• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1305-1309
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• 1998

A diabetic 73-year-old man had admitted and examined gastrofiberoscopy due to dyspagia and weight loss of 6 kg during two months. He was confirmed diagnosis of esophageal squamous cell carcinoma. During the esophgography, we found the dye spillage into pericardia! space from the esophagus with air collection A following chest roentgenogram revealed a typical pneumopericardium with pericardial air filling. Although intensive care was done. he expired 4 days later. We report a case of typical pnemopericardium caused secondary to esophageal cancer.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.255-259
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• 2006

The operation for esophageal cancer is both complex and challenging, and may be associated with significant morbidity and mortality compared to other oncologic surgeries. Minimally invasive surgeries have been applied on various kinds of surgery to enhance better recovery with minimal surgical complications. But for the esophageal cancer, it has not been actively applied yet. With improvement in instrumentations and increasing experience with endoscopic surgical techniques, minimally invasive surgical approaches to esophageal cancer are being explored to determine feasibility, results and potential advantages. We experienced eight cases of minimally invasive surgery for esophageal cancer and report here focusing on surgical techniques and tips.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.403-411
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• 2023

Background: The concept of oligo-recurrence has not been generally applied in esophageal cancer. This study aimed to determine the prognostic significance of the number of recurrences in esophageal cancer. Methods: Patients with squamous cell carcinoma who underwent curative esophagectomy with R0 or R1 resection and who experienced a confirmed recurrence were included. The study included 321 eligible participants from March 2001 to December 2019. The relationship between the number of recurrences and post-recurrence survival was investigated. Results: The mean age was 63.8±8.1 years, and the majority of the participants (97.5%) were men. The median time to recurrence was 10.7 months, and the median survival time after recurrence was 8.8 months. Multiple recurrences with simultaneous local, regional, and distant locations were common (38%). In terms of the number of recurrences, single recurrences were the most common (38.3%) and had the best post-recurrence survival rate (median, 17.1 months; p<0.001). Patients with 2 or 3 recurrences showed equivalent survival to each other and longer survival than those with 4 or more (median, 9.4 months; p<0.001). In the multivariable analysis, the significant predictors of post-recurrence survival were body mass index, minimally invasive esophagectomy, N stage, R0 resection, post-recurrence treatment, and the number of recurrences (p<0.05). Conclusion: After esophagectomy, the number of recurrences was the most significant risk factor influencing post-recurrence survival in patients with esophageal cancer. In esophageal cancer, oligo-recurrence can be defined as a recurrence with three or fewer metastases. More intensive treatment might be recommended if oligo-recurrence occurs.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.4
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• pp.1463-1469
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• 2015

Background: To evaluate the safety and efficacy of combined chemoradiotherapy or radiotherapy alone in elderly patients with esophageal carcinoma to identify the best method of treatment. Materials and Methods: One hundred and sixteen patients with esophageal carcinoma aged 70 and older who received definitive radiotherapy or chemoradiotherapy entered the study. Overall survival (OS), disease-free survival (DFS) and treatment-related toxicities were assessed. Results: The median OS of the overall population was 17.9 months. For patients treated with cCRT, sCRT and radiotherapy alone, the median OS was 22.3 months, 18.0 months and 12.4 months respectively(P=0.044). Median OS for patients treated with radiotherapy dose ${\geq}60Gy$ and <60Gy was 20.2 months and 10.9 months respectively (p=0.017). By univariate analysis, Chemoradiotherapy (include cCRT and sCRT) and radiotherapy dose ${\geq}60Gy$ were found to achieve higher survival rates compared with radiotherapy alone and radiotherapy dose <60Gy (P=0.015, P=0.017). By multivariate analysis, chemoradiotherapy (HR=1.645, P=0.022) and radiotherapy dose ${\geq}60Gy$ (HR=1.642, P=0.025) were identified as independent prognostic factors of OS. Conclusions: Definitive concurrent chemoradiotherapy could be considered as a feasible and effective treatment in esophageal carcinoma patients aged 70 and older. Radiotherapy dose 60Gy is an effective treatment option compared with standard dose radiotherapy, while higher doses are not beneficial to improve survival.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10299-10306
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• 2015

