Cases Of Esophageal Cancer Research Articles

Distance to Health Care Facilities, Lifestyle Risk Factors, and Stage at Diagnosis in relation to Geographic Pattern of Esophageal Cancer in Tanzania, 2006-2016.

Esophageal cancer is an aggressive, often deadly disease globally that represents a significant health problem in Tanzania. The WHO reported 604,100 new esophageal cancer cases worldwide during 2020 and 544,076 deaths (Sung, 2021; World Health Organization, 2020). In Eastern Africa, 16,137 cases and 15,188 deaths were related to this disease in 2020. Esophageal cancer is associated with various etiologic risk factors, and access to the disease treatment is a major barrier to survival. This study examined associations between the prevalence of four geographically stratified, population-level, etiologic risk factors (tobacco use, unprotected water use, solid fuel source use, and poverty), as well as two access-to-care predictors (persons per hospital and distance from residence to where esophageal cancer treatment occurs). Regional- and coarser-scale zonal incidence rates were calculated for 2006 through 2016 and evaluated for geographic differences in relation to risk factors and access to care predictors using Poisson regression. Differences in the geographic distribution of esophageal cancer were observed. Distance from the region of residence to the treatment center (Ocean Road Cancer Institute) was statistically associated with the geographic pattern of esophageal cancer incidence. Further research into etiologic risk factors, dietary practices, and nutrition is needed to better understand the associations with esophageal cancer in Tanzania and other parts of Eastern Africa.

Dietary acid load and esophageal cancer risk: A case-control study.

BackgroundA high dietary acid load (DAL) can produce metabolic acidosis, which is linked to cancer development through mechanisms of inflammation and cell transformation. There is limited epidemiological evidence linking DAL and cancer risk; however, none of the published studies focused on DAL and esophageal cancer (EC) risk in particular. Therefore, we sought to explore this association in the present study.MethodsA case‐control study was performed in 1295 male patients (185 squamous cell EC cases and 1110 age‐frequency and urban/rural residence matched controls) through a multitopic inquiry, including a food frequency questionnaire. Food‐derived nutrients were calculated from available databases. The DAL was calculated based on two validated measures: Potential renal acid load (PRAL) score and net endogenous acid production (NEAP) score. Odds ratios (OR) and their 95% confidence intervals (95% CI) were estimated by unconditional logistic regression, adjusting for confounders.ResultsWe found direct, significant associations between dietary acid load and EC risk: (OR = 2.28, 95% CI: 1.44–3.61, ptrend <0.0001) and (OR = 2.17, 95% CI: 1.38–3.41, ptrend <0.0001) for highest PRAL and NEAP tertiles, respectively. Our data raise the possibility that a high DAL may contribute to EC development. Both acid load scores were directly associated with animal‐based foods (mainly meat) and inversely associated with the intake of plant‐based foods.ConclusionTo the best of our knowledge, this is the first epidemiological case–control study analyzing associations of DAL and squamous cell EC risk. Further research is warranted to confirm our findings.

Real-World Efficacy and Safety of Sintilimab-Based Regimens against Advanced Esophageal Cancer: A Single-Center Retrospective Observational Study.

This study is aimed at assessing the sintilimab-based regimens' safety and efficacy for advanced esophageal cancer (EC) treatment in the real world. Cases of advanced EC treated with sintilimab-based regimens in the Anyang Tumor Hospital between 1 January 2020 and 1 August 2021 were retrospectively examined. Progression-free survival (PFS), overall survival (OS), disease control rate (DCR), objective response rate (ORR), and adverse events (AEs) were evaluated. Among the 50 included patients, the median PFS was 11.3 months (95% CI: 5.0-17.6 months), and the 1-year PFS rate was 49.2%. The median OS was not reached, and the 1-year OS rate was 67.1%. Complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were seen in 14% (n = 7), 46% (n = 23), 32% (n = 16), and 8% (n = 4) of the 50 patients, respectively. Therefore, the ORR and DCR were 60% (30/50) and 92% (46/50), respectively. The CR rate of patients with radiotherapy was higher than that without radiotherapy (25% vs. 3.8%, P = 0.031). The 1-year OS rate was higher in patients with radiotherapy than in patients without radiotherapy (85.9% vs. 53.2%, P = 0.020). The most observed AEs included anemia, decrease in white blood cell count, nausea/vomiting, and hypoproteinemia. Sintilimab-based regimens achieved good disease control and tolerance for treating advanced EC in the real world. Combined radiotherapy can improve the efficacy and deserves further study.

