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Esophageal cancer surgery

Gustav Linder, Jakob Hedberg, Martin Björck, Magnus Sundbom
In esophageal cancer surgery, perfusion of the gastric conduit is a critical issue. Measurement of gastric intramucosal pH (pHi ) is a method to identify anaerobic metabolism as a sign of impaired perfusion. In this study we aimed to monitor changes in the perfusion of the gastric conduit at key steps during and after esophagectomy. pHi was measured per- and postoperatively using intermittent gastric tonometry in 32 patients undergoing open, 65%, or video-assisted thoracoscopic esophagectomy for esophageal cancer...
October 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Jun-Tao Tan, Yang Yang, Nai-Qun Mao, De-Sen Liu, Ding-Ming Huang, Hong Pan, Tong Xie, Qi Pan, Li Yang, Jian-Hong Zhong, Chuan-Tian Zuo
This study aims to evaluate the effect of neoadjuvant chemoradiotherapy (NCRT) on perioperative immune function during surgery to treat resectable locally advanced esophageal cancer. Records were retrospectively analyzed for 220 patients with locally advanced esophageal cancer, of whom 112 received surgery alone and 98 received neoadjuvant NCRT plus surgery. The two groups were compared in terms of proportions of CD3(+) , CD4(+) , CD8(+) , and natural kill (NK) cells, as well as the ratio of CD4(+) to CD8(+) cells...
October 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Wilda D Rosmolen, Pythia T Nieuwkerk, Roos E Pouw, Mark I van Berge Henegouwen, Jacques J G H M Bergman, Mirjam A G Sprangers
Endoscopic therapy is the treatment of choice for high grade intraepithelial neoplasia (HGIN) or early cancer (≤T1sm1) in Barrett's esophagus (BE). We prospectively evaluated the effect of endoscopic treatment on quality of life (QOL) and fear of cancer (recurrence) and compared this with the effect of Barrett's surveillance or surgery. Patients treated endoscopically for early Barrett's neoplasia (n = 42, HGIN - T1sm1N0M0) were compared with three groups: patients with non-dysplastic BE undergoing surveillance (n = 44); patients treated surgically for early BE neoplasia (HGIN - T2N0M0, n = 21); patients treated surgically for advanced BE cancer (T1N1M0 - T3N1M0, n = 19)...
October 21, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Nadia Haj Mohammad, Sophia De Rooij, Maarten Hulshof, Jelle Ruurda, Bas Wijnhoven, Frans Erdkamp, Meindert Sosef, Suzanne Gisbertz, Mark van Berge Henegouwen, Mirjam Sprangers, Hanneke van Laarhoven
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation (nCRT) followed by esophagectomy is a treatment with curative intent for resectable esophageal cancer. The aim of this study was to measure activities of daily living (ADL) and quality of life (QoL), and to examine correlates of changes in ADL and QoL. METHODS: A prospective study was performed with three time points (baseline, 1 week after the end of nCRT, 3-months post-surgery) together with a cross-sectional post-treatment study...
October 20, 2016: Journal of Surgical Oncology
Hiroyuki Daiko, Takeo Fujita, Takashi Kojima
Postoperative chemotherapy was initially conducted with surgical treatment as part of a multimodal treatment strategy for esophageal squamous cell carcinoma. Subsequently, a randomized trial comparing post- versus pre-operative chemotherapy with cisplatin and 5-fluorouracil demonstrated the superior efficacy of neoadjuvant treatment with FP(CF). However, the results of subgroup analysis based on T factor revealed no efficacy for cT3 tumors. To improve the survival rate in patients with cT3 tumors, treatments with neoadjuvant chemotherapy using FP(CF)plus docetaxel and concurrent FP(CF)plus radiation were conducted to assess the feasibility of preoperative adjuvant treatment and surgery after neoadjuvant treatment...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Alexander W Phillips, Barry Dent, Maziar Navidi, Arul Immanuel, S Michael Griffin
OBJECTIVE: The aim of the present study was to determine whether trainee involvement in esophageal cancer resection is associated with adverse patient outcomes. BACKGROUND: Operative experience for surgical trainees is under threat. A number of factors have been implicated in this leading to fewer hours for training. Esophagogastric cancer training is particularly vulnerable due to the publication of individual surgeon results and a perception that dual consultant operating improves patient outcomes...
October 17, 2016: Annals of Surgery
Shun-Mao Yang, Wei-Ling Hsiao, Jui-Hsiang Lin, Pei-Ming Huang, Jang-Ming Lee
BACKGROUND: Barbed sutures are widely used in various laparoscopic digestive surgeries. The purpose of this paper is to present our initial experience of laparoscopic percutaneous jejunostomy with unidirectional barbed sutures in esophageal cancer patients and compare it with our early cases using traditional transabdominal sutures. METHODS: A total of 118 esophageal cancer patients who underwent laparoscopic percutaneous jejunostomy were identified in a single institution in Taiwan from June 2014 to May 2016...
