PS01.149: APPLICATION OF SINGLE-PORT VIDEO-ASSISTED THORACOSCOPE IN TREATING THORACIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA USING MCKEOWN APPROACH

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 92-92
Author(s):  
Qiang Lv
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Conflicts Of Interest ◽  
Single Port ◽  
Postoperative Recovery ◽  
Postoperative Hospital Stay ◽  
Intraoperative Blood Loss ◽  
Video Assisted

Abstract Background This study aims to investigate the feasibility of single-port video-assisted thoracoscope (SPVATS) in treating thoracic esophageal squamous cell carcinoma (TESCC) using McKeown approach. Methods METHODS: 25 McKeown approach-based SPVATS surgeries (19 males and 6 females, aged 42–70years) were carried out from January 2015 to December 2017 to treat TESCC. Results RESULTS: All the patients were successfully completed SPVATS, with average thoracic surgery time as 150 min, intraoperative blood loss as 30–260 ml (average 90 ml), and postoperative hospital stay as 9–16d (average 12d). Conclusion SPVATS was technically feasible and safe in treating TESCC using McKeown approach, with less trauma and rapid postoperative recovery, so it could be used as a new surgical option for McKeown approach-based TESCC treatment. Disclosure All authors have declared no conflicts of interest.

PS02.235: POOR ORAL HEALTH INCREASES RISK OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA: THE FOLLOW-UP STUDY OF THE LINXIAN NUTRITION INTERVENTION TRIAL

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 188-189
Author(s):  
Pei Yu ◽  
Su Zhang ◽  
Ming Wang ◽  
He Liang ◽  
Hu Fan ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Oral Health ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Conflicts Of Interest ◽  
Risk Of Death ◽  
Increased Risk ◽  
Cumulative Rate

Abstract Background Several studies have suggested an association between poor oral health and esophageal squamous cell carcinoma (ESCC). We conduct this study to further examine the association between oral hygiene and ESCC risk in Linxian, the high risk area of China. Methods We recruit 29,553 healthy and 3318 esophageal squamous dysplasia participants aged between 40 and 69 in 1985 and then followed up until April, 2015. Basic characteristics were collected and oral related diseases were examined by trained doctors. Cox regression models were used to calculate hazard rations (HRs) and 95% confidence intervals (CIs). Results In general group, 2577 participants’ dead for ESCC and the cumulative rate of ESCC death was 12.9%. Teeth loss more than 20, before age of 40, bleeding of teeth, chapped lips, oral leukoplakia were significantly associated with risk of death from ESCC, and with 1.28 (95% CI: 1.18–1.38), 1.12 (95% CI: 1.03–1.23), 1.28 (95% CI: 1.13–1.45), 1.14 (95% CI: 1.04–1.25), 1.23 (95% CI: 1.12–1.35) fold increased risk of death from ESCC respectively in models adjusted for potential confounders. In dysplasia group, 540 participants’ dead for ESCC and the cumulative rate was 24.7%. Those who loss teeth more than 20, before age of 40, bleeding of teeth, have 1.24 (95% CI: 1.02–1.51), 1.25 (95%CI: 1.02–1.52), 1.35(95%CI: 1.06–1.70) fold increased risk after adjustment. Association between chapped lips and ESCC death was not found. Conclusion Severe teeth loss, early age teeth loss and teeth bleeding were associated with ESCC death and excess risk increased as dysplasia occurred. Chapped lips loss association with ESCC death in dysplasia group, it may reveals that it react before dysplasia change. Further studies are warranted to find the mechanism association and improvements of protecting oral health should be done. Disclosure All authors have declared no conflicts of interest.

PS02.086: ENDOSCOPIC RESPONSE EVALUATION OF NEOADJUVANT CHEMOTHERAPY CAN PREDICT PATHOLOGICAL RESPONSE AND SURVIVAL IN PATIENTS WITH ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 145-145
Author(s):  
Yohei Nagai ◽  
Naoya Yoshida ◽  
Yoshifumi Baba ◽  
Hideo Baba
Keyword(s):  
Squamous Cell Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Clinical Response ◽  
Squamous Cell ◽  
Conflicts Of Interest ◽  
Pathological Response ◽  
Response Evaluation ◽  
Radical Esophagectomy