Time-trend of the incidence and mortality of esophageal cancer from 2010 to 2018 and its statistics in 2018 in Henan, China.

BackgroundIt is great of significance to figure the time-trend of esophageal cancer (EC) and its current status for effective prevention and control, especially in EC high risk areas. As one of world-renowned high-risk areas, the epidemiology of EC in Henan has not been recently updated. Therefore, we aimed to depict the status quo of EC and analyze its time-trend in Henan.MethodsThe EC data were extracted from the Henan Provincial Cancer registry database derived from the population based cancer registry system, which covered 30.51% of the whole population in Henan and were qualified according to national and international guidelines. The incidence and mortality of EC were estimated by area (rural/urban), gender, and age groups. The age-standardized rates (ASRs) were calculated according to the Segi’s population. Joinpoint regression was used to calculate annual percentage change (APC) and average annual percentage change (AAPC) to evaluate the time-trend of EC.ResultsAs estimated, there were 29,913 new EC cases in Henan, 2018. The crude incidence and the age-standardized incidence rate by world standard population (ASIRW) was 27.43/105 and 19.96/105, respectively. The incidence in males and rural was 1.83 and 1.51 times higher than that in females and urban areas, respectively. Meanwhile, it was estimated that 22,688 deaths occurred in 2018. The crude mortality and the age-standardized mortality rate by world standard population (ASMRW) were 20.80/105 and 14.47/105, respectively. Similarly, males and rural areas had higher mortality compared with females and urban areas. The age-specific incidence and mortality of EC showed significant increasing after 60–64 years group. In general, the time-trend of incidence (APC: −8.9, P<0.001) and mortality (APC: −7.6, P<0.001) of EC showed a significant decreasing trend since 2014, and downward trend were also observed in rural areas for incidence (APC: −5.2, P<0.001) and mortality (APC: −3.9, P<0.001) from 2010 to 2018.ConclusionsThe EC incidence and mortality in Henan has exhibited a significant declining trend in past years. Nonetheless, the disease burden remains high, especially in males and rural areas. Therefore, the ongoing prevention and control strategies of EC should be maintained alongside the establishment of more effective strategies.

A Case of Unresectable Advanced Esophageal Cancer with Tuberculosis and Immune Thrombocytopenic Purpura Due to Nivolumab

A Case of Unresectable Advanced Esophageal Cancer with Tuberculosis and Immune Thrombocytopenic Purpura Due to Nivolumab

Interleukin 13 participates in terminal differentiation of esophageal squamous cell carcinoma cells.

BackgroundIn China, esophageal squamous cell carcinoma (ESCC) accounts for more than 90% of all esophageal cancer cases. Interleukin 13 (IL-13) was widely reported to play a key role in tumor progression. Our previous study reported that IL-13 was a favorable predictive marker for the overall survival of esophageal squamous cell carcinoma (ESCC) patients, but how IL-13 contributes to ESCC progression remains unknown. This study aims to explore the role of IL-13 and its underlying downstream molecular mechanisms in ESCC progression.MethodsTissue microarrays including 262 primary ESCC tumor tissues were collected and analyzed. The expression of IL-13 in ESCC tumor tissue was detected with immunohistochemistry staining (IHC). Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to qualify the expressions of KRT13, KRT4 and 15-lipoxygenase-1 (15-LOX-1) in cultured ESCC cell lines with recombinant IL-13 treatment.ResultsIL-13 was expressed in the esophageal epithelium cells and ESCC tumor cells. High IL-13 expression in ESCC tumor cells predicted a good prognosis for patients. Recombinant human IL-13 raised KRT13 and 15-LOX-1 mRNA levels, but lowered KRT4 mRNA level 15-LOX-1 in ESCC cells in vitro.ConclusionsIn summary, our study suggests that IL-13 might improve the prognosis of ESCC by promoting the terminal differentiation of ESCC cells. This may offer potential new therapeutic target for early treatment of ESCC.

