共查询到20条相似文献,搜索用时 15 毫秒
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Takanori Inose MD Hiroyuki Kato MD PhD Hitoshi Kimura MD PhD Ahmad Faried MD PhD Naritaka Tanaka MD Makoto Sakai MD Akihiko Sano MD Makoto Sohda MD PhD Masanobu Nakajima MD PhD Yasuyuki Fukai MD PhD Tatsuya Miyazaki MD PhD Norihiro Masuda MD PhD Minoru Fukuchi MD PhD Hiroyuki Kuwano MD PhD 《Annals of surgical oncology》2009,16(6):1704-1710
Background Failure of gap junction formation affects the development of various types of cancer. We aimed to clarify the clinicopathologic
outcome and prognostic significance of connexin (Cx) 26 in human esophageal squamous cell carcinoma (ESCC).
Methods Immunohistochemical staining for Cx26 was performed on surgical specimens obtained from 123 patients with ESCC.
Results There was no positive staining for Cx26-specific expression in normal esophageal squamous cells. Primary ESCC with Cx26-positive
expression was detected in the cytoplasm of cancer cell nests in 60 cases. Cx26 expression was correlated with N (lymph node
metastasis, P = 0.014) and the number of metastatic lymph nodes (P = 0.047). The 5-year survival rates of ESCC patients with Cx26-positive expression were significantly lower than those with
Cx26-negative expression (positive, 39.7%; negative, 65.7%; P = 0.007). By multivariate analysis, tumor–node–metastasis (TNM) clinical classification (T, P < 0.001; N, P = 0.002; M, P = 0.046) and Cx26 (P = 0.024) were independent prognosis predictors of ESCC.
Conclusions These results suggest that abnormal expression of Cx26 participates in the progress of ESCC. 相似文献
3.
Tsuchikawa T Md MM Yamamura Y Shichinohe T Hirano S Kondo S 《Annals of surgical oncology》2012,19(5):1713-1719
Background
Esophageal cancer is an aggressive cancer with poor prognosis. However, little is known about the immune response in the tumor microenvironment after neoadjuvant chemotherapy. 相似文献4.
Yasunori Akutsu MD PhD Hisahiro Matsubara MD PhD Masayuki Kano MD PhD Akihiro Usui MD PhD Yasuo Yoneyama MD PhD Norimasa Ikeda MD Aki Komatsu BS Gulbostan Yusup MD 《Annals of surgical oncology》2011,18(3):832-837
Background
Heat-shock protein gp96 plays an important role in antitumor immunoreactions. Gp96 has a close relationship with antitumor immunity. This study evaluated the correlation between gp96 expression and the prognosis in esophageal squamous cell carcinoma.Methods
Seventy-eight patients with primarily resected esophageal squamous cell carcinoma were enrolled onto this study, and gp96 expression was evaluated by immunohistochemical staining. The association of clinicopathological factors and patients’ survival was calculated by univariate (log rank test) and multivariate (Cox proportional hazard regression method) analyses.Results
Fifty-seven (73%) of 78 cases were gp96 positive, and 21 were negative (27%). The survival of patients with gp96-negative disease was significantly shorter (5-year survival, 22.9 months) than with gp96-positive disease (45.8 months; P = 0.049), and the multivariate analysis showed that gp96 negativity is an independent risk factor for poor survival (hazard ratio, 2.577; P = 0.040). Gp96-negative cases had more metastatic lymph nodes than did negative cases, especially in T1 cases (4.8 in gp96-negative cases vs. 0.84 in gp96-positive cases; P = 0.064)Conclusions
The downregulation of gp96 expression is closely correlated with poor survival in esophageal squamous cell carcinoma. 相似文献5.
Doki Y Yasuda T Miyata H Fujiwara Y Takiguchi S Yamasaki M Makari Y Matsuyama J Masuoka T Monden M 《Surgery today》2007,37(7):590-595
Thoracic esophageal cancers frequently metastasize to the right recurrent nerve nodes (RRNNs). In fact, huge RRNNs invading
the trachea sometimes remain after definitive chemoradiation therapy (CRT), despite complete remission of the primary lesion.
