Survival Of Esophageal Cancer Patients Research Articles

Textbook Outcome after Robotic and Laparoscopic Ivor Lewis Esophagectomy is Associated with Improved Survival – A Propensity Score Matched Analysis

Esophagectomy is central to curative therapy for esophageal cancer (EC). Perioperative outcomes affect both disease-free and overall survival in oncological esophageal surgery. The adoption of robotic techniques may improve surgical outcome. However, the complex nature of perioperative outcomes is not adequately captured by individual quality measures. All patients after minimally invasive esophagectomy (MIE) or robotic-assisted MIE (RAMIE) junction between 2015 and 2022 were included. Textbook outcome was defined as negative resection margins (R0), retrieval of >20 lymph nodes, no major complications, reinterventions, ICU readmission, 30-day readmission or mortality and hospital stay <21 days. Individual propensity scores were calculated using a logistic regression model. Factors affecting TO were evaluated using a logistic regression model while multivariate Cox proportional-hazards model was used to evaluate TO and survival. Of 236 patients included in this study, 106 (44.91%) achieved TO. TO was achieved in 71 cases after MIE (n=71 (41.21%)) and 31 after RAMIE (n=31 (57.41%)(p=0.036). RAMIE was associated with achievement of TO (OR: 2.01; 95% CI: 1.07-3.80; p=0.031) in the overall cohort. Achievement of TO was due to a reduction in major complications in the RAMIE group. Patients with perioperative TO had a higher 3 year disease-free survival (DFS) rate and overall survival rate (UV: HR 2.49, 95% CI: 1.18-5.26, p=0.016; MV: HR 4.30, 95% CI: 1.60-11.55, p=0.004) compared to those without perioperative TO and disease-free survival (UV: HR 2.28, 95% CI: 1.24-4.19, p=0.008; MV: HR 2.82, 95% CI: 1.26-6.32, p=0.011) after 2 year follow up. RAMIE is associated with an increased TO achievement. Achieving TO is associated with enhanced long-term survival in esophageal cancer patients and warrants continued emphasis on surgical quality improvement.

Nomogram model for predicting long-term survival in esophageal cancer patients with metastasis after treatment: a SEER-based study.

There is a large variance in the long-term survival of esophageal cancer (EC) patients with metastasis after treatment. This study was designed to analyze long-term survival of metastatic EC patients after surgery, radiotherapy and chemotherapy. A retrospective cohort of EC patients with metastasis received surgery, radiotherapy and chemotherapy from 2004 to 2015 was obtained from the Surveillance, Epidemiology and End Results (SEER) database. Univariate Cox and complete subset regression analyses were performed to select prognostic factors. Nomograms were established to predict 3-, 5-, and 8-year overall survival (OS), and their performance was evaluated by receiver operating characteristic (ROC) curve and calibration curve. Age at diagnosis [hazard ratio (HR): 1.01; 95% confidence interval (CI): 1.00, 1.02; P=0.04], EC of other sites (HR: 1.78; 95% CI: 1.29, 2.45; P<0.001), lymph node involvement (HR: 1.37; 95% CI: 1.08, 1.37; P=0.009), and poorly differentiated or undifferentiated (grade III or IV) (HR: 1.39; 95% CI: 1.20, 1.76; P=0.006) was the independent risk factors for poor OS in EC patients. Female (HR: 0.58; 95% CI: 0.38, 0.88; P=0.01) showed reduced risks of showing poor OS compared with male population. The established nomograms based on these predictors showed satisfactory discrimination efficacy for predicting 3-, 5-, and 8-year OS in metastatic EC patients after treatment. The nomograms showed good efficacy in predicting 3-, 5-, and 8-year OS among metastatic EC patients after surgery, radiotherapy and chemotherapy.

Evaluating the Impact of Post-Esophagectomy Exercise on 2- and 5-Year Survival: Findings from the PERFECT Trial.

