• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7587-7593
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• 2013

Background: Cancers of gastric and esophagus are the most frequent gastrointestinal (GI) tract cancers in Iran. This study aimed to analyze time trends of GI tract cancers in Guilan province by gender and age to provide solid scientific evidence for cancer prevention and control. Materials and Methods: The data were obtained from the Guilan Cancer Registry System and Guilan Provincial Health Center, over the 15 year period between 1997 and 2011. Crude incidence and age standardized (AS)incidence rates were calculated and annual percent change was estimated by Joinpoint software for long term trend analysis. Results: During the study period, 8,332 cases of GI malignances with a male to female ratio of 1:1.73 were registered in Guilan province. The AS rates for esophageal, gastric, colon and rectal cancers were 5.97, 14.5, 7.59 and 3.58 per 105 respectively. While the trend was declining and relatively constant for esophageal and gastric cancer, respectively, the incidence trend for colon and rectal cancers was of increase over the period of the study. Conclusions: The results indicated that the incidence of GI cancers was relatively low in Guilan province compared to neighboring provinces. An effective cancer control program including prevention measures, early detection and effective treatment needs to be implemented to reduce cancer morbidity and mortality.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4187-4193
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• 2013

Background: Evaluation of Human papilloma virus (HPV) and its association with promoter methylation of candidate genes, p53 and Aurora A in esophageal cancer. Materials and Methods: One hundred forty-one esophageal tissue samples from different pathologies were evaluated for HPV infection by PCR, while the promoter methylation status of p53 and Aurora A was assessed by methylation-specific restriction based PCR assay. Statistical analyses were performed with MedCalc and MDR software. Results: Based on endoscopy and histopathology, samples were categorized: cancers (n=56), precancers (n=7), esophagitis (n=19) and normals (n=59). HPV infection was found to be less common in cancers (19.6%), whereas its prevalence was relatively high in precancers (71.4%), esophagitis (57.8%) and normals (45.7%). p53 promoter methylation did not show any significant difference between cancer and normal tissues, whereas Aurora A promoter methylation demonstrated significant association with disease (p=0.00016, OR:5.6452, 95%CI:2.18 to 14.6) when compared to normals. Aurora A methylation and HPV infection was found in a higher percentages of precancer (66.6%), esophagitis (54.5%) and normal (45.2%) when compared to cancers (14.2%). Conclusions: Aurora A promoter methylation is significantly associated with esophageal cancer, but the effect of HPV infection on this epigenetic alteration is not significant. However MDR analysis showed that the hypostatic effect of HPV was nullified when the cases had Aurora methylation and tobacco exposure. Further HPV sub-typing may give an insight into its reduced prevalence in esophageal cancer verses normal tissue. However, with the present data it is difficult to assign any significant role to HPV in the etiopathology of esophageal cancer.

• Journal of Chest Surgery
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• v.26 no.3
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• pp.214-218
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• 1993

Extensive lymphnode dissection combined with thoracic esophagectomy improved prognosis of esophageal cancer, but there is still high postoperative recurrence rate. The immunologic capacity of esophageal cancer patients is compromised by surgery and adjuvant chemotherapy. Therefore immunological therapy for esophageal cancer patients seems rational. We have adopted postoperative immunochemotherapy since 1988. From 1988 to 1992, 31 patients with thoracic esophageal cancer underwent esophagectomy and radical lymphnode dissection, and selected patient with early esophageal cancer and unfit for thoracotomy underwent transhiatal esophagectomy in Korea University Hospital. Mean age of patients was 56 years. There were 28 squamous cell cancers, 2 adenocarcinomas and one mixed tumor. There were 4 stage I, 3 stage II, 18 stage III, and 6 stage IV cases. There were no opeartive death. Postoperative complications included anastomotic leakage in 9%, pneumonia 3 %, cylothorax 3%, recurrent laryngeal neve paresis in 3% of all patients. Curative resection group[n=19] received immunotherapy. Noncurative resection group[n=12] received postoperative immunochemotherapy, including PS-K, CDDP, and 5-FU. Operative survivors were followed from 4 months to 5 years. There were 3 lost of follow-up. Actuarial survival rate is 79% to one year, 54% to two years and 27% to five years.In conclusion, an transthoracic esophagectomy combined with systematic lymph node dissection and postoperative immunochemotherapy could improve survival rate for esophageal cancer.

