Prevalence Of Esophageal Cancer Research Articles

Analysis of the incidence and mortality trends of esophageal cancer in cancer registry areas of China and Japan.

This study aims to analyze the prevalence trend of esophageal cancer in Japan and China to provide suggestions for the prevention and treatment of esophageal cancer. The results showed that the incidence rate for the years 2010-2018 significantly decreased with an APC of 5.66%, and the mortality rate from 2010 to 2015 had an APC of -5.87% in China. However, the incidence rate of Japanese women showed an upward trend, with an APC of 4.09% from 2010 to 2019. The mortality rate of esophageal cancer in Japan showed a downward trend, with an APC of -2.96% from 2010 to 2021. From 2010 to 2018, Chinese esophageal squamous cell carcinoma accounted for the highest proportion, accounting for 85.96%, with the largest distribution in the middle, accounting for 47.25%. Patients are mostly diagnosed at stage III, and the relative survival rate from 2012 to 2015 was 30.3%. Japan also has the highest proportion of squamous cell carcinoma, and the lesions are also mostly located in the middle segment. While Japanese esophageal cancer patients are mostly diagnosed at stage I, and the relative survival rate was 41.5% in Japan from 2009 to 2011. The results of this article indicate that the current prevalence of esophageal cancer in China and Japan is generally declining, and the quality of life of patients is gradually improving, but effective screening and prevention strategies are still needed to reduce the burden of this disease.

Clinical Value of Endoscopic Esophageal Screening in Head and Neck Squamous Cell Carcinoma Patients.

To investigate the clinical benefit of routine esophageal screening in newly diagnosed head and neck squamous cell carcinoma (HNSCC) patients. Retrospective cohort study. Tertiary medical center. This retrospective study selected newly diagnosed HNSCC patients from the Chang Gung Research Database between January 2007 and December 2019. Patients who underwent endoscopic esophageal examinations within 2 months of the initial diagnosis of HNSCC were included in the screening group. The clinical outcomes of the screening and nonscreening groups were analyzed. In total, 13,627 HNSCC patients were included, comprising 1032 females and 12,640 males (mean age 55.0 years), and the esophageal screening group included 7033 (51.4%) patients. The prevalence rate of esophageal tumors was 4.5%. Hypopharyngeal cancer patients were the most likely to have (13.4%) second primary esophageal tumors. The American Joint Committee on Cancer stage of the esophageal tumor was lower in the esophageal screening group than in the nonesophageal screening group. The oral, oropharyngeal, and hypopharyngeal cancer patients in the esophageal screening group had better survival outcomes than their counterparts in the nonesophageal screening group. Endoscopic esophageal screening of newly diagnosed HNSCC patients can detect esophageal tumors at an early stage and improve overall survival. Esophageal screening could be a routine survey in HNSCC patients, particularly those with lifestyle risk factors and in countries with a high prevalence of esophageal cancer.

Risk Assessment of Esophageal Cancer Prevalence in North East India

Background: The North East (NE) India region has a quite distinct gene pool with over 160 scheduled tribes and 400 other sub-tribal populations. This region is the fourth contributor to the gene pool of the Indian sub-continent, which has associations with Tibeto-Burman speakers and Austro-Asiatic speakers settled in East and NE-India with Asian ties. Methods: Literature search and studies have shown that in India, notwithstanding the lack of data on population coverage, there exists no such evidence for a decline in age-standardized mortality rates in cancer and the number of deaths mostly in individuals less than 70 years. Results: Analytical epidemiological studies using molecular markers are currently the need of NEIndia for prognostication of cancers in this region, which are quite different from the rest of India, such as esophageal cancer, lung cancer in females, stomach cancer, and nasopharyngeal cancers. In addition, there is a dire need for translational research in NE-India, as for cancer survival, it is not always feasible to generalize the current international guidelines for cancer to the population of NEIndia so that high survival rates are achieved just like the rest of India and high-income rich countries. Factors, such as difference in incidence rate, socioeconomic factors, tumor biology and availability of resource in this region, determine the survival rates. Conclusion: In this review, various factors involved in the high cancer burden in this region are discussed, particularly focusing on the genetic basis.