We performed salvage lymphadenectomy of a large RRNN combined with partial resection of the trachea in two patients. Using
an anterior approach, we removed part of the sternum, clavicle, and the first and second costal cartilage; then, we removed
the RRNNs with combined resection of the lateral quarter circumference of the trachea, the esophageal wall, and the recurrent
nerve. Reconstruction was done with a musculocutaneous patch of major pectoral muscle to cover the tracheal defect. The only
minor complication was venous thrombosis in one patient. Thus, combined removal of the RRNN and trachea was performed safely
as a salvage operation after definitive CRT for esophageal squamous cell carcinoma. 相似文献
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《Seminars in thoracic and cardiovascular surgery》2023,35(3):603-614
Download : Download video (2MB) 相似文献
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Yoichi Hamai Jun Hihara Junya Taomoto Ichiko Yamakita Yuta Ibuki Morihito Okada 《World journal of surgery》2014,38(8):2046-2051
Background
Neoadjuvant chemoradiotherapy (nCRT) followed by esophagectomy confers a survival benefit on patients with esophageal cancer. However, nCRT might be less meaningful for poor responders. Thus, being able to predict responses would help ensure the selection of optimal therapy.Methods
We reviewed data from 123 patients with esophageal squamous cell carcinoma (ESCC) who underwent nCRT that comprised concurrent radiation (40 Gy) and chemotherapy followed by esophagectomy. We assessed associations between clinical and blood data obtained before starting nCRT and the pathologic response.Results
We compared good (Japan Esophageal Society response evaluation criteria grades 3/2; n = 89, 72.4 %) and poor (grades 1/0; n = 34, 27.6 %) responders. Performance status (p = 0.02), hemoglobin level (p = 0.005), and platelet counts (p = 0.03) were statistically significant pretherapeutic factors for a response to nCRT. Multivariable analysis subsequently selected the hemoglobin level (odds ratio 1.52; 95 % confidence interval 1.08–2.15; p = 0.02) as the sole independent predictor. Receiver operating characteristic curves showed that the optimal cutoff for pretherapeutic hemoglobin was 13 g/dl for predicting a response. We found that 48.8 and 17.1 % of patients with hemoglobin level ≤13 and >13 g/dl, respectively, were poor responders (p = 0.0002), with 5-year overall survival rates of 40.9 and 58.9 %, respectively (p = 0.048).Conclusions
Pretherapeutic hemoglobin levels can influence responses and survival after nCRT for ESCC. Thus, hemoglobin levels can serve as a useful marker for tailoring optimal therapies for individual patients with advanced ESCC. 相似文献8.
鳞状细胞癌抗原在食管癌临床的应用 总被引:2,自引:0,他引:2
采用微粒酶免疫荧光法测定了40例食管癌和7例术后复发病人的血清鳞状细胞癌(SCC)抗原含量,取20例正常人,15例食管良性病人和15例腺癌病人作对照。结果表明,食管癌和术后复发病人的血清SCC抗原含量显著高于正常人、良性病人和腺癌病人(P值分别<0.001、0.01和0.05),SCC抗原与临床病期、细胞的分化程度有关。这提示血清SCC抗原是食管癌理想的肿瘤标志物,对食管癌的诊断、预示术后复发和判断食管癌的恶性程度都有重要的临床价值。 相似文献
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Daniel King Hung Tong Simon Law Dora Lai Wan Kwong Kwok Wah Chan Alfred King Yin Lam Kam Ho Wong 《Annals of surgical oncology》2010,17(8):2184-2192
Background
Whether the TNM staging system is applicable after neoadjuvant chemoradiation in esophageal cancer is controversial. The aim of this study was to evaluate the prognostic value of histopathological regression of the primary tumor in postchemoradiated patients. 相似文献10.
