Survival Rate Of Esophageal Cancer Research Articles

Understanding the Spectrum of Esophageal Cancer Disparities

Esophageal cancer carries an immense burden of disease. Despite advances in cancer care, the survival rate of esophageal cancer has not significantly improved over the last 30 years. The burden of disease is greater on minorities, immigrants, and lower socioeconomic groups in the United States. Research has consistently shown that these communities suffer from persistently worse outcomes. Minorities are noted to have increased risk of developing esophageal cancer, have worse stage at presentation, and limited access to the newest advancements and best treatment options. The reason for these disparities is multifactorial and the US health system must address and correct the underlying reasons to ensure just health care for all.

Patterns of Palliative Treatments in Stage IV Esophageal Cancer.

Background: The 5year survival rate of esophageal cancer is under 20%. Studies have shown that early palliative treatments can improve patient quality of life and lower depressed mood without expediting mortality. Despite these benefits, few studies have analyzed factors associated with the national variation among patients who received palliative treatment for esophageal cancer. Methods: This is a retrospective study of adults diagnosed with stage IV esophageal cancer between 2004 and 2018 in the National Cancer Database (NCDB) who received palliative treatment or not (n = 43,599). Cross tabulation and binary logistic regression were performed and evaluated using SPSS. Exclusion criteria included concurrent tumors, patients under age 18, and missing data. Results: Of the 43,599 patients, 26.1% of patients received palliative interventions (n = 11,371). The majority of palliative treatment patients lived less than 6 months after diagnosis (54%) and received radiation (35.7%) or chemotherapy (34.5%) with palliative intent. The patients who received palliative treatment tended to be non-Hispanic (96.6%), white (87.2%), male (83.3%) patients between age 61 and 75 (43.8%) at a comprehensive community cancer program (38.7%) with adenocarcinoma histology (71.8%). Palliative treatment patients most commonly relied on Medicare as their primary payor (45.9%) and had a median household income over $48,000 (54.5%). Conclusion: We identified trends among stage IV esophageal cancer patients receiving palliative treatments. Patients receiving palliative treatments tended to be white, non-Hispanic men. Compared to patients who did not receive palliating treatments, this cohort was more likely to receive treatment at a comprehensive, academic, or integrated network facility.

Evaluation of multiple immune cells and patient outcomes in esophageal squamous cell carcinoma.

Recent reports indicate that immune cells in solid cancers have significant predictive and therapeutic value. IgG4 is a subclass of IgG and we recently found that it exerted an inhibitory effect in tumor immunity. We aimed to assess the significance of IgG4 and T cell subtypes in tumor prognosis. We investigated the density, distribution and relationship of five immune markers CD4, CD8, Foxp3, IL-10 and IgG4 with multiple immunostaining method in 118 esophageal squamous cell carcinoma (ESCC) together with clinical data. The relationship among different immune cell types and with clinical data were analyzed with Kaplan-Meier survival analysis and Cox proportional hazards model to identify independent risk factors among immune and clinicopathological parameters. Five-year survival rate of these patients treated with surgery reached 61%. Higher number of CD4+ plus CD8+ T cells predicted better prognosis (p=0.01) in tertiary lymphoid structure (TLS) and could add to the value of TNM staging. Density of the newly identified immune inhibitor IgG4+ B lymphocytes was found positively correlated to that of CD4+ cells (p=0.02) and IL-10+ cells (p=0.0005), but number of infiltrating IgG4+ cells by itself was not an independent factor for prognosis. However, increased serum concentration of IgG4 indicated a poor prognosis of ESCC (p=0.03). 5-year survival rate of esophageal cancer after surgery has been significantly improved. Increased T cells in TLS predicted better survival, suggesting that T cells in TLS may actively participate in anti-tumor immunity. Serum IgG4 could be a useful predictor of prognosis.