Esophageal Carcinoma and Associated Risk Factors: A Case-control Study in Two Tertiary Care Hospitals of Kabul, Afghanistan.

PurposeEsophageal cancer (EC) is the most common cancer among males in Afghanistan, thus we aimed to conduct a case-control study to determine the associated risk factors with EC in two tertiary care hospitals of Kabul, Afghanistan.Patients and MethodsWe enrolled 132 EC cases and 132 controls and used conditional logistic regression to estimate the odds ratio (OR) with consideration of 95% confidence interval (CI).ResultsThe results of our study revealed that esophageal squamous cell carcinoma (ESCC) was the predominant type of EC constituting 75.8% of the cases. The results of the multivariate logistic analysis showed that males and older ages were at increased risk of developing EC (OR: 4.62, 95%CI, p-value=0.026) and (OR: 1.070, 95%CI, p-value <0.001), respectively. In addition, living in rural areas (OR: 46.64, 95%CI, p-value <0.001), being uneducated (OR: 13.94, 95%CI, p-value=0.042), using oral snuff (OR: 6.10, 95%CI, p-value=0.029), drinking hot tea (OR: 5.719, 95%CI, p-value=0.005), lack of physical exercise (OR: 32.548, 95%CI, p-value=0.001), less fresh fruit consumption (OR: 93.18, 95%CI, p-value<0.001) and family history of cancer (OR: 14.50, 95%CI, p-value=0.003) were significantly associated with the development of EC, while body mass index (BMI), smoking, alcohol drinking, consumption of spicy food and pickled vegetables did not have a significant association with EC. Moreover, the majority of the cases (83.3%) in our study were from to low-income families and the majority were unemployed (93.9%), of whom (50%) were farmers, who did not show statistically significant association.ConclusionOur study concluded that EC risk was higher in older ages, males, rural residents, uneducated people, oral-snuff users, hot tea drinkers, fewer fresh fruit consumers, lack of physical exercise, and family history of cancer. Further detailed studies and screening policies of the affected groups are suggested to further elaborate on the subject.

Application Value of the Diagnosis during Early Carcinoma of Upper Digestive Tract Based on Optical Enhanced Endoscopic Technique.

Objective The diagnostic value of optical enhanced endoscopy in early cancer of upper digestive tract was studied by comparing the disease accuracy, tumor type, invasion, and various surgical indicators between the two groups. Methods 188 patients with early upper gastrointestinal cancer treated in our hospital from January 2020 to February 2021 were selected as the research objects. The patients were randomly divided into the observation group and control group with 94 cases in each group. Results The accuracy of early detection of early carcinoma of upper digestive tract in the observation group was 94.68% and that in the control group was 76.60%. The accuracy of the observation group was significantly higher than that in the control group, with statistical significance (P < 0.05). In the observation group, 36 cases of early gastric cancer, 28 cases of early esophageal cancer, and 30 cases of early colorectal cancer were detected; 25 cases of early gastric cancer, 19 cases of early esophageal cancer, and 28 cases of early colorectal cancer were detected; 26 cases of early carcinoma of upper digestive tract infiltration were detected; and 68 cases were not detected, and the detection rate was 27.66%, which was higher than 9.57% in the control group, and the difference was statistically significant (P < 0.05). After different methods of treatment, no death occurred in all patients. Except for the operation time, the surgical indexes of the observation group were better than the control group, the difference was statistically significant (P < 0.05). Conclusion Optical enhanced endoscopic technique had obvious effect in the diagnosis of patients with early cancer of upper digestive tract, it was helpful to improve the clinical detection rate of early carcinoma of upper digestive tract and had certain diagnostic ability for the invasion depth of early cancer of high upper gastrointestinal tract, which was conducive to the detection of clinical invasion lesions and had high clinical promotion and application value.