The esophageal squamous cell carcinoma (ESCC) is thought to develop through a multi-stage process. Epigenetic gene silencing constitutes an alternative or complementary mechanism to mutational events in tumorigenesis. Posttranscriptional regulation of human leukocyte antigen class I (HLA-I) and antigen processing machinery (APM) proteins expression may be associated with novel epigenetic modifications in cancer development. In the present study, we determined the expression levels of HLA-I antigen and APM components by immunohistochemistry. Then by a bisulfite-sequencing PCR (BSP) approach, we identified target CpG islands methylated at the gene promoter region of APM family genes in a ESCC cell line (ECa109), and further quantitative analysis of CpG site specific methylation of these genes in cases of Kazakh primary ESCCs with corresponding non-cancerous esophageal tissues using the Sequenom MassARRAY platform. Here we showed that the development of ESCCs was accompanied by partial or total loss of protein expression of HLA-B, TAP2, LMP7, tapasin and ERp57. The results demonstrated that although no statistical significance was found of global target CpG fragment methylation level sof HLA-B, TAP2, tapasin and ERp57 genes between ESCC and corresponding non-cancerous esophageal tissues, there was significant differences in the methylation level of several single sites between the two groups. Of thesse only the global methylation level of LMP7 gene target fragments was statistically higher ($0.0517{\pm}0.0357$) in Kazakh esophageal cancer than in neighboring normal tissues ($0.0380{\pm}0.0214$, p<0.05). Our results suggest that multiple CpG sites, but not methylation of every site leads to down regulation or deletion of gene expression. Only some of them result in genetic transcription, and silencing of HLA-B, ERp57, and LMP7 expression through hypermethylation of the promoters or other mechanisms may contribute to mechanisms of tumor escape from immune surveillance in Kazakh esophageal carcinogenesis.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.23-28
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• 2011

Diagnosis of early esophageal cancer has become more frequent as a result of improved endoscopic technology, surveillance programmes, and increasing experience and awareness on the part of endoscopists. In early esophageal cancer, squamous cell carcinoma and early adenocarcinoma must be managed differently because they have different origins, pathogenesis. and clinical characteristics. The current treatment options vary widely, from extended resection with lymphadenectomy to endoscopic mucosal resection (EMR) or ablation. None of these treatment options can be recommended universally. Instead, an individualized strategy should be based on the depth of tumor infiltration into the mucosa or submucosa, the presence or absence of lymph node metastases, the multicentricity of tumor growth, the length of the segment of intestinal metaplasia, and comorbidities of the patient. EMR has become increasingly important, both as a diagnostic tool for the staging of esophageal carcinomas and as a method of carrying out definitive treatment when the cancer meets certain criteria in which the risk of lymph-node metastasis is negligible. EMR may be sufficient in a subset of patients who have m1 or m2 squamous cell carcinoma and in patients who have isolated foci of high-grade intraepithelial neoplasia or mucosal cancer.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.665-671
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• 2004

Background: Lymph node metastasis is commonly reported in thoracic esophageal cancer, even in the early esophageal cancer which may be localized only in the mucosa or within the submucosal layer. Although lymph node metastasis greatly influence long-term outcome and cure of the disease, endoscopic mucosal resection or photodynamic therapy without lymph node dissection is widely attempted. The investigation of the pattern of lymph node metastasis and results of surgical resection of superficial esophageal cancer is needed. Material and Method: Pattern of lymph node metastsis and depth of tumor invasion were studied retrospectively from 44 patients with early esophageal cancer who underwent radical resection of the tumor from December, 1995 to August, 2001. Result: Lymph node metastasis was found in 10 patients (22.7%) out of total of 44 patients. Lymph node metastasis was found in 0% (0 of 3), 0% (0 of 4), 50% (2 of 4), and 24.24% (8 of 33) of tumors that invaded the intraepitherium, lamina propria, muscularis mucosa, and submucosa respectively. Anatomically distant lymph node metastases were found more frequently in recurrent laryngeal nerve node(5 cases of 10 patients) and in intraperitoneal node (8 cases of 10). than intrathoracic node (3 cases of 10). There was no operative mortality, however, there were 1 hospital death in patient with lamina propria cancer, 1 late death in patient with submucosal cancer. Three-year survival rates (except hospital death) were 100% in mucosal cancer and 97.0% in submucosal cancer (p>0.05), and 100% in the node negative group and 90.0% in the node positive group (p>0.05). Conclusion: The survival rate of superficial esophageal cancer patient who was recieved operative resection was excellent. But, lymph node metastasis were found in superficial esophageal cancer, even in esophageal cancer limited to the muscularis mucosa. Systemic lymph node dissection which includes recurrent laryngeal nerve nodes and intraperitoneal nodes was recommended for favorable outcome in superficial esophageal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5493-5498
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• 2014