Long-term trend of esophageal cancer survival rate in Qidong, 1972-2016

Objective: To analyze the survival of esophageal cancer cases in Qidong, Jiangsu Province from 1972 to 2016, and provide a basis for the prognosis evaluation and prevention of esophageal cancer patients. Methods: The data of esophageal cancer were obtained from the Qidong Cancer Registration and Reporting System, and the follow-up date ended December 31, 2021. Observed survival rate (OSR) and relative survival rate (RSR) were calculated by SURV 3.01 software, and Hakulinen's likelihood ratio test was used for statistical difference comparison. Joinpoint regression model was used to conduct the average annual percentage change (AAPC) in esophageal cancer survival rate, and the ARIMA model was used to predict the trend of esophageal cancer survival rate. Results: During 1972 to 2016, there were 5 112 new cases of esophageal cancer in Qidong. The OSR of esophageal cancer at 1, 5 and 10 years were 24.43%, 6.93% and 4.43%, and the RSR at 1, 5 and 10 years were 25.88%, 9.35% and 8.34%, respectively. Dividing 1972-2016 into 9 periods, compared with 1972-1976, the 5-year RSR from 2012-2016 increased from 4.47% to 17.85%, and the RSR trend of the 9 periods was statistically significant (χ(2)=263.43, P<0.001). The survival rate of female with esophageal cancer was slightly higher than that of male, however, there was no significant difference in RSR between male and female (χ(2)=9.40, P=0.401). The 5-OSR and 5-RSR for male were 6.73% and 9.11%, and for female were 7.37% and 9.87%, respectively. The 5-RSR for the age groups of 45-54, 55-64, 65-74, and over 75 years old were 11.99%, 11.21%, 8.17% and 7.08%, respectively. There was a statistically significant difference in RSR among different age groups (χ(2)=98.19, P<0.001). The time trend results showed that the overall AAPC of the 5-RSR of esophageal cancer in Qidong from 1972 to 2016 was 3.89% (t=11.98, P<0.001). The 5-RSR uptrend was consistent among different genders, and the uptrend was greater in female (AAPC=4.25% for male, and AAPC=5.72% for female, P<0.05). Furthermore, the 5-RSR of esophageal cancer in all age groups showed an upward trend, and the upward trend was statistically significant in the 55-64-year-old group (AAPC=4.23%, P<0.05) and the 65-74-year-old group (AAPC=6.82%, P<0.05), there was no statistical significance in the 45-54-year-old group (AAPC=2.17%, P>0.05) and more than 75 years old group (AAPC=1.82%, P>0.05). Survival rate prediction of esophageal cancer showed that by 2026, 5-RSR will increase to 24.79%. Conclusions: During 1972 to 2016, the overall survival rate of esophageal cancer in the whole population of Qidong has improved to a certain extent, but there is still a large room for improvement. More emphasis should be continued to strengthen on the early diagnosis and early treatment of esophageal cancer.

Analysis of tumour markers in esophageal carcinoma with different age groups

BackgroundEsophageal cancer has been reported in various countries, including Saudi Arabia, India and United States. Many biomarkers have been used to detect cancers at an early stage to improve the survival rate of esophageal cancer. MethodsThe present study investigated the biomarkers, biglycan, myeloperoxidase, cytokine (TNF-α, IFN-γ, IL-10 and IL-12) and carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and carbohydrate antigen L1 cell adhesion molecule from the tumour and non-tumour samples. ResultsThe increased amount of circulatory biglycan level was detected using the ELISA method in tumour cases compared to control samples (p < 0.001). The expression of biglycan was high in certain tumour cases and was statistically significant (p < 0.01). The variation of myeloperoxidase markers in control and experimental subjects were statistically significant (p < 0.01). Among cancer patients, elevated levels of carcinoembryonic antigen (28.3 ± 1.2 ng/ml and 30.3 ± 1.1 ng/ml), squamous cell carcinoma antigen (5.3 ± 1.1 ng/ml and 4.9 ± 0.5) and carbohydrate antigen 19–9 (18.3 ± 1.1 ng/ml and 15.1 ± 2.6 ng/ml) were detected in male and female cases (p < 0.001). In the normal tissues, the expression of L1 cell adhesion molecule was high and was expressed in low amount in tumour tissues in both male and female individuals (<0.001). ConclusionThese biomarkers are useful for the early diagnosis of esophageal cancer.

Multistrategy Improved Sparrow Search Algorithm Optimized Deep Neural Network for Esophageal Cancer.