Effect of system analysis of reactive oxygen species on prognosis and treatment decisions for patients with esophageal squamous carcinoma.

e16005 Background: The prevalence of esophageal cancer has recently grown, particularly esophageal squamous cell carcinoma (ESCC). Combining conventional treatment with targeted therapy and immunotherapy has shown unexpectedly positive results in improving the prognosis of patients with ESCC. More study is needed to determine the prognosis for patients with ESCC and establish the appropriate course of treatment. ROS controls different aspects of cell death from signaling to death, and ROS also regulates the tumor environment, affecting various stromal cells that provide metabolic support, blood supply, and immune response to tumors. Although reactive oxygen species (ROS) play an important role in tumorigenesis, it is difficult to reliably predict the effects of ROS-modulating therapies. Methods: This study aimed to establish a ROS-related score (ROSS) model to individually predict the overall survival and therapeutic effects for ESCC patients. Clinical data were derived from the TCGA-ESCA cohort through "UCSC", as well as the whole genome data. The driver ROS genes were identified based on univariate Cox regression. Following that, ROSS was created via a systematic machine-learning pipeline. The association of ROS with immune infiltration and biological function was subsequently assessed by systematic bioinformatics analysis. Finally, we evaluated the predictive efficacy of ROSS for immunotherapy sensitivity using predictive algorithms and real-world immunotherapy cohorts. Results: Patients with significant ROSS had fewer favorable outcomes, according to the data. The proliferation of ESCA cells treated with core ROS gene knocked down was also detected by CCK8. Both univariate and multivariate Cox regression indicated ROSS to be an independent prognostic factor for ESCC patients; however, subgroup analysis eliminated this finding. The functional assay revealed that immune response and cytotoxicity pathways are associated with ROSS, as the subgroup with low ROSS has an active immune microenvironment. Furthermore, patients with low ROSS responded better to chemotherapy, targeted therapy, and immunotherapy. Conclusions: In this study, we systematically analyzed the ROS-related genes in ESCC and developed a ROSS model to assess prognosis and provide guidelines for treatment decisions. This discovery gave rise to a fresh concept for novel therapeutic procedures for the clinical treatment of ESCC.

Long-Term Excessive Selenium Supplementation Affects Gene Expression in Esophageal Tissue of Rats.

Esophageal cancer is one of the leading causes of cancer death and the seventh most prevalent cancer worldwide. Considering the positive association of high selenium with the prevalence of esophageal cancer, we have investigated the effect of high doses of selenium on gene expression in the normal esophageal tissue of rats. Twenty male rats were randomly divided into four groups: control group, group 2mg Se/L, 10mg Se/L, and 20mg Se/L rats fed with a basal basic diet and 2, 10, and 20mg Se/L as sodium selenite in drinking water, respectively, for 20weeks. Serum malondialdehyde and glutathione peroxidase activity were measured. Moreover, the expression and concentration of the cyclin D1, cyclin E, KRAS, p53, NF-kB, TGF-β, and MGMT in the esophageal tissue were analyzed and compared between the four groups. In normal esophageal tissue, selenium supplementations (2, 10, and 20mg Se/L) increased the mRNA levels of cyclin D1, P53, KRAS, NF-κB p65, and MGMT and decreased the mRNA level of TGFß1. The concentrations of cyclin D1 and MGMT were also significantly increased by selenium supplementations. Selenium supplementations had no significant effect on serum MDA but significantly increased GPX activity. The present study suggests that selenium supplementation (2, 10, and 20mg Se/L) affects gene expression related to inflammation, Cell proliferation, and apoptosis in the normal esophageal tissue. However, there were no observed abnormalities other than reduced growth with supplementation of 20mg/L as Na2SeO3 in rats.

