• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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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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• 제13권1호
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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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• 제15권8호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1951-1955
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• 2013

Background: Associations between the methylenetetrahydrofolate reductase (MTHFR) A1298C polymorphism and esophageal cancer risk have been reported in many articles recently, but results were controversial. Therefore the present meta-analysis was conducted to to provide a more precise estimation. Methods: Odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the strength of associations. Results: Finally, six case-control studies involving a total of 1,302 cases and 2,391controls for the A1298C polymorphism were included. The meta-analysis showed that significantly increased risk for Asians (CC versus AA, OR=3.799, 95%CI=1.541-9.365, P=0.004; CCversusCA+AA, OR=3.997, 95%CI=1.614-9.900, P=0.003) and Caucasians (CC versus AA, OR=1.797, 95%CI=1.335-2.418, P=0.000; CC+CA versus AA,OR=1.240, 95%CI=1.031-1.492, P=0.022; CCversusCA+AA, OR=1.693, 95%CI=1.280-2.240, P=0.000). In addition, there was an association with risk for both ESCC (CC versus AA, OR=2.529, 95%CI=1.688-3.788, P=0.000; CCversusCA+AA, OR=2.572, 95%CI=1.761-3.758, P=0.000) and esophageal adenocarcinoma (EAC) (CC versus AA, OR=1.592, 95%CI=1.139-2.227, P=0.007; CC+CA versus AA,OR=1.247, 95%CI=1.016-1.530, P=0.035; CCversusCA+AA, OR=1.466, 95%CI=1.069-2.011, P=0.018). Conclusion: This meta-analysis suggested associations of the A1298C polymorphism with increased risk of esophageal cancer in both Asians and Caucasians. In addition, we found that the MTHFR A1298C polymorphism might influence risk ofESCC and EAC in the overall studies.

• 대한암한의학회지
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• 제22권1호
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• pp.37-48
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• 2017

Objectives: The purpose of this study was to suggest the direction for the development of a clinical practice guideline (CPG) for esophageal cancer (EC). Methods: We collected and analyzed CPGs and related data about esophageal cancer by searching the database of domestic and foreign articles. Results: There were little contents or proposals related to Korean Medicine (KM) or Traditional Chinese Medicine (TCM), those related to KM or TCM can be found only in "Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine (惡性腫瘤中醫診療指南)". They were symptom factors, syndrome differentiation (SD) and 'treatment process of esophageal cancer by combination of western medicine and Korean medicine'. Conclusions: The topics of the development Korean medicine CPG for EC are (1) the method and procedure about combination of western medicine and Korean medicine (2) the process of SD and diagnosis (3) safety and efficacy of the herbal medicine and preparation (4) availability and timing of the tools related to KM or TCM like acupuncture, moxibustion, massage, etc.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제16권3호
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• pp.1111-1116
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• 2015

Background: To investigate the relationship between pathologic tumor response to concurrent chemoradiotherapy and variation of serum VEGF in patients with esophageal cancer. Materials and Methods: Forty six patients with esophageal cancer who were treated with concurrent chemo-radiotherapy were enrolled. Endoscopic and pathologic examination was conducted before and four weeks afterwards. Serum level of VEGF was documented before, four weeks later and after chemo-radiotherapy. The relationship between pathologic response and the variation of serum level of VEGF and its influence on the prognosis were investigated. Results: Serum level of VEGF decreased remarkably during and after chemo-radiotherapy in patients whose pathologic response was severe (F=5.393, 4.587, P(0.05). There were no statistical differences of serum VEGF level before, during and after chemo-radiotherapy for patients whose pathologic response was moderate or mild. There were 18 (85.7%), 7 (53.8%) and 6 patients (50.0%) whose serum VEGF level dropped in the severe, moderate and mild group, respectively, with significant differences among these groups (p=0.046). Two year survival rates of patients with severe, moderate and mild pathologic response were 61.9%, 53.8% and 33.3% respectively, and no statistically difference between severe and mild group regarding OS (p=0.245) was tested. Conclusions: Tumor pathologic response during chemo-radiotherapy and the changes of serum VEGF lever could predict curative effects of chemo-radiotherapy in patients with esophageal cancer.

• Journal of Chest Surgery
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• 제24권9호
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• pp.895-902
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• 1991

The surgical experience on 18 patients with benign or malignant stricture of the esophagus who underwent isoperistaltic interposition of left colon from April 1989 to July 1991 was reviewed. During same period 22 esophageal reconstructions with colon were performed, but 3 patients who had intraabdominal adhesion in the left upper quadrant and one patient who had uncertainty of blood supply of left colic artery could not undergo iso-peristaltic interposition of left colon. There were 12 male and 6 female patients ranging from 16 to 65 years of age. 12 patients had corrosive esophageal stricture, two had cancer of esophagus, and another two had hypopharyngeal cancer. The postoperative complications developed in 7 patients [38.8%] and most frequently encountered complication was cervical anastomotic leakage, which was successfully managed with simple drainage in all cases but one malignant patient. There was no operative mortality. The esophageal reconstruction with isoperistaltic left colon resulted in good function in 14 patients[77.8%], fair in 3 patients[16.7], and poor in 1 patient[5.6%]. In this experience esophageal reconstruction using isoperistaltic left colon is a satisfactory method that can be accomplished with acceptable morbidity and mortality.

• Journal of Medicine and Life Science
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• 제17권1호
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• pp.21-24
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• 2020

Intramural esophageal dissection is a rare disorder characterized by a separation of the mucosa and/or submucosa from deeper muscular layers of the esophagus, with or without perforation. Iatrogenic instrumentation such as endoscopy is one of the major causes of IED. We report a case of IED after endoscopy in a patient with hypopharyngeal cancer treated with concurrent chemoradiotherapy, and suggest that a history of chemoradiotherapy can be a risk factor of IED on endoscopy. In this case, chest computed tomography scans show not only typical esophageal double lumen but also eccentric esophageal wall thickening and abnormally thin the other side esophageal wall, and this CT finding may also be important to diagnose IED.

• Journal of Chest Surgery
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• 제56권5호
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• pp.362-366
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• 2023

The stomach has become the most commonly used site for grafts to replace the esophagus in esophageal cancer surgery because of its good blood supply and ability to enable single-reconstruction anastomosis. However, anastomotic failure is a serious complication after esophageal cancer surgery. Unlike anastomotic leakage due to local ischemia, gastric tube necrosis is a life-threatening condition with a high mortality rate. Gastric tube necrosis involves extensive ischemia due to a decreased blood supply, and an urgent operation is mandatory in most cases. Endoscopic vacuum therapy (EVT) has been used for anastomotic leakage after esophageal surgery. In recent years, it has been successfully used for more extensive disease, including large esophageal perforation as an indication for reoperation. Hence, we report a case of extensive gastric tube necrosis treated by EVT after an Ivor Lewis operation.