Deep neural network is a complex pattern recognition network system. It is widely favored by scholars for its strong nonlinear fitting ability. However, training deep neural network models on small datasets typically realizes worse performance than shallow neural network. In this study, a strategy to improve the sparrow search algorithm based on the iterative map, iterative perturbation, and Gaussian mutation is developed. This optimized strategy improved the sparrow search algorithm validated by fourteen benchmark functions, and the algorithm has the best search accuracy and the fastest convergence speed. An algorithm based on the iterative map, iterative perturbation, and Gaussian mutation improved sparrow search algorithm is designed to optimize deep neural networks. The modified sparrow algorithm is exploited to search for the optimal connection weights of deep neural network. This algorithm is implemented for the esophageal cancer dataset along with the other six algorithms. The proposed model is able to achieve 0.92 under all the eight scoring criteria, which is better than the performance of the other six algorithms. Therefore, an optimized deep neural network based on an improved sparrow search algorithm with iterative map, iterative perturbation, and Gaussian mutation is an effective approach to predict the survival rate of esophageal cancer.

262. A STUDY OF METASTATIC LOCATION AND PROGNOSIS FOR ESOPHAGEAL CANCER WITH ONE OR TWO METASTATIC LYMPH NODES

Abstract Esophageal cancer has high frequency of lymph node (LN) metastasis and poor prognosis, and often relapse early even after radical esophagectomy. Extensive LN dissection has made it possible to grasp the detailed metastatic status and the relationship between LN metastasis and prognosis. It is necessary to study more about metastatic style and prognostic factors for minimalization of surgical invasion and individualization of treatment. We analyzed about metastatic location, prognosis and recurrence for esophageal cancer cases with a few LN metastasis. We study 168 stageII, III esophageal cancer cases that underwent radical esophageal resection with regional LN dissection (D2 or more) from January 2015 to December 2017. Those cases included 37 or 29 cases with one or two LN metastasis. The number of cases on each tumor location (Ce/Ut/Mt/Lt/Ae) were 4/19/80/55/10 cases. On LN dissection, D2 were 68 cases and D3 were 100 cases. In a comparison of survival rate, age (&amp;lt;65/≧65), lymphatic invasion, the number of metastatic lymph node have significant difference. The 5-years overall survival rate of esophageal cancer with one or two metastatic LNs was each 82.9% or 65%. Most of a few LN metastasis cases have first group LN metastasis (11th Japanese Classification of Esophageal Cancer), for example No.106rec or abdominal LNs, but we didn’t sometimes detect them prior to surgery. Esophageal cancer with a few metastatic lymph nodes had relatively good prognosis, and metastasis was likely to stay nearby the primary lesion. However, it is difficult to detect metastasis precisely prior to surgery, so developing the further technique of diagnosis and individualized treatment are expected in the future.

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

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

The Involvement of WDHD1 in the Occurrence of Esophageal Cancer as a Downstream Target of PI3K/AKT Pathway.

Esophageal cancer is one of the most common malignant tumors in the world, which is characterized by high incidence, strong invasiveness, high mortality, and poor prognosis. At present, the therapies include surgery, endoscopic resection, radiotherapy and chemotherapy, targeted therapy, and immunotherapy. The five-year survival rate of esophageal cancer has not been significantly improved, although the medical level has been continuously improved and the management and application of different therapies have been improved day by day. At present, an abnormal gene expression is still regarded as an important factor in the occurrence and development of esophageal cancer. WD repeat and HMG-box DNA binding protein 1(WDHD1), as a key gene, plays an important role in the occurrence of esophageal cancer. It is known that the protein encoded by WDHD1 is the downstream target of the PI3K/AKT pathway. When PI3Ks is activated by extracellular signals, PI(4,5)P2 on the inner side of the plasma membrane will be converted into PI(3,4,5)P3. Then, PI(3,4,5)P3 can be converted into PI(3,4)P2,PI(4)P and PI(3)P by dephosphorylation of some regulatory factors. PI(3,4,5)P3 recruited AKT to the plasma membrane and combined with its pH domain, resulting in conformational change of AKT. Subsequently, AKT was completely activated by PDK1 and PDK2 and begins to move to the cytoplasm and nucleus. In this process, AKT continuously phosphorylates downstream substrates. WDHD1, as a downstream target of AKT, is also phosphorylated and induces DNA replication. Besides the abnormal regulation of cells by other downstream targets of AKT, it also becomes a potential pathway that may eventually lead to the occurrence of esophageal cancer.

