National Cancer Institute®
Last Modified: January 1, 2002
UI - 11370494
AU - Rich T
TI - Chemoradiation in conservation therapy for esophageal cancer.
SO - Hematol Oncol Clin North Am 2001 Apr;15(2):291-302
AD - Department of Radiation Oncology, University of Virginia Health Science Center, Charlottesville, Virginia, USA.
Irradiation alone can be highly beneficial for patients with advanced or metastatic esophageal cancer, but external beam irradiation alone is now usually reserved for patients only requiring palliation. Higher cure rates are achieved with irradiation delivered with radiosensitizing chemotherapy based on clinical trials performed over the last decade. Chemoradiation programs based on the modest success with infusional 5-FU, cisplatin, and 50 Gy are justified for either palliative or curative treatment as long as the toxicity is acceptable. One challenge is to increase the incidence of pathologic complete response rates without incurring unacceptable acute toxicity, which is the major dose-limiting factor in current trials. Newer methods that may ameliorate acute injury are different dose schedules for chemoradiation and different methods of dose delivery. Infusional administration of chemotherapy and new dose planning and delivery systems for irradiation (conformal irradiation) are currently under study. Organ preservation for larger numbers of patients may be possible if any of these methods hold up to the early indications of success.
UI - 11407448
AU - Benazzo M; Bertino G; Lanza L; Occhini A; Mira E
TI - Voice restoration after circumferential pharyngolaryngectomy with free jejunum repair.
SO - Eur Arch Otorhinolaryngol 2001 May;258(4):173-6
AD - Clinica Otorinolaringoiatrica, Universita degli Studi di Pavia, IRCCS Policlinico S. Matteo, Italy.
Speech restoration after circumferential pharyngolaryngectomy with free jejunal repair for advanced tumors of the hypopharyngo-esophageal tract remains a difficult problem to solve. We report here the results of secondary voice restoration in six patients who received a Provox 2 type prosthesis and intensive speech therapy after circumferential pharyngolaryngectomy with free jejunum repair. No patient had operative or post-operative complications due to insertion of the prosthesis. No patient had to have the prosthesis removed during the follow-up (8 to 14 months). Analysis of some acoustic parameters of voice (fundamental frequency, waveform perturbations) and qualitative characteristics of speech (intelligibility, pleasantness and acceptability) demonstrated that all the patients were able to produce satisfactory speech after tracheojejunum puncture and speech therapy and were satisfied with their own ability to communicate. Our results are reassuring and we therefore advise that in patients undergoing free jejunum flap reconstruction of the hypopharyngo-esophageal tract voice restoration should be attempted by placing a voice prosthesis through a secondary tracheo-esophageal puncture and providing intensive speech training.
UI - 11434585
AU - Lambert R
TI - Barrett's oesophagus: better left alone?
SO - Eur J Gastroenterol Hepatol 2001 Jun;13(6):627-30
AD - International Agency for Research on Cancer, Lyon, France. email@example.com
The risk of oesophageal adenocarcinoma in patients with Barrett's oesophagus is overrated in most publications, including meta-analyses. The upper limit of the overall risk is currently estimated at 0.5 per 100 patients per year. This means that one cancer may occur out of 200 patients followed for one year. Furthermore, a large fraction of patients with Barrett's oesophagus have a precarious health status, either from advanced age or from a chronic severe disease. Management is based upon a careful index endoscopy; accordingly, patients positive for dysplasia must be strictly observed or treated. Endoscopic surveillance protocols aiming at early detection of neoplasia--and treatment--in patients without dysplasia are unjustified in most cases. On the other hand, a minority of male patients--providing a good performance status--should enter into surveillance protocols when high-risk factors such as a long history of reflux symptoms and smoking habits are present.
UI - 11434588
AU - Gudlaugsdottir S; van Blankenstein M; Dees J; Wilson JH
TI - A majority of patients with Barrett's oesophagus are unlikely to benefit from endoscopic cancer surveillance.
