scholarly journals Complete Excision of the Jejunum and Vessels for the Treatment of Esophageal Cancer

2020 ◽  
Author(s):  
Hexiao Tang ◽  
Lecai Xiong ◽  
Yuquan Bai ◽  
Li Zhang ◽  
Minglin Zhu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Chest Pain ◽  
Blood Vessels ◽  
Tumor Resection ◽  
Esophageal Tumor ◽  
Complete Excision ◽  
Surgical Method ◽  
Colonic Polyposis

Herein, we reported a case of complete excision of the jejunum for the treatment of esophageal cancer. A 62-year-old male was admitted with complaints of “difficulty in eating for one month and chest pain for 10 days". For complete gastrectomy and colonic polyposis, we chose the jejunum. We completely excised the jejunum and its vessels, anastomosed to the esophageal tumor resection, with no significant complications. This case showed that complete excision of the jejunum with bowel and vessels is an alternative surgical method for the treatment of esophageal cancer with free bowel shortage and no torsion of blood vessels.

PS02.176: LINE-1 METHYLATION LEVEL AND LOCAL IMMUNE RESPONSE IN ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 172-172
Author(s):  
Yoshifumi Baba ◽  
Taisuke Yagi ◽  
Yuki Kiyozumi ◽  
Yukiharu Hiyoshi ◽  
Masaaki Iwatsuki ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Immune Response ◽  
Esophageal Cancer ◽  
Methylation Level ◽  
Cpg Island ◽  
Surrogate Marker ◽  
Esophageal Tumor ◽  
Local Immune Response ◽  
Dna Hypomethylation ◽  
Response Status

Abstract Background In cancer cells, DNA methylation may be altered in two principle ways; global DNA hypomethylation and site-specific CpG island promoter hypermethylation. Since Long interspersed element-1 (LINE-1 or L1; a repetitive DNA retrotransposon) constitutes a substantial portion (approximately 17%) of the human genome, the extent of LINE-1 methylation is regarded as a surrogate marker of global DNA methylation. In previous studies, we demonstrated that LINE-1 hypomethylation was strongly associated with a poor prognosis in esophageal cancer, supporting its potential role as a prognostic marker (Ann Surg 2012). We also found that LINE-1-hypomethylated tumors showed highly frequent genomic gains at various loci containing candidate oncogenes such as CDK6 (Clin Cancer Res 2014). Given that immunotherapy, as represented by PD-1/PD-L1-targeting antibodies, has increasingly gained attention as a novel treatment strategy for esophageal cancer, better understanding of local immune response status in esophageal cancer is important. The aim of this study is to evaluate the relationship between LINE-1 methylation level and local immune response in esophageal cancer. Methods Using a non-biased database of 305 curatively resected esophageal cancers, we evaluated PD-L1 expression and TIL status (CD8 expression) by immunohistochemical analysis (Ann Surg 2017). Results TIL positivity was significantly correlated with longer overall survival (log-rank P < 0.0001). TIL-negative cases demonstrated significantly lower LINE-1 methylation level compared with TIL-positive cases (P = 0.012). This finding certainly supports that LINE-1 methylation level may influence the local immune response status. Conclusion PD-L1 expression was not related with LINE-1 methylation level. Further investigations in this field would provide deeper insights into esophageal tumor immunology and assist the development of new therapeutic strategies against esophageal cancer. Disclosure All authors have declared no conflicts of interest.

scholarly journals The largest reported intrathoracic lipoma: a case report and current perspectives review

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohammed Aldahmashi ◽  
Abdalmotaleb Elmadawy ◽  
Mahmoud Mahdy ◽  
Mohamed Alaa
Keyword(s):  
Single Case ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Complete Excision ◽  
Case Presentation ◽  
Medical Checkup ◽  
Excellent Outcome ◽  
The Right ◽  
Intrathoracic Mass

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

Chest Pain after Endoscopic Submucosal Dissection for Esophageal Cancer: The Simple and Clinically Useful Surrogate Marker for Transmural Thermal Injury by Electrocoagulation

Digestion ◽  
2020 ◽  
pp. 1-8
Author(s):  
Makoto Sakai ◽  
Makoto Sohda ◽  
Hideyuki Saito ◽  
Yasunari Ubukata ◽  
Nobuhiro Nakazawa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Chest Pain ◽  
Endoscopic Submucosal Dissection ◽  
Thermal Injury ◽  
Surrogate Marker ◽  
Multivariate Logistic Regression Analysis ◽  
Related Factors ◽  
Independent Predictive Factor ◽  
Submucosal Dissection ◽  
Wbc Count

