Survival Of Esophageal Cancer Patients Research Articles

Small Cuts, Big Difference? The Impact of a Minimally Invasive Thoracic Phase during Ivor Lewis Esophagectomy on Long-Term Quality of Life of Esophageal Cancer Patients

Abstract Background Due to improved survival of esophageal cancer patients, long-term quality of life (QoL) is increasingly gaining importance. We analyzed QoL of patients treated with open Ivor Lewis esophagectomy (Open-E) or a hybrid operation including laparotomy and a robot-assisted thoracic phase (hRob-E), as well as a standard group of healthy individuals. Aims The aim of this study is to evaluate the impact of a minimally invasive compared to an open approach during the thoracic phase of Ivor Lewis esophagectomies on quality of life. Methods With a median follow-up of 36 months after hRob-E (n=28) and 40 months after Open-E (n=43), patients' QoL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and the EORTC Esophagus specific QoL questionnaire 18 (QLQ-OES18). Results Patients showed similar clinical-histological characteristics, yet hRob-E patients had significantly higher ASA scores at surgery (p<0.001). Patients and healthy controls reported similar global health status, emotional and cognitive functions. All of the surgically treated cancer patients reported reduced role and social functioning, fatigue, nausea and vomiting, dyspnea and diarrhea. However, physical functioning of Open-E patients was significantly reduced compared to healthy controls (p=0.019). In addition, a trend towards a better pain score after hRob-E compared to Open-E emerged (p=0.063). Regarding QLQ-OES18, hRob-E and Open-E treated patients similarly reported eating problems, reflux, and troubles swallowing saliva. Conclusion The general health status is not impaired after esophagectomy. Despite higher ASA scores, QoL of hRob-E patients is similar to that of patients operated with Open-E. Moreover, patients after hRob-E appear to have a better score regarding physical functioning and a better pain profile than patients after Open-E, indicating a benefit of a minimally invasive approach during the thoracic phase.

Exploring Potential Biomarkers in Oesophageal Cancer: A Comprehensive Analysis.

Oesophageal cancer (OC) is the sixth leading cause of cancer-related death worldwide. OC is highly aggressive, primarily due to its late stage of diagnosis and poor prognosis for patients' survival. Therefore, the establishment of new biomarkers that will be measured with non-invasive techniques at low cost is a critical issue in improving the diagnosis of OC. In this review, we summarize several original studies concerning the potential significance of selected chemokines and their receptors, including inflammatory proteins such as interleukin-6 (IL-6) and C-reactive protein (CRP), hematopoietic growth factors (HGFs), claudins (CLDNs), matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), adamalysines (ADAMs), as well as DNA- and RNA-based biomarkers, in OC. The presented results indicate the significant correlation between the CXCL12, CXCR4, CXCL8/CXCR2, M-CSF, MMP-2, MMP-9 ADAM17, ADAMTS-6, and CLDN7 levels and tumor stage, as well as the clinicopathological parameters of OC, such as the presence of lymph node and/or distant metastases. CXCL12, CXCL8/CXCR2, IL-6, TIMP-2, ADAM9, and ADAMTS-6 were prognostic factors for the overall survival of OC patients. Furthermore, IL-6, CXCR4, CXCL8, and MMP-9 indicate higher diagnostic utility based on the area under the ROC curve (AUC) than well-established OC tumor markers, whereas CLDN18.2 can be used in novel targeted therapies for OC patients.

Long-term quality of life after hybrid robot-assisted and open Ivor Lewis esophagectomy for esophageal cancer in a single center: a comparative analysis

