CI 1.26 approximately 2.91, P = 0.002), length of the primary lesion (HR 1.75, 95% CI 1.17 approximately 2.63, P = 0.007), and chemotherapy (HR 0.42, 95% CI 0.28 approximately 0.65, P = 0.000) were independent prognostic factors.
  • CONCLUSION: Esophageal small cell carcinoma is a systemic disease.
  • The tumor stage (LD or ED), length of the primary lesion and chemotherapy are independent prognostic factors.
  • Therefore, a systemic therapy based on chemotherapy should be recommended.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Small Cell / therapy. Esophageal Neoplasms / therapy. Esophagectomy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Lymph Node Excision. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Proportional Hazards Models. Radiotherapy, High-Energy. Retrospective Studies. Survival Rate

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  • (PMID = 19538888.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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8. Moorjani N, Junemann-Ramirez M, Judd O, Fox B, Rahamim JS: Endoscopic ultrasound in esophageal carcinoma: comparison with multislice computed tomography and importance in the clinical decision making process. Minerva Chir; 2007 Aug;62(4):217-23
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  • [Title] Endoscopic ultrasound in esophageal carcinoma: comparison with multislice computed tomography and importance in the clinical decision making process.
  • AIM: As resective surgery for oesophageal carcinoma is only appropriate for a selected cohort of patients, preoperative staging plays an important role in the management of these patients.
  • This study assessed the accuracy of endoscopic ultrasound (EUS) staging in comparison with computerised tomography (CT) staging and the impact of EUS in management of patients with oesophageal carcinoma undergoing gastro-esophagectomy.
  • METHODS: Ninety-six consecutive patients with oesophageal carcinoma underwent preoperative staging with multislice CT and EUS.
  • Of these, 50 patients underwent gastro-esophagectomy, allowing preoperative staging data from these imaging modalities to be compared to postoperative histopathological staging, classified according to the TNM system.
  • Management plans for these patients made without use of EUS were then compared to those following EUS staging.
  • RESULTS: The overall accuracy rate of EUS for T staging was 64%, showing good agreement with postoperative histopathological staging of the resected specimen (weighted k=0.42, 95%CI= 0.32-0.52).
  • In terms of clinical decision making, the T stage accuracy rose to 90% when differentiating T1 from T2/3 lesions.
  • In terms of N staging, the overall accuracy was 72% (weighted k=0.44, 95% CI=0.34-0.54).
  • In comparison, N staging by CT was significantly less accurate (62% vs 72%, P<0.01, chi squared) and showed poor agreement with postoperative histopathological nodal staging (weighted k=0.24, 95%CI =0.11-0.37).
  • Importantly, in 56% of patients, staging information obtained from EUS instigated change in management compared to that configured without EUS.
  • CONCLUSION: EUS enhances preoperative staging of oesophageal cancer and is important in preoperative clinical decision making process, especially with increasing use of neoadjuvant chemotherapy.
  • [MeSH-major] Carcinoma / radiography. Carcinoma / ultrasonography. Endosonography. Esophageal Neoplasms / radiography. Esophageal Neoplasms / ultrasonography. Tomography, X-Ray Computed
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Esophagectomy. Female. Gastrectomy. Humans. Male. Middle Aged. Neoadjuvant Therapy / methods. Neoplasm Staging. Retrospective Studies. Treatment Outcome