Early neoplasia identification in Barrett's esophagus via attentive hierarchical aggregation and self-distillation.

Automatic surveillance of early neoplasia in Barrett's esophagus (BE) is of great significance for improving the survival rate of esophageal cancer. It remains, however, a challenging task due to (1) the large variation of early neoplasia, (2) the existence of hard mimics, (3) the complicated anatomical and lighting environment in endoscopic images, and (4) the intrinsic real-time requirement of this application. We propose a novel end-to-end network equipped with an attentive hierarchical aggregation module and a self-distillation mechanism to comprehensively address these challenges. The hierarchical aggregation module is proposed to capture the complementariness of adjacent layers and hence strengthen the representation capability of each aggregated feature. Meanwhile, an attention mask is developed to selectively integrate the logits of each feature, which not only improves the prediction accuracy but also enhances the prediction interpretability. Furthermore, an efficient self-distillation mechanism is implemented based on a teacher-student architecture, where the student aims at capturing abstract high-level features while the teacher is applied to bring more low-level semantic details to calibrate the classification results. The proposed techniques are effective yet lightweight, improving the classification performance without sacrificing time performance, and thus achieving real-time inference. We extensively evaluate the proposed method on the MICCAI EndoVis Challenge Dataset. Experimental results demonstrate the proposed method can achieve competitive accuracy with a much faster speed than state-of-the-arts.

Improvement in the Survival of Esophageal Cancer Patients at Cancer Institute of Iran after Implementation of the Neo-adjuvant Chemo-radiation: Retrospective Cohort Study

Background: Iran is a high-risk area with a poor prognosis for esophageal cancer. We conducted the present study to evaluate the survival rate of esophageal cancer after the introduction of neo-adjuvant chemo-radiation at the Cancer Institute of Iran. Method: We performed a retrospective cohort study and abstracted the data of 421 patients who referred to the Cancer Institute of Iran between 2007 and 2011. Life table and Kaplan-Meier approaches were applied to estimate 1-, 3-, and 5-year survival rates and corresponding 95% confidence intervals (CI). Multiple Cox regression model was recruited for investigating the association between 5-year survival rate and prognostic factors. Results: We found that 1-, 3-, and 5-year survival rates were 66.7%, 28.2, and 20.9%, respectively. The hazard ratio (HR) was significantly higher among the patients who has received definitive chemo-radiation therapy (Hazard ratio (HR) = 2.2, 95% confidence interval (CI): 1.1, 4.2), surgery (HR= 2.0 95% CI: 1.0, 3.7), and palliative care (HR= 4.2, 95% CI: 2.1, 1.8) compared with those who received neo-adjuvant chemo-radiation and surgery. We also found that the 5-year survival rate was doubled in the current study conducted between 2007 and 2011 (20.9%) compared with the previous one conducted between 1997 and 2006 (10.0%). Additionally, a considerable improvement was observed in 1- and 3-year survival rate of esophageal cancer at the Cancer Institute of Iran. Conclusion: Following the administration of neo-adjuvant chemo-radiation therapy, the prognosis of esophageal cancer has improved significantly at the Cancer Institute of Iran during the last decade. More data from other cancer centers and provinces of Iran are required.

