• Proceedings of the KTCVS Conference
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• 1997.04a
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• pp.53-56
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• 1997

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5415-5420
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• 2012

The aim of this study was to investigate QoL (quality of life) of patients with esophageal cancer in northern Henan province, China, and to accurate evaluate and reflect the relationship between patient characteristics and QoL. In the high risk area of esophageal cancer in the north of Henan province, 735 patients with esophageal cancer were investigated. The Eysenck personality questionnaire (EPQ) and QoL were analyzed by using the questionnaire of general situation, EPQ, QLQ-C30 and QLQ-OES18. The effects of personal character on the QoL of esophageal carcinoma patients were analyzed by SPSS 11.0 software. The QoL of esophageal cancer patients in Northern Henan region was significantly affected by character. The difference between choleric and type of melancholic temperament types was significant (P<0.01), also in OESEAT, OESTA, OESCO and OESSP (P<0.05). Differences in personal character can thus influence the quality of esophageal cancer patient lives.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.76-79
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• 2005

The coexistence of mesenchymal tumor and carcinoma in the esophagus is extremely rare. We report a case of squamous cell carcinoma located at the mucosal surface over leiomyoma of the esophagus. A 76-year-old man with complaints of 3 months onset of odynophagia was diagnosed preoperatively as squamous cell carcinoma over submucosal tumor with calcification. Esophagectomy and esophagogastrostomy were performed through the right thoracotomy and upper median laparotomy. The patient is doing well without evidence of recurrence in the 25 months after resection. We discuss the pathogenesis and possible relations between the two tumors.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.803-807
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• 2012

For patients with neck and upper thoracic esophageal carcinoma, it is difficult to control lymph node metastases with conventional dose therapy. In this study, we assessed the feasibility of simplified intensity-modulated radiotherapy (sIMRT) and concurrent chemotherapy for 44 patients and boosted high-dose to metastatic lymph nodes. Three radiation treatment volumes were defined: PGTVnd, with which 68.1Gy was delivered in high dose group (hsIMRT group), and 60Gy in the conventional dose group (csIMRT group); PTV1, featuring 63.9Gy in the hsIMRT group and 60Gy in the csIMRT group; PTV2, with 54Gy given to both groups. The sIMRT plan included 5 equi-angular coplanar beams. All patients received the cisplatin and 5-FU regimen concurrently with radiotherapy. The treatment was completed within six weeks and one case with grade three acute bronchitis was observed in hsIMRT group. For esophageal lesions, 80% complete response (CR) and 20% partial response (PR) rates were found in the hsIMRT group, and 79.2% CR, with 20.8% PR, in the csIMRT group; for lymph node lesions, 75% CR and 25% PR rates were observed in the hsIMRT group, with 45.8% and 37.5% respectively in the csIMRT group (P<0.05). The differences in 1-, 2- and 3-year relapse-free survival rates were all statistically significant (P<0.05). The major toxicity observed in both groups was Grade I~II leucopenia. sIMRT can generate a desirable dose distribution in treatment of neck and upper thoracic esophageal carcinoma with a better short-term efficacy. Boosted high dosing to metastatic lymph nodes can increase the relapse-free survival rate.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.865-868
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• 1987

Adenoid cystic carcinoma of the esophagus has been relatively an uncommon, slow growing tumor. A 51 year-old man patient had a tumor in the lower third of the esophagus which was incidentally found during an examination for UPPER C-I series, and resected successfully without Thoracotomy. The tumor exhibited a polypoid appearance covered by normal esophageal epithelium, localized entirely in the submucosal layer of the esophagus and morphologically identical to adenoid cystic carcinoma in the salivary glands.

• Journal of Chest Surgery
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• v.33 no.7
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• pp.570-575
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• 2000

Background; Surgical resection remains the mainstay of treatment for esophageal cancer. Despite recent advances in surgical therapy, i.e. en bloc resection and extended lymphadenectomy, the overall long-term prognosis of patients with esophageal carcinoma has not, however, improved during the last decades. One of the major reasons in its relatively high recurrence rate. Material and Method; A retrospective review of recurrent patte군 of cancer in 42 patients who underwent curative surgery for primary esophageal cancer was performed clinically and histo-phthologically. Result; Nineteen patients had developed recurrece during the 18 to 52 months(mean 34.2 nonths), 8 had local recurrences, 1 had both, and 11 had systemic recurrences. Twelve patients(63%) had developed recurrence within 1 year, 5 patients(26%) between 1 year to 2 patients(11%) after 2 years. The recurrence rate according to growth pattern of tumor or presence of microinvasive findings was not statistically significant, but it increased significantly in clinical tumor stage III than stage IIA, B and in patients with the number of metastatic lymph node over ten. Conclusion; Post-operative recurrences of esophageal cancer appear as a high rate even though curative wide resection was done. Several clinical and histo-pathological factors correlate with the recurrence.