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  • (PMID = 17641581.001).
  • [ISSN] 0026-4733
  • [Journal-full-title] Minerva chirurgica
  • [ISO-abbreviation] Minerva Chir
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Italy
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9. Malaisrie SC, Untch B, Aranha GV, Mohideen N, Hantel A, Pickleman J: Neoadjuvant chemoradiotherapy for locally advanced esophageal cancer: experience at a single institution. Arch Surg; 2004 May;139(5):532-8; discussion 538-9
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  • [Title] Neoadjuvant chemoradiotherapy for locally advanced esophageal cancer: experience at a single institution.
  • HYPOTHESIS: Patients receiving neoadjuvant chemoradiotherapy followed by surgery (CRS) undergo downstaging of their tumor and have improved survival when compared with patients undergoing surgery followed by adjuvant chemoradiotherapy (SCR).
  • PATIENTS: One hundred twenty-three patients with squamous cell carcinoma and adenocarcinoma of the esophagus underwent Ivor-Lewis esophagectomy from January 1, 1990, through December 31, 2001.
  • INTERVENTIONS: Patients were candidates for neoadjuvant or adjuvant therapy if they had locally advanced disease (T3/T4 N0 or any T stage with N1).
  • Neoadjuvant and adjuvant therapies were nonrandomized and based on the preference of the treating oncologist and surgeon.
  • RESULTS: Pathological downstaging (as characterized by TNM staging) was observed in 20 (64%) of the patients receiving CRS.
  • No 30-day mortality was observed in either treatment group.
  • No statistical difference in survival was observed between groups, although a trend suggested improved survival with neoadjuvant therapy (3-year survival in CRS and SCR groups was 45% and 22%, respectively; P =.15).
  • CONCLUSIONS: Neoadjuvant chemoradiotherapy effectively downstages cancer in patients with locally advanced esophageal disease.
  • Morbidity and operative mortality were not significantly different between patients receiving neoadjuvant and adjuvant therapy.
  • [MeSH-major] Adenocarcinoma / mortality. Adenocarcinoma / surgery. Esophageal Neoplasms / mortality. Esophageal Neoplasms / surgery. Neoadjuvant Therapy
  • [MeSH-minor] Aged. Carcinoma, Small Cell / mortality. Carcinoma, Small Cell / surgery. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / mortality. Carcinoma, Squamous Cell / radiotherapy. Carcinoma, Squamous Cell / surgery. Chemotherapy, Adjuvant. Esophagectomy / methods. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis

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  • (PMID = 15136354.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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10. Power DG, Reynolds JV: Localized adenocarcinoma of the esophagogastric junction--is there a standard of care? Cancer Treat Rev; 2010 Aug;36(5):400-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Most patients present with locally advanced resectable disease and treatment can be curative.
  • However, no accepted standard treatment exists.
  • Cancer specialists frequently differ on optimum treatment strategies.
  • Areas of debate include the aetiology of AEG, TNM staging, type and extent of resection, relative benefits of preoperative chemotherapy versus preoperative chemoradiation (CRT) versus post-operative CRT, use of early PET scan, and integration of targeted therapy.
  • R0 resection and pathologic complete responses (pCR) predict long-term survival, and most treatment strategies target this as a proxy measure of improved outcome.
  • Some preoperative chemotherapy trials show a benefit but the numbers of true AEG tumours in these studies is unclear.
  • The MAGIC study was powered for gastric cancer only, with just 27% of patients having AEG.
  • Compared with chemotherapy alone, preoperative CRT trials show higher rates of pCR.
  • A large randomized study, with significant toxicity, has shown long-term benefit with adjuvant CRT after resection of gastric cancer (20% AEG).
  • Trimodality therapy is likely to be optimum with surgery shifted to later in the treatment pathway.
  • Rectal cancer provides an analogous paradigm in this regard.
  • [MeSH-major] Adenocarcinoma / therapy. Esophageal Neoplasms / therapy. Esophagogastric Junction. Stomach Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy / methods. Humans. Neoplasm Staging. Treatment Outcome

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  • [Copyright] Copyright 2010 Elsevier Ltd. All rights reserved.
  • (PMID = 20117883.001).
  • [ISSN] 1532-1967
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 119
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11. Dabrowski A, Skoczylas T, Ciechański A, Wallner G, Zinkiewicz K, Cwik G, Górczyński R, Borowski A: Dukes' classification as a prognostic factor in patients with squamous cell carcinoma of the thoracic esophagus undergoing combined-modality treatment. Med Sci Monit; 2006 Oct;12(10):CR409-15
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  • [Title] Dukes' classification as a prognostic factor in patients with squamous cell carcinoma of the thoracic esophagus undergoing combined-modality treatment.
  • BACKGROUND: Several disadvantages of the TNM classification have resulted in a search for a simpler, clearer, and more reliable staging system for esophageal cancer.
  • We evaluated Dukes' classification as a prognostic indicator in 81 patients with squamous cell carcinoma of the thoracic esophagus treated with combined-modality therapy.
  • MATERIAL/METHODS: The pathological staging was determined according to the TNM and Dukes' classification.
  • RESULTS: The differences in cumulative survival rates between TNM I and TNM IIa, between TNM IIa and TNM IIb and between TNM IIb and TNM III patients were 20.2% (37.2 vs. 46.6), 27.5% (46.6 vs. 33.8) and 60.7% (33.8 vs. 13.3), respectively, and were not statistically significant (P = 0.58, P = 0.53 and P = 0.18).
  • The cumulative survival rates for TNM III and TNM IV patients were similar (13.3 and 14.3).
  • CONCLUSIONS: Dukes' staging system for esophageal cancer is simpler, clearer and more accurate, and could thus be a better prognostic tool than the TNM classification.
  • [MeSH-major] Carcinoma, Squamous Cell. Esophageal Neoplasms
  • [MeSH-minor] Adult. Aged. Drug Therapy, Combination. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Survival Rate