A case of early esophageal cancer on esophageal varices treated by endoscopic submucosal dissection after endoscopic variceal ligation

A case of early esophageal cancer on esophageal varices treated by endoscopic submucosal dissection after endoscopic variceal ligation

Esophagus Cancer: Epidemiological, Clinical, Para Clinic and Evolving Aspects at Brazzaville Chu

Introduction: Our study aimed to describe the epidemiological, clinical, paraclinical and evolutionary aspects of esophageal cancer. Patients and Methods: This is a descriptive retrospective study carried out over 08 years (January 2012 to December 2020) in the gastroenterology and internal medicine department of the Brazzaville University Hospital. We included the files of patients hospitalized for CO retained on a clinical and endoscopic argument bundles. Results: During the study period, 34 cases of esophageal cancer were diagnosed, ie a hospital frequency of 0.63%. The average age was 52.97 years with extremes ranging from 29-90 years. They are made up of 24 men and 10 women with a sex ratio of 2.4 in favor of men. Alcohol-smoking poisoning was found in 21 male patients with an average of 27 packs / year. The main symptom at diagnosis was dysphagia (55.88%). Esogastroduodenal fibroscopy showed ulcerative budding and hemorrhagic lesions (50%), the site of which was mainly the abdominal esophagus (64.70%). Adenocarcinoma was the most common histologic type, 16 patients received palliative care. Conclusion: Esophageal cancer is common in males over the age of 50. Dysphagia is the most frequent reason for consultation. The distal esophagus is the most common site of esophageal cancer and the histologic type is adenocarcinoma. Among our patients, 16 received palliative care.

Abstract 4008: Transcriptomic signatures in esophageal adenocarcinoma define distinct subtypes with therapeutic relevance

Abstract Background &amp; Aims: Esophageal cancer is the fifth most common solid cancer globally, and esophageal adenocarcinoma (EAC) is the predominant histological subtype in the western world. Patients often present at an advanced stage and overall-5-year survival rates are less than 15%. In many patients, the response to neoadjuvant therapy is encouraging at first, but most will develop metastatic disease several years later. Recently, we observed plasticity along the epithelial-to-mesenchymal (EMT) axis in EAC tumor cells upon therapeutic pressure. The last decade has seen the discovery of static molecular subtypes in cancers and a poor-prognosis mesenchymal subtype has been reported in multiple gastrointestinal cancers, but not in EAC. Here, we set out to identify transcriptomic subtypes and the frequency of their occurrence during EAC progression, and exposure to therapy in a clinical setting. Methods: A cohort comprising of 174 esophageal cancer cases (n=100 pre-treatment biopsies, n=46 neoadjuvantly-treated resection specimens, and n=28 metastatic biopsies) with 12 esophageal cancer cell lines (8 primary and 4 ATCC cell lines) was RNA-sequenced. To circumvent non-tumor signals confounding the analysis, we leveraged non-negative matrix factorization (NMF) as a virtual microdissection tool. Patients were subtyped by consensus clustering the top 50 exemplar genes per tumor-cell intrinsic signature. Next, the subtypes were validated in two independent cohorts and clinical correlates were analyzed. In addition, we perturbed subtype-specific regulators to functionally assess the existence of the subtypes. Results: Here, we identified 7 biological signatures involved in primary and metastatic EAC. Two of these were unambiguously tumor-intrinsic signals. All seven signatures associated with tumor cellularity scores estimated by an experienced pathologist confirming the reliability of NMF as a virtual microdissection tool. Upon clustering two EAC subtypes emerged: Intestinal-like (IL) and Mesenchymal-like (ML). ML-subtyped patients were observed with increased frequency after neoadjuvant treatment, and following metastatic dissemination. This association was validated in an independent cohort. Lastly, we identified HMGA2 as a key transcription factor for the ML-subtype. Genetic perturbation of HMGA2 induced an IL-associated phenotype. Conclusion: Our study demonstrate for the first time from clinical transcriptomics data that EAC cells can exist in distinct cell states. In addition, the abundance of either cell states, that constitute to tumor subtype, alter when exposed to chemoradiation or following metastatic spread. These subtypes offer a valuable method to design more informed personalized treatment approaches for EAC patients; for existing and future subtype-directed treatments. Citation Format: Mark P.G. Dings, Amber P. Zalm, Marjolein F. Lansbergen, César Oyarce, Sybren L. Meijer, Cynthia Waasdorp, Jan Paul Medema, Hanneke van Laarhoven, Maarten F. Bijlsma. Transcriptomic signatures in esophageal adenocarcinoma define distinct subtypes with therapeutic relevance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 4008.