Abstract Background To investigate the association between endoscopic response evaluation of neoadjuvant chemotherapy (NAC) with pathological response and survival in patients with esophageal squamous cell carcinoma (ESCC). Methods We retrospectively reviewed the medical records of patients with the aid of a prospectively entered database. One hundred and eleven consecutive patients with ESCC who underwent radical esophagectomy after NAC were included. All patients were divided into two groups according to endoscopic response after NAC: endoscopic non-responders in whom NAC was poorly or moderately effective, and endoscopic responders in whom NAC was highly effective or completely effective. The clinical response after NAC was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST). Results The pretreatment clinical stage was IB in 5 patients (5%), II in 18 (16%), III in 72 (65%), and IV in 16 (14%). All patients received two courses of chemotherapy. Chemotherapy consisted of docetaxel, cisplatin (CDDP), and 5-fluorouracil (5-FU; the DCF regimen) in 82 patients (74%), and 5-FU and CDDP (FP) in 29 (26%). All patients underwent radical esophagectomy with 2- or 3-field lymph node dissection. The postoperative mortality and morbidity rates were 0.9% and 26%, respectively. Pathological stage (ypStage) was 0 in 1 patient (1%), I in 16 (14%), II in 31 (28%), III in 48 (43%), and IV in 15 (13%). Twenty-two patients (20%) were pathological responders, and this group of patients had better overall survival than pathological non-responders (P = 0.02). Pathological response was significantly correlated with tumor depth (cT) (P < 0.01), protruding type of tumor (P = 0.01) before NAC, and clinical response (P < 0.01) and endoscopic response (P < 0.01) after NAC. Of these clinical factors, clinical response and endoscopic response were significantly correlated with prognosis. Conclusion Endoscopic response after NAC can predict the pathological response and prognosis of patients who received NAC followed by surgery. Endoscopic findings are clinically significant to assess the response of NAC in patients with ESCC. Disclosure All authors have declared no conflicts of interest.

PS02.157: ESOPHAGEAL SQUAMOUS CELL CARCINOMA IS ASSOCIATED WITH CHRONIC DISEASES AS WELL AS UNHEALTHY LIFESTYLES

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 166-166
Author(s):  
Jun Nakamura ◽  
Noriaki Manabe ◽  
Ken Haruma ◽  
Rui Nakato ◽  
Takahisa Murao ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Medical History ◽  
Chronic Diseases ◽  
Squamous Cell ◽  
Large Scale ◽  
Conflicts Of Interest ◽  
Gastrointestinal Diseases ◽  
History Of

Abstract Background Cancer and other chronic diseases such as cardiovascular disease, diabetes, chronic kidney disease, and respiratory disease share common risk factors, including aging and unhealthy lifestyles (eg, smoking and alcohol misuse). Although the recent prospective cohort large-scale study showed chronic diseases contributed to more than one fifth of the risk for incident cancer and more than one third of the risk for cancer death, the relation between esophageal squamous cell carcinoma (ESCC) and non-cancer chronic diseases (NCCD) still remain unknown. The aim of this study is to assess the independent and joint associations of major NCCD and ESCC. Methods From April 2011 to March 2017, 406 consecutive patients with ESCC diagnosed pathologically were enrolled. Their medical records as to patients’ background, the reason for their consultation, lifestyles, and medical history were investigated retrospectively in detail. Results As to the reason for their consultation, 45 patients (25.3%) were diagnosed at annual medical checkup (no symptoms), 125 (70.2%) consulted a doctor for any symptoms such as dysphagia, and 8 (4.5%) had other reasons. As to lifestyles, 304 (78.1%) were drinkers of alcohol (daily amount of alcohol consumption > 20g) and 302 (77.4%) were smokers (Brinkman index > 200), respectively. As to the medical history related to cancer or gastrointestinal diseases, 25 (6.8%) had a history of laryngopharyngeal cancer, 20 (5.1%) had a history of gastric cancer, 2 (0.5%) had a history of breast cancer, one (0.3%) had a history of sclerodema, and one (0.3%) had a history of esophageal achalasia. Of the 406 ESCC patients, 305 were early ESCC and the remaining 101 were advanced ESCC. As to the medical history in patients with advanced ESCC, 22 (21.8%) had a history of cancer of other organs, and 48 (47.5%) had NCCD including hypertension (35 patients), diabetes (18 patients), and hyperlipidemia (12 patients). Conclusion NCCD is an overlooked risk factor for ESCC, as important as two major lifestyle factors combined (drinkers of alcohol and smokers). General physicians who follow up NCCD patients should pay attention to the coexistence of ESCC. Disclosure All authors have declared no conflicts of interest.

