جستجوی مقالات مرتبط با کلیدواژه « Esophageal Cancer » در نشریات گروه « پزشکی »

The therapeutic potential of Quercus infectoria (QI) gall, including its anti-inflammatory, antioxidant, and anticancer properties, is well-known. However, its impact on lung, gastric, and esophageal cancer cells remain unclear. This study aims to explore the effects of QI gall aqueous extract on cell viability, apoptosis, and gene expression in A549, BGC823, and KYSE-30 cell lines.

A549, BGC823, and KYSE-30 cells were seeded in complete medium and incubated with different concentrations of QI gall extract for 24 hours. Cell viability was measured by an MTT [3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide] assay. The induction of apoptosis was assessed through flow cytometric analysis after the adding FITC-conjugated Annexin V (Annexin V-FITC) and propidium iodide (PI). The mRNA expression levels of CCND1, TP53, BCL2, and BAX genes were determined using Real-time Quantitative Polymerase Chain Reaction analysis.

The MTT assay demonstrated that treatment with QI gall extract significantly reduced the number of viable cells in the A549, BGC823, and KYSE-30 cell lines at IC50 concentrations of 440.1, 437.1, and 465.2 mg/ml, respectively. Additionally, compared to untreated cell population, the percentages of early apoptosis, late apoptosis, and necrosis in the A549, BGC823, and KYSE-30 cells significantly increased following treatment with QI gall extract (P< 0.05). Also, the treatment with QI gall extract influenced the expression of CCND1, TP53, BCL2, and BAX genes.

The present findings indicated that the gall extract of QI can inhibit the growth of A549, BGC823, and KYSE-30 cells by inducing apoptosis, which may be mediated via mitochondria‑dependent pathway.

This paper aimed to investigate the radiation dosimetry and dose deposition to the surrounded organs at risk (OARs) with different radial and longitudinal margins based on the normal tissue complication probability (NTCP) and dose-volume histogram (DVH) methods.

Fifteen patients with histologically diagnosed esophageal cancer were retrospectively selected. From the clinical target volume (CTV), eight planning target volumes (PTV) were expanded for each patient, with one group of four radial margins (3mm, 5mm, 7mm, 10mm) and the other group of four longitudinal margins (3mm, 5mm, 7mm, 10mm). Then, eight plans with the prescription dose of 50.4Gy were designed in the tomotherapy system. Within each group, doses for the OARs and NTCP-based risk of pneumonitis and pericardial disease were compared.

Almost all the dose parameters in both groups, except for the Dmax (maximum dose) of the spinal cord in the longitudinal direction, showed significant linearly increasing trends with the expansion of margins. For same dose parameters, the increased slopes in the radial direction were larger than those in the longitudinal. Heart V30Gy (the percent volume of receiving 30Gy) grew fastest compared to other clinical constraint indexes in both groups, and the most significant difference in the risk of pneumonitis was observed in the radial group when the margin was expanded from 3 to 10mm.

In order to lower the likelihood of radiation-related toxicity, radial margin expansion should be more strictly controlled in the radiotherapy of esophageal cancer with tomotherapy.

We aim to present incidence rates and geographical distribution of most common early-onset gastrointestinal cancers (EOGICs), including early-onset esophageal cancer (EOEC), gastric cancer (EOGC) and colorectal cancer (EOCRC) in Iran, 2014- 2018.

Data on new cases of EOEC, EOGC and EOCRC were obtained from publicly available annual reports of the Iranian National Population-based Cancer Registry (INPCR). Incidence rates were calculated using the population data available from the Statistical center of Iran. We considered the World standard population for calculation of age-standardized incidence rates (ASR). We also calculated 95% confidence intervals (CIs) for ASR. All rates are presented per 100 000 person-years.

