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Abramson Cancer CenterNCI CANCERLIT® Search: Esophageal Neoplasms - April 2002
National Cancer Institute®
Last Modified: April 1, 2002
Table of Contents
1
UI - 11346101
AU - Duggan AE; Harvey MA
TI -
Gastro-oesophageal reflux disease: not so benign.
SO - Med J Aust 2001 Apr 2;174(7):323-4
2
UI - 11686031
AU - Aiba K
TI -
Upper gastrointestinal tumors.
SO - Cancer Chemother Biol Response Modif 2001;19():535-45
AD - Japanese Foundation for Cancer Research, Cancer Chemotherapy Center,
Kami-Ikebukuro 1-37-1, Toshima-ku, Tokyo 170-8455, Japan.
3
UI - 11700825
AU - Watson DI
TI -
Gastro-oesophageal reflux disease: not so benign.
SO - Med J Aust 2001 Oct 1;175(7):390-1
4
UI - 11750229
AU - Stein HJ; Brucher BL; Sendler A; Siewert JR
TI -
Esophageal cancer: patient evaluation and pre-treatment staging.
SO - Surg Oncol 2001 Nov;10(3):103-11
AD - Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar der
Technischen Universitat Munchen, Ismaningerstr. 22, D-81675, Munchen,
Germany. stein@nt1.chir.med.tu-muenchen.de
Improvements in the overall survival of patients with esophageal cancer
can in the future only be achieved by tailored therapeutic strategies
which are based on the individual histologic tumor type, tumor location,
tumor stage at the time of presentation, consideration of established
prognostic factors and the physiologic status of the patient. The major
aim of every diagnostic strategy is to assess whether a complete
macroscopic and microscopic tumor resection (i.e. an R0 resection) can
be achieved by primary surgical approach with a high degree of
likelihood. This requires histologic classification of the tumor type
(squamous cell cancer or adenocarcinoma), the exclusion of distant solid
organ metastases, localization of the primary tumor in relation to the
tracheobronchial tree, and determination of the T-category and the
surrounding structures of the primary tumor. This is currently achieved
by a combination of contrast radiography, endoscopy with biopsy,
endoscopic ultrasonography and CT scan. PET scanning will in the future
be more widely used in esophageal cancer staging because it appears to
be superior to current imaging modalities in the exclusion of distant
solid organ and lymph node metastases and allows early assessment of
response of the primary tumor to neoadjuvant treatment. Systematic risk
analysis with a dedicated composite scoring system is essential to
assess the physiologic status of the patient and reduce postoperative
mortality. Only hospitals with a sufficient case load of esophageal
cancer patients ('hospital volume') and a dedicated interest in the
management of this disease ('centers of excellence') can provide the
required expertise and standards for patient evaluation and tailored
therapy.
5
UI - 11750230
AU - Lerut T; Coosemans W; Decker G; De Leyn P; Nafteux P; Van Raemdonck D
TI -
Cancer of the esophagus and gastro-esophageal junction: potentially
curative therapies.
SO - Surg Oncol 2001 Nov;10(3):113-22
AD - Department Thoracic Surgery, Catholic University Leuven, U.Z.
Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium.
toni.lerut@uz.kuleuven.ac.be
The definition of potential curative tumors of the esophagus and
gastro-esophageal junction remains problematic. This is due to a lack of
accuracy in clinical staging despite recent advances in CT, endoscopic
ultrasonography (EUS), positron emission tomography scan and minimally
invasive staging modalities. As a result much controversy persists
regarding indications for surgery and extent of resection and
lymphadenectomy. Today surgery with curative option results in five-year
survival of over 30%. Multimodality regimens, especially neoadjuvant
chemoradiotherapy, seem to be beneficial in patients with a complete
response on pathologic staging. Other indications are investigational
and should be studied within carefully monitored study protocols. In
early carcinoma T(is)-T(1a) endoluminal ablation technique seem to open
promising perspectives provided of discrimination between T(is)-T(1a)
and T(1b) can be made by the use of 20mhz EUS probes.
6
UI - 11750231
AU - Mason R
TI -
Palliation of oesophageal cancer.
SO - Surg Oncol 2001 Nov;10(3):123-6
AD - Guy's and St Thomas' Hospitals, St. Thomas Street, SE1 9RT, London, UK.
7
UI - 11750232
AU - Blazeby JM
TI -
Measurement of outcome.
SO - Surg Oncol 2001 Nov;10(3):127-33
AD - University Division of Surgery, Bristol Royal Infirmary, Level 7, BS2
8HW, Bristol, UK. jmblazeby@hotmail.com
The outcomes of treatment of oesophageal cancer include traditional
biological and physical measures, such as mortality and morbidity data,
disease free and overall survival, clinical and pathological response
rates and symptom control. Such factors are essential and should be
recorded prospectively for clinical audit. Using this type of
information alone to evaluate effectiveness of treatment is inadequate,
however, because the diagnosis and treatment of oesophageal cancer has a
major impact on functional well-being (including psycho-social
function), general health perceptions and overall quality of life
(QL)/satisfaction with health and health care. These aspects of
patients' well-being need to be considered, in addition to standard
outcomes in the evaluation of treatment of oesophageal cancer. Recent
needs to judge the economic efficiency of health care by comparing
health outcomes with costs may also be part of treatment appraisal. This
article reviews surgical, oncological, patient-based and economic
outcomes in oesophageal cancer.
