• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.5
• /
• pp.1783-1786
• /
• 2012

Objectives: To analyze esophageal cancer incidence and pathological data of Zhongshan in China in 1970-2007, and to provide scientific information for its prevention and control. Methods: From Zhongshan Cancer Registry esophageal cancer incident and pathological data were obtained. Pathological proportions and trends were calculated and analyzed. Results: Although there was a continuously and obviously increasing trend for male incidence rates in 1970-2007 in Zhongshan, squamous cell carcinoma (SCC) and adenocarcinoma (AD) incident proportions during 1990-2007 remained relatively stable. Moreover, SCC was the major pathological type, accounting for 70.6 percent of all new cases, while AD were relatively few and accounted for only 2.66 percent throughout the period. Conclusion: The male esophageal cancer incident pattern in Zhongshan in 1970-2007 was quite different from most other domestic areas. The data suggest that etiological analysis should be enhanced for improved control in Zhongshan.

• Journal of Digestive Cancer Research
• /
• v.1 no.1
• /
• pp.53-57
• /
• 2013

There is no established treatment for esophageal carcinoma with metastasis. For the metastatic esophageal squamous cell carcinoma, chemotherapy or best supportive care according to patient's performance status are accepted as an available treatment. We report a case of complete remission after concurrent chemoradiotherapy for esophageal squamous cell carcinoma with metastatic lesion in 5th thoracic vertebrae. A 57-year-old man with ongoing dysphagia and weight loss was admitted to our hospital. On the endoscopic and radiologic imaging evaluation,the patient was diagnosed as a squamous cell carcinoma of esophagus with solitary metastatic lesion in 5th thoracic vertebrae. The patient was treated with combination chemotherapy (5-fluorouracil (5-FU) and cisplatin) and concurrent radiotherapy for two months to relieve dysphagia. Because metastatic lesion in thoracic vertebrae was located near the primary esophageal tumor, the metastatic lesion could be included within the radiation field. After concurrent chemoradiotherapy, consecutive 4 cycles of chemotherapy had been carried out. Primary esophageal tumor with metastatic lymph nodes and metastatic lesion in 5th thoracic vertebrae disappeared on follow up computed tomography (CT) and positron emission tomography-CT (PET-CT). Follow up endoscopic biopsy revealed no remnant malignant cells at previous primary cancer lesion.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3183-3186
• /
• 2013

Purpose: The 7th edition of the American Joint Committee on Cancer Staging Manual for esophageal cancer (EC) categorizes N stage according to the number of metastatic lymph nodes (LNs), irrespective of the site. The aim of this study was to determine the prognostic value of subcarinal LN metastasis in patients undergoing esophagectomy for esophageal squamous cell carcinoma (ESCC). Methods: A retrospective analysis of 507 consecutive patients with ESCC was conducted. Potential clinicopathological factors that could influence subcarinal LN metastasis were statistically analyzed. Univariate and multivariate analyses were also performed to evaluate the prognostic parameters for survival. Results: The frequency of subcarinal LN metastasis was 22.9% (116/507). Logistic regression analysis showed that tumor length (>3cm vs ${\leq}3cm$; P=0.027), tumor location (lower vs upper/middle; P=0.009), vessel involvement (Yes vs No; P=0.001) and depth of invasion (T3-4a vs T1-2; P=0.012) were associated with 2.085-, 1.810-, 2.535- and 2.201- fold increases, respectively, for risk of subcarinal LN metastasis. Multivariate analyses showed that differentiation (poor vs well/moderate; P=0.001), subcarinal LN metastasis (yes vs no; P=0.033), depth of invasion (T3-4a vs T1-2; P=0.014) and N staging (N1-3 vs N0; P=0.001) were independent prognostic factors. In addition, patients with subcarinal LN metastasis had a significantly lower 5-year cumulative survival rate than those without (26.7% vs 60.9%; P<0.001). Conclusions: Subcarinal LN metastasis is a predictive factor for long-term survival in patients with ESCC.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.8
• /
• pp.4153-4156
• /
• 2012

Purpose: To investigate the efficacy and toxicity of a combination of gemcitabine with nedaplatin (GN) or cisplatin (GC) for patients with unresectable or recurrent esophagus squamous cell carcinoma. Methods: Gemcitabine was administered at 1 g/m2 intravenously on days 1 and 8; and nedaplatin or cisplatin were administered at 80 mg/m2 intravenously on day 1. We analyzed the response rate, overall survival time, progression-free survival time, and toxicity in 21 patients treated with GN and 27 patients treated with GC. Results: In patients treated with gemcitabine plus nedaplatin, the ORR was 47.6%, the median progression-free survival time was 4.1 months, and the median survival time was 9.3 months. In patients treated with gemcitabine plus cisplatin, the ORR was 48.2%, the median progression-free survival time was 3.9 months, and the median survival time was 9.1 months, respectively. There were no statistically significant differences in ORR, PFS and OS between the two groups. In both, the most commonly observed toxicities were thrombocytopenia and fatigue. Nausea and vomiting was more frequent in the GC group than in the GN group. Conclusion: Gemcitabine based chemotherapy was effective and tolerable for patients with unresectable or recurrent esophagus squamous cell carcinoma refractory to first line chemotherapy.