PS01.226: FEASIBILITY OF CONVERSION THORACOSCOPIC ESOPHAGECTOMY AFTER TRIPLET CHEMOTHERAPY WITH DOCETAXEL, CISPLATIN, AND 5-FLUOROURACIL FOR T4 ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 114-114
Author(s):  
Yuji Akiyama ◽  
Takeshi Iwaya ◽  
Fumitaka Endo ◽  
Haruka Nikai ◽  
Akira Umemura ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Distant Metastasis ◽  
Conflicts Of Interest ◽  
Operation Time ◽  
Thoracoscopic Esophagectomy ◽  
Conversion Surgery ◽  
The Mean

Abstract Background Recently, induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (DCF) has been reported effective for T4 esophageal squamous cell carcinoma. The aim of this study was to investigate the safety and feasibility of thoracoscopic esophagectomy (TE) as conversion surgery after DCF for T4 esophageal squamous cell carcinoma. Methods Medical records of 64 consecutive patients with T4 (with or without distant metastasis) thoracic esophageal squamous cell carcinoma treated with induction DCF chemotherapy were reviewed. Twenty-tree patients underwent conversion TE after induction DCF. Results The invading organs of T4 tumor were tracheobronchus in 8 patients, thoracic aorta in 13 patients, and pericaridium and diaphragm in 3 patients each. Average courses of DCF treatment were 2.8 courses. The mean total operation time was 556.3 min and that of the thoracic procedure was 258.9 min. The mean blood loss was 166.2 mL and that during the thoracic procedure was 33.5 mL. All patients underwent complete resection under TE. No patient experienced accidental conversion to open thoracotomy or intraoperative morbidity including adjacent organ injury. Postoperative morbidity rate was 34.8%. There were no serious complications related to surgery requiring reoperation. Postoperative hospital stay was 24.3 (range, 13–38) days. Five patients had recurrence: four had distant metastasis (lung (2), liver (3), one patient had overlapped), and one had mediastinal lymph node recurrence. There was no local recurrence at the site of primary T4 tumor. Conclusion TE as conversion surgery after DCF therapy for initial T4 esophageal squamous cell carcinoma can be safely performed. The strategy of induction DCF followed by conversion TE could be an alternative in the treatment for T4 advanced esophageal squamous cell carcinoma. Disclosure All authors have declared no conflicts of interest.

RA10.01: TREATMENT STRATEGY OF ESOPHAGEAL CANCER FROM THE EXPRESSION OF HER2 AND EGFR

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 42-42
Author(s):  
Seiya Inoue ◽  
Takeshi Nishino ◽  
Masakazu Goto ◽  
Daisuke Yoshida ◽  
Akira Tangoku
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Conflicts Of Interest ◽  
Expression Patterns ◽  
Her2 Positive ◽  
Tissue Samples ◽  
Egfr Expression ◽  
Neo Adjuvant Chemotherapy

Abstract Background Neo-adjuvant chemotherapy (NAC) became to be a standard therapeutic strategy for advanced esophageal squamous cell carcinoma in Japan. However the multidrug combination chemotherapy with 5-FU, cisplatin (FP) and docetaxel (DFP) has been well known more effective than FP, biomarker predict efficacy of NAC is not known yet. We have reported that expression of HER2 and EGFR had correlated to the response of neoadjuvant chemotherapy and prognosis. Therefore we started to evaluate them in all cases using biopsy tissue samples from 2012. Methods The tissues were collected from 122 patients with esophageal squamous cell carcinoma before NAC with DFP from August 2012 to August 2017, and expression of HER2 and EGFR were measured with Immunohistochemistry. HER2 positive were 2 + and 3 + expression in immunostaining. The number of the patients were 20 cases in stageII, 91 cases in stageIII, and 11 cases in stageIV. These results were compared with response to NAC and outcome of the patients. Results There were no differences in patient background factors such as sex, age, location and stage.One hundred nineteen of 122 cases (97.5%) were positive for EGFR and HER2 positive cases were 12 cases (9.8%). Expression patterns of EGFR and HER2 were examined, EGFR positive-HER2 negative cases were the most common pattern, and 107 cases (87.7%), both positive were 12 cases (9.8%), and both negative were 3 cases (2.4%), EGFR negative-HER2 positive were not observed. The response rates of chemotherapy was 46.2% in the EGFR positive cases, it was 42.9% in EGFR positive-HER2 negative cases. It was 75% in HER2 and EGFR positive cases, and it was significantly higher than the other pattern (P = 0.034). HER2 expression was suggested to be a biomarker of NAC with DFP especially in stage III. Conclusion HER2 and EGFR expression was shown to be a predictor of NAC response. The patients with both negative pattern showed poorer response. The expression pattern of HER2 and EGFR can be useful biomarker of NAC response with DFP. Disclosure All authors have declared no conflicts of interest.