8
UI - 11750227
AU - Pera M; Pera M
TI -
Recent changes in the epidemiology of esophageal cancer.
SO - Surg Oncol 2001 Nov;10(3):81-90
AD - Service of Gastrointestinal Surgery, Institute of Digestive Diseases,
IDIBAPS-Institut d'Investigacions Biomediques August Pi i Sunyer,
Hospital Clinic, University of Barcelona Medical School, Barcelona,
Spain. mpera@medicina.ub.es
9
UI - 11803146
AU - Geh JI
TI -
The use of chemoradiotherapy in oesophageal cancer.
SO - Eur J Cancer 2002 Jan;38(2):300-13
AD - The Cancer Centre at the Queen Elizabeth Hospital, Edgbaston, Birmingham
B15 2TH, UK. iangeh@hotmail.com
The results of treatment for oesophageal carcinoma remain poor and few
patients are curable by surgery alone. The use of chemoradiotherapy
(CRT) given as a definitive treatment or in combination with surgery may
improve locoregional control and survival, when compared with
radiotherapy or surgery alone. Using the keywords "chemoradiotherapy"
and "radiochemotherapy", a Medline-based literature review (1980-2001)
was performed. Additional literature was obtained from original papers
and published meeting abstracts. Two-year survival rates of 28-72% in
squamous cell carcinoma and 14-29% in adenocarcinoma from definitive CRT
were reported. This is comparable to results achievable by surgery
alone. The use of preoperative CRT followed by surgery may further
improve survival, but current data are insufficient to justify this
approach within routine clinical practice. Acute treatment-related
toxicity is increased with CRT. In selected patients with localised
unresectable oesophageal cancer, definitive CRT is recommended. There
are uncertainties about the role of routine surgery following CRT in
patients with resectable disease. For the future, the pretreatment
staging of patients needs to be improved and standardised, the optimal
CRT regimen needs to be defined and the role of predictive markers for
CRT response needs to be developed.
10
UI - 11875723
AU - Polee MB; Eskens FA; van der Burg ME; Splinter TA; Siersema PD; Tilanus
TI -
HW; Verweij J; Stoter G; van der Gaast A
Phase II study of bi-weekly administration of paclitaxel and cisplatin
in patients with advanced oesophageal cancer.
SO - Br J Cancer 2002 Mar 4;86(5):669-73
AD - Department of Medical Oncology, University Hospital Rotterdam-Dijkzigt,
Rotterdam, The Netherlands.
In a phase I study we demonstrated the feasibility of a bi-weekly
combination of paclitaxel 180 mg x m(-2) with cisplatin 60 mg x m(-2).
In this study we further assessed toxicity and efficacy of this schedule
in the treatment of advanced cancer of the oesophagus or the
gastro-oesophageal junction. Patients received paclitaxel 180 mg x m(-2)
administered over 3 h followed by a 3-h infusion of cisplatin 60 mg x
m(-2). Patients were retreated every 2 weeks unless granulocytes were
<0.75x10(9) or platelets <75x10(9). Patients were evaluated after three
and six cycles and responding patients received a maximum of eight
cycles. Fifty-one patients were enrolled into the study. The median age
was 56 years (range 32-78). WHO performance status were: 0 (19
patients); 1 (29 patients); 2 (three patients). All patients received at
least three cycles of chemotherapy and all were evaluable for toxicity
and response. Haematological toxicity consisted of uncomplicated
neutropenia grade 3 in 39% and grade 4 in 31% of patients. Five patients
(10%) were hospitalised, three patients because of treatment related
complications and two patients because of infections without
neutropenia. Sensory neurotoxicity was the predominant
non-haematological toxicity; grade 1 and 2 neurotoxicity was observed in
43 and 20% of patients, respectively. Response evaluation in 51 patients
with measurable disease: complete response 4%, partial response 39%,
stable disease 43% and progressive disease in 14% of the patients. The
median duration of response was 8 months. The median survival for all
patients was 9 (range 2-29+) months and the one-year survival rate was
43%. Four patients who received additional local treatment (two patients
surgery and two patients radiotherapy) are still disease free after a
follow-up of 20-29 months. This bi-weekly treatment of paclitaxel and
cisplatin is well tolerated by patients with advanced oesophageal
cancer. The toxicity profile of this regimen compares favourable to that
of previously used cisplatin- and paclitaxel-based regimens. Trials are
underway evaluating this bi-weekly regimen in a neo-adjuvant setting.