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  • (PMID = 17006399.001).
  • [ISSN] 1234-1010
  • [Journal-full-title] Medical science monitor : international medical journal of experimental and clinical research
  • [ISO-abbreviation] Med. Sci. Monit.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Poland
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12. Valentí V, Fares S, Reynolds N, Cohen P, Theodoro N, Martínez-Isla A: [Open and laparoscopic transhiatal oesophagectomy for cancer of the oesophagus: analysis of resection margins and lymph nodes]. Cir Esp; 2008 Jan;83(1):24-7
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  • [Title] [Open and laparoscopic transhiatal oesophagectomy for cancer of the oesophagus: analysis of resection margins and lymph nodes].
  • INTRODUCTION: Surgical treatment of cancer of the oesophagus is associated with a high morbidity and mortality.
  • Minimally invasive surgery has been proposed as an alternative to try to reduce these complications; however, at this time there are not many studies that evaluate the oncological validity of this method.
  • MATERIAL AND METHOD: Between April 2003 and February 2007, 40 patients diagnosed with distal oesophageal cancer were surgically intervened at Charing Cross Hospital, London, 24 open and 16 by laparoscopy in accordance with the surgeon responsible.
  • Of these, 50% received neoadjuvant chemotherapy.
  • In all cases, the pathological tumour stage (TNM), the tumour distal margin, tumour proximal margin, tumour circumference and number of resected lymph nodes, were collected in a data base.
  • The mean distal tumour margin for the group treated by open surgery was 4.9 cm compared to 4.3 in the group treated by laparoscopy (p = 0.578).
  • CONCLUSIONS: In our experience, laparoscopic surgery for cancer of the oesophagus appears to show similar initial results to those of open surgery as regards the number of resected lymph nodes and resection margins.
  • [MeSH-major] Adenocarcinoma / surgery. Esophageal Neoplasms / surgery. Esophagectomy / methods. Laparoscopy. Lymph Node Excision
  • [MeSH-minor] Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Data Interpretation, Statistical. Esophagus / pathology. Female. Humans. Male. Middle Aged. Minimally Invasive Surgical Procedures. Neoplasm Staging. Treatment Outcome

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  • [ErratumIn] Cir Esp. 2008 Dec;84(6):295. Fares, Rally [corrected to Fares, Sally]
  • (PMID = 18208745.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] Comparative Study; English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] Spain
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13. Ajani J, D'Amico TA, Hayman JA, Meropol NJ, Minsky B, National Comprehensive Cancer Network: Gastric cancer. Clinical practice guidelines in oncology. J Natl Compr Canc Netw; 2003 Jan;1(1):28-39
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  • [Title] Gastric cancer. Clinical practice guidelines in oncology.
  • Gastric cancer is rampant in several countries around the world.
  • Its incidence in the West has been on the decline for more than 40 years; however, the location of gastric cancer has shifted proximally in the past 15 years.
  • Diffuse histology is also more common now than intestinal type of histology.
  • Advances have been made in staging procedures such as laparoscopy and endoscopic ultrasonography and in possible functional imaging techniques.
  • The current TNM classification requires an examination of at least 15 lymph nodes; therefore, at least a D1 dissection is recommended.
  • Patients with locoregional gastric carcinoma should also be referred to high-volume treatment centers.
  • Combination chemotherapy and radiotherapy in the adjuvant setting for select group of patients is considered the new standard in the United States.
  • The NCCN Gastric Cancer Guidelines portray uniformity in the systemic approach to cancer in the United States.
  • We look forward to the results of investigations of a number of new chemotherapeutic agents, including antireceptor agents, vaccines, gene therapy, and antiangiogenic agents.
  • The panel anticipates many advances in the treatment of esophageal carcinoma in the future.
  • [MeSH-minor] Humans. Medical Oncology. Neoplasm Staging