Abstract 943: Modeling and dissecting of esophageal squamous cell carcinoma initiation

Abstract Esophageal cancer is the 7th common cancer with the 6th highest cancer mortality rate worldwide. The 5-year survival rate of esophageal cancer is 10 ~ 25%. Esophageal cancer is mainly divided into esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma. ESCC accounts for 80% of all esophageal cancer cases and shows a poor prognosis due to a lack of symptoms at early stages. Given that early diagnosis of ESCC may lead to better outcomes, understanding the biology of ESCC initiation is imperative. To recapitulate the early events of ESCC, we employed the murine esophageal organoid (EO) system recently developed. Based on in silico analyses, we selected nine candidate genes (TP53, CDKN2A, NOTCH1, NOTCH3, KMT2D, KMT2C, FAT1, FAT4, and AJUBA) frequently mutated in ESCC patients. The EOs were then genetically manipulated with the combinatorial ablation of nine genes by CRISPR/Cas9 system. The EOs carrying PN (Trp53 and Notch1 KO), PC (Trp53 and Cdkn2a KO), and PCN (Trp53, Cdkn2a, and Notch1 KO) showed hyperplastic and neoplastic properties with impaired squamous cell differentiation and organoid integrity, compared to the wild-type (WT) EOs. Single-cell RNA-seq (scRNA-seq) analyses of WT, PC, PN, and PCN organoids showed the highest enrichment of ESCC cancer stem cell markers in PCN organoids. Unlike the cell lineage in WT EOs, neoplastic EOs (PC, PN, and PCN) exhibited distinct cell lineage along with multiple root cell clusters. While WT EOs failed to become neoplastic, PN, PC, and PCN EOs displayed the transforming activity in vitro and in vivo xenograft transplantation assays. Intriguingly, in allograft mouse models, while PN organoids-derived cells barely developed tumors, PC and PCN organoids-derived cells developed tumors with marked downregulation of genes related to antigen processing and presentation. These results suggest that combinatorial loss of P53, CDKN2A, and NOTCH1 play a pivotal role in ESCC neoplasia, stemness, and immune checkpoint, unveiling the biology of ESCC initiation. Citation Format: Kyung Pil Ko, Gengyi Zou, Yuanjian Huang, Bongjun Kim, Jie Zhang, Sohee Jun, Jae-Il Park. Modeling and dissecting of esophageal squamous cell carcinoma initiation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 943.

Tobacco and other risk factors for esophageal squamous cell carcinoma in Lilongwe Malawi: Results from the Lilongwe esophageal cancer case: Control study.