Copyright 2002 Cancer Research UK
11
UI - 11900221
AU - Bidoli P; Bajetta E; Stani SC; De CD; Santoro A; Valente M; Zucali R;
TI -
Valagussa P; Ravasi G; Bonadonna G
Ten-year survival with chemotherapy and radiotherapy in patients with
squamous cell carcinoma of the esophagus.
SO - Cancer 2002 Jan 15;94(2):352-61
AD - Division of Medical Oncology B, Istituto Nazionale per lo Studio e la
Cura dei Tumori, Milan, Italy. paolo.bidoli@virgilio.it
BACKGROUND: The effects of multimodality treatment on the survival of
patients with esophageal carcinoma are unclear. The authors performed a
prospective, Phase II study to assess the long-term results of
chemotherapy plus radiotherapy (RT) on patients with esophageal squamous
cell carcinoma. METHODS: Of 106 consecutive patients who were recruited
between 1985 and 1992, 101 patients were evaluable. Cisplatin (100 mg/m2
per day) on Day 1 and fluorouracil (1000 mg/m2 per day) on Days 1-4 were
given for two cycles, with concomitant RT (30 grays [Gy] in 15
fractions) over 19 days. Patients with potentially resectable tumors
were then assessed for curative surgery; the other patients received two
more courses of chemotherapy and further RT (20 Gy in 10 fractions).
RESULTS. Of 40 patients who were candidates for surgery, 32 patients
underwent surgery, and 24 patients had complete resection; 8 patients
(25%) had no residual tumor in the specimen, and 12 patients (37%) had
microscopic foci only. Surgical mortality was high (22%). Of 61
nonsurgical patients, 37 patients (61%) achieved complete clinical
remission, and 14 patients (23%) achieved partial remission. The median
survival for the entire series was 15 months (range, 1-136 months). The
overall survival rate was 22% at 5 years and 12% at 10 years. At 10
years, freedom from disease progression was similar in the two groups
(24%), whereas the median survival (22 months vs. 12 months) and the
overall survival rates (17% vs. 9%) were better in nonsurgical patients
compared with surgical patients, respectively, probably in relation to
high surgical mortality. The larynx was preserved in 28% of 32 patients
with cervical disease sites, with a 10-year disease free survival rate
of 31%. Three deaths were attributed to nonsurgical treatments.
CONCLUSIONS. Careful multidisciplinary pretreatment evaluation can
identify patients who are ineligible for surgery without compromising
long-term results. For patients with inoperable disease,
chemoradiotherapy can produce relatively good long-term results. The
combined approach without surgery can permit laryngeal preservation in a
useful fraction of patients.
12
UI - 11900242
AU - Araki K; Ohno S; Egashira A; Saeki H; Kawaguchi H; Sugimachi K
TI -
Pathologic features of superficial esophageal squamous cell carcinoma
with lymph node and distal metastasis.
SO - Cancer 2002 Jan 15;94(2):570-5
AD - Department of Surgery and Science, Faculty of Medicine, Kyushu
University, Fukuoka, Japan. ayushi@mint.ocn.ne.jp
BACKGROUND: Endoscopic mucosal resection (EMR) is a less invasive
localized treatment for patients with esophageal carcinoma. However,
indications for EMR use in cases of superficial esophageal carcinoma are
controversial. The authors evaluated histopathologic risk factors for
lymph node metastasis and recurrence. METHODS: In the specimens
resected, the authors examined depth, the superficial area and the area
attached to or infiltrating the lamina muscularis mucosa. RESULTS: The
authors found that the superficial area and the attached or infiltrated
area reflected the depth of the tumor. However, there was a recurrence
of esophageal carcinoma even in m3 cases attached only to the lamina
muscularis mucosa. CONCLUSIONS: The authors concluded that ml and m2
esophageal carcinoma had almost no risk of lymph node metastasis and
recurrence no matter how extensive the superficial area. In addition,
sm2 and sm3 carcinoma have a high frequency of lymph node metastasis and
recurrence. M3 and sm1 carcinoma run the risk of lymph node metastasis
and recurrence however small the superficial area and the area attached
to or infiltrating the lamina muscularis mucosa. Treatment strategies
for patients with superficial esophageal carcinoma, including EMR,
should take the above findings into account.
13
UI - 11845368
AU - Javaid B; Watt P; Krasner N
TI -
Photodynamic therapy (PDT) for oesophageal dysplasia and early carcinoma
with mTHPC (m-tetrahydroxyphenyl chlorin): a preliminary study.
SO - Lasers Med Sci 2002;17(1):51-6
AD - Aintree Centre for Gastroenterology and Liver Disease, University
Hospital Aintree, Liverpool, UK.