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  • (PMID = 19764148.001).
  • [ISSN] 1540-1405
  • [Journal-full-title] Journal of the National Comprehensive Cancer Network : JNCCN
  • [ISO-abbreviation] J Natl Compr Canc Netw
  • [Language] eng
  • [Publication-type] Journal Article; Practice Guideline
  • [Publication-country] United States
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14. Launois B, Raoul JL, Leprise E, Meunier B: [Neoadjuvant treatment in surgery of esophageal cancer]. Bull Acad Natl Med; 2000;184(8):1703-13; discussion 1714
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  • [Title] [Neoadjuvant treatment in surgery of esophageal cancer].
  • [Transliterated title] Le traitement néoadjuvant dans la chirurgie du cancer de l'oesophage.
  • We conducted a prospective study on neoadjuvant treatment for squamous cell carcinoma of the esophagus, modifying the chemotherapy protocol by adding l-folinic acid and giving bifractionated radiotherapy with a cis-diaminedichloroplatinum (CDDP) injection before each fraction.
  • Thirty-two patients, 30 men, 2 women, mean age 56.2-8.9 years, with resectable squamous celi carcinoma of the esophagus (TNM stage I = 4, IIA = 4, IIB = 13, III = 11) were included.
  • Chemotherapy, CDDP (80 mg/m2: D2), 5-fluorouracil (5-FU; 600 mg/m2, D1-4), and 1-folinic acid (200 mg/m2, DI-4), was given in two sessions with a 3-week interval during which the patients received radiotherapy (45 Gy), two fractions per day (150 cGy/fraction).
  • Patients underwent surgery 4 to 7 weeks after neoadjuvant therapy.
  • This new therapeutic combination is aggressive and associated with a high postoperative mortality but has a remarkable histological effect since complete response was achieved in 56% (95% CI: 39-73%) of the patients and 5-year survival reached 47%, a very high rate in our experience.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / surgery. Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / surgery. Esophagectomy. Neoadjuvant Therapy / methods
  • [MeSH-minor] Cisplatin / administration & dosage. Female. Fluorouracil / administration & dosage. Humans. Leucovorin / administration & dosage. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy Dosage. Radiotherapy, Adjuvant. Survival Analysis. Treatment Outcome

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  • (PMID = 11471389.001).
  • [ISSN] 0001-4079
  • [Journal-full-title] Bulletin de l'Académie nationale de médecine
  • [ISO-abbreviation] Bull. Acad. Natl. Med.
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil
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15. Zhang X, Watson DI, Lally C, Bessell JR: Endoscopic ultrasound for preoperative staging of esophageal carcinoma. Surg Endosc; 2005 Dec;19(12):1618-21
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  • [Title] Endoscopic ultrasound for preoperative staging of esophageal carcinoma.
  • BACKGROUND: Endoscopic ultrasound (EUS) is potentially the best method for pretreatment staging of esophageal carcinoma once distant metastases have been excluded by other methods.
  • However, its apparent accuracy might be influenced by the use of neoadjuvant therapy.
  • To determine the accuracy of EUS in patients undergoing esophageal resection, the authors reviewed their experience with EUS.
  • METHODS: A total of 73 patients with esophageal carcinoma who underwent an esophagectomy between April 2000 and February 2005 were examined using preoperative EUS and computed tomography (CT).
  • Both EUS and CT scan were used to determine the depth of tumor penetration (T-stage) and the presence of lymph node metastases (N-stage).
  • These results then were compared with staging determined after pathologic examination of the resected surgical specimen.
  • RESULTS: For patients not undergoing neoadjuvant therapy, T-stage was accurately determined by EUS in 79%, N-stage in 74%, and tumor node metastasis (TNM) classification in 65% of the cases.
  • However, when patients who had undergone neoadjuvant chemoradiotherapy were included, the overall accuracy of EUS was 64% for T-stage, 63% for N-stage, and 53% for TNM classification.
  • For the patients who underwent neoadjuvant therapy, EUS indicated a more advanced T-stage in 49%, N-stage in 38%, and TNM classification in 51% of the cases, as compared with pathology.
  • CONCLUSION: For patients who do not undergo preoperative neoadjuvant chemotherapy and radiotherapy, EUS is a more accurate method for determining T- and N-stage resected esophageal carcinomas.
  • Neoadjuvant therapy, however, results in apparent overstaging, predominantly because of tumor downstaging, and this reduces the apparent accuracy of EUS (and CT scanning) in this patient group.
  • Nevertheless, EUS staging before neoadjuvant therapy could be more accurate than pathologic staging after treatment, thereby providing better initial staging information, which can be used to facilitate treatment.
  • [MeSH-major] Esophageal Neoplasms / diagnostic imaging. Esophageal Neoplasms / pathology. Preoperative Care. Ultrasonography, Interventional
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Reproducibility of Results