PurposeDue to improved survival of esophageal cancer patients, long-term quality of life (QoL) is increasingly gaining importance. The aim of this study is to compare QoL outcomes between open Ivor Lewis esophagectomy (Open-E) and a hybrid approach including laparotomy and a robot-assisted thoracic phase (hRob-E). Additionally, a standard group of healthy individuals serves as reference.MethodsWith a median follow-up of 36 months after hRob-E (n = 28) and 40 months after Open-E (n = 43), patients’ QoL was assessed using the European Organization for Research and Treatment of Cancer (EORTC) QoL Questionnaire Core 30 (QLQ-C30) and the EORTC Esophagus specific QoL questionnaire 18 (QLQ-OES18).ResultsPatients showed similar clinical-pathological characteristics, but hRob-E patients had significantly higher ASA scores at surgery (p < 0.001). Patients and healthy controls reported similar global health status and emotional and cognitive functions. However, physical functioning of Open-E patients was significantly reduced compared to healthy controls (p = 0.019). Operated patients reported reduced role and social functioning, fatigue, nausea and vomiting, dyspnea, and diarrhea. A trend towards a better pain score after hRob-E compared to Open-E emerged (p = 0.063). Regarding QLQ-OES18, hRob-E- and Open-E-treated patients similarly reported eating problems, reflux, and troubles swallowing saliva.ConclusionsThe global health status is not impaired after esophagectomy. Despite higher ASA scores, QoL of hRob-E patients is similar to that of patients operated with Open-E. Moreover, patients after hRob-E appear to have a better score regarding physical functioning and a better pain profile than patients after Open-E, indicating a benefit of minimally invasive surgery.

CT-Based Radiomics Combined with Genomics may Predict Survival in Esophageal Cancer Patients Receiving Definitive Chemoradiotherapy.

Definitive chemoradiotherapy (dCRT) is a standard treatment option for locally advanced stage inoperable esophageal squamous cell carcinoma (ESCC). Evaluating clinical outcome prior to dCRT remains challenging. The purpose of this study was to evaluate the predictive power of contrast-enhanced computed tomography (CT)-based radiomics in combination with genomics for the treatment efficacy of ESCC patients after dCRT. A total of 118 ESCC patients who received dCRT were enrolled in this retrospective study. These patients were randomly divided into the training group (N = 82) or the validation group (N = 36). Radiomic features were derived from the region of primary tumor on pretreatment CT images, also known as the region of interest (ROI), and clinical features were generated from medical records. The least absolute shrinkage and selection operator (LASSO) regression was conducted to select optimal radiomic features, and Rad-score was calculated to predict progression-free survival (PFS) in the training group. Genomic DNA was extracted from formalin-fixed and paraffin-embedded pre-treatment biopsy tissue. The univariate and multivariate COX analyses were undertaken to determine the predictors for developing models. The area under receiver operating characteristic curve (AUC) and the C-index were used to evaluate the predicting performance and the discriminating ability of prediction models, respectively. A total of 851 radiomic features were extracted from each CT image. The final Rad-score were constructed from 6 radiomic features to predict PFS. Multivariate analysis demonstrated that Rad-score and HRR pathway alterations were independent prognostic factors correlated with PFS. The C-index of integration model in combination with radiomics and genomics was better than that of radiomics or genomics model in the training group (0.616 vs 0.587 or 0.557) and the validation group (0.649 vs 0.625 or 0.586). Kaplan-Meier survival analysis also showed significant differences between different risk subgroups in the training and validation groups. The Rad-score based on pre-treatment CT and HRR pathway alterations could predict PFS for patients with ESCC after dCRT, with better predictive efficacy of combined radiomics and genomics models.

External validation of a nomogram predicting conditional survival after tri-modality treatment of esophageal cancer

BackgroundA conditional survival nomogram was developed at a single high-volume center to predict 5-year overall survival for esophageal cancer patients after neoadjuvant chemoradiation and esophagectomy. The aim of this study was to externally validate the nomogram in a cohort of patients with esophageal adeno- or squamous cell carcinoma from another high-volume center. MethodsConsecutive patients with an esophageal adeno- or squamous cell carcinoma who had undergone esophagectomy after being treated with preoperative chemoradiation between 2004 and 2016 were selected from a prospectively maintained institutional database. The level of discrimination for prediction of 5-year overall survival was quantified by Harrell’s C statistic. Calibration of the conditional survival nomogram was visualized by plotting predicted 5-year survival and observed 5-year survival for comparison. ResultsOf the 296 patients examined, the probability of 5-year overall survival directly after surgery was 45% and increased to 51%, 68%, 78%, and 89% for each additional year survived. The predicted 5-year overall survival differed from the observed survival, with a calibration slope of 0.54, 0.55, 0.59, 0.73, and 1.09 directly after surgery and 1, 2, 3, and 4 years of survival after surgery, respectively. The nomogram's discrimination level for 5-year survival was moderate, with a C statistic of 0.65 compared to the 0.70 reported in the original study. ConclusionThe nomogram model has moderate predictive discrimination and accuracy, supporting its applicability to external cohorts to predict conditional survival. Further validation studies should empirically assess the model for predictive performance.