PS02.104: CLINICAL STUDY OF PROSPECTIVE RANDOMIZED CONTROLLED TRIALS ON ADJUVANT THERAPIES IN TREATMENT OF RESECTABLE PIB-III (PT2–4AN0–1M0) ESOPHAGEAL SQUAMOUS CELL CARCINOMA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 150-150
Author(s):  
Bin Zheng ◽  
Maohui Chen ◽  
Canxing Wu ◽  
Taidui Zeng ◽  
Shuliang Zhang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Side Effects ◽  
Adjuvant Chemotherapy ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Conflicts Of Interest ◽  
Adjuvant Chemoradiotherapy ◽  
Randomized Controlled

Abstract Background Esophageal squamous cell carcinoma (ESCC) patients have relatively poor prognosis after operation. The study was designed to analyse the effect of surgery alone, surgery with adjuvant chemotherapy and surgery with chemoradiotherapy on prognosis in the patients with pathologic stage pIB-III (pT2–4aN0–1M0) who received radical esophagectomy. Methods We carried out the prospective randomized study. In this study, we analyzed 104 patients who had undergone minimally invasive esophagectomy for thoracic ESCC and been assessed as pathological stage pIB-III (pT2–4aN0–1M0) from January 2013 to October 2015 in our institute. 48 patients are treated with surgery alone (S group),33 patients received surgery and adjuvant chemotherapy (CT group), and 23 patients received surgery and adjuvant chemoradiotherapy (CRT group). We do the follow up for all the patients, collect the clilnical, patholigical data of them, and analyze the overal survival (OS) and disease-free survival (DFS) of them. Results The basic clinical characteristics of three groups were comparable. The average age was (52.1 ± 9.7) years old. The median follow‐up period was 39 months. The 3-year OS of the patients in the S group, CT group, and CRT group were 37.5%,18.8%, 65.2%, respectively. According to the follow-up data, both the 3-year OS and the 3-year DFS of the patients in the CRT group were better than those of the patients in the S group and CT group group (P < 0.05). However, the incidence rates of side effects and complications in CRT group were higher than those in S group and CT group, without signicant differences. One patient died in S group in perioperative period, because of postoperaive pulmonary embolism, and no patients died in CT group and CRT group in peri-treatment period. Conclusion Our prospective, randomized controlled trial showed that surgery with adjuvant chemoradiotherapy could improve 3-year OS and DFS compared with treatment of surgery alone or surgery with adjuvant chemotherapy.The side effects and complications of surgery with adjuvant chemoradiotherapy were acceptable. However, because our study enrolled limited patients, and the follow-up time was not long enough, we need to collect more patients and longer follow-up to further comfirm our conclusion. Disclosure All authors have declared no conflicts of interest.

PS02.133: THE EFFICACY AND SAFETY OF S-1 MONOTHERAPY FOR RECURRENT OR METASTATIC ESOPHAGEAL SQUAMOUS CELL CARCINOMA REFRACTORY OR INTOLERABLE TO PLATINUM PLUS 5-FU

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 158-159 ◽  
Author(s):  
Takahiko Ito ◽  
Yoshitaka Honma ◽  
Takahiro Miyamoto ◽  
Hidekazu Hirano ◽  
Hirokazu Shoji ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Progressive Disease ◽  
Conflicts Of Interest ◽  
Good Control ◽  
Progression Free Survival ◽  
The Other ◽  
Standard Regimen

Abstract Background Platinum plus 5-fluorouracil (FP) is recognized as the standard regimen of palliative chemotherapy for recurrent or metastatic esophageal squamous cell carcinoma (ESCC). Although taxane is widely selected for 2nd line regimen, other options are very limited. In Japan, S-1 is available for esophageal cancer. In this retrospective study, we evaluated the efficacy of S-1 monotherapy for recurrent or metastatic (advanced) ESCC refractory or intolerable to FP. Methods The subjects of this study were 11 patients with advanced ESCC who received S-1 after failure of FP. The endpoints evaluating efficacy were overall survival (OS), progression free survival (PFS), and overall response rate (ORR) in patients with target lesions (TLs). Results The characteristics of the subjects were: median age 69 years, PS (0/1) 5/6, number of prior chemotherapy regimens (1/2/3 ≥ ) 4/4/3. 9 patients were refractory and 2 were intolerant to prior FP. 9 patients had good control of the primary lesions. Only 2 patients received post-S-1 therapy. The median OS and PFS were 11.7and 3.0 months. Two of 9 patients with TLs, one refractory and the other intolerant to prior FP, achieved partial response (PR) while the remaining 7 patients showed progressive disease (ORR 22%). The other 2 patients without TLs showed nonCR/nonPD. Common treatment-related adverse events included grade 3 leukopenia for 1 patients (9.1%), but there were no serious cases. Conclusion ORR of 22% suggests modest activity of S-1 for advanced ESCC refractory or intolerable to platinum plus 5-FU (FP). However, more than half of the patients showed progressive disease. Future study exploring optimal patient selection for S-1 is warranted. Disclosure All authors have declared no conflicts of interest.

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