The Novel Conduit: Challenges of Esophagectomy After Bariatric Surgery

Metabolic surgery has been on the rise over the last 2 decades. As more literature has been being published regarding its efficacy in treating metabolic syndrome as well as advancements in surgical training and safety rise with it, metabolic surgery will in no doubt continue to increase in prevalence. Concomitantly, the prevalence of esophageal cancer is increasing. We present two cases of patients who are status post sleeve gastrectomy and require esophagectomy. These patients do not have the availability of a gastric conduit, and colon interposition graft was planned for their reconstructions. We here review the two unique case scenarios as well as an overview of colon interposition technique and workup considerations. The need this reconstruction technique will likely increase in the years to come and metabolic surgery and esophageal cancer both continue to rise.

Camrelizumab in combination with fluorouracil or taxol plus platinum chemotherapy as first-line treatment of esophageal squamous cell carcinoma: A multicenter, open-label, prospective cohort study.

e16084 Background: The introduction of immune checkpoint inhibitors (ICIs) after chemotherapy and targeted therapy has altered the treatment pattern of esophageal squamous cell carcinoma (ESCC). However, using ICIs alone results in a poor response rate. Fortunately, fundamental research indicates that chemotherapy might trigger immunogenic death of tumor cells by releasing tumor antigens, hence eliminating immune system repression of tumor cells. On this basis, a number of clinical studies, including KEYNOTE-590, CheckmMate-648, ORIENT-15, and ESCORT-1st, on the first-line treatment of ESCC with ICIs coupled with chemotherapy, including fluorouracil or taxol and platinum (PF or TP), were conducted and yielded favorable results. However, the advantage of safety and effectiveness of ICIs combination with PF and TP in Chinese ESCC remains unknown. Furthermore, since the southeast part of Shanxi province has a high prevalence of esophageal cancer, the geographical features of ESCC patients will be examined. Methods: Camrelizumab was maintained after 6 cycles of camrelizumab in combination with PF or TP chemotherapy. From May 2020 to February 2022, our study has included 40 locally progressed and advanced ESCC patients. Camrelizumab was administered in combination with PF to 11 patients and TP to 29 patients. Every 6 weeks, efficacy was examined using RECIST 1.1, and 33 patients were evaluated. This research was registered with the Chinese Clinical Trials Registry (ChiCTR2000037942). Results: The median treatment time was 5.8m. 82.5% (33/40) patients were availably evaluated. The objective response rate (ORR) was 72.7% (24/33) and the disease control rate (DCR) was 97.0% (32/33). There is no statistically significant difference in ORR ( p=0.1779) and DCR ( p=0.1005) between PF and TP (55.6% vs 79.2%, 88.9% vs 100%) regimens. At this moment, mPFS has not been achieved. The most common adverse events (AEs) were anemia (22.5%, 9/40), lymphocytopenia (15%, 6/40), neutropenia(15%, 6/40), reactive cutaneous capillary endothelial proliferation (RCCEP) (12.5%, 5/40) and fatigue (7.5%, 3/40). Thrombocytopenia (2.5%, 1/40), neutropenia (2.5%, 1/40) and leukopenia (2.5%, 1/40) were the most common grade 3 or 4 toxicities The most frequently reported immune-related AEs were RCCEP (12.5%, 5/40) and hypothyroidism (7.5%, 3/40). There were no new significant adverse events. Conclusions: Camrelizumab in combination with chemotherapy is a promising regimen with good tolerability in the first-line treatment of ESCC. Compared with FP, TP had more therapeutic advantages, But the result is a stage summary, and further observation is needed. Clinical trial information: ChiCTR2000037942. [Table: see text]

The Relationship Between Achalasia and Esophageal Cancer: The Experience of a Tertiary Center

We examined the prevalence of esophageal cancer in 828 patients diagnosed with achalasia and the characteristics of patients who developed esophageal cancer. The demographic characteristics and medical records of the patients who were followed up with a diagnosis of achalasia between 1995 and 2019 were investigated from the patient files. The mean age of the patients was 51 ± 17.3, 390 of them were males (47.1%) and 438 were females (52.9%). The mean diagnosis age of the patients was 45.4 years. The median follow-up duration of the patients was 73 months (12-480). Esophageal cancer developed in 5 patients (0.6%) during follow-up. Three of these 5 patients had squamous cell carcinoma (60%) and 2 had adenocarcinoma (40%). Three of these patients were males (60%) and 2 were females (40%). The mean age of the patients was 68 (56-78), and cancer developed after a median of 156 months (24-216) after the achalasia diagnosis. Balloon dilation therapy was performed for the treatment of achalasia in all 5 patients who developed esophageal cancer. Achalasia patients have an increased risk of developing esophageal cancer compared to the general population, and patients should be followed closely for cancer development.