Two novel clinical tools to predict the risk of bone metastasis and overall survival in esophageal cancer patients: a large population-based retrospective cohort study.

The aim of this study was to construct two web-based nomograms to predict the probability of bone metastasis (BM) in esophageal cancer (EC) patients and the prognostic of EC patients with BM (ECBM). We collected the data of EC and ECBM patients in the Surveillance, Epidemiology and End Results (SEER) database from 2010 to 2015. Independent risk variables for the development of BM in EC patients were identified using univariate and multivariate logistic regression analyses. Univariate and multivariate Cox regression analyses were used to assess independent prognostic variables in ECBM patients. And then, constructed two nomograms to predict the risk of bone metastases and overall survival (OS) of ECBM patients. Survival differences were studied by Kaplan-Meier (K-M) survival analysis. The predictive efficacy and clinical applicability of these two nomograms were assessed by using receiver operating characteristic (ROC) curve, the area under curve (AUC), calibration curve and decision curve analysis (DCA). We selected a total of 6839 patients with EC, of which 326 (4.77%) had BM at the time of initial diagnosis. The results of K-M survival and Cox regression analysis showed significant effects of BM on the OS in EC patients. Age, N stage, tumor size and brain/liver/lung organ metastasis were identified as BM-related risk variables. Chemotherapy and brain/liver organ metastasis were identified as ECBM-related prognostic variables. The ROC, AUC, calibration curves and DCA of two nomograms all showed excellent predictive efficacy and clinical applicability. These two nomograms were constructed and validated, which could objectively predict the risk of BM in EC patients and the prognostic in ECBM patients. These tools are expected to make valuable contributions in clinical work, informing surgeons in making decisions about patient care.

Timely assessment of 5-year relative survival of esophageal cancer patients in Taizhou, Zhejiang province.

Timely assessment of 5-year relative survival of esophageal cancer patients in Taizhou, Zhejiang province.

Co-Expression of Chromatin Assembly Factor 1 Subunit A and Proliferating Cell Nuclear Antigen Is a Prognostic Biomarker of Esophageal Cancer

(1) Background: Esophageal cancer (EC) is an important global health challenge. Due to the lack of necessary biomarkers and therapeutic targets, the survival of EC patients is poor. The EC proteomic data of 124 patients recently published by our group provides a database for research in this field. (2) Methods: Bioinformatics analysis was used to identify DNA replication and repair-related proteins in EC. Proximity ligation assay, colony formation assay, DNA fiber assay, and flow cytometry were used to study the effects of related proteins on EC cells. Kaplan–Meier survival analysis was used to evaluate the relationship between gene expression and the survival time of EC patients. (3) Results: Chromatin assembly factor 1 subunit A (CHAF1A) was highly correlated with proliferating cell nuclear antigen (PCNA) expression in EC. CHAF1A and PCNA colocalized in the nucleus of EC cells. Compared with the knockdown of CHAF1A or PCNA alone, the double knockdown of CHAF1A and PCNA could significantly inhibit EC cell proliferation. Mechanistically, CHAF1A and PCNA synergistically accelerated DNA replication and promoted S-phase progression. EC patients with high expression of both CHAF1A and PCNA had a worse survival rate. (4) Conclusion: we identify CHAF1A and PCNA as key cell cycle-related proteins leading to the malignant progression of EC, and these proteins could serve as important prognostic biomarkers and targets for EC.