Despite recent treatment advances, esophageal cancer still has poor survival and a high morbidity. Exploratory evidence suggests that exercise can reduce cancer-related mortality and recurrence rates. Here, we investigated the effects of an exercise intervention in the first year after esophagectomy on survival in participants of the Physical ExeRcise Following Esophageal Cancer Treatment (PERFECT)-trial. In the PERFECT-trial, esophageal cancer patients who had undergone esophagectomy were randomized to a 12-week exercise program (EX) or the control group (CG). We assessed 2- and 5-year (progression-free) survival. (Un)adjusted Cox Proportional-Hazards models were used to calculate hazard ratios (HRs) for comparison between the trial arms. Sensitivity analyses, excluding patients with events within the exercise intervention period, were performed. In total, 120 participants (EX = 61; CG = 59) were included in the PERFECT-trial. After 2-year follow-up, no significant difference in the risk of death or progression between EX and CG was found (adjusted HR = 1.65, 95% CI [0.75-3.63] and 1.38, 95% CI [0.76-2.50], respectively). After excluding patients with events during the intervention period (EX = 8; CG = 4), 2-year HRs for death (1.03, 95% CI [0.41-2.56]) and progression (1.26, 95% CI [0.64-2.48]) both decreased and remained insignificant. No significant effects were found on 5-year mortality (1.03, 95% CI [0.57-1.84]) and progression (1.21, 95% CI [0.72-2.04]) either. Sensitivity-analysis resulted in attenuated 5-year HRs for mortality (0.82, 95% CI [0.42-1.58]) and progression (1.08, 95% CI [0.61-1.92]). The results indicate no benefit of a 12-week exercise program in the first year post-esophagectomy on 2- and 5-year (progression-free) survival in esophageal cancer patients. The absence of beneficial effects may be explained by the relatively short exercise program, which was performed after treatment completion.

199. YOUNGER AGE AS AN INDEPENDENT FACTOR FOR SUBSEQUENT HEAD AND NECK CANCER AFTER CURATIVE ESOPHAGECTOMY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract Background Post-operative survival of esophageal cancer patients has improved with advances in technology and treatment modalities. However, squamous cell carcinoma often affects the esophagus together with the head and neck regions, with second primary head and neck cancer (SPHNC) adversely influencing the patients’ quality of life. Therefore, patients with esophageal squamous cell carcinoma (ESCC) should be carefully followed up post-operatively. This study evaluated the risk of developing SPHNCs after an esophagectomy for ESCC. Methods Patients with ESCC who underwent curative esophagectomy from January 2008 to December 2017 from two tertiary medical centers, Taipei Veteran General Hospital and Kaohsiung Veteran General Hospital, were retrospectively reviewed. SPHNC development was documented according to anatomic region and the cumulative incidence rate and risk factors were analyzed. Results The median observation time of the 435 patients included in our study was 48.5 months [interquartile range (IQR) 16.7–92.4 months]. Among the ESCC patients after curative esophagectomy, younger age &amp;lt;50 [hazard ratio (HR) 4.13, 95% CI: 2.53–6.75, p &amp;lt; 0.001) was the only independent factor for developing SPHNCs in the multivariable analysis. The cumulative incidence rate of SPHNCs of patients aged &amp;lt; 50 years old was 14.3%, 22.1%, and 34.2% after 3, 5, and 10 years, respectively. Conclusion There was a high risk of secondary cancer after ESCC in the upper aerodigestive tract, especially the head and neck regions, therefore active surveillance is strongly recommended, especially in younger patients.