Prevention Strategies for Esophageal Cancer-An Expert Review.

Simple SummaryIn the last decades, there has been a rapid increase in the incidence and prevalence of esophageal cancer in many countries around the world. Although several important risk factors have been identified, strong evidence-based preventive strategies are still lacking, and the prognosis of patients diagnosed with esophageal cancer remains poor, with an average survival rate of 5 years for only 20%. This review is an attempt to summarize the epidemiology and risk factors of EC and to highlight the unresolved aspects of current prevention strategies in order to plan more fruitful future initiatives aimed at ameliorating the disappointing prognosis of this kind of digestive tumor.In the last 30 years, we have witnessed a rapid increase in the incidence and prevalence of esophageal cancer in many countries around the word. However, despite advancements in diagnostic technologies, the early detection of this cancer is rare, and its prognosis remains poor, with only about 20% of these patients surviving for 5 years. The two major forms are the esophageal squamous cell carcinoma (ESCC), which is particularly frequent in the so-called Asian belt, and the esophageal adenocarcinoma (EAC), which prevails in Western populations. This review provides a summary of the epidemiological features and risk factors associated with these tumors. Moreover, a major focus is posed on reporting and highlighting the various preventing strategies proposed by the most important international scientific societies, particularly in high-risk populations, with the final aim of detecting these lesions as early as possible and therefore favoring their definite cure. Indeed, we have conducted analysis with attention to the current primary, secondary and tertiary prevention guidelines in both ESCC and EAC, attempting to emphasize unresolved research and clinical problems related to these topics in order to improve our diagnostic strategies and management.

The prevalence of esophageal cancer after caustic and pesticide ingestion: A nationwide cohort study.

Habits such as smoking and alcohol drinking and existing esophageal malfunction are considered the main risk factors for esophageal carcinogenesis. Caustic ingestion of acidic or alkaline agents or strong irritants can induce severe esophageal corrosive injury and increase esophageal cancer risk. We studied the relationship between esophageal carcinoma and acute detergent or pesticide poisoning by using nationwide health insurance data. Methodology/Principle findings: We compared a pesticide/detergent intoxication cohort (N = 21,840) and an age- and gender-matched control cohort (N = 21,840) identified from the National Health Insurance Research Database between 2000 and 2011. We used the multivariable Cox proportional model to determine esophageal carcinoma risk. The overall incidence density of esophageal cancer was 1.66 per 10,000 person-years in the comparison cohort and 4.36 per 10,000 person-years in the pesticide/detergent intoxication cohort. The corresponding adjusted hazard ratio (HR) for esophageal cancer was 2.33 (95% confidence interval [CI] = 1.41-3.86) in the pesticide/detergent intoxication cohort compared with the control cohort. Patients with corrosive and detergent intoxication did not have a higher risk of esophageal cancer (adjusted HR = 0.98, 95% CI = 0.29-3.33) than those without pesticide/detergent intoxication. However, patients with pesticide intoxication had a significantly higher risk of esophageal cancer (adjusted HR = 2.52, 95% CI = 1.52-4.18) than those without pesticide/detergent intoxication. Conclusion: In the present study, after adjusting for conventional risk factors, we observed that pesticide intoxication could exert substantial effects through increased esophageal cancer risk. However, patients with detergent intoxication may not have an increased risk of esophageal cancer.

Epidemiology of esophageal cancer: update in global trends, etiology and risk factors.