Barrett's oesophagus is a premalignant condition in which stratified
squamous type mucosa of the normal oesophagus is replaced by specialised
intestinal type columnar mucosa. Oesophageal resection was previously
considered to be the treatment of choice for high-grade dysplasia or
superficial carcinoma arising in this columnar-lined mucosa. We treated
four patients with Barrett's oesophagus and high-grade dysplasia, and
one patient with superficial oesophageal carcinoma with photodynamic
therapy (PDT) using an argon-pumped dye laser light (652 nm). PDT was
also delivered using a xenon arc lamp (Paterson lamp, light 652 nm +/-
15 nm) in two patients with Barrett's oesophagus and high-grade
dysplasia. mTHPC (m-tetrahydroxyphenyl chlorin) 0.15 mg/kg was used as a
photosensitiser in all the patients. We have been able to demonstrate
the elimination of columnar-lined oesophageal mucosa, reduction in the
length of the Barrett's segment or downgrading of the dysplasia in all
of the patients. There is no evidence of recurrence in the patient who
had oesophageal carcinoma, at 27 months follow-up. We conclude that
mTHPC is useful as a photosensitiser for PDT in the management of
Barrett's oesophagus with high-grade dysplasia or superficial carcinoma
and the Paterson lamp is a potential alternative light source for PDT.
14
UI - 11904306
AU - Gupta RA; DuBois RN
TI -
Cyclooxygenase-2 inhibitor therapy for the prevention of esophageal
adenocarcinoma in Barrett's esophagus.
SO - J Natl Cancer Inst 2002 Mar 20;94(6):406-7
15
UI - 11788885
AU - Obara K; Ghazizadeh M; Shimizu H; Arai R; Tenjin T; Suzuki S; Moriyama
TI -
Y; Kawanami O
Comparative genomic hybridization study of genetic changes associated
with vindesine resistance in esophageal carcinoma.
SO - Int J Oncol 2002 Feb;20(2):255-60
AD - Center for Digestive Disease, Nippon Medical School Second Hospital,
Kawasaki, Kanagawa 211-8533, Japan. obara@gd5.so-net.ne.jp
The acquisition of drug-resistance is a major problem for cancer
patients undergoing chemotherapy. To clarify genetic alterations in
cancer cells that develop drug-resistance, comparative genomic
hybridization (CGH) was applied to esophageal squamous cell carcinoma
cell lines (SH-1V1, SH-1V2, SH-1V4 and SH-1V8) and
chemoresistance-related genes in altered chromosomal regions were
evaluated. These cell lines were derived from the parental SH-1 cell
line, after multiple steps of selection by an increasing exposure to
vindesine. SH-1V8 cells were strongly resistant to vindesine. DNA copy
number at 16p which includes the MRP (multidrug resistance related
protein) gene was markedly increased in all cell lines examined.
Increased DNA copy numbers were found at the regions of 5q31-32,
10q11.1-23, and 14q32-qter in SH-1V8 cells that acquired resistance to
other drugs as well. Both SH-1V4 and SH-1V8 showed increased DNA copy
numbers at 7q11.1-22, 16q12.1-qter, 19p13.2-13.3, 19q11-13.2 and
20q13.1-qter. The chromosomal region of 7q11.1-22 including MDR-1
(multidrug resistance-1) gene was highly amplified in SH-1V4 and SH-1V8.
Amplification of the MRP region suggests the prerequisite of developing
resistance to vindesine, and further amplification of MDR-1 may play a
critical role in acquiring drug-resistance. Several unknown genes
related to the induction of chemoresistance might be concealed in other
altered chromosomal regions.
16
UI - 11788891
AU - Kase S; Osaki M; Adachi H; Kaibara N; Ito H
TI -
Expression of Fas and Fas ligand in esophageal tissue mucosa and
carcinomas.
SO - Int J Oncol 2002 Feb;20(2):291-7
AD - First Department of Pathology, Faculty of Medicine, Tottori University,
Tottori 683-8503, Japan. kaseron@grape.med.tottori-u.ac.jp
The Fas ligand (FasL) and its receptor Fas play a key role in the
initiation of an apoptotic pathway. We describe the expression of Fas
receptor and ligand pair antigens in surgical samples collected from a
cohot of 89 patients compared with 89 squamous cell carcinomas (SCCs),
45 dysplasias and 42 normal mucosae of the esophagus. TUNEL method was
performed in 89 SCCs. Evaluation of FasL on normal mucosae displayed a
heterogeneous immunoreaction in a minority of specimens, whereas SCCs
exhibited a more extended and homogeneous reactivity. Fas-positive
carcinoma cells revealed frequent apoptosis. Furthermore, a
significantly longer disease-free survival can be observed in patients
with Fas-positive tumors than in Fas-negative carcinomas and in patients
with FasL-negative tumors than in FasL-positive carcinomas. In
conclusion, FasL expression may play an important role in tumor
progression. On the other hand, Fas-expressing carcinoma cells were
associated with frequent apoptosis. Both FasL and Fas expressions
correlate with prognostic significance in esophageal SCCs.