SO - Eur J Gastroenterol Hepatol 2001 Jun;13(6):639-45
AD - Department of Internal Medicine, University Hospital Rotterdam, The Netherlands. firstname.lastname@example.org
BACKGROUND: Endoscopic cancer surveillance has been advocated for patients with Barrett's oesophagus. However, only a small minority of patients dies from adenocarcinoma in Barrett's oesophagus. It has been calculated that endoscopic cancer surveillance will only add to the quality of life of individuals in whom the incidence of adenocarcinoma in Barrett's oesophagus is greater than 1/200 patient-years. OBJECTIVE: To determine the proportion of a consecutive cohort of patients, in whom Barrett's oesophagus was diagnosed over a 5-year period, likely to benefit from endoscopic cancer surveillance. METHODS: All patients who had died during the observation period or were over 75 years old and those with diseases likely to impair survival were excluded. Next, all patients in whom the risk of developing adenocarcinoma in Barrett's oesophagus fell below 1/200 patient-years were excluded (including all women, all men under the age of 60 and all men with Barrett's oesophagus of < 3 cm in length). Patients with dysplasia of any degree and/or presence of an ulcer or stricture in Barrett's oesophagus were reinstated. RESULTS: Of 335 adult patients diagnosed with Barrett's oesophagus but without adenocarcinoma or high-grade dysplasia, 75 had died from unrelated causes, 47 had other diseases limiting survival and 59 were over 75 years old. After exclusion of all women, all men with Barrett's oesophagus of < 3 cm in length and all men under 60 years old, 15 patients were left. However, 32 were reinstated because of risk factors and another five because of insufficient data, resulting in 52 of the original 335 patients (15.5%) being eligible for endoscopic cancer surveillance. CONCLUSION: This study suggests that less than 20% of patients identified with Barrett's oesophagus at routine endoscopy would benefit from endoscopic cancer surveillance. Prospective surveillance programmes should be limited to patients with an increased cancer risk and a good health profile.
UI - 11432622
AU - Petit T; Georges C; Jung GM; Borel C; Bronner G; Flesch H; Massard G;
TI - Velten M; Haegele P; Schraub S Systematic esophageal endoscopy screening in patients previously treated for head and neck squamous-cell carcinoma.
SO - Ann Oncol 2001 May;12(5):643-6
AD - Department of Medical Oncology, Centre de Lutte Contre le Cancer Paul Strauss, Strasbourg, France. email@example.com
BACKGROUND: An attempt was made to improve metachronous oesophageal cancer prognosis through bi-annual systematic esophageal endoscopy screening in patients treated for head and neck cancer. PATIENTS AND METHODS: Bi-annual esophageal endoscopy, without a staining procedure, was performed in 1560 patients from 1987 to 1997. The distribution of previous head and neck cancer was oral cavity (20%), oropharynx (30%), hypopharynx (34%), and larynx (16%). All patients had initial panendoscopic inspection before HNSCC treatment. Esophageal tumors were considered to be second synchronous primaries when discovered within the first six months of initial tumor diagnosis. RESULTS: Fifty metachronous esophageal asymptomatic cancers (42 T1 and 7 in situ carcinomas) were diagnosed by endoscopy. The median time between the HNC and the esophageal carcinoma was 43 months (7-137 months). Metachronous esophageal carcinoma was discovered in 2.6% of patients with oral cavity tumor, 5.7% of patients with oropharynx tumor, 2.3% of patients with hypopharynx tumor, and 1.7% of patients with larynx tumor. Causes of death were: 41.1% related to esophageal tumor with tumor progression, metastatic evolution, or treatment toxicity; 28.9% related to non malignant causes; 26.6% related to a cancer that was not of esophageal origin. CONCLUSIONS: Over a 10-year period, systematic bi-annual esophageal endoscopy uncovered metachronous esophageal tumors in 3.2% of 1560 patients originally treated for head and neck carcinoma, developing in a median time of 47 months. Patients with initial oropharyngeal tumors had a significantly higher risk of metachronous esophageal SCC, compared to the other tumor sites (P < 0.02 with Fisher exact test). Given the elevated death rate not related to the esophageal cancer and the median survival of 16 months, any potential benefit from this time-consuming procedure is debatable.
UI - 11467379
AU - Ampil FL; Caldito G; Li BD; Pelser R
TI - Computed tomographic staging of esophageal cancer and prognosis.
SO - Radiat Med 2001 May-Jun;19(3):127-9
AD - Department of Radiology, Louisiana State University Health Sciences Center, Shreveport 71130, USA.
The purpose of this retrospective study was to examine whether computed tomography (CT)-determined staging of esophageal cancer (EC) has prognostic correlation. The results showed a strong relevance of staging of EC by CT to survival (p<0.01).
UI - 11473332
AU - McManus K; Khan I; McGuigan J
TI - Self-expanding oesophageal stents: strategies for re-intervention.