Esophageal cancer is the eighth most common type of cancer worldwide and constitutes the sixth leading cause of cancer deaths. It is characterized by its high mortality rate, poor prognosis at time of diagnosis and variability based on geographic location. Present day, the prevalence of esophageal cancer is in transition. Although esophageal squamous cell carcinoma continues to be the most prevalent type worldwide, esophageal adenocarcinoma is quickly becoming the most prevalent type in developed countries. Risk factors for the development of esophageal squamous cell carcinoma include low socioeconomic status, consumption of tobacco, alcohol, hot beverages, and nitrosamines. Additionally, micronutrient deficiencies have also been linked to the development of esophageal squamous cell cancer. These include vitamin C, vitamin E, and folate. With respect to esophageal adenocarcinoma, risk factors include Barrett's esophagus, gastroesophageal reflux disease, obesity, and tobacco consumption. Screening for esophageal cancer will likely play an essential role in prevention, and consequently, mortality in the future. Present day, there are no established guidelines for esophageal squamous cell cancer screening. Guidelines for esophageal adenocarcinoma are more well established but lack concrete evidence in the form of randomized controlled trials. This review will discuss the epidemiology, risk factors, and current prevention strategies for esophageal cancer in depth. It is our aim to raise awareness on the aforementioned topics to increase public health efforts in eradicating this disease.

Fumonisin B1 induces toxicity in human leukocytes at low concentrations: Are computational studies effective to determine biosafety?

Fumonisin B1 is a mycotoxin produced by Fusarium verticillioides and Fusarium proliferatum found in various crops, particularly maize. Besides carcinogenicity, other manifestations have been registered in different animals and in humans. In the case of humans, epidemiological studies have reported high prevalence of esophageal cancer in populations exposed to fumonisins. This study aimed to evaluate the minimum concentration of FB1 capable of inducing cytotoxicity (cell viability test), genotoxicity (comet assay) and mutagenicity (micronucleus) in cultured human leukocytes and to evaluate the effectiveness of in silico tests to predict FB1 toxicity. All concentrations analyzed (200; 100; 50; 5; 0.5; 0.05; 0.005 μg/mL and 300; 30; 3; 1; 0.1; 0.01 fg/mL) except the lowest demonstrated dose-dependent toxicity in all parameters analyzed (p < 0.05 to p < 0.0001). As for predictions, only the Lazar software showed carcinogenicity of FB1 for rats. Thus, it is evident that FB1 is able to induce dose-dependent damage at low concentrations, and that computational tests, although desirable for prediction, are not effective as biological tests to determine toxicity, at least of FB 1 and within the experimental conditions tested.

Prevalencia del Cáncer de Esófago y su tratamiento Quirúrgico en un Hospital de alta complejidad durante el periodo enero 2016- diciembre 2018

Prevalencia del Cáncer de Esófago y su tratamiento Quirúrgico en un Hospital de alta complejidad durante el periodo enero 2016- diciembre 2018

TENDENCIES OF THE MORTALITY RATES FROM ESOPHAGEAL CANCER IN THE EU COUNTRIES AND UKRAINE

Summary. In this article the problems of the prevalence of esophageal cancer and the distribution of mortality rates from this disease are considered in EU countries. The rates of mortality from esophageal cancer are analyzed by statistical methods and time series analysis. A study is carried out of the features of the tendencies of mortality rates from esophageal cancer in six EU countries and in Ukraine. It is emphasized that various factors, such as the environmental situation, socio-demographic characteristics of the population, culture and nature of nutrition, the general health status of the population, the availability of resources and the level of healthcare in the region should be took into account for development of the programmes for the prevention of prevalence of esophageal cancer. By means of the models for time series analysis we forecast the rates of mortality from esophageal cancer for six countries of EU and for Ukraine, which can be used for the development of the national strategies to reduce the prevalence and mortality from esophageal cancer.

Obesity and outcomes for esophagectomy

: Obesity is increasing worldwide. At the same time, the prevalence of esophageal cancer markedly increased in Western countries during recent decades. Several studies on the influence of a high body mass index (BMI) on the postoperative course and survival after esophagectomy have shown contradictory results. This study is a narrative overview of the literature on esophagectomy outcomes in obese patients. Obesity is technically challenging to surgeons mostly in complex procedures. Although it cannot be an independent contraindication to esophagectomy visceral fat seems to worsen perioperative morbidity; therefore, surgeons should ensure meticulous management of co-morbidities and maintain a low threshold for the investigation and management of complications.