17
UI - 11836677
AU - Zhang L; Xing D; He Z; Lin D
TI -
[p53 gene codon 72 polymorphism and susceptibility to esophageal
squamous cell carcinoma in a Chinese population]
SO - Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2002 Feb;19(1):10-3
AD - Department of Pathology, Cancer Institute & Hospital, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, 100021 P. R.
China.
OBJECTIVE: To investigate the relationship between p53 codon 72
polymorphism and susceptibility to esophageal squamous cell carcinoma in
China. METHODS: The p53 genotypes were determined by polymerase chain
reaction-restriction fragment length polymorphism among 204 healthy
controls and 91 patients with esophageal squamous cell carcinoma (ESCC).
RESULTS: There was no significant difference between patients and
controls with respect to allele frequency for the p53 Pro allele (0.480
versus 0.588, P=0.11); however, the Pro/Pro genotype of p53 among cases
(39.6%) was significantly (P<0.05) more frequent than that among
controls (21.1%). Subjects homozygous for the p53 Pro allele had a more
than 2-fold increased risk of developing ESCC (OR=2.18; 95%CI=1.10-4.35,
adjusted for age, sex, and smoking), whereas the Arg/Pro genotype was
not associated with elevated risk of the cancer (adjusted OR=0.84;
95%CI=0.42-1.68). No interaction between smoking and Pro/Pro genotype
was observed for risk of ESCC. CONCLUSION: The p53 codon 72 polymorphism
may play a role in susceptibility to esophageal carcinogenesis.
18
UI - 11865364
AU - Sane S; Baba M; Kusano C; Shirao K; Yamada H; Aikou T
TI -
Influence of exogenous fat emulsion on pulmonary gas exchange after
major surgery.
SO - World J Surg 2002 Mar;26(3):297-302
AD - First Department of Surgery, Kagoshima University School of Medicine,
8-35-1, Sakuragaoka, Kagoshima 890-8520, Japan.
souji-sane@po2.synapse.ne.jp
The use of fat emulsion in total parenteral nutrition (TPN) is closely
related to changes in respiratory function. The aim of this study was to
evaluate the influence of exogenous fat emulsion on pulmonary gas
exchange in the early period after major surgery. Total parenteral
nutrition was administered to 18 patients for 6 days after esophagectomy
for carcinoma. Half of the patients received glucose (glucose group),
and the other half received glucose and fat (fat group). The fat
emulsion was continuously infused for 24 hours over 6 days. Glucose
utilization was significantly higher in the glucose group than in the
fat group. Fat utilization was significantly higher in the fat group
than in the glucose group. Carbon dioxide (CO2) production and
respiratory quotient were significantly decreased in the fat group
compared to the glucose group. There were no differences in the
pulmonary vascular resistance index or alveolar-arterial difference in
oxygen tension between the two groups. Although exogenous fat emulsion
utilized as energy substrate decreases CO2 production after major
surgery, it does not clinically influence the pulmonary hemodynamics or
diffusion capacity.
19
UI - 11870151
AU - Willett CG
TI -
Radiation dose escalation in combined-modality therapy for esophageal
cancer.
SO - J Clin Oncol 2002 Mar 1;20(5):1151-3
20
UI - 11870157
AU - Minsky BD; Pajak TF; Ginsberg RJ; Pisansky TM; Martenson J; Komaki R;
TI -
Okawara G; Rosenthal SA; Kelsen DP
INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of
combined-modality therapy for esophageal cancer: high-dose versus
standard-dose radiation therapy.
SO - J Clin Oncol 2002 Mar 1;20(5):1167-74
AD - Department of Radiation Oncology, Memorial Sloan-Kettering Cancer
Center, New York, NY 10021, USA. minskyb@mskcc.org
PURPOSE: To compare the local/regional control, survival, and toxicity
of combined-modality therapy using high-dose (64.8 Gy) versus
standard-dose (50.4 Gy) radiation therapy for the treatment of patients
with esophageal cancer. PATIENTS AND METHODS: A total of 236 patients
with clinical stage T1 to T4, N0/1, M0 squamous cell carcinoma or
adenocarcinoma selected for a nonsurgical approach, after stratification
by weight loss, primary tumor size, and histology, were randomized to
receive combined-modality therapy consisting of four monthly cycles of
fluorouracil (5-FU) (1,000 mg/m(2)/24 hours for 4 days) and cisplatin
(75 mg/m(2) bolus day 1) with concurrent 64.8 Gy versus the same
chemotherapy schedule but with concurrent 50.4 Gy. The trial was stopped
after an interim analysis. The median follow-up was 16.4 months for all
patients and 29.5 months for patients still alive. RESULTS: For the 218
eligible patients, there was no significant difference in median
survival (13.0 v 18.1 months), 2-year survival (31% v 40%), or
local/regional failure and local/regional persistence of disease (56% v
52%) between the high-dose and standard-dose arms. Although 11
treatment-related deaths occurred in the high-dose arm compared with two
in the standard-dose arm, seven of the 11 deaths occurred in patients
who had received 50.4 Gy or less. CONCLUSION: The higher radiation dose
did not increase survival or local/regional control. Although there was
a higher treatment-related mortality rate in the patients assigned to
the high-dose radiation arm, it did not seem to be related to the higher
radiation dose. The standard radiation dose for patients treated with
concurrent 5-FU and cisplatin chemotherapy is 50.4 Gy.
