Correlation of pre-operative coexistence of organ dysfunction with overall survival of patients with squamous cell carcinoma of the thoracic esophagus

2004 ◽  
Author(s):  
Tadahiro Nozoe ◽  
Takahiro Ezaki ◽  
Ikuo Takahashi ◽  
Hideo Baba ◽  
Yoshihiko Maehara
2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 86-86
Author(s):  
Shigeru Tsunoda ◽  
Kazutaka Obama ◽  
Shigeo Hisamori ◽  
Kyoichi Hashimoto ◽  
Yoshiro Itatani ◽  
...  

Abstract Background Supraclavicular lymph nodes (No 104) were upgraded from group 3 to group 2, which needs to be dissected in D2 surgery, for tumors located in middle thoracic esophagus in the 11th edition of Japanese classification of esophageal cancer. However, it is not based on prospective study and the evidence level remains moderate. Current evidence regarding supraclavicular lymphadenectomy is mainly based on retrospective cohort study of efficacy index without proper control. The aim of this study is to retrospectively investigate the clinical impact of supraclavicular lymphadenectomy for middle esophageal cancer. Methods A total of 240 consecutive patients who underwent R0 esophageal resection for clinical Stage I, II, III (UICC 8th) primary esophageal squamous cell carcinoma from 2005 to 2017 in Kyoto University Hospital were investigated. Patients who underwent salvage surgery after definitive chemoradiotherapy were excluded. Among them, 99 patients had middle esophageal cancer. All patients underwent at least abdominal and mediastinal lymphadenectomy including cervical paraesophageal (No 101) and paratracheal (No 106rec) nodes. After propensity score matching, 42 patients (21 each for with (3F) and without (2F) supraclavicular lymphadenectomy) were selected for comparison. Results In the propensity-matched population (n = 42), the 5-year overall survival of clinical Stage I (n = 15)/II (n = 9)/III (n = 18) was 100%/52%/57%. Though cStage, neoadjuvant therapy, ASA-PS and date of surgery (early, middle and late period) were well matched, the 5-year overall survival in 2F and 3F were 82% and 68%. The hazard ratio (3F/2F) for overall death was 2.6 (95% CI, 0.79–9.97; P = 0.1178). In terms of short term outcomes, postoperative morbidity graded as Clavien-Dindo grade 2 or higher was 48% in the both group, while respiratory complication (Clavien-Dindo grade 2 or higher) was 14% in 2F and 29% in 3F, respectively. The odds ratio was 2.4 (95% CI, 0.51–11.3; P = 0.2593). Conclusion This observational study failed to show any clinical benefit of supraclavicular lymphadenectomy. Given the nature of retrospective study, there might be overlooked confounding factors to select 2F or 3F. Further prospective study is warranted. Disclosure All authors have declared no conflicts of interest.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qi-Fan Yang ◽  
Di Wu ◽  
Jian Wang ◽  
Li Ba ◽  
Chen Tian ◽  
...  

AbstractLung squamous cell carcinoma (LUSC) possesses a poor prognosis even for stages I–III resected patients. Reliable prognostic biomarkers that can stratify and predict clinical outcomes for stage I–III resected LUSC patients are urgently needed. Based on gene expression of LUSC tissue samples from five public datasets, consisting of 687 cases, we developed an immune-related prognostic model (IPM) according to immune genes from ImmPort database. Then, we comprehensively analyzed the immune microenvironment and mutation burden that are significantly associated with this model. According to the IPM, patients were stratified into high- and low-risk groups with markedly distinct survival benefits. We found that patients with high immune risk possessed a higher proportion of immunosuppressive cells such as macrophages M0, and presented higher expression of CD47, CD73, SIRPA, and TIM-3. Moreover, When further stratified based on the tumor mutation burden (TMB) and risk score, patients with high TMB and low immune risk had a remarkable prolonged overall survival compared to patients with low TMB and high immune risk. Finally, a nomogram combing the IPM with clinical factors was established to provide a more precise evaluation of prognosis. The proposed immune relevant model is a promising biomarker for predicting overall survival in stage I–III LUSC. Thus, it may shed light on identifying patient subset at high risk of adverse prognosis from an immunological perspective.


Author(s):  
Roberto Milazzotto ◽  
Rocco Luca Emanuele Liardo ◽  
Giuseppe Privitera ◽  
Luigi Raffaele ◽  
Vincenzo Salamone ◽  
...  

Abstract Aim: Conjunctival squamous cell carcinoma (SCC) is a rare tumour of the ocular region and microscopic radical surgical is difficult. There are no single guidelines for therapeutic management and the role of radiation therapy is not clearly defined although conventionally photon or electron beams are used. Proton beam radiotherapy (PBRT) is a new option for a conservative approach and allows good sparing of the organs at risk. Materials and methods: After surgical resection, we collected 15 cases treated at our institution with PBRT. The dose delivered was between 48 and 60 Gy relative biological effectiveness (RBE), with fractions of 12–15 Gy RBE. Results: After an average period of 48 months, the patients achieved excellent disease control (overall survival and disease-free survival: 86·6%), with minimal acute and late toxicity. Findings: In this work, we present our experience on the use of PBRT technique in SCC treatment. A larger sample of patients is needed to draw conclusions about the impact of this treatment on disease recurrence and overall survival.


