Article

Prevention and management of early esophageal cancer.

University of California, 2340 Sutter Street, San Francisco, CA 94115, USA.
Current Treatment Options in Oncology (Impact Factor: 3.24). 11/2004; 5(5):405-16. DOI: 10.1007/s11864-004-0030-6
Source: PubMed

ABSTRACT Early esophageal cancer is defined by its limitation to the esophageal mucosa and submucosa. It has become a curable malignant disease, in sharp contrast to the dismal prognosis of esophageal cancer at advanced stages, which still represents the majority of patients. Understanding the risk factors, establishing surveillance programs for patients at risk, and developing preventative interventions such as dietary and lifestyle changes or pharmacologic interventions hold the potential of reducing the incidence of the disease and of shifting the stage distribution toward early cancer. Endoscopic ultrasound examination is pivotal for distinguishing early from advanced stages of the disease because it allows for accurate assessment of tumor infiltration and regional lymph node involvement. The therapeutic mainstay for early esophageal cancer remains surgery. New, less invasive surgical techniques are being tested that are associated with less morbidity and mortality than standard radical esophagectomies. For patients who are not candidates for surgery, definitive chemoradiation is a viable alternative. New endoscopic ablation techniques, such as endoscopic mucosa resection and photodynamic therapy, are potential alternatives to surgery in patients with cancers limited to the mucosa. For patients with adenocarcinoma of the gastroesophageal junction with submucosal involvement, adjuvant chemoradiation should be considered because of its potential to increase survival.

0 Followers
 · 
84 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: More studies are needed to clarify treatments and prognosis of early esophageal squamous cell carcinoma (ESCC). This retrospective study was designed to review the outcome of surgical treatment for early ESCC, evaluate the results of a left thoracotomy for selected patients with early ESCC, and identify factors affecting lymph node metastases and survival. The clinicopathological data of 228 patients with early ESCC who underwent transthoracic esophagectomy with lymphadenectomy without preoperative adjuvant treatment were reviewed. The χ2 test or Fisher's exact test were used to detect factors related to lymph node metastasis. Univariate and multivariate analyses were performed to identify prognostic factors. There were 152 males and 76 females with a median age of 55 years. Two hundred and eight patients underwent a left thoracotomy, and the remaining 20 patients with lymph nodes in the upper mediastinum more than 5 mm in short-axis diameter by computed tomography scan underwent a right thoracotomy. No lymph node metastasis was found in the 18 patients with carcinoma in situ, while lymph node metastases were detected in 1.6% (1/62) of patients with mucosal tumours and 18.2% (27/148) of patients with submucosal tumours. Only 7 patients showed upper mediastinal lymph node metastases in the follow-up. The 5- and 10-year overall survival rates were 81.4% and 70.1%, respectively. Only histologic grade (P<0.001) and pT category (P=0.001) significantly correlated with the presence of lymph node metastases. In multivariate analysis, only histologic grade (P=0.026) and pT category (P=0.008) were independent prognostic factors. A left thoracotomy is acceptable for selected patients with early ESCC. Histologic grade and pT category affected the presence of lymph node metastases and were independent prognostic factors for early ESCC.
    Asian Pacific journal of cancer prevention: APJCP 06/2013; 14(6):3825-30. DOI:10.7314/APJCP.2013.14.6.3825 · 1.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The members of the microRNA (miR)-17-92 cluster have been reported to be highly expressed in several cancers. However, whether their expression is associated with clinicopathologic factors, the prognosis of patients in esophageal squamous cell carcinoma (ESCC) remains unknown. Using SYBR green real-time quantitative reverse transcription polymerase chain reaction, we detected the expression of members of the miR-17-92 cluster, including miR-17, miR-18a, miR-19a, miR-20a, miR-19b, and miR-92a, in 105 surgical specimens from ESCC patients. We then investigated their impact on clinicopathologic factors and survival. All six members of the miR-17-92 cluster had a significantly higher level of expression in the 105 ESCC tissue specimens than in normal esophageal mucosa (p < 0.05). The miR-18a expression positively correlated with tumor stage (p = 0.025). Meanwhile, miR-92a expression positively correlated with clinical stage (p = 0.022), and miR-19b expression positively correlated with tumor size (p = 0.005), lymph node metastasis (p = 0.040), and clinical stage (p = 0.011). The overexpression of miR-17a was correlated positively with lymph node metastasis (p = 0.035) and clinical stage (p = 0.022). MiR-18a, miR-17, and miR-19a were prognostic indicators for progression-free survival and overall survival. both in univariate analysis and in multivariate analysis. This study suggests that miR-17, miR-18a, and miR-19a can serve as potential unfavorable prognostic biomarkers in ESCC which are associated with some clinicopathologic factors. However, the regulatory pathway associated with potential candidate miRNAs remains to be explored.
    The Annals of thoracic surgery 12/2013; 97(3). DOI:10.1016/j.athoracsur.2013.10.042 · 3.65 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Bile first attracted man's interest long ago. The actual tumour-promoting effects of a bile acid were reported in 1939 for deoxycholic acid. Ever since, much evidence has accumulated that supports an important role for bile acids as cancer promoters in humans through DNA damage and selection for apoptosis-resistant cells, both of which can lead to increased mutation rates. The evidence reviewed here indicates that, in humans, bile acids are likely to be implicated in the aetiology of a number of different important cancers in terms of morbidity and mortality, such as cancer of the colon, oesophagus, stomach, pancreas, gall bladder and cancer of the breast.
    International Journal of Food Sciences and Nutrition 07/2009; DOI:10.1080/09637480902970967 · 1.20 Impact Factor

Preview

Download
0 Downloads
Available from