Overall, 19,679 new cases of EOGIC were registered by the INPCR between 2014 and 2018. The ASRs (95% CI) of EOEC, EOGC and EOCRC were 0.49 (95% CI: 0.47–0.51), 1.67 (1.63–1.71), and 3.07 (3.01–3.13) per 100,000 person-years, respectively. Our findings indicate decreasing and constant trends in the ASR of EOEC and EOGC during the study period, 2014-2018. There was an increasing trend in the ASR of EOCRC. We also found geographical disparities in the incidence rates of EOGICs across provinces of Iran, suggesting the highest ASRs of EOEC in Golestan (1.3), EOGC in Ilam (2.99) and EOCRC in Ilam (4.49).

Our findings suggested that the incidence rate of EOCRC is consistently increasing. We also found variations in the incidence of EOGICs among different provinces. Further investigations are recommended to clarify the time trends and risk factors of EOGICs in Iran.

Splenosis occurs as a result of autotransplantation of splenic tissue following splenic injury or splenectomy. A 56-year-old man with esophageal cancer underwent thoracoscopic-assisted subtotal esophagectomy accompanied by three-field lymph node dissection, and retrosternal gastric tube reconstruction. The spleen was injured during the surgery and was removed. A retrosternal nodule of 12 mm in diameter was detected near the reconstructed gastric tube on computed tomography (CT) performed 3 years and 6 months postoperatively.Retrospectively, the nodule was observed in the same area on early postoperative CT and gradually increased in size. No accessory spleen was identified on the preoperative CT. Splenosis was suspected, and 99mTc-Sn-colloid single photon emission computed tomography (SPECT)/CT was performed. It revealed intense uptake in the retrosternal nodule, consistent with the diagnosis of thoracic splenosis. Subsequently, the patient has been under observation without treatment. 99mTc-labeled colloid SPECT/CT allowed confident diagnosis of thoracic splenosis following esophageal cancer surgery. This examination is considered valuable for the evaluation of ectopic splenic tissue.

One of the top causes of cancer-related deaths globally is esophageal cancer. In investigations of cell toxicity, the MTT test is one of the most often used cell viability/cytotoxicity assays for cellular metabolic activity. Nowadays, lactobacilli with probiotic effectiveness are now acknowledged as a prophylactic agent against cancer. The anti-tumor product of these bacteria have been designated in numerous studies. This investigation examined the probiotic Lactobacillus casei's in vivo impact on esophageal cancer. The MTT technique was used in this work to evaluate the cytotoxicity of L. casei (supernatant and full cell culture) to 5fu on the cancer cell line Kyse30. L. casei was able to decrease cell survival in supernatant and full cell culture (Kyse30). The possible impact of L. casei, particularly their supernatant, on esophageal cancer was initially evaluated in this research. As a result, lactobacilli species show promise for future research and development as cancer treatments.

Esophageal cancer is a research priority due to its invasive nature and poor prognosis. It ranks sixth in mortality among all forms of cancer and esophagectomy is the most conventional treatment. Jejunostomy tube feeding can reduce complications in patients and hospital costs. This study aimed to evaluate the cost-effectiveness of jejunostomy tube feeding, as opposed to the common nutritional method.

A retrospective case-control study was conducted at a teaching hospital in Iran in 2015. The sample of the study included 100 candidates for esophagectomy. In the case group (enteral), a Jejunostomy tube was inserted for 50 patients undergoing esophagectomy. The control group (parenteral) consisted of 50 patients undergoing esophagectomy without jejunostomy tube.  

The median oral intake was on the third day in the case group, with a shorter hospital stay (P=0.02) compared to the control group. The mean total costs of hospitalization per patient in the case group and in the control group were 2228 and 3666 US dollars, respectively. The cost-effectiveness ratio of the jejunostomy tube against the common nutritional method was about 40 US dollars per day of the median decrease in oral intake.  

According to our findings, jejunostomy tube is cost-effective and preferable to the common nutritional method with a decreased median of oral intake start day, a decreased span of hospitalization, fewer complications in the nutritional support of the patients undergoing esophagectomy, and finally, more comfort for patients. The decrease in the average length of stay in hospitals is also important from the point of view of policymaking. So, this method can be a cost-effective alternative to the common nutritional method.