<b><i>Background:</i></b> Endoscopic submucosal dissection (ESD) of early esophageal cancer (EC) is becoming more widespread. Post-ESD coagulation syndrome (CS) has been proposed as temporary inflammatory signs that occur during the post-ESD period caused by transmural thermal injury by electrocoagulation. This retrospective study aimed to evaluate the association between chest pain and abnormal levels of inflammatory markers during the post-esophageal ESD period. We also investigate the clinical importance of chest pain to define the post-esophageal ESD CS. <b><i>Methods:</i></b> We examined 42 patients with thoracic EC who underwent ESD. <b><i>Results:</i></b> The incidence of chest pain after esophageal ESD is 35.7% and associated with elevation of WBC count on postoperative day 1 (WBC day 1) (<i>p</i> = 0.022). Multivariate logistic regression analysis using the procedure-related factors revealed that WBC day 1 was an independent predictive factor for chest pain (<i>p</i> = 0.034). The elevation of WBC count is associated with the resected esophageal circumference (<i>p</i> for trend = 0.018), specimen size (<i>p</i> = 0.031), and procedural time (<i>p</i> = 0.004). The incidence of post-esophageal ESD CS was estimated ranging from 11.9 to 54.8% using previously reported criteria. <b><i>Conclusions:</i></b> The incidence of chest pain after ESD was only associated with postoperative elevation of WBC day 1. In considering the elevation of WBC count associated with procedure-related factors, chest pain possibly reflected transmural thermal injury by electrocoagulation during ESD. Post-esophageal ESD chest pain is a simple and clinically useful surrogate marker for transmural thermal injury and is a vital sign of post-esophageal ESD CS.

scholarly journals Comparison Between Size and Stage of Preoperative Tumor Defined by Preoperative Magnetic Resonance Imaging and Postoperative Specimens After Radical Resection of Esophageal Cancer

2019 ◽  
Vol 18 ◽  
pp. 153303381987626
Author(s):  
Zhenzhen Gao ◽  
Beibei Hua ◽  
Xiaolin Ge ◽  
Jinyuan Liu ◽  
Lei Xue ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Esophageal Cancer ◽  
Magnetic Resonance ◽  
Esophageal Tumor ◽  
Preoperative Treatment ◽  
Pathological Stage ◽  
Resonance Imaging ◽  
Surgical Specimen ◽  
Tumor Length ◽  
N Staging

Background: Our objective is to explore the accuracy of magnetic resonance imaging in determining the preoperative T and N staging, pathological stage, and the length of esophageal tumor in patients with esophageal cancer. Methods: This retrospective analysis included 57 patients admitted to the Department of Thoracic Surgery of The First Affiliated Hospital of Nanjing Medical University between January 2015 and December 2016. Postoperative pathological results were used as the reference to verify the accuracy of magnetic resonance imaging in evaluating tumor T and N staging, pathological stage, and tumor length. The correlation between tumor lengths—measured using magnetic resonance imaging and the surgical specimen measurements—was evaluated. Results: The mean age of the patients was 64.6 ± 7.2 years, with a range of 47 to 77 years. The overall accuracy rate of magnetic resonance imaging in T staging of esophageal cancer was 63.2%; magnetic resonance imaging was generally consistent in the N staging of esophageal cancer. Magnetic resonance imaging and surgical evaluation of tumor length were in excellent agreement (κ = .82, P < .001), while that of gastroscopy and postoperative pathology was moderate (κ = .63, P < .001). Conclusion: Magnetic resonance imaging is highly accurate in determining the preoperative T and N staging, pathologic stage, and tumor length in patients with esophageal cancer, which is important in deciding the choice of preoperative treatment and the surgical approach.

Bleomycin Infusions Combined with Radiotherapy in the Treatment of Inoperable Esophageal Cancer

1980 ◽  
Vol 66 (5) ◽  
pp. 615-621 ◽  
Author(s):  
Krsto Kolarić ◽  
Željko Maričić ◽  
Anton Roth ◽  
Ivo Dujmović
Keyword(s):  
Esophageal Cancer ◽  
Complete Remission ◽  
Total Dose ◽  
Median Survival ◽  
Median Duration ◽  
Stable Disease ◽  
Response Rate ◽  
Combined Treatment ◽  
Esophageal Tumor ◽  
Retrosternal Pain