21
UI - 11875696
AU - Ke L; Yu P; Zhang ZX; Huang SS; Huang G; Ma XH
TI -
Congou tea drinking and oesophageal cancer in South China.
SO - Br J Cancer 2002 Feb 1;86(3):346-7
AD - Preventive Branch, Shantou University Medical College, Shantou 515031,
China. kli@stu.edu.cn
The study from a large hospital-based case-control for 1248 cases with
oesophageal cancer and the same number of controls in South China showed
that Congou, a grade of Chinese black tea, may protect against cancers
of the oesophagus and reduce the risk of a combination of alcohol
drinking and smoking (especially smoking), regardless of temperature
when drinking. Copyright 2002 The Cancer Research Campaign
22
UI - 11911344
AU - Cucino C; Sonnenberg A
TI -
Occupational mortality from squamous cell carcinoma of the esophagus in
the United States during 1991-1996.
SO - Dig Dis Sci 2002 Mar;47(3):568-72
AD - The Department of Veterans Affairs Medical Center and The University of
New Mexico, Albuquerque 87108, USA.
The epidemiology of esophageal squamous cell cancer has remained poorly
understood. The occupational distribution of this cancer may provide
clues about its yet unknown etiology. Data files from the National
Center for Health Statistics (NCHS) of the United States offer a unique
source to study causes of death, broken down by occupation and industry.
The number of deaths from esophageal cancer was retrieved from the
computerized US vital statistics. Mortality by occupation or industry
was expressed as standardized proportional mortality ratio (PMR),
adjusted by age, gender, and ethnicity. Between 1991 and 1996, 63,717
subjects died from esophageal squamous cell carcinoma. Mortality was
particularly high among nonwhites and men. The industrial and the
occupational distributions shared a similar pattern. Mortality from
esophageal squamous cell carcinoma occurred more frequently among
subjects exposed to silica dust, such as brickmasons and stonemasons,
concrete and terrazzo finishers, roofers, and construction laborers. It
was also high in such industries as unspecified machinery or
manufacturing and such occupations as unspecified material handlers,
janitors, or cleaners. It was low in industries and occupations
associated with agriculture, clergy, work in religious organizations,
and textiles. In conclusion, mortality from esophageal squamous cell
carcinoma appeared to be low in occupations associated with less
consumption of alcohol and tobacco. It was high among occupations
potentially associated with exposure to silica dust and chemical
solvents or detergents.
23
UI - 11908337
AU - Righini C; Mouret P; Wu D; Blanchet C; Reyt E
TI -
[Is hepatic ultrasonography necessary in the initial check-up of
patients with squamous cell carcinoma of the upper respiratory and
digestive tract?]
SO - Ann Otolaryngol Chir Cervicofac 2001 Dec;118(6):359-64
AD - Service ORL, CHU de Grenoble, BP 217, 38043 Grenoble.
CRighini@chu-grenoble.fr
PURPOSE OF THE STUDY: The purpose of our study was to determine the
position and value of ultrasound scan of the liver in the initial
check-up of patients treated for a squamous cell carcinoma of the upper
respiratory and digestive tract. MATERIAL AND METHODS: Our study is
based on a retrospective review of 267 patients (249 males and 18
females) managed in the E.N.T. Department of Grenoble universitary
hospital from 1993 to 1995 for a upper respiratory and digestive tract
malignant tumor. No patient has been previously treated. The site of the
primary tumor was: the oropharynx (108 cases), the hypopharynx (88
cases), the oral cavity (44 cases), the larynx (20 cases), the
rhinopharynx (6 cases) and the cervical oesophagus (1 case). Endoscopic
procedure with biopsy was performed for all the patients. Histologic
examination revealed an invasive squamous cell carcinoma in all the
cases. The complete check up included a ultrasound scan of the liver and
a chest X-ray for all the patients. RESULTS: Ultrasound scan of the
liver revealed one or several metastases in 4 cases (1.5%). The primary
tumor was hypopharyngeal in 3 cases (2 stages III, 1 stage IV) and
oropharyngeal in 1 case (stage III). In three cases, carcinoma was
poorly differentiated. Ultrasound scan of the liver was doubtful for 8
patients (3%). The primary tumor was oropharyngeal in 6 cases (1 stage
I, 3 stages III, 2 stages IV), laryngeal in 1 case (stage III) and
hypopharyngeal in case (stage IV). In six cases carcinoma was well
differentiated. All the complementary examinations concluded to a benign
liver disease, with a mean diagnosis delay of 4 weeks for the 8
patients. The mean follow-up duration of the 8 patients was 22 months
(range 9 to 42 months). None presented any metastases during the follow
up. CONCLUSION: Our results compared with those of the literature
revealed that ultrasound scan of the liver is a few specific examination
which may be recommended for hypopharyngeal tumors, or for a large
cervical adenopathy (N2 or N3), a poor differentiated tumor wherever the
site of the primary tumor is.