Prognostic value of radiomic features in patients with esophageal cancer treated with chemoradiotherapy.

The aim of the present study was to evaluate the prognostic value of radiomic features in patients who underwent chemoradiotherapy for esophageal cancer. In this retrospective study, two independent cohorts of esophageal cancer patients treated with chemoradiotherapy were included. Radiomics features of each patient were extracted from pre-treatment computed tomography (CT) images. Radiomic features were selected by employing univariate and multivariate analyses in the test cohort. Selected radiomic features were verified in the validation cohort. The endpoint of the present study was overall survival. A total of 101 esophageal cancer patients were included in our study, with 71 patients in the test cohort and 30 patients in the validation cohort. Univariate analysis identified 158 radiomic features as prognostic factors for overall survival in the test cohort. A multivariate analysis revealed that root mean squared and Low-High-High (LHH) median were prognostic factors for overall survival with a hazard ratio of 2.23 (95% confidence interval [CI]: 1.16-4.70, P = 0.017) and 0.26 (95% CI: 0.13-0.54, P < 0.001), respectively. In the validation cohort, root mean squared high/LHH median low group had the most preferable prognosis with a median overall survival of 73.30 months (95% CI: 32.13-NA), whereas root mean squared low/LHH median low group had the poorest prognosis with a median overall survival of 9.72 months (95% CI: 2.50-NA), with a P value of < 0.001. We identified two radiomic features that might be independent prognostic factors of overall survival of esophageal cancer patients treated with chemoradiotherapy.

MicroRNA-532 Promotes Proliferation, Metastasis and Autophagy in Esophageal Cancer via Targeting Naked Cuticle 1

The aim of this study was to elucidate the role of microRNA-532 in influencing the progression of esophageal cancer and cell autophagy through negatively regulating Naked cuticle 1 (NKD1) level. Relative levels of microRNA-532 and NKD1 in esophageal cancer tissues and corresponding paracancerous ones were detected. The relationship between microRNA-532 level and overall survival in esophageal cancer patients was statistically analyzed. Subsequently, regulatory effects of microRNA-532 and NKD1 on viability, metastasis and autophagy in TE-1 and EC-109 cells were examined. The interaction between microRNA-532 and NKD1 was finally explored. MicroRNA-532 was upregulated in esophageal cancer tissues and its high level indicated poor prognosis in esophageal cancer patients. Serving as the downstream gene binding microRNA-532, NKD1 level was negatively regulated by microRNA-532. Knockdown of microRNA-532 weakened viability and metastasis, as well as downregulated autophagy-associated genes (Atg5, LC-3I and LC-3II) in TE-1 and EC-109 cells. Knockdown of NKD1 achieved the opposite results. MicroRNA-532 promotes proliferation, metastasis and autophagy in esophageal cancer by downregulating NKD1. It is believed that microRNA-532 may be a promising therapeutic target for esophageal cancer.

The association between statin use and prognosis in esophageal cancer patients: A meta-analysis.

The impact of statin use on the survival of esophageal cancer patients remains unclear now. The aim of this study was to identify the relationship between statin use and the long-term survival of esophageal cancer patients. The PubMed, EMBASE, and Web of Science databases were searched up to August 20, 2022, for relevant studies. The endpoints included overall survival (OS), cancer-specific survival (CSS), recurrence-free survival, and hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were pooled to assess the association between statin use and the prognosis of esophageal cancer patients. Subgroup analysis based on the pathological type (adenocarcinoma vs squamous cell carcinoma), dose of statin use and tumor stage (tumor-node-metastasis I-III vs IV) was further performed. All statistical analyses were conducted using STATA 12.0 software. A total of 7 retrospective studies involving 25,711 participants were included in this meta-analysis. The pooled results indicated that statin use was significantly associated with improved OS (HR = 0.80, 95% CI: 0.74-0.87, P < .001), CSS (HR = 0.77, 95% CI: 0.74-0.89, P < .001), and recurrence-free survival (HR = 0.38, 95% CI: 0.16-0.87, P = .022). Furthermore, subgroup analysis stratified by the pathological type, dose of statin use and tumor stage for OS and CSS showed similar results and indicated the protective role of statin use in the prognosis of esophageal cancer patients. Statin use is significantly associated with improved long-term survival of esophageal cancer patients and might serve as a promising prognostic indicator in esophageal cancer. However, more prospective high-quality studies are still needed to verify our findings.

