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Esophagogastric cancer

Tetsushi Nakajima, Tsutomu Sato, Kazuki Kano, Yukio Maezawa, Kenki Segami, Hirohito Fujikawa, Kousuke Ikeda, Takanobu Yamada, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa
A 63-year-old man with dysphagia was referred to our hospital. He was found to have a type 2 tumor extending from the lower thoracic esophagus to the esophagogastric junction via upper gastrointestinal endoscopy. A biopsy revealed adenocarcinoma with overexpression of the human epidermal growth factor type 2(HER2). The tumor was type I according to Siewert's classification, as the epicenter of the tumor was 27mm to the oral side from the esophago-gastric junction. The clinical diagnosis was T3N1M1, stage IV according to the Japanese Classification of Gastric Carcinoma, and T3N2M0, stage III per the Japanese Classification of Esophageal Cancer...
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
Ryu Ishihara, Tsuneo Oyama, Seiichiro Abe, Hiroaki Takahashi, Hiroyuki Ono, Junko Fujisaki, Mitsuru Kaise, Kenichi Goda, Kenro Kawada, Tomoyuki Koike, Manabu Takeuchi, Rie Matsuda, Dai Hirasawa, Masayoshi Yamada, Junichi Kodaira, Masaki Tanaka, Masami Omae, Akira Matsui, Takashi Kanesaka, Akiko Takahashi, Shinichi Hirooka, Masahiro Saito, Yosuke Tsuji, Yuki Maeda, Hiroharu Yamashita, Ichiro Oda, Yasuhiko Tomita, Takashi Matsunaga, Shuji Terai, Soji Ozawa, Tatsuyuki Kawano, Yasuyuki Seto
BACKGROUND: Little is known about the specific risks of metastasis in esophageal adenocarcinoma in relation to invasion depth or other pathologic factors. METHODS: We conducted a multicenter retrospective study in 13 high-volume centers in Japan from January 2000 to October 2014 to elucidate the risk of metastasis of esophageal adenocarcinoma. A total of 458 patients (217 surgically resected and 241 endoscopically resected) with esophageal adenocarcinoma or esophagogastric adenocarcinoma involving the esophagus were included...
October 18, 2016: Journal of Gastroenterology
Frans van Workum, Stefan A W Bouwense, Misha D P Luyer, Grard A P Nieuwenhuijzen, Donald L van der Peet, Freek Daams, Ewout A Kouwenhoven, Marc J van Det, Frits J H van den Wildenberg, Fatih Polat, Suzanne S Gisbertz, Mark I van Berge Henegouwen, Joos Heisterkamp, Barbara S Langenhoff, Ingrid S Martijnse, Janneke P Grutters, Bastiaan R Klarenbeek, Maroeska M Rovers, Camiel Rosman
BACKGROUND: Currently, a cervical esophagogastric anastomosis (CEA) is often performed after minimally invasive esophagectomy (MIE). However, the CEA is associated with a considerable incidence of anastomotic leakage requiring reintervention or reoperation and moderate functional results. An intrathoracic esophagogastric anastomosis (IEA) might reduce the incidence of anastomotic leakage, improve functional results and reduce costs. The objective of the ICAN trial is to compare anastomotic leakage and postoperative morbidity, mortality, quality of life and cost-effectiveness between CEA and IEA after MIE...
October 18, 2016: Trials
Jimmy Hwang
Esophagogastric cancers (EGCa) are a leading cause of cancer related mortality worldwide. It has been recognized that they represent heterogenous diseases based on histology and anatomy. However, it is also increasingly evident that these are diverse malignancies based on genetic alterations, and this is increasingly making these diseases amenable to targeted therapies. While epidermal growth factor receptor (EGFR) and mTOR inhibitors have failed to prove effective in the treatment of advanced EGCa, vascular endothelial growth factor (VEGF) inihibitor have now been demonstrated to improve survival, at least in the 2nd line setting of adenocarcinomas...
October 2016: Journal of Gastrointestinal Oncology
T W Rice, L-Q Chen, W L Hofstetter, B M Smithers, V W Rusch, B P L Wijnhoven, K L Chen, A R Davies, X B D'Journo, K A Kesler, J D Luketich, M K Ferguson, J V Räsänen, R van Hillegersberg, W Fang, L Durand, I Cecconello, W H Allum, R J Cerfolio, M Pera, S M Griffin, R Burger, J-F Liu, M S Allen, S Law, T J Watson, G E Darling, W J Scott, A Duranceau, C E Denlinger, P H Schipper, T E M R Lerut, M B Orringer, H Ishwaran, C Apperson-Hansen, L M DiPaola, M E Semple, E H Blackstone
We report data-simple descriptions of patient characteristics, cancer categories, and non-risk-adjusted survival-for patients with pathologically staged cancer of the esophagus and esophagogastric junction after resection or ablation with no preoperative therapy from the Worldwide Esophageal Cancer Collaboration (WECC). Thirty-three institutions from six continents submitted de-identified data using standard definitions: demographics, comorbidities, clinical cancer categories, and all-cause mortality from first management decision...