• Radiation Oncology Journal
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• v.1 no.1
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• pp.55-60
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• 1983

To evaluate the usefulness of computed tomography (CT) in radiotherapy treatment planning in malignant tumors of thoracic cage, the computer generated dose distributions were compared between plans based on conventional studies and those based on CT scan. 22 cases of thoracic malignancies, 15 lung cancers and 7 esophageal cancers, diagnosed and treated in Department of Therapeutic Radiology of Seoul National University Hospital from September, 1982 to April, 1983, were analyzed. In lung cancers, dose distribution in plans using AP, PA parallel opposing ports with posterior spinal cord block and in plans using box technique both based on conventional studies were compared with dose distribution using AP, PA and two oblique ports based on CT scan. In esophageal cancers, dose distribution in plans based on conventional studies and those based on CT scans, both using 3 port technique were compared. The results are as follows: 1. Parallel opposing field technique were inadequate in all cases of lung cancers, as portion of primary tumor in 13 of 15 cases and portion of mediastinum in all were out of high dose volume. 2. Box technique was inadequate in 5 of 15 lung cancers as portion of primary tumor was not covered and in every case the irradiated normal lung volume was quite large. 3. Plans based on CT scan were superior to those based on conventional studies as tumor was demarcated better with CT and so complete coverage of tumor and preservation of more normal lung volume could be made. 4. In 1 case of lung cancer, tumor localization was nearly impossible with conventional studies, but after CT scan tumor was more clearly defined and localized. 5. In 1 of 7 esophageal cancers, the radiation volume should be increased for marginal coverage after CT scan. 6. Depth dose correction for tissue inhomogeneity is possible with CT, and exact tumor dose can be calculated. As a result radiotherapy treatment planning based on CT scan has a pteat advantage over that based on conventional studies.

• Journal of Gastric Cancer
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• v.19 no.2
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• pp.139-147
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• 2019

The incidence of esophagogastric junction (EGJ) cancer has been significantly increasing in Western countries. Appropriate planning for surgical therapy requires a reliable classification of EGJ cancers with respect to their exact location. Clinically, the most accepted classification of EGJ cancers is "adenocarcinoma of the EGJ" (AEG or "Siewert"), which divides tumor center localization into AEG type I (distal esophagus), AEG type II ("true junction"), and AEG type III (subcardial stomach). Treatment strategies in western countries routinely employ perioperative chemotherapy or neoadjuvant chemoradiation for cases of locally advanced cancers. The standard surgical treatment strategies are esophagectomy for AEG type I and gastrectomy for AEG type III cancers. For "true junctional cancers," i.e., AEG type II, whether the extension of resection in the oral or aboral direction represents the most effective surgical therapy remains debatable. This article reviews the history of surgical EGJ cancer treatment and current surgical strategies from a Western perspective.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.9
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• pp.3945-3949
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• 2014

Background: A cancer registry program has been established in East Azerbaijan and this has emphasized the importance of cancers of gastrointestinal tract in this region. The aim of the present pathology-based cancer registry report is to renew epidemiologic aspects of gastrointestinal tract cancers and estimate recent trends. Materials and Methods: A survey team reviewed and collected all records of cancer cases from all referral and valid pathology laboratories of East Azerbaijan province during September 2007-2011. Crude rates, age-specific rates of cancer incidence and annual percent change were calculated. Results: The total newly diagnosed cancer cases (n=6,889)comprised 4,341 males (63.0%) and 2,540 females (36.9%). Gastric cancer was the most common GI tract cancer with an ASR (per $10^5$) of 23.1 for males and 7.69 for females. The ASRs for esophageal and colorectal cancers were 9.69 and 11.2 in males and 7.35 and 8.93 in females. Trend analysis showed a significant decline for esophageal cancer and increasing incidence for colorectal cancer in females. Conclusions: The prevalence of gastric cancer is high in East Azerbaijan province of Iran. This pathology based cancer registry showed an ascending trend for colorectal cancer and decreasing trend for esophageal cancer in females during 2007-2011.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6031-6034
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• 2013