Association between hospital safety-net burden and receipt of trimodality therapy and survival for patients with esophageal cancer

BackgroundTo examine the relationship between hospital safety-net burden and (1) receipt of surgery after chemoradiation (trimodality therapy) and (2) survival in esophageal cancer patients. MethodsThe National Cancer Database was queried to identify 22,842 clinical stage II to IVa esophageal cancer patients diagnosed in 2004 to 2015. The treatment facilities were categorized by proportion of uninsured/Medicaid-insured patients into percentiles. No safety-net burden hospitals (0–37th percentile) treated no uninsured/Medicaid-insured patients, whereas low (38–75th percentile) and high (76–100th percentile) safety-net burden hospitals treated a median (range) of 8.8% (0.87%–16.7%) and 23.6% (16.8%–100%), respectively. Adjusted odds ratios and hazard ratios with 95% confidence intervals were computed, adjusting for patient, tumor, and treatment characteristics. ResultsCompared to no safety-net burden hospital patients, high safety-net burden hospital patients were significantly more likely to be young, Black, and low-income. Age, female sex, Black race, Hispanic ethnicity, nonprivate insurance, lower income, higher comorbidity score, upper esophageal location, squamous cell histology, higher stage, time to treatment, and treatment at a community program or a low-volume facility were associated with lower odds of receiving trimodality therapy. Adjusting for these factors, high safety-net burden hospital patients were less likely to receive surgery after chemoradiation versus no safety-net burden hospital patients (adjusted odds ratio 0.77 [95% confidence interval 0.68–0.86], P < .0001); no difference was detected comparing low safety-net burden hospitals versus no safety-net burden hospitals (adjusted odds ratio 1.01 [0.92–1.11], P = .874). No significant survival difference was noted by safety-net burden (low safety-net burden hospitals versus no safety-net burden hospitals: adjusted hazard ratio 1.01 [0.96–1.06], P = .704; high safety-net burden hospital versus no safety-net burden hospitals: adjusted hazard ratio 0.99 [0.93–1.06], P = .859). ConclusionAdjusting for patient, tumor, and treatment factors, high safety-net burden hospital patients were less likely to undergo surgery after chemoradiation but without significant survival differences.

LncRNA SSTR5-AS1 Predicts Poor Prognosis and Contributes to the Progression of Esophageal Cancer.

Esophageal cancer (ESCA), as a common cancer worldwide, is a main cause of cancer-related mortality. Long noncoding RNAs (lncRNAs) have been shown in an increasing number of studies to be capable of playing an important regulatory function in human malignancies. Our study is aimed at delving into the prognostic value and potential function of lncRNA SSTR5-AS1 (SSTR5-AS1) in ESCA. The gene expression data of 182 ESCA samples from TCGA and 653 nontumor specimens from GTEx. The expressions of SSTR5-AS1 were analyzed. We investigated whether there was a correlation between the expression of SSTR5-AS1 and the clinical aspects of ESCA. In order to compare survival curves, the Kaplan-Meier method together with the log-rank test was utilized. The univariate and multivariate Cox regression models were used to analyze the data in order to determine the SSTR5-AS1 expression's significance as a prognostic factor in ESCA patients. In order to investigate the level of SSTR5-AS1 expression in ESCA cells, RT-PCR was utilized. CCK-8 trials served as a model for the loss-of-function tests. In this study, we found that the expressions of SSTR5-AS1 were increased in ESCA specimens compared with nontumor specimens. According to the ROC assays, high SSTR5-AS1 expression had an AUC value of 0.7812 (95% CI: 0.7406 to 0.8217) for ESCA. Patients who had a high level of SSTR5-AS1 expression had a lower overall survival rate than those who had a low level of SSTR5-AS1 expression. In addition, multivariate analysis suggested that SSTR5-AS1 was an independent predictor of overall survival for ESCA patients. Moreover, RT-PCR experiments indicated that SSTR5-AS1 expression was distinctly increased in three ESCA cells compared with HET1A cells. CCK-8 experiments indicated that silence of SSTR5-AS1 distinctly inhibited the proliferation of ESCA cells. Overall, ESCA patients with elevated SSTR5-AS1 had a worse chance of survival, suggesting it could be used as a prognostic and diagnostic biomarker for ESCA.