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  • (PMID = 16211436.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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16. Rohatgi P, Swisher SG, Correa AM, Wu TT, Liao Z, Komaki R, Walsh GL, Vaporciyan AA, Rice DC, Roth JA, Ajani JA: Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response. Cancer; 2005 Dec 1;104(11):2365-72
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  • [Title] Characterization of pathologic complete response after preoperative chemoradiotherapy in carcinoma of the esophagus and outcome after pathologic complete response.
  • BACKGROUND: The purpose of the current study was to test the hypothesis that a lower clinical TNM stage is associated with a higher rate of pathologic complete response (pathCR) in patients with esophageal carcinoma receiving preoperative chemoradiotherapy and to determine whether outcome after pathCR is related to clinical stage or treatment.
  • METHODS: Clinical parameters and surgical specimens of patients with esophageal carcinoma undergoing preoperative chemoradiotherapy were analyzed to identify predictors of pathCR.
  • In patients with American Joint Committee on Cancer (AJCC) Stage II carcinoma, the proportion achieving pathCR was significantly larger than that achieving <pathCR (65% vs. 35%; P = 0.03).
  • The proportion of patients who received induction chemotherapy was higher in the pathCR group than in the <pathCR group (54% vs. 46%; P = 0.05).
  • However, neither TNM classification, primary tumor location, histologic type, gender, therapy sequence, or radiation dose (45 grays [Gy] vs. 50.4 Gy) were found to have any influence on OS or DFS.
  • CONCLUSIONS: Patients with clinical AJCC Stage II esophageal carcinoma are more likely to achieve a pathCR after preoperative chemoradiotherapy than are those with Stage III carcinoma.
  • Chemoradiotherapy as primary therapy for patients with Stage I esophageal carcinoma warrants investigation as a means to preserve their esophagus.
  • [MeSH-major] Esophageal Neoplasms / drug therapy. Esophageal Neoplasms / radiotherapy
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / radiotherapy. Adult. Aged. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 16245310.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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17. Jiao X, Sonett J, Gamliel Z, Doyle A, Schuetz J, Greenwald B, Suntharalingam M, Krasna MJ: Trimodality treatment versus surgery alone for esophageal cancer. A stratified analysis with minimally invasive pretreatment staging. J Cardiovasc Surg (Torino); 2002 Aug;43(4):531-7
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  • [Title] Trimodality treatment versus surgery alone for esophageal cancer. A stratified analysis with minimally invasive pretreatment staging.
  • BACKGROUND: Accurate pretreatment staging of esophageal cancer (EC) is important in the evaluation and comparison of results of different treatment modalities.
  • Few studies using minimally invasive staging techniques for this purpose have been reported.
  • We previously demonstrated the usefulness of the thoracoscopic/laparoscopic (Ts/Ls) technique in pretreatment staging of EC.
  • This study was conducted to evaluate the impact of trimodality based on pretreatment Ts/Ls staging diagnosis on EC.
  • Group A (44 patients) underwent pretreatment Ts/Ls staging and had trimodality treatment.
  • Preoperative therapy consisted of concurrent chemotherapy (5-FU + cisplatinum) and radiotherapy.
  • The study focused on stratified comparison of patterns of recurrence and survival in different pretreatment surgical T, N, and TNM stage categories.
  • There were no significant differences in recurrence pattern and survival in different N categories and TNM stages between 2 groups.
  • CONCLUSIONS: Pretreatment Ts/Ls staging can provide accurate staging information for EC patients.
  • Trimodality treatment was successful in local control for patients with squamous cell carcinoma.
  • Pretreatment lymph node status was the most important prognosticator regardless of treatment modality.
  • Pretreatment pathological staging should be included in the future clinical trials on multimodality treatments in EC patients.
  • [MeSH-major] Adenocarcinoma / therapy. Carcinoma, Squamous Cell / therapy. Esophageal Neoplasms / therapy
  • [MeSH-minor] Aged. Case-Control Studies. Combined Modality Therapy. Disease-Free Survival. Esophagus / pathology. Female. Humans. Male. Middle Aged. Multivariate Analysis. Neoplasm Recurrence, Local / epidemiology. Neoplasm Staging. Retrospective Studies