We aimed to report demographic features, tumor characteristics, and survival outcomes of the patients with esophageal cancer (EC) in the Eastern Anatolian Region of Turkey, where upper gastrointestinal tumors are endemic.

Our retrospective investigation was performed on patients with EC treated in Erzurum Regional Training and Research Hospital Clinics of Medical and Radiation Oncology between 2005 and 2017. The patients with stage IIA-IV disease and completed at least one treatment modality (surgery/ definitive chemoradiotherapy(CRT)/palliative chemotherapy(CT) or radiotherapy(RT)) had enrolled in the study. The demographic and clinicopathological characteristics, TNM stage, oncological treatment modalities applied, and survival outcomes were statistically analyzed.

Our study consisted of 251(women, 57.4%) patients with EC with a female/male ratio of 1.34/1. The median age of the patients was determined as 62 years. The primary tumor was frequently localized in the middle(46.6%) and lower(46.2%) part of the esophagus, and the majority had squamous cell carcinoma histopathological subtype(86.1%). The median follow-up period and overall survival (OS) time were 21.2 and 19.0 months, respectively. A five-year OS rate was detected as 19.3%. As a result of multivariate analysis; grade, stage and concurrent CRT were determined as independent prognostic factors (p=0.004, p=0.019, and p=0.014, respectively). The median OS of stage II-III and IV patients were 25.79 versus 10.02 months (p<0.001). Among stage II-III patients, the best median OS was in the surgery+ adjuvan RT/CRT group(37.02 months). In stage IV patients, the median OS of female patients was found to be statistically significantly higher than that of males(15.77 versus 9.29 months p=0.007).

EC is a significant health problem in the Eastern Anatolian Region of Turkey. Differences were detected according to age and gender, tumor characteristics, histological subtype, and disease stage rates in patients with EC living in this region, but the survival rate was similar with the literture. Surgery+ adjuvant RT/CRT provided better OS in the non-metastatic patients than other treatment modalities.

Esophageal cancer is an invasive tumor with rapid growth and a poor prognosis. The annual incidence of esophageal cancer in the United States is 6 per 100 000 men and 1.6 per 100 000 women. This is different in the case of Iran, and the number of patients in the country is higher than in other countries. In this evaluation, the researchers present the experience with open Transhiatal Esophagectomy (Orringer) technique outcomes.

This study aimed at evaluating the Orringer technique and its complications in patients with esophageal cancer for 25 years at the Cancer Research Center of Shahid Beheshti University of Medical Sciences.

This is a descriptive study conducted from the beginning of 1988 to 2016. In this study, 114 patients with a mean age of 55 years and a gender classification of 60% male and 40% female were evaluated.

After resection, more than 98% of patients were in the T3 N1 - N3 stage. There were 4 mortalities: 2 were due to descending aorta tearing, 1 was due to tracheobronchial tearing, and 1 was pneumonia From 40 cases of pleural effusion, only 5 cases (12.5%) needed a thoracotomy tube. Only 2 patients needed intervention from 30 patients with dysphagia; 1 case was relieved by balloon dilatation and the other needed a free jejunal flap. Five-year survivals were 30% and 20% versus 48% and 23% in the neoadjuvant and non-neoadjuvant groups, respectively.

The present studyandother experiencesshowedthat non-radical surgery such as the Orringer technique is acceptable and compassable compared to radical surgery in 3 fields.

Esophageal cancer is one of the main causes of cancer mortality in the world. Golestan province, in the northern part of Iran, has the highest esophageal cancer rate in the world. The north and south districts of Golestan province can be classified as low and high-risk areas for esophageal cancer. One of the potential risk factors for esophageal cancer in this population is a nutrientdeficient diet. Dietary antioxidant compounds such as selenium, vitamin E, vitamin A, and β-carotene are reactive oxygen species (ROC) scavengers that play a key role in cellular responses to oxidative stress and preventing DNA damage. This study aims to compare the serum levels of selenium, vitamin E, and vitamin A in healthy individuals in high and low-risk areas of esophageal cancer.