Esophageal cancer is the second commonest cancer in Malawi, and 95% of all cases are esophageal squamous cell carcinoma (ESCC). Very little is known about the epidemiology of ESCC in Malawi including risk factors. The main objective of the study was to evaluate and describe risk factors of ESCC in Malawi. We conducted a case-control study from 2017 to 2020 at two hospitals in Lilongwe, Malawi and consenting adults were eligible for inclusion. Endoscopy was conducted on all cases and biopsies were obtained for histological confirmation. Controls were selected from patients or their guardians in orthopedic, dental and ophthalmology wards and they were frequency matched by sex, age, and region of origin to cases. An electronic structured questionnaire was delivered by a trained interviewer. Multivariate conditional logistic regression models were used to assess the associations between subject characteristics, habits, and medical history and risk of ESCC. During the study period, 300 cases and 300 controls were enrolled into the study. Median age of cases and controls was 56 years and 62% of the cases were male. Among cases, 30% were ever cigarette smokers as were 22% of controls. Smoking cigarettes had an adjusted odds ratio of 2.4 (95% CI 1.4-4.2 p = 0.003). HIV+ status was present in 11% of cases and 4% controls, which resulted in an adjusted odds ratio was 4.0 (95% CI 1.8-9.0 p = 0.001). Drinking hot tea was associated with an adjusted odd ratio of 2.9 (95% CI 1.3-6.3 p = 0.007). Mold on stored grain has an adjusted odd ratio of 1.6 (95% CI 1.1-2.5 p = 0.021). Reducing smoking cigarettes, consumption of scalding hot tea, and consumption of contaminated grain, could potentially help reduce the burden of ESCC in Malawi. Further investigation of the association between HIV status and ESCC are warranted.

The Global Landscape of Esophageal Squamous Cell Carcinoma and Esophageal Adenocarcinoma Incidence and Mortality in 2020 and Projections to 2040: New Estimates From GLOBOCAN 2020

The aim of this study was to provide an overview of the burden of esophageal cancer in 185 countries in 2020 and projections for the year2040. Estimates of esophageal cancer cases and deaths were extracted from the GLOBOCAN database for 2020. Age-standardized incidence and mortality rates were calculated overall, by sex, histologic subtype (adenocarcinoma [AC] and squamous cell carcinoma [SCC]), country, and level of human development for 185 countries. The predicted burden of incidence and mortality in 2040 was calculated based on global demographic projections. Globally, there were an estimated 604,100 new cases of, and 544,100 deaths from, esophageal cancer in 2020, corresponding to age-standardized incidence and mortality rates of 6.3 and 5.6 per 100,000, respectively. Most cases were SCCs (85% [512,500 cases]) and 14% (85,700 cases) were ACs. Incidence and mortality rates were 2- to 3-fold higher in male (9.3 and 8.2, respectively) compared with female (3.6 and 3.2, respectively) individuals. Global variations in incidence and mortality were observed across countries and world regions; the highest rates occurred in Eastern Asia and Southern and Eastern Africa and the lowest occurred in Western Africa and Central America regions. If rates remain stable, 957,000 new cases (141,300 AC cases and 806,000 SCC cases) and 880,000 deaths from esophageal cancer are expected in2040. These updated estimates of the global burden of esophageal cancer represent an important baseline for setting priorities in policy making and developing and accelerating cancer control initiatives to reduce the current and projected burden. Although primary prevention remains key, screening and early detection represent important components of esophageal cancer control in high-risk populations.

Mapping of Lymph Node Metastasis From Thoracic Esophageal Cancer: A Retrospective Study.

This retrospective study was designed to investigate the optimal extent of dissection for thoracic esophageal cancer (EC) based on the incidence of lymph node metastasis (LNM). We retrospectively identified 1014 patients with thoracic esophageal carcinoma who underwent esophagectomy at our institution between May 2018 and November 2020. Also, the location and rate of LNM in relation to the postoperative pathological results were retrieved. We separately counted the metastasis rates of routinely excised lymph node stations according to the Japan Esophageal Society (JES) staging system. A total of 1666 consecutive patients were screened, and 1014 were enrolled. Generally, the rates of LNM in thoracic EC may be arranged in the descending order of station 7 > station 106recR > station 2 > station 106recL. Esophageal cancer in the middle and lower thoracic segment also had a high rate of LNM along bilateral recurrent laryngeal nerve. Stations 106tbL and 111 were the lowest frequent sites of metastasis with rate less than 5%; only the patients with clinically positive LNs need to dissect. The cT3-4, cN+, or G3 were independent risk factors for LNM and neoadjuvant therapy did not change the distribution of LNM for thoracic EC cases. This study accurately identified the distribution of LNM for thoracic EC patients. Neoadjuvant therapy could not change the overall distribution of LNM in thoracic EC patients. However, whether LNs dissection at stations 106tbL and 111 is related to the survival of thoracic EC or not, needs a long follow-up time to verify.