October 17, 2016: Surgical Endoscopy
Zhaohui Jin, Harry H Yoon
Preliminary clinical studies of anti-programmed cell death-1 (anti-PD-1) therapy in gastro-esophageal cancers have suggested promising single-agent activity. In patients who received prior treatment for advanced disease, pembrolizumab has been associated with a response rate of 20% in programmed cell death-1 ligand 1 (PD-L1)-positive tumors, and nivolumab with a response rate of 12% in unselected tumors. Both agents yielded a median duration of response lasting ~6-7 months. PD-L1 expression and microsatellite instability (MSI) have emerged as potential predictive markers for PD-1/PD-L1 blockade...
October 2016: Journal of Gastrointestinal Oncology
Sadamoto Zenda, Takashi Kojima, Ken Kato, Sachiko Izumi, Taijiro Ozawa, Naomi Kiyota, Chikatoshi Katada, Takahiro Tsushima, Yoshinori Ito, Tetsuo Akimoto, Yasuhisa Hasegawa, Miyuki Kanamaru, Hiroyuki Daiko
PURPOSE: To clarify, in a multicenter, single-arm, phase 2 study (UMIN Clinical Trials Registry no. UMIN000001439), the clinical profile of chemoradiotherapy (CRT) for cervical esophageal cancer. PATIENTS AND METHODS: Patients with operable cervical esophageal cancer, excluding candidates for endoscopic resection, were enrolled. Protocol treatment consisted of CRT and adjuvant chemotherapy (CT). First, patients received concurrent CRT with 5-fluorouracil (5-FU) plus cisplatin (CDDP)...
September 3, 2016: International Journal of Radiation Oncology, Biology, Physics
Helen M Heneghan, Claire Donohoe, Jessie Elliot, Zuhair Ahmed, Vinod Malik, Narayamasamy Ravi, John V Reynolds
OBJECTIVE: The aim of this study is to assess CT-PET and endoscopic assessment postneoadjuvant chemoradiotherapy (nCRT) in predicting complete pathologic response (pCR) in locally advanced esophageal cancer (LAEC). DESIGN: A prospective cohort study. BACKGROUND: nCRT is increasingly standard of care in LAEC, with pCR a surrogate for excellent outcome. Predicting pCR before surgery, with metabolic imaging and endoscopy, may spare patients' operative intervention...
November 2016: Annals of Surgery
Jorn Beukinga, Jan Binne Hulshoff, Lisanne van Dijk, Christina Muijs, Johannes Burgerhof, Gursah Kats-Ugurlu, Riemer Slart, Cornelis Slump, Véronique Mul, John Plukker
: Adequate prediction of tumor response to neoadjuvant chemoradiotherapy (nCRT) in esophageal cancer (EC) patients is important in a more personalized treatment. The current best clinical method to predict pathologic complete response is the maximal standardized uptake value (SUVmax) in (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) imaging. To improve the prediction of response, we constructed a model to predict complete response to nCRT in EC based on pre-treatment clinical parameters and (18)F-FDG PET/CT derived textural features...
October 13, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Benjamin C Knight, Peter G Devitt, David I Watson, Lorelle T Smith, Glyn G Jamieson, Sarah K Thompson
OBJECTIVE: To assess the long-term efficacy of antireflux surgery on Barrett's esophagus (BE) using BRAVO wireless pH monitoring. BACKGROUND: BE is associated with chronic gastroesophageal reflux and esophageal cancer. Till date, studies have failed to demonstrate that preventing gastroesophageal reflux with antireflux surgery halts the progression of BE, often because of difficulties in objectively proving an effective antireflux barrier. METHODS: Since 1991, all patients undergoing antireflux surgery across 2 hospital sites have been followed in a prospective database...
October 4, 2016: Annals of Surgery
Lihong Wang, Chenjing Zhu, Xuelei Ma, Kai Shen, Hongmei Li, Yuanyuan Hu, Linghong Guo, Jing Zhang, Ping Li
PURPOSE: Enhanced recovery program (ERP) was reported to be beneficial to patients undergoing esophageal surgery. However, evidence for ERP as a new standard perioperative pathway is insufficient. This meta-analysis aims to systematically investigate the differences between ERP and traditional care in terms of postoperative outcomes. METHODS: Studies comparing ERP with traditional care were searched in Pubmed and Ovid databases and subsequently analyzed. The primary outcome of interest was postoperative length of hospital stay (LOHS), and the secondary outcomes of interest were postoperative morbidity, mortality, and 30-day readmission rates...
October 10, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Prameela Konda, Di Ai, Carlos E Guerra, Andrea Rodriguez-Restrepo, Reza J Mehran, David Rice, Wayne Hofstetter, Jagtar Heir, Peter Kwater, Vijaya Gottumukkala, Mike Hernandez, Juan P Cata
OBJECTIVE: To identify risks factors associated with acute kidney injury (AKI) after esophageal cancer surgery. DESIGN: This was a retrospective study. SETTING: Single academic center. PARTICIPANTS: Subjects with non-metastatic esophageal cancer. Patients were excluded if they were younger than 18 years and had missing data. MEASUREMENTS AND MAIN RESULTS: Primary outcome of the study was AKI according to AKI Network criteria...