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  • (PMID = 12124569.001).
  • [ISSN] 0021-9509
  • [Journal-full-title] The Journal of cardiovascular surgery
  • [ISO-abbreviation] J Cardiovasc Surg (Torino)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
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18. Machlenkin S, Melzer E, Idelevich E, Ziv-Sokolovsky N, Klein Y, Kashtan H: Endoscopic ultrasound: doubtful accuracy for restaging esophageal cancer after preoperative chemotherapy. Isr Med Assoc J; 2009 Mar;11(3):166-9
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  • [Title] Endoscopic ultrasound: doubtful accuracy for restaging esophageal cancer after preoperative chemotherapy.
  • BACKGROUND: The role of endoscopic ultrasound in evaluating the response of esophageal cancer to neoadjuvant chemotherapy is controversial.
  • METHODS: The disease stage of patients with esophageal cancer was established by means of the TNM classification system.
  • The initial staging was determined by chest and abdominal computed tomography and EUS.
  • Upon completion of the chemotherapy, patients were restaged and then underwent esophagectomy.
  • The results of the EUS staging were compared with the results of the surgical pathology staging.
  • RESULTS: NAC was conducted in 20 patients with initial stage IIB and III carcinoma of the esophagus (study group).
  • Post-chemotherapy EUS accurately predicted the surgical pathology stage in 6 patients (30%).
  • Pathological down-staging was noted in 8 patients (40%).
  • Thirteen patients with initial stage I-IIA underwent primary esophagectomy after the initial staging (control group).
  • CONCLUSIONS: EUS is an accurate modality for initial staging of esophageal carcinoma.
  • However, it is not a reliable tool for restaging esophageal cancer after NAC and it cannot predict response to chemotherapy.
  • [MeSH-major] Endosonography. Esophageal Neoplasms / pathology. Esophageal Neoplasms / ultrasonography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Esophagectomy. Female. Humans. Male. Middle Aged. Neoadjuvant Therapy. Neoplasm Staging / methods. Postoperative Period. Reproducibility of Results. Retrospective Studies