Better Prognosis and Survival in Esophageal Cancer Survivors After Comorbid Second Primary Malignancies: A SEER Database-Based Study.

BackgroundWith the development of surgical techniques and advances in systemic treatments, the survival time of esophageal cancer survivors has increased; however, the chance of developing a second primary malignancy (SPM) has also increased. These patients’ prognosis and treatment plans remain inconclusive.ObjectivesWe aimed to evaluate and predict the survival of patients with esophageal cancer with second primary tumors, to provide insights and the latest data on whether to pursue more aggressive treatment.Materials and MethodsWe selected esophageal cancer cases from the latest available data from the SEER database on April 15, 2021. We performed life table analysis, Kaplan–Meier analysis, and univariate and multivariate Cox proportional hazards analysis to assess the patient data. We conducted multiple Cox regression equation analyses under multiple covariate adjustment models, and performed a stratified analysis of multiple Cox regression equation analysis based on different covariates. To describe our study population more simply and clearly, we defined the group of patients with esophageal cancer combined with a second primary malignant tumor (the first of two or more primaries) as the EC-SPM group.ResultsOur analysis of 73,456 patients with esophageal cancer found the median survival time of the EC-SPM group was 47.00 months (95% confidence interval (CI), 43.87–50.13), and the mean survival time was 74.67 months (95% CI, 72.12–77.22). Kaplan–Meier curves of different esophageal cancer survivors showed that the survival of the EC-SPM group was significantly better than that of the other groups (p < 0.01). Univariate Cox regression analysis showed that compared with only one malignancy only group, the hazard ratio (HR) of the EC-SPM group was 0.95 (95% CI, 0.92–0.99; p < 0.05). In the multivariate Cox regression analysis under different adjustment models, the EC-SPM group had a reduced risk of death compared with the one primary malignancy only group (HR < 1, p < 0.05).ConclusionSurvivors of esophageal cancer with a second primary malignant cancer have a better prognosis, but require more aggressive treatment. This study provided new evidence and new ideas for future research on the pathophysiological mechanism and treatment concepts of esophageal cancer combined with SPM.

HIV prevalence among oesophageal cancer patients in rural South Africa

Esophageal cancer (EC) is the ninth most common cancer worldwide, with 604,100 new cases each year and ranking sixth in terms of mortality. Individuals infected with human immunodeficiency virus (HIV) have a higher prevalence of certain malignancies compared with the general population. There have been reports suggesting an increased risk of EC among people living with HIV infection. Therefore, this study aimed to investigate the prevalence of HIV infection among EC patients in rural Africa. This is a records-based retrospective descriptive study of patients presenting with EC referred from surrounding hospitals in the Eastern Cape to Frere Hospital from January 2016 to December 2018. A total of 125 EC cases were recorded during this period. Information collected from patients’ records included age, sex, ethnic group, HIV status, tumour location and stage of the disease. Fourteen patients were diagnosed with HIV, translating to a prevalence of 11% (95% confidence interval (CI): 5–15). There was no relationship between the risk of HIV infection and the stages of EC (p = .122). In addition to this, the risk of HIV infection showed no relationship to tumour location (p = .531). In summary, we found that the overall prevalence of HIV infection in EC patients was 11% and this was not associated with the stage or location of cancer at diagnosis in this rural population.