Hiroshi Okumura MD PhD Yasuto Uchikado MD PhD Itaru Omoto MD Yoshiaki Kita MD PhD Ken Sasaki MD PhD Takaaki Arigami MD PhD Yoshikazu Uenosono MD PhD Daisuke Matsushita MD Yoshiyuki Hiraki MD PhD Tetsuhiro Owaki MD PhD Sumiya Ishigami MD PhD Shoji Natsugoe MD PhD 《Annals of surgical oncology》2014,21(9):2845-2849
Background
The prognosis of patients with esophageal squamous-cell cancer (ESCC) and multiple lymph-node metastases is quite poor. We examined whether neoadjuvant chemoradiation therapy (CRT) has a beneficial effect in such patients.Methods
A total of 50 consecutive patients with T3–4 tumors and without organ metastases were prospectively enrolled. Of those patients, 20, who had four or more nodal metastases, underwent neoadjuvant CRT (CRT group), and the remaining 30 patients, who had three or fewer nodal metastases, underwent surgery alone (surgery group). CRT consisted of 5-fluorouracil plus cisplatin and 40 Gy of radiation. The groups’ clinical outcomes were compared.Results
Surgery was performed in 48 patients: all enrolled patients except for 2 who had organ metastasis after CRT. In the CRT group, the number of patients with pathological complete response was observed in 8 patients (44 %), mean nodal metastases number was changed from 8.2 to 2.6 and 9 patients had pN0. The 3-year survival rate was 76 % in the CRT group (4 patients relapsed) and 68 % in the surgery group (8 patients relapsed), which is not a statistically significant difference (P = 0.61).Conclusions
Neoadjuvant CRT is beneficial for locally advanced ESCC with four or more lymph-node metastases. 相似文献11.
Yoichi Tabira Masahiro Yasunaga Tomonori Sakaguchi Yuji Yamaguchi Toshiyuki Okuma Michio Kawasuji 《World journal of surgery》2008,26(12):1446
The outcome of node-negative esophageal
carcinoma and the prognostic significance of lymph node micrometastasis
remain unknown. The aim of this retrospective study was to clarify
these two points. A series of 98 patients who underwent curative
operation for histologically node-negative (pN0 in TNM classification)
esophageal carcinoma were enrolled in the study. We reviewed the cause
of death of these patients. The survival curves were calculated and
compared after stratifications according to clinicopathologic
parameters. Lymph node micrometastasis in the patients with recurrences
was examined using immunohistochemical staining of cytokeratin. Their
ages ranged from 45 to 83 years (mean 64.3 years). There were 83 men
and 15 women. Altogether, 54 patients were still alive, and 44 had
died. A total of 9 patients died from recurrence of their esophageal
carcinoma, 33 died from other causes (pneumonia 11, extraesophageal
carcinoma 7, and so on), and 2 died from unknown causes. Eight patients
had locoregional recurrences, and two patients had distant recurrences.
The overall survival rate for the 98 patients was 58.2%. The survival
for patients with pT2 or pT3 tumors was significantly worse than for
those with pTis or pT1 tumors (p = 0.02, log-rank
test). Other clinicopathologic factors did not affect the prognosis.
Immunohistochemical study found no lymph node micrometastasis in 365
lymph nodes resected from the patients with recurrences. Only the depth
of tumor invasion affected the outcome of patients with node-negative
esophageal carcinoma. Altogether, 75% of patients died of other causes
without recurrence, with the two main causes of death being pulmonary
complications and extraesophageal carcinoma in these patients. Lymph
node micrometastasis was not associated with recurrence in this series. 相似文献
12.
Yasunori Akutsu Hisahiro Matsubara Kiyohiko Shuto Masaya Uesato Mikito Mori Isamu Hoshino Toru Shiratori Yukimasa Miyazawa Hisao Ito Takashi Uno 《World journal of surgery》2009,33(5):1002-1009
Background Chemoradiation therapy (CRT) has the strongest antitumor effect against local tumors of esophageal cancer; however, no standard
strategy has yet been established to achieve a clinical complete response (CR) after CRT. The aim of this study was to clarify
when a decision can be made to perform further treatment for a clinical CR.