October 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Daisuke Taniguchi, Hiroshi Saeki, Yuichiro Nakashima, Ryosuke Tsutsumi, Sho Nishimura, Kensuke Kudou, Yu Nakaji, Hirotada Tajiri, Satoshi Tsutsumi, Takafumi Yukaya, Ryota Nakanishi, Masahiko Sugiyama, Hideto Sonoda, Kippei Ohgaki, Eiji Oki, Yoshihiko Maehara
A 65-year-old man with cT3N2M0 stage III cervical esophageal cancer underwent subtotal esophagectomy and gastric tube reconstruction through the retrosternal route after neoadjuvant chemoradiotherapy. The anastomosis was located adjacent to the left side of the trachea, and a circular stapler was used for anastomosis. Postoperative anastomotic leakage occurred, and an esophagotracheal fistula between the esophagogastric anastomotic site and cartilage portion of the trachea was observed on postoperative day 44...
December 2016: Surgical Case Reports
K Lehmann, D Eshmuminov, P Bauerfeind, C Gubler, P Veit-Haibach, A Weber, H Abdul-Rahman, M Fischer, C Reiner, P M Schneider
INTRODUCTION: The accuracy of preoperative lymph-node staging in patients with adenocarcinoma of the esophagogastric junction (AEG) or gastric cancer (GC) is low. The aim of this study was to assess the accuracy of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT) for lymph-node staging in patients with AEG or GC, with or without neoadjuvant treatment. PATIENTS AND METHODS: 221 consecutive patients with GC (n = 88) or AEG (n = 133) were evaluated...
September 7, 2016: European Journal of Surgical Oncology
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
September 24, 2016: Annals of Thoracic Surgery
David H Ilson
PURPOSE OF REVIEW: This article reviews the recent seminal studies in esophagogastric cancer. RECENT FINDINGS: Regular low aspirin use may reduce the risk of esophagogastric cancer. Laparoscopic resection of locally advanced gastric cancer appears equivalent to open resection. There is no survival benefit for the addition of postoperative radiation therapy to adjuvant chemotherapy after primary gastric cancer resection. For tumors of the esophagus and gastroesophageal junction, the combination of preoperative radiation therapy with concurrent chemotherapy may be required to ensure achievement of a negative surgical margin and to reduce local tumor recurrence...
November 2016: Current Opinion in Gastroenterology
Nikhil Suresh Ghadyalpatil, Chopra Supriya, Patil Prachi, Dsouza Ashwin, Saklani Avanish
GI cancer is not one cancer but is a term for the group of cancers that affect the digestive system including gastric cancer (GC), colorectal cancer (CRC), hepatocellular carcinoma (HCC), esophageal cancer (EC), and pancreatic cancer (PC). Overall, the GI cancers are responsible for more cancers and more deaths from cancer than any other organ. 5 year survival of these cancers remains low compared to western world. Unlike the rest of the world where organ based specialities hepatobiliary, pancreatic, colorectal and esophagogastric exist, these cancers are managed in India by either a gastrointestinal surgeons, surgical oncologist, or a general surgeon with varying outcomes...
July 2016: South Asian Journal of Cancer
Markus Moehler, Irina Gepfner-Tuma, Annett Maderer, Peter C Thuss-Patience, Joern Ruessel, Susanna Hegewisch-Becker, Hansjochen Wilke, Salah-Eddin Al-Batran, Mohammad-Reza Rafiyan, Florian Weißinger, Hans-Joachim Schmoll, Frank Kullmann, Ludwig Fischer von Weikersthal, Jens T Siveke, Jens Weusmann, Stephan Kanzler, Carl Christoph Schimanski, Melanie Otte, Lukas Schollenberger, Jochem Koenig, Peter R Galle
BACKGROUND: As a multi-targeted anti-angiogenic receptor tyrosine kinase (RTK) inhibitor sunitinib (SUN) has been established for renal cancer and gastrointestinal stromal tumors. In advanced refractory esophagogastric cancer patients, monotherapy with SUN was associated with good tolerability but limited tumor response. METHODS: This double-blind, placebo-controlled, multicenter, phase II clinical trial was conducted to evaluate the efficacy, safety and tolerability of SUN as an adjunct to second and third-line FOLFIRI (NCT01020630)...
2016: BMC Cancer
Nuray Kepil, Sebnem Batur, Ceyda Sonmez Wetherilt, Sibel Erdamar Cetin
Accurate identification of human epidermal growth factor receptor 2 (HER-2) status in advanced gastric cancer patients is of utmost importance in terms of treatment planning. This study aimed to examine the HER-2 status in advanced gastric cancer patients using both immunohistochemistry (IHC) and silver in situ hybridization (SISH) techniques and to investigate concordance and diagnostic accuracy. In addition, associations between clinical parameters and HER 2 status were examined. A total of 313 patients diagnosed with locally advanced (Stage III: T3-4, N+) recurrent or metastatic adenocarcinoma of the stomach or esophagogastric junction, between 2009 and 2015, were included...