ASO Visual Abstract: The Impact of Pretreatment Esophageal Stenosis on Survival in Esophageal Cancer Patients.

ASO Visual Abstract: The Impact of Pretreatment Esophageal Stenosis on Survival in Esophageal Cancer Patients.

The Effect of Monocyte Count on Disease-free Survival in Esophageal Cancer Patients

The Effect of Monocyte Count on Disease-free Survival in Esophageal Cancer Patients

Clinical characteristics and survival of esophageal cancer patients: annual report of the surgical treatment in Shanghai Chest Hospital, 2017

Clinical characteristics and survival of esophageal cancer patients: annual report of the surgical treatment in Shanghai Chest Hospital, 2017

The effectiveness of adjuvant treatment approaches for resectable esophageal cancer: A single-center experience.

In general, neoadjuvant treatment is the standard for clinical stage II/III esophageal cancer (EC), whereas the effect of adjuvant treatment on survival still remains controversial. The aim of this study was to investigate the efficacy of adjuvant treatment modalities on the survival of EC patients. A total of 63 patients with stage II-IVA EC who had undergone curative surgery between the years 2002 and 2020 were included in the study. Patients' data were retrospectively collected from oncologic follow-up files. Various treatment regimens were administered during this period, including chemotherapy and chemoradiotherapy. The median age was 56 years (24-73), and the number of males was slightly higher than females (male/female: 33/30). While 32 (51%) patients received postoperative adjuvant treatment, the remaining 31 (49%) patients underwent surgery alone. The median overall survival (OS) was 45.9 months (95% confidence interval [CI]: 25.1-66.8) in patients receiving adjuvant therapy and 37.6 months (95% CI: 20.9-54.4) in patients not receiving adjuvant therapy. The 8.3-month survival difference was statistically insignificant (P = 0.54). The 1-, 3-, and 5-year OS rates were 87.5% versus 77.4%, 58.4% versus 51.6%, and 40.8% versus 27.6% for patients with and without adjuvant therapy, respectively. Pathological stage (P = 0.028) and lymph node status (P = 0.044) were significant prognostic factors for survival. This study did not support the benefit of adjuvant treatment compared with surgery alone in completely resected EC patients. The reason for this result may be related to the small sample size and different treatment regimens due to the change in treatment options over time.

The Impact of Pretreatment Esophageal Stenosis on Survival of Esophageal Cancer Patients.

Little is known about the survival impacts of pretreatment cancerous stenosis on patients with esophageal carcinoma (EC). The clinicopathologic characteristics of patients who underwent surgery for EC between January 2010 and December 2018 were retrospectively reviewed. Esophageal stenosis was defined as present when a thin endoscope could not be passed through the tumor site. The impacts of stenosis on overall survival (OS) and cancer-specific survival (CSS) were evaluated using Cox hazards analysis. Of the 496 EC patients in this study, 51 (10.3 %) had pretreatment esophageal stenosis. Stenosis was associated with lower body mass index (P < 0.001) and higher pStage (P < 0.001). The 3-year OS rate for the patients with stenosis was significantly poorer than for the patients without stenosis (40.2 % vs 69.6 %; hazard ratio [HR], 2.19; P < 0.001). The survival outcomes, especially CSS, for the patients with stenosis were significantly poorer than for the patients without stenosis for both pStage II-III (P = 0.009) and pStage IV (P = 0.006) disease. The OS and CSS curves were well stratified by the presence of stenosis even in early-stage (pStage II) patients (P = 0.04 and P < 0.01, respectively). Multivariable analysis showed esophageal stenosis, pStage III-IV disease, and non-curative resection to be independently associated with poor OS (HR, 1.61; P = 0.02) and poor CSS (HR,1.67; P = 0.02). Higher pStage was an independent predictor of poor CSS for patients without stenosis, but not for those with stenosis. Esophageal carcinoma patients with pretreatment stenosis had significantly poorer survival outcomes, especially poorer CSS, than those without stenosis in both early- and advanced-stage diseases.