SO - Endoscopy 2001 Jul;33(7):601-4
AD - Department of Thoracic Surgery, Royal Victoria Hospital, Belfast, Northern Ireland, UK. firstname.lastname@example.org
BACKGROUND AND STUDY AIMS: Self-expanding metal stents have become accepted palliation for inoperable malignant oesophageal obstruction, the cost of the devices being offset against the ease of insertion and the reduced complication rate. However, re-intervention is often required for obstruction, malposition, migration and tumour progression. The marginal cost of re-stenting is generally higher than other modalities. This study aims to determine the rate of re-intervention and the effectiveness of the various intervention modalities. PATIENTS AND METHODS: A population of 165 patients, treated in a tertiary referral oesophageal centre, (132 with oesophageal cancer, 31 with mediastinal metastases from other tumours, two with benign conditions) whose initial re-interventions were required in 44 patients and were successful in 51 (68%). Rigid oesophagoscopy and removal of food bolus was successful in three out of three, dilation in one of 11, rigid oesophagoscopy and physical debridement in 12 of 17 and laser debridement in 12 of 20. Re-stenting was the primary re-intervention in 10 cases and was ultimately necessary in 14 patients (with 11 self-expanding metal stents, three Celestin) who had previously undergone other forms of re-intervention. It was not successful in one case. The median survival following first re-intervention was 9.8 weeks (compared with 14.3 weeks for initial stenting) and was longer in those receiving radiotherapy (23.6 weeks) or chemotherapy (14.4 weeks). CONCLUSIONS: While repeated stenting is usually successful, debridement and laser vaporization are viable alternatives for proximal tumour overgrowth or ingrowth in the upper or middle third of the oesophagus. Distal tumour growth or ingrowth at the oesophagogastric junction are best treated with a second stent. Repeated treatment is justified, as survival following first re-intervention is comparable to that after initial stenting, particularly in those patients who are able to undergo chemotherapy or radiotherapy.
UI - 11495153
AU - Shimada H; Okazumi S; Takeda A; Nabeya Y; Matsubara H; Funami Y; Hayashi
TI - H; Gunji Y; Suzuki T; Ochiai T Presence of serum p53 antibodies is associated with decreased in vitro chemosensitivity in patients with esophageal cancer.
SO - Surg Today 2001;31(7):591-6
AD - Department of Academic Surgery, Chiba University Graduate School of Medicine, Japan.
Resistance to chemotherapy remains a serious problem inhibiting the successful treatment of advanced esophageal cancer. A number of studies have revealed that p53 genetic alteration and protein overexpression can predict chemosensitivity. Furthermore, p53 protein overexpression in cancer tissues has been found to induce serum p53 antibodies (p53-Abs). This study was conducted to examine whether analysis of serum p53 Abs could predict the chemosensitivity of esophageal cancer. Serum analysis of p53 antibodies was performed by enzyme-linked immunosorbent assay in 19 patients with esophageal squamous cell carcinoma preoperatively, then surgically resected specimens were stained immunohistochemically for p53 protein expression. Tumor tissues were also analyzed for chemosensitivity by the histoculture drug response assay (HDRA) using cis-dichlorodiammineplatinum(II) (CDDP), 5-fluorouracil (5-FU), and adriamycin (ADM). Serum p53-Abs were present in 47% (9/19) of the patients and immunohistochemical analysis revealed overexpression of p53 protein in 42% (8/19) of the tumors. The presence of serum p53 antibodies was significantly correlated with p53 immunoreactivity (P = 0.005). The inhibition index of patients positive for p53-Abs was significantly lower than that of patients negative for p53-Abs (P < 0.001). This tendency was also observed in the inhibition index to 5-FU. The presence of serum p53-Abs was associated with decreased in vitro chemosensitivity to CDDP and 5-FU. Thus, the detection of serum p53-Abs is suggested to be useful for predicting chemosensitivity in patients with esophageal cancer.
UI - 11472311
AU - Souza RF; Morales CP; Spechler SJ
TI - Review article: a conceptual approach to understanding the molecular mechanisms of cancer development in Barrett's oesophagus.