This study describes recent trends in incidence, survival and prevalence of subgroups of esophageal and gastric cancer in Linzhou city between 2003 and 2009. Data of esophageal and gastric cancer for the period of interest were extracted from the Linzhou Cancer Registry. Using information on tumor morphology or anatomical site, data were divided into six groups; esophageal squamous cell carcinoma, esophageal adenocarcinoma, other and unspecified types of esophageal cancer, and cardia, non-cardia, and unspecified anatomical site of stomach cancer. Incidence, survival and prevalence rates for each of the six cancer groups were calculated. The majority of esophageal cancers were squamous cell carcinomas (82%). Cardiac cancer was the major gastric cancer group (64%). The incidence of esophageal squamous cell carcinoma and gastric cardiac cancer increased between 2003 and 2009. Both esophageal and gastric cancer had a higher incidence in males compared with females. Overall survival was poor in all sub-groups with 1 year survival ranging from 45.9 to 65.6% and 5 year survival ranging from 14.7 to 30.5%. Prevalence of esophageal squamous cell carcinoma and gastric cardiac cancer was high (accounting for 80% overall). An increased focus on prevention and early diagnosis, especially in esophageal squamous cell carcinoma and gastric cardiac cancer, is required.

• Journal of Yeungnam Medical Science
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• v.5 no.1
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• pp.147-151
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• 1988

Esophageal cancers are highly malignant neoplasms. Prognosis of esophageal cancer treated by external irradiation alone is rather poor because of local recurrence and distant metastasis. Recently intracavitary irradiation has been used as a boost therapy after external irradation to optain better local control. One case of esophageal cancer has been treated by high dose rate remote-controlled afterloading unit as boost therapy after external irradiation. The result was excellent in short term follow up esophagogram but esophageal bleeding and esophagotracheal fistula were noted in further follow up examination after inappropriate posttreatment management including insufficient chemotherapy due to poor general condition. We reviewed possible causes of esophageal bleeding and esophagotracheal fistula after external irradiation and high dose rate ICR.

• Genomics & Informatics
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• v.13 no.4
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• pp.132-136
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• 2015

Studies of cancer heterogeneity have received considerable attention recently, because the presence or absence of resistant sub-clones may determine whether or not certain therapeutic treatments are effective. Previously, we have reported G64, a co-regulated gene module composed of 64 different genes, can differentiate tumor intra- or inter-subpopulations in lung adenocarcinomas (LADCs). Here, we investigated whether the G64 module genes were also expressed distinctively in different subpopulations of other cancers. RNA sequencing-based transcriptome data derived from 22 cancers, except LADC, were downloaded from The Cancer Genome Atlas (TCGA). Interestingly, the 22 cancers also expressed the G64 genes in a correlated manner, as observed previously in an LADC study. Considering that gene expression levels were continuous among different tumor samples, tumor subpopulations were investigated using extreme expressional ranges of G64-i.e., tumor subpopulation with the lowest 15% of G64 expression, tumor subpopulation with the highest 15% of G64 expression, and tumor subpopulation with intermediate expression. In each of the 22 cancers, we examined whether patient survival was different among the three different subgroups and found that G64 could differentiate tumor subpopulations in six other cancers, including sarcoma, kidney, brain, liver, and esophageal cancers.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10193-10198
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• 2015

Background: Cancer is a major cause of mortality in developing countries and correct and valid information about the epidemiology of this disease is the first step in the planning of health care in each region. The aim of this study was to determine the relative frequency, mean age and sex ratio of the most 10 common non-skin cancers in the world and Iran, among patients referred to an oncology clinic. Materials and Methods: This descriptive study was conducted in Mashhad, north east of Iran. The data obtained from the records of patients referred to the private oncology center between the years of 1985-2012". According to the latest report of GLOBOCAN study commonest malignancies included were lung, breast, colorectal, prostate, stomach, liver, cervix, esophageal, bladder cancers and Non-Hodgkin lymphoma. Results: A total of 4,606 cases were analyzed. The mean age was $55.5{\pm}13.8years$ (male: $59.5{\pm}13.9$, female: $52.6{\pm}12.9$). Overall, breast cancer (1,264 cases, relative frequency of 27.4%) was the most prevalent cancer; however the mean ages of diagnosis were not significantly different between 5-year time period divisions (p=0.290). The most common cancer in men was esophageal cancer (26.3%).The lowest mean age was related to women diagnosed with breast cancer ($48.5{\pm}11.8$) and men with non-Hodgkins lymphoma ($48.4{\pm}17.8$). There were statistically significant differences between the mean age of men and women with gastric (p=0.003) and esophageal cancers (p<0.001). Male to female sex ratios in our study for bladder, lung and stomach cancers were 6.57, 2.60 and 2.50 respectively. Conclusions: The results showed that breast cancer tends to be found in younger female patients and bladder cancer appears more often in men. Screening in target population in addition to early diagnosis may reduce death and disability.