Methods We evaluated 78 patients that underwent an esophagectomy after neoadjuvant CRT in our department between 1998 and 2007. The
study investigated the clinical and pathologic results of neoadjuvant CRT.
Results Of the 78 cases, 19 (24.3%) were a pathologic CR (Grade 3). Pathologic CR could be estimated in only 3 of 8 clinical CR cases
(37.5%). On the other hand, 12 (20.7%) of the 58 clinical partial response (PR) cases achieved pathologic CR. Likewise, 4
cases (36.4%) achieved pathologic CR among the clinical no change/progressive disease (NC/PD) patients.
Conclusions The clinical evaluation for CRT does not reflect the pathologic effectiveness and, even if clinical CR was achieved, viable
cancer cells were still present at the primary site in the majority of the population. 相似文献
13.
Po-Kuei Hsu Chien-Sheng Huang Yu-Chung Wu Teh-Ying Chou Wen-Hu Hsu 《World journal of surgery》2014,38(2):402-409
Background
The impact of minimally invasive esophagectomy on patient prognosis, particularly disease-free survival (DFS), has not been well addressed. We compared the clinical outcomes of open and thoracoscopic esophagectomy in patients with esophageal squamous cell carcinoma (ESCC).Methods
Sixty-three and 66 patients, nonrandomized, underwent open and thoracoscopic esophagectomies for ESCC between 2008 and 2011 were included. The clinicopathological data were reviewed retrospectively. Perioperative outcome, overall survival (OS), DFS, and the recurrence sites after open and thoracoscopic esophagectomy were compared.Results
The open and thoracoscopic groups were comparable with regard to the total number of harvested lymph nodes and the percentage patients undergoing R0 resection. Fewer patients in the thoracoscopic group had pneumonia and wound complications. Intensive care unit (ICU) stay also was shorter in the thoracoscopic group. The recurrence pattern was similar in the two groups. In the open and thoracoscopic groups, the 3-year OS rates were 47.6 and 70.9 % (p = 0.031), respectively, and the 3-year DFS rates were 35 and 62.4 % (p = 0.007), respectively. However, the trends in better OS and DFS in the thoracoscopic group were not significant after stratification according to pathologic stage.Conclusions
The perioperative benefit of thoracoscopic esophagectomy included fewer postoperative complications and shorter ICU stays. Mid-term OS and DFS associated with thoracoscopic techniques are at least equivalent to those associated with open procedures. 相似文献14.
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Mayanagi Shuhei Haneda Ryoma Inoue Masazumi Ishii Kenjiro Tsubosa Yasuhiro 《Annals of surgical oncology》2022,29(8):4863-4870
Annals of Surgical Oncology - Extensive lymph node dissection increases the risk of postoperative complications, especially in salvage surgery, after definitive chemoradiotherapy (≥ 50 Gy) in... 相似文献
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Yin-Kai Chao MD PhD Chen-Kan Tseng MD Yu-Wen Wen PhD Yun-Hen Liu MD Yung-Liang Wan MD Cheng-Tung Chiu MD Wen-Cheng Chang MD Hsien-Kun Chang MD 《Annals of surgical oncology》2013,20(9):3000-3008
Background
Two randomized trials have shown that in patients with good response to neoadjuvant chemoradiotherapy (nCRT), a nonoperative approach (additional CRT) had equal survival to scheduled esophagectomy. However, controversy exists because of the high locoregional recurrence (LR) following a nonoperative approach. Endoscopic complete response (e-CR) determined by endoscopic finding is a good criterion for predicting local control after definitive CRT. We evaluated whether e-CR could also be used to select patients for nonoperative treatment after nCRT.Methods
We retrospectively analyzed esophageal squamous cell carcinoma (SCC) patients with e-CR after nCRT between 1999 and 2006. Patients were divided into two groups by the type of treatment given after e-CR (group A, scheduled esophagectomy; group B, no scheduled surgery and continued CRT).Results
There were 71 and 79 patients in groups A and B, respectively with similar pre/post-nCRT characteristics. Despite similarity in survival and recurrence between groups, the recurrence site differed significantly. LR occurred more frequently in group B, whereas systemic recurrence was the predominant failure pattern in group A (P < .001). With use of multivariate analysis on group B, we determined that pretreatment depth of tumor invasion ≥T3 [odds ratio (OR), 11.19; 95 % CI, 1.4–89; unfavorable, P = .023] and tumor length ≥6 cm (OR, 3.069; 95 % CI, 1.17–8.1; unfavorable, P = .023) were predictors for LR. Patients with initial clinical T2 and <6 cm tumor had comparable LR (5 %) to the surgery group; these patients were candidates for nonoperative treatment after nCRT.Conclusion
In esophageal SCC patients who achieved e-CR after nCRT, pretreatment tumor depth and length were good indicators to select candidates for nonoperative treatment. 相似文献17.