August 31, 2016: Bosnian Journal of Basic Medical Sciences
Emil Ter Veer, Nadia Haj Mohammad, Gert van Valkenhoef, Lok Lam Ngai, Rosa M A Mali, Maarten C Anderegg, Martijn G H van Oijen, Hanneke W M van Laarhoven
BACKGROUND: A globally accepted standard first-line chemotherapy regimen in advanced esophagogastric cancer (AEGC) is not clearly established. We conducted a systematic review to investigate the efficacy and safety of first-line chemotherapy using Network meta-analysis (NMA). METHODS: Medline, EMBASE, CENTRAL, and conferences were searched until June 2015 for randomized controlled trials that compared regimens containing: fluoropyrimidine (F), platinum (cisplatin [C] and oxaliplatin [Ox]), taxane (T), anthracycline (A), irinotecan (I), or methotrexate (M)...
October 2016: Journal of the National Cancer Institute
Takuya Hattori, Kazuhiro Sentani, Yui Hattori, Naohide Oue, Wataru Yasui
Invasive micropapillary carcinoma (IMPC), an aggressive variant of adenocarcinoma, is associated with a poor prognosis. Although IMPC has been reported to occur in various organs, pure IMPC has only been reported in the breast, pancreas and colon. There are no reports of IMPC of the esophagogastric junction (EGJ). According to previous reports on gastric IMPC, IMPC occupied, at most, 90 % of the whole tumor. IMPC is reported to occur least frequently in the gastric cardia. We herein report a rare case of pure IMPC of the EGJ...
October 2016: Pathology International
Yoshitake Ueda, Norio Shiraishi, Manabu Toujigamori, Hidefumi Shiroshita, Tsuyoshi Etoh, Masafumi Inomata
BACKGROUND AND OBJECTIVES: There is no standardized method of reconstruction in laparoscopic proximal gastrectomy (LPG). We present a novel technique of reconstruction with a long, narrow gastric tube in LPG for early gastric cancer (EGC). METHODS: During the laparoscopic procedure, the upper part of the stomach is fully mobilized with perigastric and suprapancreatic lymphadenectomy, and then the abdominal esophagus is transected. After a minilaparotomy is created, the entire stomach is pulled outside...
July 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Marco E Allaix, Jason M Long, Marco G Patti
The last 25 years have witnessed a steady increase in the use of minimally invasive esophagectomy for the treatment of esophageal cancer. However, it is unclear which the optimal minimally invasive approach is: totally minimally invasive or hybrid (laparoscopic assisted or thoracoscopic assisted)? The current evidence from nonrandomized control trials suggests that hybrid laparoscopic-assisted esophagectomy couples the benefits of laparoscopy and the advantages of thoracotomy, leading to reduced surgical trauma without jeopardizing survival compared with open esophagectomy...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Maria C Russell
Gastric cancer remains a significant worldwide health concern. While surgery is required for cure, all but the earliest of cancers will require multimodality therapy. Chemotherapy and chemoradiation in the neoadjuvant and adjuvant settings have shown to improve overall survival, but the sequencing of treatment is controversial. As healthcare expenses surge, it is increasingly important to impart value to these treatments. This review will look at the intersection of effective treatment and costs for gastric cancer...
September 2016: Journal of Surgical Oncology
Hideaki Bando, Larry Rubinstein, Pamela Harris, Takayuki Yoshino, Toshihiko Doi, Atsushi Ohtsu, John Welch, Naoko Takebe
BACKGROUND: In phase 1 trials, an important entry criterion is life expectancy predicted to be more than 90 days, which is generally difficult to predict. The Royal Marsden Hospital (RMH) prognostic score that is determined by lactate dehydrogenase level, albumin level, and number of metastatic sites of disease was developed to help project patient outcomes. There have been no systematic analyses to evaluate the utility of the RMH prognostic score for esophagogastric cancer patients...
August 10, 2016: Gastric Cancer
Xiaofei Lu, Lingling Duan, Hongqin Xie, Xiaoxia Lu, Daolin Lu, Daopeng Lu, Nan Jiang, Yuxin Chen
OBJECTIVE: Adenocarcinoma of esophagogastric junction (AEG) is a lethal malignancy featured with early metastasis, poor prognosis, and few treatment options. Matrix metalloproteinase (MMP) and metalloproteinase suppressor (TIMP) have been considered to be associated with cancer invasion and metastasis. In our study, we evaluated expressions of MMP-9, MMP-2, TIMP-1, and TIMP-2 in AEG and their correlation with clinicopathological parameters and the overall survival rate. METHODS: Expressions of MMP-9, MMP-2, TIMP-1, and TIMP-2 in specimens from 120 AEGs were detected by immunohistochemistry...
2016: OncoTargets and Therapy
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