354 Cumulative Increase in the Prevalence of Esophageal Cancer in Patients With Gastroesophageal Reflux Disease (GERD) and Multiple Risk Factors

INTRODUCTION: The 2015 ACG clinical guidelines on Barrett’s esophagus (BE) recommend endoscopic screening for men with chronic and/or frequent GERD and two or more risk factors for BE or esophageal adenocarcinoma (EAC). However, the additive effect of these risk factors is not known. Our objective was to determine both the individual and combined effect of multiple risk factors on the prevalence of BE associated neoplasia. METHODS: Data were obtained from a commercial de-identified patient database (Explorys, IBM, Inc.) that integrates electronic health records from 26 major U.S. hospital systems from 1999 to May 2019. We identified adult patients (≥18 years) with chronic GERD for ≥5 years (having a GERD diagnosis from May 2014 to May 2019) using Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT). Controls were defined as any patient in the Explorys database with chronic GERD, whereas cases were defined as those with chronic GERD and one or more additional BE/EAC associated risk factors per ACG guidelines such as male sex, smoking, age &gt; 50 years, and Caucasian race. Odds ratios (OR) and confidence intervals (CI) for the ORs were calculated for the risk of association of each individual risk factor and with multiple risk factors combined. RESULTS: A total of 4,424,810 patients had GERD for ≥5 years. When compared to GERD controls, cases with GERD and obesity (BMI &gt;30) had a 1.4 (95% CI 1.24 – 1.55) times higher odds of a primary neoplasm of the lower esophagus. Addition of each individual risk factor as described in Table 1 shows the incremental effect of these risk factors on development of primary neoplasm of the lower esophagus. With any three out of four risk factors (chronic GERD and age &gt;50 + any three out of four associated risk factors), the odds of having a primary neoplasm of the lower esophagus increased to 6.26 (5.77 – 6.79) when compared to GERD controls. CONCLUSION: The incremental and strong association of multiple risk factors with primary neoplasm of the lower esophagus suggests a role for screening endoscopies when clinicians encounter GERD patients with multiple associated risk factors. Although this was a retrospective analysis that relied on diagnosis coding, and despite other limitations of Explorys such as lack of histology reports, and unavailability of family history of BE/EAC, our study further validates the utility of the 2015 ACG Barrett’s guidelines in everyday clinical practice.

A population-based survey of gastroesophageal reflux disease in a region with high prevalence of esophageal cancer in China

Background:The exact relationship between gastroesophageal reflux disease (GERD) and esophageal squamous cell cancer (ESCC) is far from clarification. The aim of this study was to investigate the epidemiology of GERD in a region with high prevalence of ESCC in China.Methods:A population-based, cross-sectional study was conducted in a high ESCC prevalent area, Anyang, Henan, China. All subjects fulfilled questionnaires and underwent gastroendoscopy with routine esophageal biopsy. The subjects were divided into GERD subtypes (reflux esophagitis [RE] and non-erosive reflux disease [NERD]) and controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine risk factors for RE and NERD.Results:A total of 2844 subjects were finally enrolled. The prevalence of GERD (RE + NERD) was 17.3%. Among them, 271 (9.53%) adults were diagnosed with RE. The prevalence of RE increased with age (7.09% in 45–50 years, 8.00% in 51–60 years, and 9.53% in 61–69 years, χ2 = 62.216, P < 0.001). Sixty-seven (2.36%) subjects were diagnosed with the silent RE. A total of 221 (7.77%) subjects were diagnosed with NERD. Frequent liquid food consumption (OR [95% CI]: 1.502 [1.076–2.095]) was independent risk factor for RE as well as age, male gender, high body mass index (BMI), ever smoking. Age was independent risk factor for NERD. For silent RE, age, male gender, and frequent liquid food consumption were risk factors.Conclusions:In the population with high prevalence of ESCC, a high prevalence of GERD and inverted proportion of RE/NERD were presented. Age was an independent risk factor for GERD. The male gender, high BMI, smoking, and frequent liquid food consumption may be risk factors for RE but not for NERD.