目的探讨食管鳞状上皮细胞癌(食管鳞癌)中细胞凋亡的表达及其临床意义。方法应用末端脱氧核苷酸转移酶介导的dUTP缺口末端标记(TUNEL)法,研究人食管鳞癌细胞凋亡的表达水平。结果38例手术切除的食管鳞癌组织平均细胞凋亡指数ApoLI为12.10±5.13‰。角化型ApoLI高于非角化型(P<0.01);肿瘤分化越好,细胞凋亡越多,低度、中度、高度分化ApoLI有差异(P<0.05);不同性别、年龄、肿瘤部位、长度、深度,其ApoLI并无差异;以10‰为界将ApoLI分组绘制Kaplan-Meier生存曲线,ApoLI≥10‰组术后生存率高。结论细胞凋亡与原发食管鳞癌临床病理特征密切相关,并可用于食管鳞癌预后判断。 相似文献
18.
Nakanishi Y Ohara M Doumen H Kimura N Ishidate T Kondo S 《World journal of surgery》2011,35(2):349-356
Background
Tumor budding is defined as an isolated single cancer cell or a cluster of cancer cells composed of fewer than five cells at the invasive front of a tumor. The aim of the present study was to identify correlations between tumor budding and clinicopathological factors and their impact on postoperative prognosis in invasive squamous cell carcinoma of the thoracic esophagus. 相似文献19.
Sakai M Suzuki S Sano A Tanaka N Inose T Sohda M Nakajima M Miyazaki T Kuwano H 《Annals of surgical oncology》2012,19(6):1911-1917
Background
Extranodal invasion (ENI) has been reported to be associated with a poor prognosis in several malignancies. However, previous studies have included perinodal fat tissue tumor deposits in their definitions of ENI. To investigate the precise nature of ENI in esophageal squamous cell carcinoma (ESCC), we excluded these tumor deposits from our definition of ENI and defined tumor cell invasion through the lymph node capsule and into the perinodal tissues as lymph node capsular invasion (LNCI). The aim of the current study was to elucidate the significance of LNCI in ESCC.Methods
We investigated the associations between LNCI and other clinicopathologic features in 139 surgically resected ESCC. We also investigated the prognostic significance of LNCI in ESCC.Results
LNCI was detected in 35 (25.2%) of 139 patients. The overall survival rate of the ESCC patients with LNCI was significantly lower than that of the ESCC patients with lymph node metastasis who were negative for LNCI. The survival difference between the patients with 1?C3 lymph node metastases without LNCI and those with no lymph node metastasis was not significant. LNCI was significantly associated with distant organ recurrence. LNCI was also found to be an independent predictor of overall survival in addition to the number of lymph node metastases.Conclusions
LNCI in ESCC patients is an indicator of distant organ recurrence and a worse prognosis. LNCI could be used as a candidate marker for designing more precise staging and therapeutic strategies for ESCC. 相似文献20.