Nomograms for predicting survival in early-onset esophageal cancer

ABSTRACT Background: This study aimed to develop nomograms predicting the overall survival (OS) of patients younger than 50 years old with esophageal cancer. Methods: We selected patients included 2004–2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed using significant variables from multivariable Cox analyses. The discrimination and calibration power of the models were evaluated using concordance indexes (C-indexes) and calibration curves. Decision curve analysis was used to assess the clinical net benefits of the nomograms. Results: Of 1,997 selected patients, 53.2% had advanced-stage tumor. Race, grade, T stage, N stage, and treatment were independent factors affecting OS in early-stage patients. The C-indexes of the corresponding nomogram were 0.710 (95% CI = 0.684–0.736) and 0.681 (95% CI = 0.640–0.722) in training and validation sets, respectively. Grade, marital status, and treatment were independent factors affecting OS in advanced-stage patients. The C-indexes of the corresponding nomogram were 0.677 (95% CI = 0.653–0.701) and 0.675 (95% CI = 0.638–0.712) in training and validation sets, respectively. Calibration curves demonstrated high consistency between predicted and actual survival. Conclusion: We constructed and verified nomograms that could accurately predict the survival rate of esophageal cancer in patients younger than 50 years old. This may help clinicians better understand prognostic factors.

Clinical characteristics and survival of 5283 esophageal cancer patients: A multicenter study from eighteen hospitals across six regions in China.

ObjectiveThis study aimed to investigate the potential determining epidemiological and clinical risk factors affecting the survival of esophageal cancer (EC) patients across multiple hospitals in China.MethodsThis was a multicenter study comprising of newly diagnosed EC cases from Beijing, Hebei, Henan, Hubei, Zhejiang, and Guangdong Province of China. Their baseline characteristics and treatment methods data were collected from their medical records. The EpiData software was used for data quality control. The Kaplan‐Meier method was used to estimate their overall survival (OS), and the Cox's proportional hazard regression model was used to estimate hazard ratios (HR) and 95% confidence interval (CI).ResultsThe 3‐ and 5‐year OS rates of the 5283 investigated EC patients were 49.98% and 39.07%, respectively. Their median survival was 36.00 months. The median survival time of females was longer than that of males (females vs. males: 45.00 vs. 33.00, P < 0.001). The 5‐year OS rate of patients who never‐smoked was higher than that of smokers (never‐smokers vs smokers: 40.73% vs. 37.84%, P = 0.001). There was no significant difference in the 5‐year OS rate between drinkers and never‐drinkers (drinkers vs never‐drinkers: 34.22% vs. 29.65%, P = 0.330). In multivariate analysis, pathological stage (stage II: HR = 1.80, 95% CI = 1.40‐2.31; stage III: HR = 2.62, 95% CI = 2.06‐3.34; stage IV: HR = 3.90, 95% CI = 2.98‐5.09), poor differentiation/undifferentiated (HR = 1.34, 95% CI = 1.11‐1.63), not married status (HR = 2.45, 95% CI = 1.49‐4.04), production and service personnel (HR = 1.36, 95% CI = 1.01‐1.83) and farming/fishing (HR = 1.40, 95% CI = 1.12‐1.76) were independent prognostic risk factors for poor EC survival. Tumors in the thoracic or abdominal part of the esophagus, female and family history of any cancer were independent factors predictive of a good EC OS.ConclusionGender, marital status, occupation, family history of any cancer, tumor topographical site, differentiation status, and pathological stage were associated with the survival rate of EC. This study reveals important clinical characteristics of esophageal cancer patients in China and provides helpful information for their clinical management and surveillance.

Abstract 1854: Oridonin inhibits cell growth of esophageal carcinoma cells via induction of apoptosis

Abstract Esophageal Cancer estimated leading deaths are more than 400,000 every year in worldwide, while 80% due to esophageal squamous cell carcinoma. In worldwide, esophageal cancer leading death ranks in sixth among cancer leading causes of death, while the 5-year survival rate of esophageal cancer is 19%. Oridonin, a tetracyclic diterpenes compound, has been indicated the anti-tumor activity for digestive system tumors. To assess the anticancer activity of oridonin on esophageal cancer, we performed cell proliferation experiment of oridonin on esophageal squamous cell carcinoma cell line TE-8 using SRB assay. We found that IC50 of oridonin on TE-8 treated for 72h is 3.0μM, which is better than positive control Gemcitabine treatment on TE-8 for 72h (5.7 μM), as well as TE-8 cells shrunk and floated with increasing concentration on oridonin. At the same time, oridonin induced a dose-dependent inhibition of cell colony formation of esophageal cancer cell line. Colony numbers of TE-8 cell line treated with 1μM and 2μM oridonin are 111 and 54, respectively, which are significantly different (p&amp;lt;0.05). Accompanying with marked morphological changes, flow cytometer results showed that oridonin triggered sub-G0/G1 cell cycle arrest in a dose-dependent manner. After treatment by 10μM and 20μM oridonin for 24h, percentage of sub-G0/G1 cells were 25.5 and 55.3%, respectively, which are significantly different (p&amp;lt;0.05). The apoptosis results showed that oridonin treatment led to the accumulation of cells in early-(Annexin V+/PI-) and late-stage (Annexin V+/PI+) apoptosis in a dose-dependent manner. Citation Format: Xiaojun Zhang, Mengtao Xing, Yangcheng Ma, Xiao Wang, Jianying Zhang. Oridonin inhibits cell growth of esophageal carcinoma cells via induction of apoptosis [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 1854.