FA02.01: PREVALENCE AND RISK FACTORS FOR ESOPHAGEAL CANCER FOLLOWING ACHALASIA TREATMENT: NATIONAL POPULATION-BASED CASE-CONTROL STUDY

Abstract Background Achalasia is associated with an increased risk of esophageal cancer, however the specific population at greatest risk remains unknown. The objectives of the present study were from a large national population based cohort study to: (i) Identify the prevalence of esophageal cancer in treated achalasia patients. (ii) Consider patient and treatment related risk factors, associated with an increased prevalence of esophageal cancer. Methods Patients with esophageal achalasia diagnosed and receiving a treatment between 2002 and 2012 were identified from the Hospital Episode Statistics database. The primary outcome measure was esophageal cancer. All patients with a diagnosis of esophageal cancer within one year of achalasia primary treatment were excluded to avoid inclusion of pseudoachalasia patients. Patient and treatment factors were compared between patients who developed esophageal cancer and those that did not using univariate and multivariate analyses. Results Over the 11-year study period 7487 patients receiving an interventional treatment for esophageal achalasia were included and 101 patients (1.3%) developed esophageal cancer. The median time to cancer development was 3 years (range 1 to 11 years) from primary achalasia treatment. Patients who developed esophageal cancer were older with a greater proportion of patients aged &gt; 60 (71.3% vs. 45.4%; P &lt; 0.001), and more commonly were primarily treated with pneumatic dilation (82.2% vs. 60.3%; P &lt; 0.001). In the esophageal cancer group there was also an increase in the number of patients requiring re-interventions (47.5% vs. 38.0%; P = 0.041) and the average total number of re-interventions per patient over the study period (1.2 vs. 0.8; P = 0.026). Subset analyses for surgical myotomy and pneumatic dilation primary treatment groups showed similar associations between re-intervention and increased risk of cancer. Multivariate analysis confirmed associations between increased patient age (&gt; 80 years, HR = 18.71; 95%CI 4.30–81.44) and pneumatic dilation (HR = 2.27; 95%CI 1.03–5.03), and risk of esophageal cancer. Conclusion This national achalasia population based case-control study identified increasing patient age, pneumatic dilation and re-intervention as potential risk factors associated with the development of esophageal cancer. Patients with these risk factors should receive more intensive endoscopic surveillance to ensure esophageal cancer is appropriately diagnosed at an early stage. Disclosure All authors have declared no conflicts of interest.

Esophageal cancer research today and tomorrow: Lessons from algae and other perspectives.

Esophageal cancer is an increasing concern due to poor prognosis, aggressive disease modalities, and a lack of efficient therapeutics. The two types of esophageal cancer: esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) are responsible for an estimated 450,000 annual deaths, with over 457,000 new patients diagnosed in 2015, making it the eighth most prevalent and the 10th most fatal cancer worldwide. As esophageal cancer prevalence continues to increase, and so does the pressing need for the development of new and effective strategies for the early diagnostics, prevention, and treatment of this cancer, as well for building the innovative research tools to understand the affected molecular mechanisms.This short review summarizes the current statistics and recent research of the problems and solutions related to the esophageal cancer, and offer a brief overview of its epidemiology, molecular alterations, and existing biomedical tools. We will discuss currently available research tools and discuss selected approaches we deem relevant to find new model systems and therapies for the future with the special focus on novel opportunities presented by the unique molecules found in algae, namely carbohydrates and lipids. Their remarkable chemical variability is connected to their striking structural and functional properties, which combined with the relative novelty of these compounds to cancer biology, warrants interest of the wide biomedical community to these molecules, especially in the esophageal cancer theory and practice.

Incidence and survival of esophageal cancer with different histological types in Linzhou between 2003 and 2012

Objective: To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012. Methods: All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model. Results: There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95%CI:-16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95%CI:-9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95%CI:-7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95%CI:-9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95%CI: 33.5%-35.6%). Conclusion: Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.