24
UI - 11869316
AU - Blant SA; Ballini JP; Caron CT; Fontolliet C; Monnier P; Laurini NR
TI -
Evolution of DNA ploidy during squamous cell carcinogenesis in the
esophagus.
SO - Dis Esophagus 2001;14(3-4):178-84
AD - Institute of Pathology University of Lausanne, CH-1011, Lausanne,
Switzerland. snezana.andrejevic@chuv.hospvd.ch
Image and flow cytometry was used to study the nuclear DNA content
(ploidy) during the squamous cell carcinogenesis in the esophagus. The
present retrospective study comprised 26 surgical specimens of squamous
cell carcinomas (SCC) in patients who underwent surgery alone at the
lymph node metastases. Diploid DNA histogram patterns were observed in
all non-pathologic tissues analyzed, either distant or proximal to the
lesion. Aneuploidy was observed in 30 (70%) of 43 lesions; 20 (62.5%) of
32 early squamous-cell carcinomas; and 10 (91%) of 11 advanced
carcinomas. In patients with various tumor stages or with multicentric
synchronous or metachronous tumors, DNA content was not different among
different tumor stages. Four of six lymph node metastases had the same
DNA content as the primary tumor. In four patients, discordance between
image and flow cytometry analysis was observed for malignant lesions
only. Ploidy status was not statistically associated with the
differentiation of the tumor, but it was associated with the stage of
tumor (P < 0.001). These findings suggest that early malignant changes
in the esophagus are already associated with alteration in DNA content,
and aneuploidy tends to correlate with progression to invasive SCC. This
cell kinetic information could help clinicians in selecting the optimal
treatment for the individual patient.
25
UI - 11869317
AU - Fagundes RB; Mello CR; Tollens P; Putten AC; Wagner MB; Moreira LF;
TI -
Barros SG
p53 protein in esophageal mucosa of individuals at high risk of squamous
cell carcinoma of the esophagus.
SO - Dis Esophagus 2001;14(3-4):185-90
AD - Gastroenterology Service, Pathology Department of the Faculdade de
Medicina da Universidade Federal do Rio Grande do Sul, RS, Brazil.
rfagundes@pro.viars.com.br
Squamous cell carcinoma of the esophagus (SCCE) is diagnosed late and
carries a poor prognosis. Biomarkers such as p53 protein expression may
be present in the esophageal mucosa long before esophageal symptoms or
lesions appear and may point toward early diagnosis. Asymptomatic
subjects at high risk for SCEE (consumption of more than 80 g of ethanol
and 10 cigarettes/day for at least 10 years) underwent upper
gastrointestinal endoscopy with biopsies of the esophageal mucosa, and
expression of p53 protein was compared with conventional histologic
findings. In 182 subjects studied, p53 protein was expressed in a
stepwise fashion according to the severity of the histologic findings:
normal mucosa (12/103 or 11.7%), mild chronic esophagitis (6/43 or 14%),
moderate chronic esophagitis (4/18 or 22.2%), severe chronic esophagitis
(1/3 or 33.3%), low-grade dysplasia (4/11 or 36.4%), high-grade
dysplasia (2/2 or 100%), and squamous cell carcinoma (2/2 or 100%)
(P=0.00025). The odds ratio and confidence intervals were calculated by
logistic regression, with multivariate adjustment for potentially
confounding variables. The risk for p53 expression was twofold for
moderate and severe chronic esophagitis and 10-fold for dysplasia and
cancer (P=0.001). p53 protein was expressed not only in cancerous
lesions, high-grade and low-grade dysplasia, as expected, but also in
mucosa considered normal or with chronic esophagitis using conventional
histology. Smokers and alcohol drinkers with normal mucosa or chronic
esophagitis that express p53 protein may represent an unrecognized
subgroup of individuals that may benefit from surveillance. Follow-up
studies of these asymptomatic subjects and molecular analysis of the p53
gene are needed to clarify this point.
26
UI - 11869318
AU - Shiozaki H; Yano M; Tsujinaka T; Inoue M; Tamura S; Doki Y; Yasuda T;
TI -
Fujiwara Y; Monden M
Lymph node metastasis along the recurrent nerve chain is an indication
for cervical lymph node dissection in thoracic esophageal cancer.
SO - Dis Esophagus 2001;14(3-4):191-6
AD - Department of Surgery and Clinical Oncology, Graduate School of
Medicine, Osaka University, Suita, Osaka, Japan.