Objective: To compare the efficacy of taxane-based regimens in the first line setting retrospectively in Chinese patients with recurrent and/or metastatic esophageal cancer. Methods: We analyzed 102 recurrent and/or metastatic esophageal cancer patients who received taxanes-based regimens in a first-line setting from January 2009 to December 2013. Sixteen (15.7%) patients were administered Nab-PTX based chemotherapy and 86 patients (84.3%) received paclitaxel (PTX) or docetaxel (DTX) based chemotherapy. Patients in the PTX/DTX group could be further divided into TP (71 patients) and TPF (15 patients) groups. Results: The objective response rate (ORR) of all patients was 20.6%, and the disease control rate (DCR) was 67.6%. The median overall survival (OS) was 10.5 months (95% CI 10.1-16.4) and the median progression-free survival (PFS) was 6.04 months (95% CI 5.09-7.91). The DCR was higher in the TPF group than the TP group (93.3% vs. 59.1%; p = 0.015 ). There were no significant differences in ORR, OS, and PFS among Nab-PTX, TPF and TP groups. Conclusions: The three regimens of Nab-PTX based, TP and TPF proved active in a first line setting of Chinese patients with recurrent and/or metastatic esophageal cancer, and should thus be regarded as alternative treatments.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.169-173
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• 2012

Objective: This study aimed to explore the differences in the curative and side effects of chemoradiotherapy on esophageal cancer (EC) among Xinjiang Han, Uigur and Kazakh patients. Methods: 170 patients with IIA stage-IV of esophageal squamous cell carcinoma were analyzed retrospectively. Based on different nationalities, they were divided into the Han, Uigur and Kazakh groups. The 1-, 2- and 3-year survival rates, incidence of the side effects (including hematological toxicities, radioactive esophagitis and percutaneous reactions) and application of antibiotics and harmonics were compared among the groups. There was no significant difference in the short-term curative effects among the Han, Uigur and Kazakh groups. The 1- 2- and 3-year survival rates of the three groups were 84%, 40%, 26%; 78%, 27%, 18%; and 60%, 21%, 12% ($x^2$=14.497, P<0.05). The incidence rate of hamatological toxicity ${\geq}$Grade 2 in the Kazakh group was significantly lower than that in the Han or Uigur group. Results: The incidence rates of radioactive esophagitis and percutaneous reactions Grade 2 in the Han group were significantly higher than those in the Uigur or Kazakh group. There was no significant difference in the types of applied antibiotics among the groups, but there were significant differences in the days of antibiotic application and proportion of patients receiving harmonics between the Hans and either of other groups. Conclusion: Chemoradiotherapy shows a better effect in the long-term survival rate among Han EC patients compared with Uigur or Kazakh EC patients. Uigur and Kazakh patients show a better tolerance to the side effects of chemoradiotherapy compared with Hans.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3675-3679
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• 2014

We assessed the association between frequency of heavy binge drinking and mortality from oropharynx and esophagus cancer after controlling for the total volume of alcohol intake among Korean men. The cohort comprised 2,677 male residents in Kangwha County, aged 55 or older in March 1985, for their upper digestive tract cancer mortality for 20.8 years up to December 31, 2005. For daily binge drinkers versus non-drinkers, the hazard ratios (95% Cls) for mortality were 4.82 (1.36, 17.1) and 6.75 (1.45, 31.4) for oropharyngeal and esophageal cancers, respectively. Even after adjusting for the volume of alcohol intake, we found the hazard ratios for frequency of binge drinking and mortality of oropharyngeal or esophageal cancer to not change appreciably: the hazard ratios were 4.90 (1.00, 27.0) and 7.17 (1.02, 50.6), respectively. For esophageal cancer, there was a strong dose-response relationship. The frequency of heavy binge drinking and not just the volume of alcohol intake may increase the risk of mortality from upper digestive tract cancer, particularly esophageal cancer in Korean men. These findings need to be confirmed in further studies with a larger sample size.