Current status of prognostic evaluation of esophageal cancer patients by circumferential resection margin

Esophageal cancer is the sixth leading cause of cancer-related death worldwide due to its high malignancy and poor prognosis. In recent decades, the applications of new technologies, devices and neoadjuvant therapy lead to the great progress in the diagnosis and treatment of esophageal cancer. However, the five-year survival rate of esophageal cancer remains unsatisfied. Clinical and pathological factors such as the primary tumor (T), regional lymph nodes (N) and distant metastasis (M) and the longitudinal margins of esophageal lesions, lymphatic invasion, peripheral nerve invasion have been identified as important predictors of the prognosis of esophageal cancer. However, the effect of circumferential resection margin on the prognosis evaluation of esophageal cancer is still controversial, and no definite identification of circumferential resection margin of esophageal cancer has been acknowledged worldwide. Therefore, the studies of circumferential resection margin involvement in predicting the prognosis of esophageal cancer are reviewed.

Postoperative Complications and Survival Rate of Esophageal Cancer: Two-period Analysis

IntroductionNowadays, treatment of esophageal cancer requires a multidisciplinary approach, in which esophagectomy remains the mainstay. The aim of this report is to assess whether multimodal treatment and minimally invasive surgery have led to a lower morbidity rate and an improvement in survival rates. MethodsRetrospective evaluation of 318 patients diagnosed with esophageal cancer including 81 esophagectomies. The periods of 2000–2007 and 2008–2015 were compared, analyzing the prognostic factors that may have an impact in morbidity and survival rate. ResultsMajor postoperative complications according to the Clavien–Dindo classification accounted for 35%, showing a decrease between the 1st and 2nd period: 41% morbidity vs 30%, 27% mortality vs 9% (P<.001) and 13.5% fistulas vs 7%. The implementation of thoracoscopic esophagectomy contributed to the outcome improvement, as shown by 19% morbidity and 5% mortality rates, with triangularized mechanical anastomosis showing 9% fistula and 5% stenosis. The overall 5-year survival rate was 19%, with a significant increase from 11% in the 1st period to 28% in the 2nd (P<.001). ConclusionsMultidisciplinary assessment of patients with esophageal cancer, as well as better selection and indication of treatment and the introduction of new minimally invasive techniques (thoracoscopy and triangularized mechanical anastomosis), have improved the morbidity and mortality rates of esophagectomies, resulting in increased survival rates of these patients.

Anticancer Effects of Dihydroartemisinin on Human Esophageal Cancer Cells In Vivo.

Despite recent advances in chemotherapy and surgical resection, the 5-year survival rate of esophageal cancer still remains at the low level. Therefore, it is very important to discover a new agent to improve the life expectancy of patients with esophageal cancer. Dihydroartemisinin (DHA), a semisynthetic derivative of artemisinin, has recently exhibited promising anticancer activity against various cancer cells. But so far, the specific mechanism remains unclear. We have previously demonstrated that DHA reduced viability of esophageal cancer cells in a dose-dependent manner in vitro and induced cell cycle arrest and apoptosis. Here, we extended our study to further observe the efficacy of DHA on esophageal cancer cells in vivo. In the present study, for the first time, we found that DHA significantly inhibits cell proliferation in xenografted tumor compared with the control. The mechanism was that DHA induced cell apoptosis in both human esophageal cancer cell lines Eca109 and Ec9706 in vivo in a dose-dependent manner. The results suggested that DHA was a promising agent against esophageal cancer in the clinical treatment.