2020 ◽  
Vol 9 (4) ◽  
pp. 1035 ◽  
Author(s):  
Yasmen Ghantous ◽  
Aysar Nashef ◽  
Imad Abu-Elnaaj

Oral squamous cell carcinoma (OSCC) is a fatal disease caused by complex interactions between environmental, genomic, and epigenetic alterations. In the current study, we aimed to identify clusters of genes whose promoter methylation status correlated with various tested clinical features. Molecular datasets of genetic and methylation analysis based on whole-genome sequencing of 159 OSCC patients were obtained from the The Cancer Genome Atlas (TCGA) data portal. Genes were clustered based on their methylation status and were tested for their association with demographic, pathological, and clinical features of the patients. Overall, seven clusters of genes were revealed that showed a significant association with the overall survival/recurrence free survival of patients. The top ranked genes within cluster 4, which showed the worst prognosis, primarily acted as paraneoplastic genes, while the genes within cluster 6 primarily acted as anti-tumor genes. A significant difference was found regarding the mean age in the different clusters. No significant correlation was found between the tumor staging and the different clusters. In conclusion, our result provided a proof-of-principle for the existence of phenotypic diversity among the epigenetic clusters of OSCC and demonstrated the utility of the use epigenetics alterations in devolving new prognostic and therapeutics tools for OSCC patients.


2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Feng Wang ◽  
Qingxia Fan ◽  
Junsheng Wang ◽  
Tao Wu ◽  
Yonggui Hong ◽  
...  

Abstract   Esophageal squamous cell carcinoma (ESCC) as a common malignancy is prevalent in East Asia and in eastern and southern Africa. Although pembrolizumab, nivolumab and camrelizumab are respectively recommended as second-line treatment for advanced ESCC due to improved overall survival (OS), objective response rate (ORR) was modest. New effective treatments are needed. Hence, the study of camrelizumab plus apatinib (VEGFR2 inhibitor) as second-line treatment for advanced ESCC was performed. Methods This ongoing phase II trial (NCT03736863) in six sites in China enrolled pts aged 18-75 with unresectable locally advanced, locally recurrent, or metastatic ESCC that progressed or were intolerant after first-line chemotherapy, and an ECOG performance status of 0-1. Pts received 200 mg camrelizumab intravenously every 2 weeks and apatinib 250 mg orally once per day in 4-week cycles until disease progression, unacceptable adverse events (AEs) or withdrawal of consent. The primary endpoint was investigator-assessed ORR. Secondary endpoints included disease control rate (DCR), progression-free survival (PFS) and OS. Results At data cutoff (Feb 28, 2021), 52 pts were enrolled, including 42 males and 50 with distant metastases, with the median age of 62 years. In the evaluable population of 39 pts, ORR without confirmation was 43.59% and DCR was 94.87%. The median duration of response was 6.9 months (95% CI 4.57–9.23). The median PFS was 6.8 month (95% CI 2.66–10.94). The 12-month overall survival was 52.2%. A total of 80.8% of pts had treatment-related AEs (TRAEs) with 46.2% of grade ≥ 3 TRAEs. The safety profile of camrelizumab and apatinib was consistent with other anti–PD-1 antibodies and angiogenesis inhibitors. Conclusion This is the first study that evaluates the combination anti–PD-1 antibody and anti-angiogenesis inhibitor as a second-line therapy for advanced ESCC. Camrelizumab plus apatinib showed encouraging clinical efficacy and acceptable safety. Further phase III randomized trials are warranted.


2021 ◽  

Pericardial effusions leading to cardiac tamponade have previously been described with esophageal cancer. However, up to eighty percent of these cases have been reported in association with chemotherapy and radiation. Patients with esophageal cancer seldom initially present with pericardial effusion resulting from esophageal pericardial fistula (EPF). Herein, we present the case of a 62-year-old man who presented with pericardial effusion with an unknown etiology at presentation. Subsequently, the patient developed cardiac tamponade and was referred to the tertiary hospital for further evaluation. Computed tomography of the chest revealed a circumferential irregular enhancing lesion at the mid-thoracic esophagus suspecting esophageal cancer with EPF and a moderate amount of pericardial effusion. The patient underwent esophagoscopy and squamous cell carcinoma was found from the esophageal biopsy. An esophageal stent was successfully placed to conceal the perforation. Eventually, the patient died 13 days after admission complicated by refractory septic shock. This case highlights an atypical presentation of esophageal cancer and an unusual cause of cardiac tamponade.


PLoS ONE ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. e63581 ◽  
Author(s):  
Yang Wang ◽  
Shijie Sheng ◽  
Jianzhi Zhang ◽  
Sijana Dzinic ◽  
Shaolei Li ◽  
...  

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