July 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Kazuto Harada, Dilsa Mizrak Kaya, Yusuke Shimodaira, Shumei Song, Hideo Baba, Jaffer A Ajani
The prognosis for patients with upper gastrointestinal cancers remains dismal despite the development of multimodality therapies that incorporate surgery, chemotherapy, and radiotherapy. Early diagnosis and personalized treatment should lead to better prognosis. Given the advances in proteomic technologies over the past decades, proteomics promises to be the most effective technique to identify novel diagnostics and therapeutic targets. Areas covered: For this review, keywords were searched in combination with "proteomics" and "gastric cancer" or "esophageal cancer" in PubMed...
October 10, 2016: Expert Review of Proteomics
Katsushi Takebayashi, Yasuhiro Tsubosa, Tomoyuki Kamijo, Yoshiyuki Iida, Atsushi Imai, Masato Nagaoka, Takashi Kitani, Masahiro Niihara, Eisuke Booka, Ayako Shimada, Masahiro Nakagawa, Tetsuro Onitsuka
BACKGROUND: Total pharyngolaryngectomy and cervical esophagectomy (TPLCE) after chemoradiotherapy remains a challenge because of the high rate of complications and few available data on outcomes and safety. The purpose of this study was to evaluate the clinical significance of salvage TPLCE and to compare treatment outcomes between hypopharyngeal cancer and cervical esophageal cancer. METHODS: Data from 37 consecutive patients who were diagnosed with potentially resectable hypopharyngeal and cervical esophageal cancer after chemoradiotherapy were retrospectively analyzed...
October 6, 2016: Annals of Surgical Oncology
L Depypere, T Lerut, J Moons, W Coosemans, G Decker, H Van Veer, P De Leyn, P Nafteux
Recurrent disease after esophagectomy bears an infaust prognosis, especially when multiple recurrences are present. But little is known about survival in patients with limited recurrence (solitary locoregional recurrence or solid organ metastasis). Herein, we report our experience with these subgroups. We analyzed 1754 consecutive patients surgically treated with curative resection for esophageal cancer and cancer of the gastroesophageal junction between 1990 and 2012. Seven subgroups were defined according to the recurrence type (locoregional vs...
October 5, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Michele Valmasoni, Elisa Sefora Pierobon, Carlo Alberto De Pasqual, Gianpietro Zanchettin, Lucia Moletta, Renato Salvador, Mario Costantini, Alberto Ruol, Stefano Merigliano
BACKGROUND: Cirrhosis is a risk factor with nonhepatic surgery, but only three series regarding esophagectomy are reported. The Model for End-Stage Liver Disease (MELD) score has shown benefit in risk evaluation, but there is no experience regarding esophagectomy. This study aimed to compare the outcomes of surgery for esophageal cancer between cirrhotic and noncirrhotic patients and to evaluate whether the MELD score has a prognostic value for risk stratification. METHODS: From the authors' esophageal cancer database, they selected all the patients with concomitant cirrhosis who underwent surgery with curative intent and a matched cohort of patients without cirrhosis...
October 4, 2016: Annals of Surgical Oncology
Shu Liu, Fuxi Zhen, Nana Sun, Jiayan Chen, Yuandong Cao, Sheng Zhang, Hongyan Cheng, Xiaolin Ge, Xinchen Sun
PURPOSE: Previous studies have demonstrated that apparent diffusion coefficient (ADC) values measured by magnetic resonance imaging have prognostic value in patients with esophageal squamous cell carcinoma (ESCC). However, the role of ADC needs to be validated in a cohort of Chinese ESCC patients. This study assessed the role of ADC in predicting the outcome of patients with ESCC treated only by chemoradiation in the People's Republic of China. PATIENTS AND METHODS: Seventy-three patients with local advanced ESCC were retrospectively analyzed in this study; none of the patients underwent surgery before or after chemoradiation...
2016: OncoTargets and Therapy
Lin Zhou, Peng Ge, Jiakuan Chen, Jian Wang, Ming Wang, Xiaofei Li, Tao Jiang
OBJECTIVE: To explore the clinical efficacy and safety of gastroepiploic tunnel esophagogastrostomy applied in minimally invasive esophagectomy and gastroesophageal cervical anastomosis. METHODS: Clinical data of 137 esophageal cancer patients who received minimally invasive esophagectomy from December 2013 to June 2015 in Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University were analyzed retrospectively, including 84 patients receiving anastomosis with tubular anastomat (circular staple group), and 53 patients receiving gastroepiploic tunnel anastomosis(tunnel group, position of tunnel anastomosis located in the side of gastrocolic omentum, about 2-3 cm apart from fundus)...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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