This study examined whether recurrent nerve chain node metastasis serves
as an indicative factor for cervical lymph node dissection in thoracic
esophageal cancer. The association of recurrent nerve chain lymph node
metastasis and cervical node metastasis was analyzed for 91 patients
with thoracic esophageal cancer who had undergone three-field lymph node
dissection. In patients with upper thoracic esophageal cancer, the
incidence of cervical lymph node metastasis was similar regardless of
recurrent nerve chain node metastasis. On the other hand, in patients
with middle or lower esophageal cancer, the incidence was significantly
higher in recurrent nerve-positive (16/31, 51.6%) than in recurrent
nerve-negative (5/43, 11.6%) patients. The prognosis of patients with
recurrent nerve chain node metastasis was significantly better in the
three-field dissection group than in the two-field dissection group,
while in patients with no recurrent nerve chain node metastasis,
survival was similar between the two groups. In conclusion, cervical
lymphadenectomy can be omitted for recurrent nerve chain node-negative
patients with middle and lower thoracic esophageal cancer.
27
UI - 11869319
AU - Ikeda K; Ishida K; Sato N; Koeda K; Aoki K; Kimura Y; Iwaya T; Ogasawara
TI -
S; Iijima S; Nakamura R; Uesugi N; Maesawa C; Saito K
Chemoradiotherapy followed by surgery for thoracic esophageal cancer
potentially or actually involving adjacent organs.
SO - Dis Esophagus 2001;14(3-4):197-201
AD - Department of Surgery 1, Iwate Medical University, Morioka, Japan.
kenikeda@iwate-med.ac.jp
The objective of this study was to evaluate the therapeutic usefulness
of chemoradiotherapy (CRT) followed by surgery in patients with
clinically T4 (cT4) esophageal cancer involving adjacent organs such as
the trachea, main bronchi, and large vessels. Thirty-seven patients with
cT4 squamous cell carcinoma of the thoracic esophagus were enrolled in
this study. The CRT regimen comprised cisplatin (70 mg/m2) on day 1,
5-fluorouracil (700 mg/m2) on days 1-4 and external irradiation (200
cGy/day, total 30 Gy) on either days 8-26 (sequential schedule, n=15) or
days 1-19 (concurrent schedule, n022). Two courses of CRT were given.
The results of CRT were complete response in nine patients, partial
response in 19, no change in three (minor response in two), and
progressive disease in six patients. The median response duration in all
responders was 172 days (range: 56-2469, n=19). After CRT, 13 patients
received surgery. In 12 of these patients, tumors were completely
resected. Histopathologic examination of the resected specimen revealed
a discrepancy between clinical response and histopathologic effect. The
median duration of survival and the 1-, 2- and 5-year survival rates
were 304 days (84-3155), 45%, 35% and 23% in all patients, respectively,
866 days (190-3155), 83%, 83% and 57% in the 13 patients whose tumors
were resected, and 187 days (84--2630), 25%, 5% and 5% in the 24
patients whose tumors were not resected. Grade 3 toxicity, especially
hematological reactions, was noted in 13.5% (5/37) of the patients.
There was one toxicity-related death (sepsis). A good outcome may be
obtained with CRT, followed by surgery when feasible. However, CRT can
cause toxic reactions, and close monitoring of patients is required.
28
UI - 11869320
AU - Chan R; Morrill S; Freeman D Jr; Colman M; Zwischenberger J
TI -
Bi-modality (chemo-radiation) versus tri-modality (chemo-radiation
followed by surgery) treatment for carcinoma of the esophagus.
SO - Dis Esophagus 2001;14(3-4):202-7
AD - Department of Radiation Oncology, University of Texas Medical Branch at
Galveston, Galveston, TX 77555-0711, USA. rhchan@utmb.edu
The purpose of the study was to investigate the difference in overall
survival in patients with localized carcinoma of esophagus treated using
chemo-radiation (bi-modality, BM) or chemo-radiation followed by surgery
(tri-modality, TM). From 1981 to 1999, 65 patients were identified who
had localized carcinoma of the esophagus treated with either concurrent
chemo-radiation (BM, n=22) or concurrent chemo-radiation followed by
surgery (TM, n=43) at the University of Texas Medical Branch at
Galveston. All 65 patients received concurrent chemotherapy and external
beam radiation. Radiation was delivered by linear accelerators
(greater-than-or-equal 6 MV), except in one patient who had part of his
treatment given by a Co-60 machine. Chemotherapy consisted of
5-fluorouracil and cisplatin plus minus vinblastine under different
regimens. Median follow-up time was 10 months (range=1-195 months) for
all patients. Of the 14 patients still alive, the median follow-up time
was 32 months (range=2-192 months). No difference in overall survival
was detected between the two treatment groups, BM vs. TM (P=0.394)
despite a selection bias favoring the TM group. Five-year survival rates
of the BM and TM groups were 17% and 18%, respectively; 10-year survival
rates were 17% and 12%, respectively. The presence of significant past
medical history (P=0.017) and a complete pathologic response in the TM
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