A combination of bleomycin, in a 12 h infusion, and radiotherapy was applied in 25 patients with untreated inoperable esophageal cancer. Bleomycin was administered 15 mg/m2 twice weekly, concurrently with irradiation (total dose 3600–4000 rad). Such combined treatment produced 3 complete remissions of the esophageal tumor, 10 partial remissions (response rate 52 % - 13/25), 3 stable disease cases, while in 9 cases the disease progressed in spite of therapy. The median duration of remissions was 8.7 months in complete responders, 6.0 months in partial responders, and 3.0 months in stable disease cases. Similarly, median survival was the longest in complete remission cases (10.3 months). Patients who did not respond to therapy had a median survival of only 2.8 months. Adverse treatment reactions were of a milder character, except retrosternal pain and burning caused by irradiation mucositis, which occurred in 80 % of patients. The trial showed that the combination of bleomycin applied in the form of 12 h infusion and irradiation can produce remissions in 50 % of inoperable esophageal cancer cases, i.e., a rate of remission which is similar to that achieved by irradiation and bleomycin applied in the form of rapid (push) i.v. injections.

Clinical Case of Treatment of Stage IV Esophageal Cancer

2021 ◽  
Vol 66 (5) ◽  
pp. 101-104
Author(s):  
I. Strikanova ◽  
Ju. Gumeneckaja ◽  
S. Dzhabrailova ◽  
K. Makarova ◽  
T. Kireeva
Keyword(s):  
Esophageal Cancer ◽  
Clinical Case ◽  
Malignant Tumors ◽  
Combined Treatment ◽  
Life Quality ◽  
Stage Iv ◽  
Pain Syndrome ◽  
Esophageal Tumor ◽  
Food Passage ◽  
Physically Active

In 2018 in Russian Federation more than 500 thousand new cases of cancer were found, including 8000 cases with malignant tumors of esophagus and more than 30 % of patients have the IV stage. Esophageal cancer takes the 6-th place in death causes connected to cancer in the world and it is still one of the main global problems in medical care. Oncologists face the problem of the most difficult choice in treatment tactics for spread stages of disease. In this situation it is recommended to provide combined treatment (surgery, neoadjuvant and adjuvant chemotherapy). Definitive radiotherapy or chemoradiotherapy (without surgery) is used for patients with unrespectable esophageal tumor. In this article we present clinical case of successful treatment of a patient with metastatic esophageal cancer. The patient got chemoradiotherapy in 2017 and after control checkup in November 2019 remission was registered. After provided treatment stopping of pain syndrome and dysphagia, food passage through esophagus was restored. The patient notes good life quality, he is physically active and socially adapted.

scholarly journals 3508 Ciclopirox Olamine Demonstrates Inhibitory Effects on Esophageal Tumor Cells

2019 ◽  
Vol 3 (s1) ◽  
pp. 5-5
Author(s):  
Randi Ryan ◽  
Shrikant Anant ◽  
Prabhu Ramamoorthy ◽  
Dharmalingam Subramaniam ◽  
Scott Weir
Keyword(s):  
Cell Cycle ◽  
Esophageal Cancer ◽  
Tumor Cells ◽  
Cell Lines ◽  
Cancer Cell ◽  
Cancer Cell Lines ◽  
Esophageal Tumor ◽  
Potential Candidate ◽  
Ciclopirox Olamine ◽  
Esophageal Cancer Cell

OBJECTIVES/SPECIFIC AIMS: Drug repositioning has the potential to accelerate translation of novel cancer chemotherapeutics from bench to bedside. The goal of this study was to determine the effects of ciclopirox olamine (CPX) on esophageal tumor cells. METHODS/STUDY POPULATION: We tested the effect of CPX on four esophageal cancer cell lines, assessing cell proliferation and viability by hexosaminidase and clonogenicity assay, respectively. We analyzed the effects of CPX on three-dimensional (3D) esophageal tumor cell spheroids. We also analyzed effects on cell cycle by flow cytometry. For mechanism, we performed western blots for proteins involved in cell cycle regulation, apoptosis and the Wnt/β-catenin pathway. For in vivo effects, we performed a murine xenograft model with intraperitoneal administration of CPX (100 mg/Kg body weight daily). RESULTS/ANTICIPATED RESULTS: CPX inhibited growth of all cell lines in a time and concentration-dependent manner. CPX also inhibited growth of esophageal spheroids. Cell cycle analysis demonstrated G0/G1 arrest in cells treated with CPX. Western blot analyses demonstrated decreased expression of cyclinD1, CDK4, CDK6, and transcriptionally active β-catenin, supporting the role of CPX in cell cycle inhibition and decreased β-catenin activity. Finally, treatment of nude mice with CPX significantly decreased tumor xenograft volume. DISCUSSION/SIGNIFICANCE OF IMPACT: CPX demonstrates anti-tumor properties in esophageal cancer cell lines. The current results justify further research into the mechanism of this inhibition. Additionally, given its established safety in humans, CPX is a potential candidate for repositioning as an adjunct treatment for esophageal cancer.