This study is a population of 242 healthy individuals. Serum selenium levels were assessed by atomic absorption spectroscopy. Vitamin E and A were assessed by reversed-phase high-performance liquid chromatography.

Vitamin E levels of healthy individuals in high-risk areas were significantly lower than in low-risk areas, while there was no significant difference between the selenium and vitamin A levels of healthy individuals in high-risk areas and low-risk areas. Also, there was no significant difference between selenium, vitamin E, and vitamin A levels in urban and rural areas and men and women in Golestan province.

High levels of selenium with lower levels of vitamin E, along with other risk factors, may be associated with esophageal squamous cell carcinoma in highrisk areas of Golestan province.

The Herat province of Afghanistan is located on the Asian Esophageal Cancer Belt (AECB), a wide area in Central and Eastern Asia where very high rates of esophageal cancer (EC) have been observed. Several risk factors have been reported in the AECB Region by previous studies. Considering lack of information in Afghanistan on this issue, a study was conducted to determine the major risk factors related to EC in order to guide protective measures.

A population-based case-control study was performed from July 2015 to August 2016 among 657 EC patients in the Herat Province and 180 histopathological confirmed cases and 189 controls were interviewed. A structured questionnaire was used and face-to-face interviews were conducted.

Low body mass index (BMI), low socio-economic status, family history of EC, consumption of dark tea, very hot beverage and qulurtoroosh were found to be statistically significant for EC and esophageal squamous cell carcinoma (ESCC) in univariate analyses. According to multivariate analyses, sex (OR=2.268; 95% CI=1.238–4.153), very hot beverages (OR=2.253; 95% CI=1.271– 3.996), qulurtoroosh (OR=5.679; 95% CI=1.787–18.815), dark tea (OR=2.757; 95% CI=1.531–4.967), high previous BMI (OR=0.215; 95% CI=0.117–0.431) and low socio-economic status (OR=1.783; 95% CI=1.007–3.177) were associated with ESCC. Being male was found to increase the risk of ESCC with OR=2.268 (95% CI=1.238–4.153).

Consuming very hot beverages dark tea and a local food, qulurtoroosh, were found as important risk factors for EC. Our findings warrant further studies and necessitate the implementation of protective measures for EC which is one of the leading cancers in the region.

 Flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) scan is employed for initial staging and restaging of esophageal cancer patients.

 The present study aimed to assess the value of a semi-quantitative parameter of 18F-FDG PET/CT scan, that is, maximum standardized uptake value (SUVmax), to determine its correlation with patient survival in two subtypes of esophageal cancer, including squamous cell carcinoma (SCC) and adenocarcinoma.

 This cross-sectional study was performed on patients with esophageal SCC and adenocarcinoma, undergoing 18F-FDG PET/CT scan for initial staging before any treatment. The 18F-FDG PET/CT semi-quantitative parameter (SUVmax) was determined by reviewing the PET/CT images. The patients were reevaluated using 18F-FDG PET/CT scan for restaging within 12 - 24 months.

 No significant difference was observed in the SUVmax values of the primary tumor, metastatic lymph nodes, or distant metastasis between the adenocarcinoma and SCC groups, regardless of response to treatment. Similarly, no significant association was found between the short-term survival of patients with adenocarcinoma and the SUVmax values of the primary tumor, metastatic lymph nodes, or distant metastasis. Based on the survival curve, one- and two-year survival rates were estimated at 75% and 63.9% in patients with SCC and at 80% and 60% in patients with adenocarcinoma, respectively. In the SCC group, a significantly higher SUVmax was detected in deceased patients with distant metastatic lesions compared to cancer survivors. According to the area under the ROC curve, the SUVmax of metastatic lesions showed high potential for predicting the mortality of SCC patients.

 The assessment of SUVmax in distant metastatic lesions by 18F-FDG-PET/CT may help predict the survival of patients with esophageal SCC. However, 18F-FDG-PET/CT findings were not associated with the survival of esophageal adenocarcinoma; therefore, further evaluations on a larger sample size and a longer follow-up are required.