• Journal of Chest Surgery
• /
• v.37 no.2
• /
• pp.184-187
• /
• 2004

The synchronous double cancer of the esophagus and lung is rare. Right lower lobectomy and Ivor Lewis procedure were performed simultaneously in a 75 year-old male patient who had synchronous double primary squamous cell carcinoma of the thoracic esophagus and right lower lobe of the lung, Left upper lobectomy was performed in a 69 year-old male patient who had squamous cell carcinoma of the left upper lobe of the lung, and four months later we performed Ivor Lewis procedure for the squamous cell carcinoma that occurred in the thoracic esophagus. The above two patients were doing well 10 months and 24 months after the operation respectively without recurrence. We treated the two cases of synchronous double cancer of the esophagus and lung with complete resection, and report this with review of literature.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.2
• /
• pp.647-651
• /
• 2012

Aim: An epidemiological study was conducted based on an esophageal cancer patient's cohort to investigate the association of folate intake and MTHFR C677T polymorphism with the prognosis of esophageal cancer in a Chinese population. Methods: 167 patients aged 37-75 years who had histological confirmed diagnosis of esophageal squamous cell cancer were collected from Jan. 2006 to Jan. 2008. MTHFR genotypes at the C677T site were analyzed by PCR-based RFLP methods, and the folate intake was computed by multiplying the food intake (in grams) and the folate content (per gram) of food in our questionnaire. Results: We found associations between the prognosis of esophageal cancer and smoking status, T and N stages. Individuals carrying the MTHFR 677CT and TT genotypes showed a shorter survival time than with the CC genotype, with adjusted HRs (95% CI) of 1.20 (0.56-2.15) and 2.29 (1.30-4.28), respectively. Similarly, those carrying MTHFR 677T allele had a 1.86-fold risk of death. A higher folate concentration showed a significant decreased risk of death, with an HR (95% CI) of 0.45 (0.18-0.87). Individuals with high folate intake and the MTHFR 677CC genotype showed a significant decreased risk of esophageal cancer (0.43, 0.25-0.89).Conclusion: Our findings supports the hypothesis that high folate intake and active MTHFR C677T polymorphism may exert protective roles in the prognosis of esophageal cancer in the Chinese population.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.6
• /
• pp.1305-1309
• /
• 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
• /
• v.53 no.4
• /
• pp.172-177
• /
• 2020

Superficial esophageal neoplasms (SENs) are being diagnosed increasingly frequently due to the screening endoscopy and advances in endoscopic techniques. Endoscopic resection (ER) is a relatively noninvasive treatment method with low morbidity and mortality that provides excellent oncologic outcomes. Endoscopic submucosal dissection is associated with higher rates of en bloc, complete and curative resections and lower rates of local recurrence than endoscopic mucosal resection. The most serious complication of ER is stricture, the treatment and prevention of which are crucial to maintain the patient's quality of life. ER for SEN is feasible, effective, and safe and can be considered a first-line treatment for SENs in which it is technically feasible.

• Journal of Digestive Cancer Reports
• /
• v.7 no.2
• /
• pp.57-60
• /
• 2019

Definitive chemoradiotherapy (CRT) with its significant efficacy and safety in esophageal cancer is reserved for patients with unresectable tumor or those who decline surgery. However, the incidence of locoregional failure or recurrence after definitive CRT remains high. Although esophagectomy is the standard treatment for locoregional failure or recurrence, this approach is associated with high mortality and morbidity. A 56-year-old man diagnosed with esophageal squamous cell carcinoma who refused to undergo surgery received definitive CRT. An endoscopy for response assessment performed after 2 months revealed a residual lesion, which was completely resected by salvage endoscopic submucosal dissection. To the best of our knowledge, endoscopic resection in locoregional failure or recurrence after definitive CRT is very rarely reported, and there are no guidelines or consensus to date. Here, we report a case of successful salvage endoscopic resection of residual lesion after definitive CRT.

• Journal of Chest Surgery
• /
• v.36 no.12
• /
• pp.952-960
• /
• 2003

It has been reported that p53 regulates the G2-M checkpoint transition through cyclin Bl, and it has been suggested that p53 plays an important role in the development and progression of various malignancies. The aim of this study is to clarify the role of the cell cycle regulators, cyclin B1 and p53 in patients with esophageal squamous cell carcinoma (ESCC). Material and Method: Tissue samples from 46 patients with ESCC were included in this study. Expression levels of cyclin Bl and p53 in samples of normal squamous epithelium, dysplasia, and tumor cells from patients with ESCC were analyzed by immunohistochemical study Result: Several cells in the basement layer of normal epithelium expressed cyclin B1. The number of cyclin B1 positive cells tended to increase as the degree of dysplasia increased from low grade to high grade. More than 10% of tumor cells were cyclin B1 positive in 19 patients (41.3%). Several clinicopathologic parameters, including tumor stage (p<0.05), pathologic Iymph node status (p<0.05) and invasion of Iymphatic vessels (p<0.05), were correlated with the overexpression of cyclin B1. Elevated expression levels of cyclin B1 also correlated with a poor prognosis in patient with ESCC in univariate analysis (p<0.05) and multivariate analysis (p<0.05), In contrast, p53 expression exhibited significant correlation with the level of cyclin B1 expression, but was not associated with prognostic parameters in patients with ESCC. Conclusion: These findings suggest that cyclin B1 is involved in the pathogenesis of carcinoma of the esophagus and that elevated levels of cyclin B1 expression, but not p53 expression, may indicate a poor prognosis for patients with ESCC.