SO - Aliment Pharmacol Ther 2001 Aug;15(8):1087-100
AD - Harold C. Simmons Comprehensive Cancer Center, University of Texas-Southwestern Medical Center at Dallas, Texas, USA. email@example.com
Oesophageal adenocarcinoma is one of the most deadly human malignancies. Gastro-oesophageal reflux disease (GERD) has been established as a strong risk factor for oesophageal adenocarcinoma, and more than 40% of adult Americans experience regular GERD symptoms. GERD can be complicated by oesophagitis, and by replacement of oesophageal squamous mucosa with metaplastic, intestinal-type epithelium (Barrett's oesophagus) that is predisposed to malignancy. Cancers in Barrett's oesophagus arise through a sequence of genetic alterations which endow unlimited proliferative capacity upon the cells by affecting components of the cell cycle clock apparatus-the pivotal molecular machinery in the cell nucleus that controls whether a cell will proliferate, differentiate, become quiescent or die. This report describes how the genetic abnormalities that have been recognized in Barrett's oesophagus might promote carcinogenesis through effects on the cell cycle clock machinery. The goal of this review is to provide the clinician with a useful conceptual basis for evaluating studies on the molecular mechanisms underlying the progression from metaplasia to carcinoma in Barrett's oesophagus.
UI - 11490788
AU - Naritaka Y; Ogawa K; Shimakawa T; Wagatsuma Y; Katsube T; Kajiwara T;
TI - Aiba M Study on endoscopic esophageal mucosal resection with ligating device. I--Clinical study.
SO - Hepatogastroenterology 2001 Jul-Aug;48(40):1015-7
AD - Department of Surgery, Tokyo Women's Medical University, Daini Hospital, 2-1-10 Nishiogu Arakawa-ku, Tokyo 116-8567, Japan. firstname.lastname@example.org
BACKGROUND/AIMS: EEMRL (endoscopic esophageal mucosal resection with a ligating device) has become increasingly popular. In this article, we review 13 clinical cases of EEMRL. METHODOLOGY: Since 1993, we have performed EEMRL to treat 15 lesions in 13 patients. Twelve squamous cell carcinomas (mucosal cancer in 10 and submucosal cancer in 2) were included among the 15 lesions. RESULTS: EEMRL failed to achieve complete resection of the 2 submucosal lesions (3.0 and 2.8 cm in maximum diameter). However, esophageal lesions could be removed successfully when 2.5 cm or less in maximum diameter. The procedure was not associated with any complication. CONCLUSIONS: Our clinical study showed that this technique may be indicated for esophageal cancer with a maximum diameter < or = 2.5 cm and confined to the mucosa. EEMRL is a technically easy and minimally invasive therapy which could be useful for the treatment of early esophageal cancer.
UI - 11527287
AU - Brierley J; Wong CS; Cummings B; Catton P; Ringash J; Catton C; McLean
TI - M; Keane T; Panzarella T Squamous cell carcinoma of the oesophagus treated with radiation and 5-fluorouracil, with and without mitomycin C.
SO - Clin Oncol (R Coll Radiol) 2001;13(3):157-63
AD - Princess Margaret Hospital/Ontario Cancer Institute, Toronto, Canada. email@example.com
A retrospective analysis was performed of patients with squamous cell carcinoma of the oesophagus without evidence of distant metastases, who were treated with radical intent. Between 1981 and 1984, and 1989 and 1991, 98 patients were treated with radiation, 5-fluorouracil (5-FU) and mitomycin C; and between 1984 and 1989, 133 patients were treated with radiation and 5-FU without mitomycin C. Actuarial survival and local control were assessed, and prognostic factors were identified for both endpoints. The standard dose of radiation prescribed was 52 Gy to the 95% isodose in 20 fractions over 4 weeks. 5-FU was given by continuous infusion as 1 g/m2 (maximum 1.5 g)/day, for 4 days. Patients who received mitomycin C were given 10 mg/m2 (maximum 18 mg) on day 1. Survival and local relapse-free rates were estimated using the method of Kaplan and Meier, and the Cox proportional hazards model was used to evaluate possible prognostic factors, including the effect of mitomycin C administration. The median survival was 15.4 months (95% confidence interval 12.7-17.2) with 31% 2-year survival (standard error (SE) 3%), and 13% 5-year survival (SE 2%). In the multivariate analysis, lower radiation dose and younger age were the only statistically significant prognostic factors for reduced overall survival and reduced relapse-free rate respectively. There was no difference in survival (chi(2) = 0.07, 1 degree of freedom (df), P=0.79) or local relapse-free rate (chi2 = 0.39, 1 df, P = 0.53) between patients treated with or without mitomycin C. The treatment was well tolerated. Further studies are required to determine the most effective combination of radiation and chemotherapy or other radiation sensitizers for squamous cell carcinoma of the oesophagus.