• Journal of Chest Surgery
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• v.36 no.1
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• pp.55-58
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• 2003

Although postanastomosis of esophageal reconstruction is rare but it is a very unwelcome complication. Previously, the problem was solved by balloon dilatation, reoperation, and feeding jejunostomy. However, balloon dilatation is not effective because of high recurrence rate, reoperation is difficult due to its operative approachableness and also jejunostomy is inconvenient for patients. Therefore, we inserted esophageal stent as a method of relieving postanastomosis stenosis, From Jan, 2001 to Dec, 2001, there were three patients with postanastomosis stenosis, who received esophageal stent insertion, one had case is benign esophageal stenosis, two had esophageal carcinoma. We followed up them over 12 months after inserting the stent, Dysphagia was improved, so we report that the clinical performance was satisfactory

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3299-3303
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• 2012

Objective: To investigate the association between xeroderma pigmentosum group D (XPD) Asp312Asn polymorphism and esophageal cancer (EC) susceptibility by meta-analysis. Methods: We searched PubMed up to April 9th, 2012, to identify relevant papers, and 8 published case-control studies including 2165 EC patients and 3141 healthy controls were yielded. Odds ratios (ORs) with relevant 95% confidence intervals (CIs) were applied to assess the association between XPD Asp312Asn polymorphism and EC susceptibility with the Comprehensive Meta-Analysis software, version 2.2. Results: Overall, the meta-analysis results suggested the XPD Asp312Asn polymorphism to be significantly associated with EC susceptibility [(Asn/Asn+Asp/Asn) vs. Asp/Asp: OR=1.20, 95%CI=1.05-1.36, p=0.01; and Asp/Asn vs. Asp/Asp: OR=1.15, 95%CI =1.01-1.31, p=0.04]. In the subgroup analysis by ethnicity and cancer type, significantly associations were found for Caucasian populations [(Asn/Asn+Asp/Asn) vs. Asp/Asp: OR=1.26, 95%CI =1.08-1.47, p<0.001; Asp/Asn vs. Asp/Asp: OR=1.19, 95%CI =1.02-1.40, p=0.03] and esophageal squamous cell carcinoma [(Asn/Asn+Asp/Asn) vs. Asp/Asp: OR=1.19, 95%CI=1.01-1.41, p=0.04]. There was no heterogeneity and no publication bias existed. Conclusions: This meta-analysis shows that the XPD Asp312Asn polymorphism may be a risk factor for developing EC, especially for Caucasian populations and esophageal squamous cell carcinoma.

• Journal of Chest Surgery
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• v.37 no.8
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• pp.691-701
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• 2004

Background: Tissue hypoxia is a characteristic of many human malignant neoplasms, and hypoxia inducible factor-1 (HIF-1) plays a pivotal role in essential adaptive response to hypoxia, and activates a signal pathway for the expression of the hypoxia-regulated genes, resulting in increased oxygen delivery or facilitating metabolic adaptation to hypoxia. Increased level of HIF-1 a has been reported in many human malignancies, but in esophageal squamous cell carcinoma, the influence of HIF-1 a on tumor biology, including neovascularization, is not still defined. Material and Method: The influence of HIF-1 a expression on angiogenic factors, correlation between the tumor proliferation and HIF-1 a expression, interaction of HIF-1 a expression and p53, and correlation between HIF-1 a expression and clinicopathological prognostic parameters were investigated, using immunohistochemical stains for HIF-1 a, VEGF, CD34, p53, and Ki-67 on 77 cases of resected esophageal squamous cell carcinoma. Result: HIF-1 a expression in cancer cells was found in 33 of 77 esophageal squamous cell carcinoma cases. The 33 cases (42.9%) showed positive stain for HIF-1 a. High HIF-1 a expression was significantly associated with several pathological parameters, such as histologic grade (p=0.032), pathological TMN stage (p=0.002), the depth of tumor invasion (p=0.022), regional lymph node metastasis (p=0.002), distant metastasis (p=0.049), and lymphatic invasion (p=0.004). High HIF-1 a expression had significant VEGF immunoreactivity (p=0.008) and Ki-67 labeling index (p<0.001), but was not correlated with microvascular density within tumors (p=0.088). The high HIF-1 a expression was correlated with aberrant p53 accumulation with a marginal significance (p=0.056). The overall 5-year survival rate was 34.9%. The survival rate of patients with a high HIF-1 a expression was worse than that of patients with low-expression tumors (log-rank test, p=0.0001). High HIF-1 a expression was independent unfavorable factors although statistical significance is marginal in multivariate analysis. Conclusion: It is suggested that (1) high HIF-1 a expression in esophageal squamous cell carcinoma is associated with tumor hypoxia, or with genetic alteration in early carcinogenesis and progressive stages, (2) high HIF-1 a expression may be associated with intratumoral neovascularization through HIF-VEGF pathway, and (3) high HIF-1 a expression is associated with poor prognosis in patients with esophageal squamous cell carcinoma and may playa role as biomarker for regional lymph node metastasis.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.293-297
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• 1976

One mid-esophageal carcinoma underwent esophagogastrectomy using an exclusive right thoracic approach entailing mobilization of the stomach through the esophageal hiatus. 62 year old male farmer was admitted with chief complaints of dysphagia and weight loss of 5 Kg. for 6 months, and regurgitation after soft meal for one week prior to this admission. Preoperative esophagogram revealed stricture with fungating mass at the level of the carina, which was diagnosed as squamous cell carcinoma at the time of esophagoscopic biopsy about 33 cm from incisor. Bronchoscopy revealed no invasive lesion or carinal fixation, and laboratory examinations were excellent for operative intervention. An exclusive right thoracic approach through right 5th rib bed was made for radical esophagectomy, mobilization of the stomach through the esophageal hiatus and primary esophagectomy. Postoperative recovery was uneventful except increased bronchial secretion due to senile emphysema, and follow up for 5 months after esophagectomy revealed good functioning esophagus with mild epigastric fullness after meal. Exclusive right thoracic approach for radical esophagectomy seems to be the procedure of choice in selected cases.