• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9955-9960
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• 2014

Background: Promoter hypermethylation is a common event in human cancer. O6-methylguanine-DNA methyltransferase (MGMT) is a gene involved in DNA repair, which is methylated in a variety of cancers. We aimed to explore the methylation status of MGMT gene among the North Eastern population where esophageal cancer incidence and exposure to carcinogens like nitrosamines is high. Materials and Methods: A total of 100 newly diagnosed esophageal cancer cases along with equal number of age, sex and ethnicity matched controls were included in this study. Methylation specific PCR was used to determine the MGMT methylation status in serum samples. Results: Aberrant promoter methylation of the MGMT gene was detected in 70% of esophageal cancer cases. Hypermethylation of MGMT gene was found to be influenced by environmental factors like betel quid and tobacco which contain potent carcinogens like nitrosamines. Tobacco chewing and tobacco smoking habit synergistically with MGMT methylation elevated the risk for esophageal cancer development [adjusted OR=5.02, 95% CI=1.35-18.74; p=0.010 for tobacco chewing and Adjusted OR=3.00, 95% CI=1.22-7.36; p=0.014 for tobacco smoking]. Conclusions: Results suggest that the DNA hypermethylation of MGMT is an important mechanism for MGMT gene silencing resulting in esophageal cancer development and is influenced by the environmental factors. Thus MGMT hypermethylation can be used as a biomarker for esophageal cancer in high incidence region of North East India.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1087-1092
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• 1992

We underwent two surgical resection of synchronous primary esophageal squamous cell carcinoma and gastric adenocarcinoma after obtaining histologic comfirmation 74-years old male pateint was recieved esophagectomy & total gastrectomy with esophagojejunostomy and 59-years old man was recieved near total esophagectomy and total gastrectomy with esophagocolo-gejunostomy. Their was no postoperative complications. The hospital day was 15 and 21 days postoperatively. All of them started oral intake at 7 days postoperatively and possible soft diet soon. We conclude that total resection of esophagus and stomach is the recommendable methods for prolong the life of double primary cancer patients of esophagus and stomach. Also, the reconstruction of the esophagus with colon or jejunal transposition is one of the recommenable procedure for curative surgical resection of double primary cancer in esophagus and stomach. And we also wish to emphasize the importance of detailed preopertive gastric examination for detect of gastric lesion and of careful intraoperative inspection of the gastric mucosa in patients with esophageal cancer whose preoperative gastric examination provide inconclusive evidence due to the severe esophageal stenosis.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.313-316
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• 2014

Airway obstruction after esophageal surgery is quite rare, and few such cases have been reported. A 57-year-old woman who underwent the Ivor Lewis procedure for esophageal carcinoma complained of a sudden onset of severe dyspnea on postoperative day 3. Chest computed tomography scan revealed that the collection of a large volume of mediastinal fluid caused marked luminal compression on the trachea and the gastric conduit. Explorative thoracotomy revealed a clear serous fluid in the space between the trachea and the gastric conduit, and all respiratory symptoms were relieved after the fluid was drained. The possibility of tracheal compression by loculated effusion, such as chyloma, should be considered in a patient who complains of respiratory deterioration after esophageal surgery.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.105-111
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• 1998

Double primary cancer is a rare disease in which two cancers occur in an individual independently. As prolonged survival of patients with malignant tumors is expected in the future due to advances in methods of treatment, the chance of double primary cancer will be increased. We experienced one case of double primary cancer which was developed in esophagus and chest wall. A 72 year-old male visited our hospital complaining of epigastric discomfort and right chest wall mass. We studied esophagus, chest wall, and other organs including gastrointestinal tract by various methods to exclude the cancer of other sites and could diagnose squamous cell carcinoma of mid-esophagus and adenocarcinoma of chest wall. The patient underwent esophagogastrostomy following esophagectomy and wide-resection of chest wall tumor. The postoperative course was uneventful.

• Clinical and Experimental Pediatrics
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• v.63 no.11
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• pp.447-450
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• 2020

Background: Esophageal stricture (ES) is an uncommon clinic entity in pediatrics that may be congenital or acquired in childhood. Acquired noncaustic ES is very rare, and clinical features of affected patients are unknown. Purpose: We aimed to evaluate the clinical findings, and outcomes of patients with acquired noncaustic ES to aid physicians in the early referral of patients to gastroenterologists. Methods: The medical data of patients with acquired noncaustic ES who were followed in our gastroenterology clinic between January 2009 and December 2019 were reviewed. Results: Acquired noncaustic ES was found in 12 of the 4,950 patients (0.24%) who underwent endoscopy during the study period. The main symptoms were dysphagia (58.3%), vomiting (33.3%), and chronic anemia (8.3%). Chronic malnutrition and underweight were found in 66.6% of the patients. The most common etiological factors were radiotherapy, peptic reflux, and achalasia (16.6%, each), while chemotherapy, squamous-cell carcinoma (SC) of the esophagus, eosinophilic esophagitis (EoE), esophageal web, epidermolysis bullosa, and esophageal diverticulum (8.2%, each) were the other etiological factors. Patients with EoE underwent endoscopic bougie dilation in addition to steroid use and elimination diet. Patients with epidermolysis bullosa and esophageal web underwent bougie dilation. Patients with peptic reflux-related ES were initially put on antireflux therapy, but during follow-up, one patient required esophageal replacement with colonic interposition. Patients with radiotherapy-related ES recovered with medical therapy. The patient with initially underwent surgical gastrostomy and tumoral mass excision. The patient then received chemotherapy and radiotherapy and underwent jejunal interposition. Patients with achalasia underwent surgical esophagomyotomy. Conclusion: The presence of solid dysphagia, malnutrition, and an associated disease may alert physicians to the presence of ES.