Analysis survival of screening and non-screening patients of esophageal cancer in Linzhou city

Objective: To evaluate effect of screening of esophageal cancer though comparing difference of survival level between screening and non-screening patients in Linzhou city. Methods: The records pathologically diagnosed as serious hyperplasia/carcinoma and esophageal cancer were drawn from database of first round screening in Linzhou city from 2005-2013 and were assigned to the screening group. The records of new esophageal cancer cases which diagnosed within 2 years before, screening from the same village aged from 40 to 69, were drawn from database of cancer registry in Linzhou city and were assigned to the non-screening group. Five or 10 year survival rate with 95%CI of patients with different malignant degree diseases in the screening group and the patients with esophageal cancer in the non-screening group was calculated respectively. The survival curves between the screening and non-screening group were compared by Log rank method. Results: All 26 908 persons were examined in first round screening in Linzhou city from 2005 to 2013. There were 374 persons with serious hyperplasia/carcinoma in situ, 157 persons with esophageal cancer (141 intramucosal carcinomas/submucosal cancers, 16 invasive cancers). The 5 year survival rate of serious hyperplasia/carcinoma, intramucosal carcinoma/submucosal cancer and invasive cancer were 95.0% (95%CI: 91.7%-97.0%) , 72.0% (95%CI: 62.7%-79.3%) and 41.7% (95%CI: 17.4%-64.6%) separately. The 5 year survival rate of esophageal cancer in screening and non-screening group were 68.7% (95%CI:59.9%-75.9%) and 40.8% (95%CI: 36.4%-45.2%). The 10 year survival rate of esophageal cancer in screening and non-screening group were 58.0% (95% CI: 44.6%-69.3%) and 34.3% (95% CI:29.1%-39.5%). The 5 or 10 year survival rate of esophageal cancer in the screening group were higher than that in the non-screening group in whatever sex or age. The survival distribution of the screening group was better than non-screening group (χ(2)=38.88, P<0.001). Conclusion: More precancerous lesions and early esophageal cancer can be detected and patients' survival level was improved through organized esophageal cancer screening, which provided support to evaluate value of organized screening.

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.

The Discovery and Validation of Biomarkers for the Diagnosis of Esophageal Squamous Dysplasia and Squamous Cell Carcinoma.

The 5-year survival rate of esophageal cancer is less than 10% in developing countries, where more than 90% of these cancers are esophageal squamous cell carcinomas (ESCC). Endoscopic screening is undertaken in high incidence areas. Biomarker analysis could reduce the subjectivity associated with histologic assessment of dysplasia and thus improve diagnostic accuracy. The aims of this study were therefore to identify biomarkers for esophageal squamous dysplasia and carcinoma. A publicly available dataset was used to identify genes with differential expression in ESCC compared with normal esophagus. Each gene was ranked by a support vector machine separation score. Expression profiles were examined, before validation by qPCR and IHC. We found that 800 genes were overexpressed in ESCC compared with normal esophagus (P < 10(-5)). Of the top 50 genes, 33 were expressed in ESCC epithelium and not in normal esophagus epithelium or stroma using the Protein Atlas website. These were taken to qPCR validation, and 20 genes were significantly overexpressed in ESCC compared with normal esophagus (P < 0.05). TNFAIP3 and CHN1 showed differential expression with IHC. TNFAIP3 expression increased gradually through normal esophagus, mild, moderate and severe dysplasia, and SCC (P < 0.0001). CHN1 staining was rarely present in the top third of normal esophagus epithelium and extended progressively towards the surface in mild, moderate, and severe dysplasia, and SCC (P < 0.0001). Two novel promising biomarkers for ESCC were identified, TNFAIP3 and CHN1. CHN1 and TNFAIP3 may improve diagnostic accuracy of screening methods for ESCC. Cancer Prev Res; 9(7); 558-66. ©2016 AACR.