UI - 11527288
AU - Archer VR; Mulholland PJ; Stocken DD; Darnton SJ; Ferry DR
TI - Combined results from three phase II trials of neoadjuvant chemotherapy in operable adenocarcinoma of the oesophagus.
SO - Clin Oncol (R Coll Radiol) 2001;13(3):164-9
AD - Queen Elizabeth Hospital, University of Birmingham, UK.
Adenocarcinoma of the oesophagus is a systemic disease at presentation in the majority of patients. This article analyses the impact of preoperative chemotherapy on a cohort of 68 patients. From 1990 to 1996, 68 patients with potentially operable adenocarcinoma of the oesophagus were entered into three sequential Phase II trials of neoadjuvant chemotherapy with cisplatin/mitomycin C/ifosfamide, cisplatin/5-fluorouracil (5-FU) and mitomycin C/cisplatin/5-FU. Twenty-four (35%) patients had a radiological (4 complete; 20 partial) response to chemotherapy, and 52 (76%) went on to have the primary tumour resected. There was only one pathological complete responder. The overall median survival was 13 months (95% confidence interval (CI) 9-16). Survival for the 28 N(0) patients was 34 months (95% CI 14-60). The pattern of failure for resected patients was predominantly systemic (16/17). These results indicate that neoadjuvant chemotherapy followed by surgery for adenocarcinoma of the oesophagus achieves excellent local control. The dominance, however, of distant recurrence after surgery underlines the fact that, in the majority of patients, the only hope of improving results in the future is to develop better systemic therapies.
UI - 11508622
AU - Matsumoto M; Natsugoe S; Nakashima S; Okumura H; Sakita H; Baba M; Takao
TI - S; Aikou T Clinical significance and prognostic value of apoptosis related proteins in superficial esophageal squamous cell carcinoma.
SO - Ann Surg Oncol 2001 Aug;8(7):598-604
AD - The First Department of Surgery, Kagoshima University School of Medicine, Japan.
BACKGROUND: The purpose of the present study was to examine the expression of cell cycle regulators [p53, p21WAF1/CIP1 (p21), and Rb] and apoptosis related proteins Bax and Bcl-X(L) and to evaluate the relationship between their expressions and clinicopathological findings in patients with superficial squamous cell carcinomas of the esophagus. METHODS: We immunohistochemically investigated the expression of p53, p21, Rb, Bax, and Bcl-X(L) in 79 patients with superficial esophageal carcinoma. RESULTS: p21 overexpression was found in mucosal carcinoma (P = 0.05) and a high Bcl-X(L) score was observed for submucosal carcinoma (P = 0.03). The patients with high Bcl-X(L) score had more frequent lymphatic invasion and lymph node metastasis than did those with low Bcl-X(L) score (P < 0.05). Univariate analysis revealed significantly shorter survival in patients with high Bcl-X(L) expression than in those with low Bcl-X(L) expression, but Bcl-X(L) expression was not identified as an independent prognostic factor by multivariate analysis. CONCLUSIONS: Because Bcl-X(L) expression correlated well with depth of tumor invasion, lymphatic invasion, and lymph node metastasis, examination of Bcl-X(L) expression will help to estimate the properties in superficial squamous cell carcinoma of the esophagus.
UI - 11509124
AU - Furuta M; Tsukiyama I; Kano Y
TI - Simultaneous intraluminal thermobrachytherapy: an in vitro study.
SO - Jpn J Cancer Res 2001 Aug;92(8):904-9
AD - Division of Radiation Therapy, Tochigi Cancer Center, Utsunomiya 320-0834, Japan. firstname.lastname@example.org
A multi-institutional study on simultaneous intraluminal thermobrachytherapy (SITB) for advanced esophageal cancer was conducted in Japan. In this study, brachytherapy was administered by a small radioactive source stepping through a catheter in the esophagus, and hyperthermia was also applied by an endoesophageal coil. However, experimental or clinical findings on the spatial distribution of its antitumor effects around the esophagus are not available. Therefore, we developed an in vitro model of SITB using a high-dose-rate iridium-192 stepping source and two human cancer cell lines (WiDr and A549), and determined the spatial distribution of the antitumor effects. According to this model, the antitumor effects steeply decreased as the source-cell distance increased when cells of both cell lines were irradiated with 5 Gy without heat. When WiDr cells, a more resistant cell line to radiation and heat, were simultaneously irradiated and heated for 30 min at 44 degrees C, the effects decreased much less steeply as the distance increased. For A549 cells, a more sensitive cell line, irradiation with hyperthermia even at 42 degrees C made the decrease in the effects smaller. The largest antitumor effects can be expected at 5 - 10 mm beneath the esophageal mucosa, where the endoesophageal coil can heat tissues most effectively. SITB can induce larger antitumor effects than brachytherapy alone, especially in submucosal disease, which would favor treatment of advanced cancer.