• Journal of Chest Surgery
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• v.28 no.11
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• pp.1025-1031
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• 1995

Thirty patients who underwent esophageal resections due to esophageal carcinoma and benign strictures, and esophagovisceral anastomoses were performed by hand suture in 11 patients[Group I and by using the end to end anastomosis[EEA stapler in 19 patients[Group II . Anastomoses were performed in the thoracic cavity in 24 patients[Right 19, Left 5 and in the cervical area in 6 patients. There was one operative mortality[3.3% in a cancer patient who underwent Ivor-Lewis operation using EEA stapler. She expired on POD 38 days due to renal failure and sepsis. There were two anastomotic leakage in the sutured group and no anastomotic leakage in the stapled group. Late anastomotic strictures occurred in 10 patients[52.6% in the stapled group compared to 2 patients[18.1% in the sutured group. Most of the patients with late anastomotic strictures responded to one or two trials of TTS dilations. Using EEA stapler in performing esophagovisceral anastomosis is a safe method with acceptable range of complication rate, and total admission period after the operation for group I was 30.3 days compared to 25.4 days in group II although it had no clinical significance. The follow up was possible in 23 patients; 5 patients in group I died within mean 12.6 months and 9 patients in group II within mean 14.2 months.

• Journal of Chest Surgery
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• v.29 no.6
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• pp.681-688
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• 1996

Most patients with carcinoma of the cervico-thoracic esophagus present with locally advanced disease. For this reason, therapeutic efforts have been largely palliative, focused on eradicating locoregional dis- ease, and have been attended by high morbidity rates. A 61 year old man was diagnosed to advanced cervicothoracic esophageal cancer(Type 1) and reli ved concurrent chromo-radiotherapy for 2 months in St. Mary's Hospital. And then he underwent transhiatal subtotal esophagectomy and radical dissection of cervical and superior mediastinal Iymph nodes with thoracoscopy. The histologic diagnosis was early esophageal cancer(Type 0-llb, SM2) and the curability of operation was calculated to highly curative(Clll). And the postoperative course was unevenful.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8657-8660
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• 2014

Background: Yanting is one of high risk areas for esophageal cancer and the screening program was therefore initiated there. This study was aimed to investigate the dietary behaviors on the risk of esophageal squamous cell carcinoma (ESCC), among the individuals with normal and abnormal esophagus mucosa. Materials and Methods: A frequency matched case-controls study was proposed to estimate the different distribution of dietary behavior between individuals of control, esophagitis and cancer groups. Cancer cases were selected from hospitals. Esophagitis cases and controls were selected from screening population for ESCC. Health workers collected data for 1 year prior to interview, in terms of length of finishing a meal, temperature of eaten food and interval between water boiling and drinking. Chi-square, Kruskal-Wallis tests and unconditional logistic regression model were used to estimate differences and associations between groups. Results: Compared with controls, length of finishing a meal ${\geq}15mins$ was related to a reduced OR for cancer (OR=0.46, 95%CI, 0.22-0.97) and even compared with cases of esophagitis, the OR of cancer was reduced to 0.30 (95%CI, 0.13-0.72). The OR for often eating food at a high temperature was 2.48 (95%CI 1.06, 5.82) for ESCC as compared with controls. Interval between water boiling and drinking of ${\geq}10mins$ was associated with lower risk of cancer: the OR was 0.18 compared with controls and 0.49 with esophagitis cases (p<0.05). Conclusions: Length of eating food ${\geq}15mins$ and interval between water boiling and drinking ${\geq}10mins$ are potentially related to reduced risk of esophageal SCC, compared with individuals with normal and abnormal esophageal mucosa. Recommendations to Yanting residents to change their dietary behaviors should be made in order to reduce cancer risk.

• Journal of Chest Surgery
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• v.22 no.1
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• pp.146-150
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• 1989

Dysphagia is common in patients with cancer of the esophagus. The rate of resectability of the lesion is low, and the majority of the patients require palliation to relieve the dysphagia. Celestin tube intubation was performed in patients with unresectable carcinoma of the esophagus, of one with malignant bronchoesophageal fistula. Dysphagia and respiratory symptoms were relieved and the patients became able to eat semi-solid food and fully ambulatory.

• Radiation Oncology Journal
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• v.17 no.2
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• pp.108-112
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• 1999

Background and Purpose : Involvement of supraclavicular Iymph nodes (SCL) is considered distant metastasis for thoracic esophageal carcinoma in AJCC staging system revised in 1997. We investigated significance of SCL involvement compared to other regional Iymph node involvement. Materials and Methods : Two-hundred eighty-nine patients with unresectable esophageal carcinoma were treated with radiation therapy from June of 1979 through December 1992. Of these patients, 25 were identified having SCL involvement. Survival rate and relapse patterns were compared with that of mediastinal and perigastric Iymph node positive patients to evaluate prognostic significance of SCL involvement. Results : Median survival for patients with SCL involvement was 7 months and 2- and 5-year overall survival rates were 12.0$\%$ and 4.0$\%$ respectably. Corresponding features for regional node positive patients were 9 month, 17.0$\%$ and 3.8$\%$. There was no significant difference between two groups. There was also no difference in patterns of recurrence. Conclusions : Results of this analysis showed that SCL involvement should be staged as nodal disease in contrast to present classification of metastatic disease.