430. PROGNOSTIC PATTERNS OF LYMPH NODES WITH COMPLETE TREATMENT RESPONSE IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER NEOADJUVANT CHEMORADIOTHERAPY AND NEOADJUVANT CHEMOTHERAPY

Abstract Background The prognostic significance of lymph nodes with pathological complete treatment response (pcr-LN) has not been well investigated in esophageal squamous cell carcinoma (ESCC). We aimed to determine the prognostic impact of pcr-LNs in ESCC after either neoadjuvant chemoradiotherapy (nCRT) or neoadjuvant chemotherapy (nCT). Methods 578 patients with ESCC from two medical facilities were analyzed retrospectively, with 303 patients receiving nCRT and 275 receiving nCT. Pcr-LNs were defined as LNs exhibiting regression changes, such as fibrosis, mucin lakes, keratinization, and giant cell responses but no evidence of living tumor cells. 5 LN status subgroups were identified based on the ypN category in 8th AJCC: ypN0/pcr-LN-, ypN0/pcr-LN+, ypN1, ypN2, and ypN3. The Kaplan-Meier approach was used to analyze the overall survival (OS), and subgroup findings were compared using the log-rank test. Multivariate analysis of OS was performed using a Cox proportional hazard model. Results 45 patients were classified into ypN0/pcr-LN+ (7.8%), 33 in the nCRT group, and 12 in the nCT group (p = 0.006). Compared to the nCRT group, the nCT group underwent a more thorough LN dissection (LN (mean (SD)): nCRT, 21.05 (8.77); nCT, 26.08 (11.66); p = 0.001). Survival analysis of OS showed the subgroup ypN0/pcr-LN+ had a significantly worse prognosis than ypN0/pcr-LN- in the nCRT group (p = 0.047), but no difference was seen in the nCT group. Multivariable analysis revealed that ypN0/pcr-LN+ patients in the nCRT group had a greater risk of mortality than ypN0/pcr-LN- patients (p = 0.0487). Conclusion The nCRT group had a more noticeable complete treatment response in LNs than the nCT group. However, in comparison to the nCT group, the nodal downstaging with radiotherapy in the nCRT group may not translate into improved outcomes. More aggressive systemic therapy might be required to improve the overall survival in esophageal cancer patients receiving neoadjuvant treatment.

1347: Influence of nutritional status on survival in esophageal cancer patients undergoing RT and surgery

1347: Influence of nutritional status on survival in esophageal cancer patients undergoing RT and surgery

Early diagnosis of esophageal cancer: How to put “early detection” into effect?

This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology , focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving “early detection”. The five-year age-standardized net survival for esophageal cancer patients falls short of expectations. Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer. While advancements in endoscopic technology have been significant, there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques. Therefore, it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer, investigate the most cost-effective screening methods suitable for different regions, and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.

Multidisciplinary team meetings improve survival in patients with esophageal cancer.

Multidisciplinary team meetings (MDTs) are recommended for patients with esophageal cancer. Improved staging, timeliness to surgery and better adherence to guidelines have been attributed to MDTs, but there are few studies published on the MDTs' effect on survival. All patients with esophageal cancer in Sweden between 2006 and 2018 were grouped according to whether they had been discussed at an MDT as part of their clinical pathway. Factors affecting group allocation were explored with multivariable logistic regression, and the impact of MDT on survival was studied with Cox-regression and the Kaplan-Meier estimator. Of 6837 included patients, 1338 patients (20%) were not discussed at an MDT. Advanced age (80-90years; odds ratio [OR] 0.25, 0.16-0.42 (95% confidence interval)) and clinical stage IVb (OR 0.65, 0.43-0.98) decreased the probability of being presented at an MDT, whereas high education level (OR 1.31, 1.02-1.67), being married (OR 1.20, 1.01-1.43), squamous histology (OR 1.50, 1.22-1.84) and later year of diagnosis (OR 1.33, 1.29-1.37 per year) increased the probability of an MDT. In multivariable adjusted analysis, MDT discussion was associated with improved survival (hazard ratios 0.72, 0.66-0.78) and median survival increased from 4.5 to 10.7months. MDTs were associated with improved survival for esophageal cancer patients. Elderly patients with advanced disease and poor socioeconomic status were less likely to be presented at an MDT, but had clear survival-benefits if they were discussed in a multidisciplinary setting.

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&amp;lt;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.

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.

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.