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  • (PMID = 19544707.001).
  • [ISSN] 1565-1088
  • [Journal-full-title] The Israel Medical Association journal : IMAJ
  • [ISO-abbreviation] Isr. Med. Assoc. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Israel
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19. Jiao X, Krasna MJ, Sonett J, Gamliel Z, Suntharalingam M, Doyle A, Greenwald B: Pretreatment surgical lymph node staging predicts results of trimodality therapy in esophageal cancer. Eur J Cardiothorac Surg; 2001 Jun;19(6):880-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pretreatment surgical lymph node staging predicts results of trimodality therapy in esophageal cancer.
  • OBJECTIVE: Prediction of responders to induction therapy in esophageal cancer (EC) patients is important.
  • In this study, we evaluated the role of thoracoscopic/laparoscopic (Ts/Ls) staging in prediction of treatment response and survival in EC patients with trimodality treatment.
  • METHODS: Retrospective study of EC patients who had undergone Ts/Ls staging and received trimodality treatment at the University of Maryland Medical Center and the Baltimore Veterans Administration Hospitals from July, 1991 to December, 1999.
  • Preoperative therapy consisted of concurrent chemotherapy (5-FU + cisplatinum) and radiotherapy.
  • RESULTS: Forty-four EC patients who underwent pretreatment Ts/Ls staging during the study period were able to complete concurrent chemoradiotherapy followed by surgical resection.
  • Twenty-seven (61.4%) patients were found to have lymph node metastasis by surgical staging.
  • Other clinicopathologic features including gender, weight loss, clinical TNM stage, surgical T stage, and histology did not correlate with treatment response.
  • Univariate analysis showed that weight loss and treatment response were important prognostic factors for disease-free survival (P=0.01 and P=0.02, respectively).
  • Histology, surgical N stage and surgical TNM stage appeared to be associated with prognosis (P=0.067-0.097).
  • CONCLUSIONS: Surgical Ts/Ls staging provides accurate evaluation of tumor spread in EC patients.
  • Pretreatment N status was the single most important predictor of response to induction treatment as well as a reliable prognosticator of survival.
  • [MeSH-major] Esophageal Neoplasms / therapy. Lymph Nodes / pathology. Neoplasm Staging / methods
  • [MeSH-minor] Aged. Analysis of Variance. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cisplatin / administration & dosage. Combined Modality Therapy. Female. Fluorouracil / administration & dosage. Humans. Lymphatic Metastasis / pathology. Male. Middle Aged. Prognosis. Retrospective Studies. Risk Factors. Treatment Outcome

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  • (PMID = 11404146.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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20. van Vliet EP, Eijkemans MJ, Steyerberg EW, Kuipers EJ, Tilanus HW, van der Gaast A, Siersema PD: The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands. Br J Cancer; 2006 Nov 6;95(9):1180-5
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  • [Title] The role of socio-economic status in the decision making on diagnosis and treatment of oesophageal cancer in The Netherlands.
  • In the United States (USA), a correlation has been demonstrated between socio-economic status (SES) of patients on the one hand, and tumour histology, stage of the disease and treatment modality of various cancer types on the other hand.
  • It is unknown whether such correlations are also involved in patients with oesophageal cancer in The Netherlands.
  • Between 1994 and 2003, 888 oesophageal cancer patients were included in a prospective database with findings on the diagnostic work-up and treatment of oesophageal cancer.
  • Multivariable logistic regression analysis showed no correlation between SES and staging procedures and preoperative TNM stage.
  • Patients with a higher SES more frequently underwent resection or were treated with chemotherapy (OR: 1.15; 95% CI 1.01-1.32 and OR: 1.16; 95% CI 1.02-1.32, respectively).
  • Socio-economic factors are involved in oesophageal cancer in The Netherlands, as patients with a higher SES are more likely to have an adenocarcinoma and patients with a lower SES a squamous cell carcinoma.
  • Moreover, the correlations between SES and different treatment modalities suggest that both patient and doctor determinants contribute to the decision on the most optimal treatment modality in patients with oesophageal cancer.
  • [MeSH-major] Esophageal Neoplasms / diagnosis. Esophageal Neoplasms / therapy. Social Class
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / therapy. Aged. Carcinoma, Squamous Cell / diagnosis. Carcinoma, Squamous Cell / therapy. Databases as Topic / statistics & numerical data. Female. Humans. Logistic Models. Male. Middle Aged. Multivariate Analysis. Neoplasm Staging. Netherlands. Prospective Studies