The incidence of malignant esophageal-respiratory fistulas in esophageal cancer patients is not so frequent. Development of fistula in esophageal cancer may be due to advanced disease or may be a radiotherapy related complication. Rarely, pulmonary abscess may develop and it is the most dreadful complication resulting in dismal outcomes. Here, we reported 2-cases of esophageal-respiratory fistula; one with esophageal bronchial fistula and other with esophageal pleural fistula.

Case reports: 

A 46-year-aged man presented with complaints of difficulty in swallowing from 4-months. CECT chest showed an esophageal growth of 8.5 cm in lower esophagus. Patient received palliative radiotherapy followed by palliative chemotherapy and showed some improvement in dysphagia. After 9–months from start of treatment, patient’s dysphagia began to worsen and he was put on oral metronomic chemotherapy. After 1-year of metronomic chemotherapy, patient developed cough and chest pain and was diagnosed as a case of esophageal-pleural fistula with chest wall collection and pleural effusion. Patient was managed conservatively and later lost to follow up. Another, 65-year-old patient presented with dysphagia from 3-months. CECT chest showed an esophageal growth of 5.5 cm in middle esophagus. Patient received palliative radiotherapy after which the dysphagia improved. On 3rd month of follow up patient’s dysphagia worsened; barium swallow showed esophageal-bronchial fistula. Patient was managed symptomatically and later lost to follow up.

Fistula formation and subsequent abscess results in poor prognosis. With advancing disease and compromised general condition of the patient, palliation of symptoms is an important challenge. Treatment becomes difficult due to rare occurrence of fistulas and non-standardization of treatment protocol. Invasive treatment includes esophageal-pulmonary resection, endoscopic placement of self-expandable covered stents, drainage of empyema and obliteration of empyema cavity, esophageal diversion, and non-invasive treatment includes best supportive care. However, even with appropriate treatment, outcome is dismal.

Esophageal cancer is one of the most prevalent types of cancer and causes of death worldwide. As the mainstream treatment, surgical resection is technically demanding and time-consuming.Therefore, the scope of its application is limited in the clinical setting. A new surgical approach is thus needed for an improved surgical effect and the prognosis of esophageal cancer.

This study aimed to investigate the effect of a modified thoracoscopic en-bloc esophagectomy on the removal of patients’ esophageal cancers and itsoutcomes.

In this study, amodified en-bloc esophagectomy was developed to remove esophageal cancer. Patients who underwent the modified en-bloc esophagectomy by right thoracoscopic approach or thoracoscope-assisted small incisional approach to have their esophageal cancers removed in Peking University First Hospital (Beijing, China) between January 2014 and January 2017, were screened and retrospectively studied. Cancer recurrence, overall survival, mortality, as well as intraoperative and postoperative outcomes, were reported.

A total of 31 patients (22 male and 9 female, mean age: 62.9 years) were included in the study. Out of 30 patients with R0 resection, eight patients had cancer recurrences in the neck, lung, liver, and bone; however, none of the recurrences was identified in the mediastinum. Six patients died during the follow-up period. By the end of December 2020, the five-year survival rate of all patients was 58.3%. The median survival time of N0 patients was 52 months, which was significantly longer than that in N1+2 patients (23 months). Additionally, there was no statistically significant difference between the median survival timeof N1 and N2 patients. Moreover, perioperative complications included pneumonia, arrhythmia, hoarseness, and chylous ascites, which were consistent with those reported previously.

The modified en-bloc esophagectomy to remove esophageal cancerby right thoracoscopic approach or thoracoscope-assisted small incisional approach was found safe and reliable due to decreased cancer recurrence, increased overall survivalrate, and prolonged survival time.