Waterjet dissection in neurosurgical procedures: clinical results in 35 patients

2002 ◽  
Vol 96 (4) ◽  
pp. 690-696 ◽  
Author(s):  
Juergen Piek ◽  
Joachim Oertel ◽  
Michael Robert Gaab
Keyword(s):  
Blood Loss ◽  
Blood Vessels ◽  
Epilepsy Surgery ◽  
Tumor Resection ◽  
Neurosurgical Procedures ◽  
Normal Brain ◽  
Content Type ◽  
Waterjet Dissection ◽  
Ica Stenosis ◽  
Fine Print

Object. Waterjet dissection represents a new minimally traumatic surgical method for dissection that can be used in various parenchymal organs, in which it allows highly precise parenchymal dissection while preserving blood vessels, resulting in reduced intraoperative blood loss. This study was performed to investigate the clinical application of this new technique in neurosurgical procedures, such as brain tumor resection and epilepsy surgery. Methods. Thirty-four patients with gliomas (Grades II–IV), cerebral metastases, temporal lobe epilepsy, or cerebellar hemangioblastomas, and one patient with internal carotid artery (ICA) stenosis were treated surgically with the aid of the waterjet. Resection was performed using waterjet dissection in combination with conventional neurosurgical procedures. Intraoperatively, the waterjet was easy to handle, and no complications due to the device were observed. Dissection of tissue was possible for all pathological conditions, and pressures between 3 and 45 bars were used. In gliomas, metastases, epilepsy surgery, and hemangioblastoma, the tissue was dissected at pressures between 3 and 17 bars, which preserved blood vessels. Dissection of meningiomas and the ICA stenosis required higher pressures (between 20 and 45 bars); with these pressures, blood vessels were also dissected. Conclusions. These results indicate that the waterjet dissection procedure can be used intraoperatively without complications. This device appears to be particularly suitable for the dissection of highly vascularized gliomas or normal brain tissue, in which tissue dissection with sparing of blood vessels can be achieved. To prove that this is a useful addition to the neurosurgical armamentarium, reduction of blood loss or postoperative brain edema compared with conventional methods should be demonstrated in future studies.

Anterior Transpetrosal-Transtentorial Approach for Sphenopetroclival Meningiomas: Surgical Method and Results in 10 Patients

Neurosurgery ◽  
1991 ◽  
Vol 28 (6) ◽  
pp. 869-876 ◽  
Author(s):  
Takeshi Kawase ◽  
Ryuzo Shiobara ◽  
Shigeo Toya
Keyword(s):  
Brain Stem ◽  
Cavernous Sinus ◽  
Tumor Resection ◽  
Petrous Bone ◽  
Lower Cranial Nerve ◽  
Surgical Method ◽  
Main Complaint ◽  
Petroclival Meningiomas ◽  
Direct View ◽  
Bridging Veins

Abstract This report presents a new surgical method and the results in 10 patients with petroclival meningiomas extending into the parasellar region (sphenopetroclival meningiomas). Minimal but effective extradural resection of the anterior petrous bone via a middle fossa craniotomy offered a direct view of the clival area with preservation of the temporal bridging veins and cochlear organs. The dural incision was extended anteriorly to Meckel's cave, and in cases with invasion of the cavernous sinus, Parkinson's triangle was enlarged by mobilization of the trigeminal nerve. This approach offered an excellent view from the mid-clivus to the cavernous sinus. Extra-as well as intradural tumor masses and dural attachments could be cleared under direct view of the pontine surface. The risk of injury to the lower cranial nerve and of retraction damage to the temporal lobe and brain stem were kept minimal by this approach. Total tumor resection was achieved in 7 patients, with no resultant mortality. Eight patients had a satisfactory postsurgical course, extraocular paresis being their main complaint. The extent of tumor resection depended on the degree of tumor adhesion to the carotid artery, and operative morbidity on the degree of tumor invasion of the brain stem. Of the 3 patients in whom subtotal tumor removal was achieved, only one experienced regrowth of the tumor and underwent a second operation during the follow-up period (6 months-6 years).

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