Clinical characteristics and survival of esophageal cancer patients: annual report of the surgical treatment in Shanghai Chest Hospital, 2016.

Esophageal cancers present a significant burden of disease and remain one of the most lethal of cancers worldwide, particular in China. Surgical treatment remains the cornerstone of esophageal cancers, and a real-world data from a high-volume esophageal cancer center have guiding significance in evaluation of the current clinical practice. This report describes the clinical characteristics, treatment outcomes, and survival of surgical treatment in patients with esophageal cancer in Shanghai Chest Hospital (SCH). All patients diagnosed with esophageal cancer who received esophagectomy or endoscopic resection at SCH in 2016 were included in this study. The baseline characteristics, treatment-related outcomes, and follow-up data were collated from the medical records and a prospectively maintained database. The clinicopathological characteristics, surgical complications, and oncologic outcomes were summarized. Kaplan-Meier method was used to estimate their survival and Cox regression model was used to estimate the associated risk factors. In 2016, a total of 546 patients with esophageal cancer received surgical or endoscopic resection at SCH (including 517 esophagectomies and 29 endoscopic resections). Most patients (52.4%) were between 60-69 years old, 79.5% were male, and for more than half of all patients (51.3%), the tumor was located at the middle thoracic esophagus. Overall, 11.0% (60/546) of patients received neoadjuvant therapy and 45.8% (250/546) of patients were treated with adjuvant therapy. Minimally invasive esophagectomy (including thoracoscopy and robot-assisted) was performed in 58.0% of patients and the R0 resection rate was 90.3%. The postoperative 30- and 90-day mortality was 0.73% and 1.1%, respectively. For the esophagectomy cohort, the 1-, 2-, 3-, 4-, and 5-year overall survival (OS) rates were 86.5%, 67.8%, 59.9%, 54.5%, 51.8%, and for cancer specific survival (CSS), the rates were 91.8%, 74.2%, 66.6%, 61.2%, and 59.1%, respectively. Through a standardized surgical procedure, the short- and long-term outcomes of patients with esophageal cancer were acceptable with good safety and oncological control in a high-volume center in China. This study reveals important surgical treatment effects of esophageal cancer patients and contributes to improvement of clinical management and future treatment development.

Combined assessment of muscle quality and quantity predicts oncological outcome in patients with esophageal cancer

BackgroundSarcopenia consists of two dysregulation patterns of body composition, myopenia and myosteatosis. The aim of this study is to compare the preoperative status of various body composition indexes including our newly developed modified intramuscular adipose tissue content (mIMAC) to investigate these clinical values in esophageal cancer patients. MethodWe assessed preoperative psoas muscle mass index (PMI), IMAC, and mIMAC in 150 esophageal cancer patients. ResultsPreoperative high IMAC and low mIMAC status were significantly associated with older age. Preoperative decreased mIMAC was significantly associated with advanced T classification and the presence of distant metastasis and low preoperative mIMAC was an independent prognostic factor for poor overall survival and disease-free survival in esophageal cancer patients. Combined assessment of preoperative mIMAC with PMI could help stratify risk for oncological outcomes. Finally, preoperative PMI and mIMAC were positively correlated with various nutritional factors in esophageal cancer patients. ConclusionCombined assessment between preoperative PMI and mIMAC could stratify risk for oncological outcomes, and preoperative mIMAC might be surrogate marker for aging and nutritional status in esophageal cancer patients.