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  • (PMID = 17031405.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2360583
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21. Lv J, Liang J, Wang J, Wang L, He J, Xiao Z, Yin W: Primary small cell carcinoma of the esophagus. J Thorac Oncol; 2008 Dec;3(12):1460-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary small cell carcinoma of the esophagus.
  • INTRODUCTION: Primary small cell esophageal carcinoma (SCEC) is a rare and aggressive disease for which there is no recommended standard treatment at this time.
  • All were staged according to the Veterans' Administration Lung Study Group staging system.
  • The TNM system for esophageal carcinoma (6th edition, American Joint Committee on Cancer) was also used for those who underwent esophagectomies.
  • Of the entire study population, the overall median survival time (MST) and 1-, 3-, and 5-year overall survival rates were 12.5 months and 52.2%, 15.9%, and 12.2%, respectively.
  • The MST of 14.5 months for cases who received chemotherapy was superior to that of 5.2 months for cases who did not (p = 0.0001).
  • Tumor stage, length of the primary lesion, and chemotherapy, but not surgery were independent prognostic factors in a multivariate analysis.
  • Tumor stage and chemotherapy were independent prognostic factors.
  • Systemic therapy, based on chemotherapy with radiotherapy, is recommended.
  • [MeSH-major] Carcinoma, Small Cell / pathology. Esophageal Neoplasms / pathology
  • [MeSH-minor] Aged. Antineoplastic Agents / therapeutic use. Combined Modality Therapy. Esophagectomy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy Dosage. Retrospective Studies. Survival Rate

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  • [CommentIn] J Thorac Oncol. 2008 Dec;3(12):1373-6 [19057258.001]
  • (PMID = 19057273.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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22. Smithers BM, Cullinan M, Thomas JM, Martin I, Barbour AP, Burmeister BH, Harvey JA, Thomson DB, Walpole ET, Gotley DC: Outcomes from salvage esophagectomy post definitive chemoradiotherapy compared with resection following preoperative neoadjuvant chemoradiotherapy. Dis Esophagus; 2007;20(6):471-7
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  • [Title] Outcomes from salvage esophagectomy post definitive chemoradiotherapy compared with resection following preoperative neoadjuvant chemoradiotherapy.
  • Chemoradiotherapy (CRT) as a definitive treatment for esophageal cancer, is being used with increasing frequency and as a result, surgeons will be required to assess more patients who have residual or recurrent local malignancy.
  • This article aimed to assess outcomes after esophagectomy following definitive CRT (dCRT) and compare any difference between them and patients who had preoperative neoadjuvant CRT (nCRT) using a similar regimen of chemotherapy.
  • The main therapeutic difference between the groups was the dose of radiotherapy (35 vs 60 Gy) and the timing of the resection following completion of the CRT (median 4 vs 28 weeks).
  • Preoperative tumor length, pathological TNM staging and R0 resection rates were the same in both groups.
  • However, some patients survive for a reasonable period of time, making resection a worthwhile option.

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  • NCI CPTC Antibody Characterization Program. NCI CPTC Antibody Characterization Program .
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  • (PMID = 17958721.001).
  • [ISSN] 1120-8694
  • [Journal-full-title] Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus
  • [ISO-abbreviation] Dis. Esophagus
  • [Language] ENG
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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23. Dabrowski A, Filip A, Zgodziński W, Dabrowska M, Polańska D, Wójcik M, Zinkiewicz K, Wallner G: Assessment of prognostic significance of cytoplasmic survivin expression in advanced oesophageal cancer. Folia Histochem Cytobiol; 2004;42(3):169-72
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  • [Title] Assessment of prognostic significance of cytoplasmic survivin expression in advanced oesophageal cancer.
  • Expression of survivin was found in colorectal cancer, neuroblastoma, bladder cancer, non-small cell lung cancer, and breast cancer.
  • There is some recent data indicating the correlation of poor prognosis and worse response to chemotherapy in patients with oesophageal squamous cell carcinoma (OSCC) expressing survivin.
  • The aim of the present study was to assess survivin expression in cancerous tissue of patients with advanced OSCC and to test the potential correlation between survivin expression and clinicopathological data.
  • No statistically significant correlation between survivin expression in the tumour and patients' gender, TNM stage, or vascular involvement was noted.
  • Univariate regression analysis revealed UICC staging as the only predictor of survival in the analysed group (p<0.05).

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  • (PMID = 15493578.001).
  • [ISSN] 0239-8508
  • [Journal-full-title] Folia histochemica et cytobiologica
  • [ISO-abbreviation] Folia Histochem. Cytobiol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / BIRC5 protein, human; 0 / Inhibitor of Apoptosis Proteins; 0 / Microtubule-Associated Proteins; 0 / Neoplasm Proteins
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