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.

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.

Salvage endoscopic submucosal dissection for the treatment of esophageal squamous cell carcinoma after local treatment failure with chemotherapy, radiotherapy, or chemoradiotherapy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 148-148
Author(s):  
Toshiro Iizuka ◽  
Daisuke Kikuchi ◽  
Shu Hoteya ◽  
Akihiro Yamada ◽  
Mitsuru Kaise
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Esophageal Squamous Cell Carcinoma ◽  
Treatment Failure ◽  
Endoscopic Submucosal Dissection ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Local Treatment ◽  
Submucosal Dissection ◽  
The Mean

148 Background: Chemotherapy (CT), radiotherapy (RT), and chemoradiotherapy (CRT) are efficacious treatment options for esophageal squamous cell carcinoma (ESCC). However, local treatment failure remains a major problem. In this study, we applied endoscopic submucosal dissection (ESD) for the treatment of ESCC after local treatment failure with CT, RT, or CRT. The efficacy, safety, and feasibility of salvage ESD were assessed. Methods: Between 2008 and 2014, 611 patients underwent ESD for superficial ESCC in our hospital. Of them, 14 required salvage ESD: 7 for local treatment failure after CT, 4 after CRT, and 3 after RT. Each patient was treated with CT using 5-fluorouracil + cisplatin or RT, which consisted of >50 Gy of irradiation with or without concurrent CT. The following clinical findings were confirmed in all patients: no evidence of lymph node or distant metastasis after treatment, and an endoscopically resectable lesion. Results: The male to female ratio was 11:3 and the mean age was 64.9 (44-81) years. Clinical stages before treatment were T1b/T2/T3/T4 in 10/1/2/1, N0/1 in 7/7, and M0/1 in 13/1, respectively. The mean tumor size was 18.6 mm, and the mean procedure time was 45.7 min. En bloc resection was achieved in 100% of cases, and the R0 resection rate was 78.6%. Histopathological assessment of specimens taken at salvage ESD revealed that 6 lesions (42.9%) had invaded the submucosal layer and had been resected noncuratively because of a positive vertical margin (n = 2) or positive lymphovascular invasion (n = 5). No immediate or delayed complications, including major bleeding or perforation, and no ESD-related deaths occurred. At a mean follow-up period of 26.5 (range, 5–55) months, local recurrence had developed at the treatment site in 2 patient. Overall, 10 patients were still alive. The remaining 4 had developed lymph node metastasis, 2 of whom had died from it. Conclusions: Salvage ESD is an option for ESCC patients with local treatment failure after CT, RT, or CRT.

scholarly journals Cyclin D1 expression predicts postoperative distant metastasis and survival in resectable esophageal squamous cell carcinoma

Oncotarget ◽  
2016 ◽  
Vol 7 (21) ◽  
pp. 31088-31096 ◽  
Author(s):  
Xue Hou ◽  
Run-Bin Liang ◽  
Jin-Chang Wei ◽  
Ying Xu ◽  
Jian-Hua Fu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Cyclin D1 ◽  
Squamous Cell ◽  
Distant Metastasis ◽  
Resectable Esophageal
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