UI - 11521977
AU - van Rees BP; Ristimaki A
TI - Cyclooxygenase-2 in carcinogenesis of the gastrointestinal tract.
SO - Scand J Gastroenterol 2001 Sep;36(9):897-903
AD - Dept. of Pathology, Academic Medical Center, Amsterdam, The Netherlands.
UI - 11525596
AU - Terry P; Lagergren J; Wolk A; Nyren O
TI - Reflux-inducing dietary factors and risk of adenocarcinoma of the esophagus and gastric cardia.
SO - Nutr Cancer 2000;38(2):186-91
AD - Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. email@example.com
Gastroesophageal reflux (GER) is the strongest known risk factor for esophageal adenocarcinoma. For long-term sufferers with severe symptoms, the excess risk may exceed 40-fold. GER has also been shown to increase the risk of cancers of the gastric cardia more than fourfold. Several foods, including dietary fat, chocolate, mints, coffee, onions, citrus fruit, and tomatoes, have been associated with temporary symptoms of reflux, most likely through a relaxation of the lower esophageal sphincter (LES). Our aim was to determine whether these foods are associated with risk of adenocarcinoma of the esophagus or gastric cardia. We studied intakes of LES-relaxing foods and other dietary habits potentially associated with reflux in a nationwide population-based case-control study in Sweden, with 185 and 258 cases of esophageal adenocarcinoma and gastric cardia adenocarcinoma, respectively, and 815 controls. We found no association between LES-relaxing foods and symptoms of chronic reflux, although this might be due to avoidance of these foods among sufferers. In addition, we found no association between dietary factors known to cause LES relaxation and the risk of adenocarcinoma of the esophagus or gastric cardia. Our findings indicate that dietary factors associated with LES relaxation and transient GER (but perhaps not severe chronic reflux) are not associated with any important risk of esophageal malignancy.
UI - 11550278
AU - Yasui K; Imoto I; Fukuda Y; Pimkhaokham A; Yang ZQ; Naruto T; Shimada Y;
TI - Nakamura Y; Inazawa J Identification of target genes within an amplicon at 14q12-q13 in esophageal squamous cell carcinoma.
SO - Genes Chromosomes Cancer 2001 Oct;32(2):112-8
AD - Department of Molecular Cytogenetics, Medical Research Institute, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
Comparative genomic hybridization studies have revealed frequent amplification of the 14q12-q13 region in esophageal squamous cell carcinoma (ESC) cell lines. To identify genes targeted for amplification, we first defined the minimal common region of amplification using fluorescence in situ hybridization in affected ESC cell lines. The amplicon covered about 6 Mb, between markers D14S1034 and L18528. Then we screened 32 ESC cell lines to discern amplifications and expression levels of 26 expressed sequence tags (ESTs) that had been localized to the amplified region. Five known genes (BAZ1A, SRP54, NFKBIA, MBIP, and HNF3A) and two uncharacterized ESTs (GenBank Accession numbers AA991861 and AA167732) within the amplicon showed amplification and consequent overexpression. Two of these transcripts were amplified in three of the primary ESCs we examined. Our findings suggest that these seven genes are candidate targets of the amplification mechanism and therefore may be associated, together or separately, with development and progression of ESC. Copyright 2001 Wiley-Liss, Inc.
UI - 11553219
AU - Udagawa H; Akiyama H
TI - Surgical treatment of esophageal cancer: Tokyo experience of the three-field technique.
SO - Dis Esophagus 2001;14(2):110-4
AD - Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan. firstname.lastname@example.org
Esophageal cancer can metastasize to the lymph nodes at a very early stage of the disease, and spread occurs both upwards and downwards. We have developed the 'three-field lymphadenectomy' (3-FD) technique, in which more than 100 lymph nodes are completely dissected from the lower neck, mediastinum, and upper abdomen. More than 700 patients have undergone 3-FD since 1984. Three-field lymphadenectomy is associated with considerable morbidity, although efforts have been made to reduce this by preserving tracheobronchial circulation and innervation. The