Esophageal cancer is the eighth-most common cancer and the sixth-most common cause of cancer death worldwide. In Iran, its prevalence is high. Surgery is recommended for tumors in early stages. This study aims to determine demographic data, therapeutic approaches, postoperative mortality, and survival rate in patients with esophageal cancer who were managed in a referral hospital. In a cohort study, the patients hospitalized during six-year period were evaluated. Demographic data, tumor characteristics, laboratory data, surgical approaches, and survival time were obtained. Statistical analysis was performed using life tables, proportional hazard Cox regression, and the Kaplan-Meier method by SPSS version 20 software. Survival curves were compared by log-rank analysis. Over six years, 92 patients were admitted of which 54 (58.7%) were male. The average age was 63.08±12.03 years. Ten patients (10.8%) were below 50 years old. Squamous cell carcinoma (SCC) was the most common type (85.8%). Fifty-three patients (57.6%) were selected for the surgery. Postoperative mortality in 30 days occurred in 7 patients (13.2%). The median survival rate was 12.8±2.92 months. The survival rate for one, three and five years were 51.94%, 24.67% and 19.48%, respectively. Two factors that had significant statistical correlation with median survival time were metastasis (P = 0.01) and vomiting (P = 0.003). Esophageal cancer is a poor prognostic disease and esophagectomy is a morbid operation. To reduce postoperative mortality and increase the survival time, better patient selection and operations by expert surgeons must be considered.

Esophageal cancer (EC) is a common cancer of the digestive system which is one of the most common cancers in our country The primary treatment of EC is surgery. Due to the development of minimally invasive techniques (MIE), in the current study, we have assessed the results of these techniques in patients with EC surgery. A total of 80 patients with middle and lower third ECs who had good conditions and were operated with MIE technique (McKeown) from 2014 to 2021, were enrolled in this study. Patients were evaluated based on the following criteria: age, sex, tumor location, pathology, peri-operative complications leading the minimally invasive esophagectomy technique to being converted to an open surgery, and early post-operative complications after surgery and mortality. A total of 80 patients with EC were enrolled in the study. 85% (n=68) of our patients were male and 15% (n=12) were female with an average age of 58.21±11.39 years old. 43.75% of the patients had a history of neo-adjuvant chemotherapy. Surgery was performed with McKeown technique without complications in 91.25% of the patients. In 8.75% of the patients tracheal injury (n=1), uncontrolled bleeding (n=1), and severe pleural adhesions VATS (n=5) led the surgery plan changing into open surgery. Post-operative complications were observed in 13.75% of patients. This study suggests using McKeown technique in patients with EC in highly experienced medical centers in order to obtain proper results with low rate of peri- and post-operative complications.

Esophageal cancer is the eighth most common cancer and the sixth most common cause of death from cancer. Esophagectomy is still the essential treatment for esophageal cancer despite its high morbidity rate. The prediction of complications that are likely to appear after surgery can be the most critical factor in reducing morbidity.

The present study aimed to examine the postoperative complications and causes of mortality in patients undergoing esophagectomy for esophageal cancer.

Data from 34 patients with esophageal adenocarcinoma or squamous cell carcinoma undergoing esophagectomy in the general surgery clinic of Çukurova University Medical School Hospital were collected and analyzed retrospectively between January 1, 2011, and January 1, 2020. Postoperative complications were identified according to the Clavien-Dindo classification (CD). The patients were assigned into two groups (Group 1 and Group 2). Group 1 and Group 2 included patients with CD grade <3 and CD grade , respectively.    

The mean±SD age of patients (n=34) undergoing resection for esophageal cancer was obtained at 56.38±11.00 years. The ratio of female to male patients was equal. The most common accompanying disease was diabetes mellitus. The number of patients with the American Society of Anesthesiologists score 3 was higher in Group 2 (P=0.034). The tumor was most frequently located in the lower thoracic esophagus of patients in Group 1 and Group 2, and the rate of cervical anastomosis was higher in Group 2. The rate of manual anastomosis was higher in both groups. Respiratory complications were the most frequent complication in both groups; however, a higher rate of respiratory complications was observed in Group 2 (P=0.038). The postoperative 30-days mortality and the reoperation rate were higher in Group 2.

Radical surgery for esophageal cancer results in a high rate of complications and death due to the location of the tumor and diagnosis at the advanced stage. Complications and mortality may result from patient-related factors and the surgical technique. The diagnosis and treatment of the correctable causes before surgery can enhance the chance of survival and the quality of life in patients.