Relationship between postoperative complications of esophageal cancer surgery and season: a retrospective study

BackgroundEsophageal cancer in China accounts for nearly half of the global esophageal cancer cases. The relationship between the occurrence of postoperative complications of esophageal cancer surgery and seasonal changes is not clear. Our purpose is to clarify the relationship between postoperative complications of esophageal cancer and season, so as to reduce the incidence of complications.MethodsWe retrospectively analyzed the medical records of patients undergoing esophageal cancer surgery in our hospital between January 2013 and December 2014. Patients were divided into the summer group (March–August) and the non-summer group (September–February) according to the seasonal climate. Pulmonary, cardiac, and other complications were recorded. Differences in postoperative complications were compared between the two groups by the chi-squared test.ResultsIn the 251 patients enrolled, the total postoperative complication rate was 37.8%. The occurrence of incision complications in the summer group was significantly higher than that in the non-summer group (10.1% vs. 3.5%, P=0.044). Pulmonary and cardiac complications in summer group were significantly rarer than those in the non-summer group (16.7% vs. 27.4%, P=0.039; and 8.0% vs. 16.8%, P=0.032, respectively).ConclusionsDuring the warm months of the year, clinicians should focus on preventing postoperative incision complications, and they should focus on preventing pulmonary and cardiac complications during the cold months.

The Incidence Rate of Esophageal Cancer in Saudi Arabia: An Observational and a Descriptive Epidemiological Analyses.

IntroductionEsophageal cancer ranks the sixth most diagnosed cancer worldwide, and the morality incidence of this disease is rapidly growing worldwide. A retrospective observational population-based epidemiological study of esophageal cancer has been conducted, and data are based on the cancer registry of the National Health Information Center Saudi from 2006 to 2016. This study described the age-standardized incidence rates (ASIRs) and crude incidence rates (CIRs) of esophageal cancer based on age groups, diagnosis year, and administrative areas in Saudi Arabia populations to examine its distributions and trends in Saudi Arabia.MethodFor the statistical assessment of data, sex ratio, t-test, the Kruskal–Wallis test, and descriptive statistics were performed using SPSS version 20.0 (IBM Corporation, Armonk, NY, USA). A total of 755 and 597 cases of esophageal cancer in men and women, respectively, were reported from 2006 to 2016 in Saudi Arabia.ResultsOut of all esophageal cases, the highest number of cases was observed in the age group <75 years among both men and women, whereas the lowest percentage and mean number of esophageal cancer cases among men and women were reported in the younger age group between 0 and 29 years. Within the geographical regions, Tabuk and Qassim regions recorded the highest mean CIR and ASIR among men. In the Northern region of Saudi Arabia, the maximum CIR and ASIR sex ratio was observed, whereas minimum mean CIR and ASIR were reported in Jouf and Jazan regions, respectively, among men. Madinah and Tabuk regions had the maximum mean CIR and ASIR, respectively, among women for esophageal cancer. The Northern region recorded minimum mean CIR and ASIR among women.ConclusionMaximum substantial changes of ASIRs for esophageal cancer in men and women from 2006 to 2016 were found in the Tabuk region, while Jazan and Northern regions exhibited least substantial changes of ASIRs in men and women, respectively.

Endoplasmic Reticulum Stress-Related Four-Biomarker Risk Classifier for Survival Evaluation in Esophageal Cancer.

Purpose Esophageal cancer (EC) is a lethal digestive tumor worldwide with a dismal clinical outcome. Endoplasmic reticulum (ER) stress poses essential implications for a variety of tumor malignant behaviors. Here, we set up an ER stress-based risk classifier for assessing patient outcome and exploiting robust targets for medical decision-making of EC cases. Methods 340 EC cases with transcriptome and survival data from two independent public datasets (TCGA and GEO) were recruited for this project. Cox regression analyses were employed to create a risk classifier based on ER stress-related genes (ERGs) which were strongly linked to EC cases' outcomes. Then, we detected and confirmed the predictive ability of our proposed classifier via a host of statistical methods, including survival analysis and ROC method. In addition, immune-associated algorithm was implemented to analyze the immune activity of EC samples. Results Four EGRs (BCAP31, HSPD1, PDHA1, and UBE2D1) were selected to build an EGR-related classifier (ERC). This classifier could distinguish the patients into different risky subgroups. The remarkable differences in patient outcome between the two groups were observed, and similar results were also confirmed in GEO cohort. In terms of the immune analysis, the ERC could forecast the infiltration level of immunocytes, such as Tregs and NK cells. Conclusion We created a four-ERG risk classifier which displays the powerful capability of survival evaluation for EC cases.