scholarly journals The Influence of Different Treatment Strategies on the Long-Term Prognosis of T1 Stage Esophageal Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Liang Pan ◽  
Xingyu Liu ◽  
Weidong Wang ◽  
Linhai Zhu ◽  
Wenfeng Yu ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Tumor Size ◽  
Factors Affecting ◽  
Ajcc Stage ◽  
Size Grade ◽  
T1 Stage ◽  
Long Term Prognosis ◽  
Better Than

ObjectiveTo compare the long-term prognosis effects of non-esophagectomy and esophagectomy on patients with T1 stage esophageal cancer.MethodsAll esophageal cancer patients in the study were included from the National Surveillance Epidemiology and End Results (SEER) database between 2005-2015. These patients were classified into non-esophagectomy group and esophagectomy group according to therapy methods and were compared in terms of esophagus cancer specific survival (ECSS) and overall survival (OS) rates.ResultsA total of 591 patients with T1 stage esophageal cancer were enrolled in this study, including 212 non-esophagectomy patients and 111 esophagectomy patients in the T1a subgroup and 37 non-esophagectomy patients and 140 esophagectomy patients in the T1b subgroup. In all T1 stage esophageal cancer patients, there was no difference in the effect of non-esophagectomy and esophagectomy on postoperative OS, but postoperative ECSS in patients treated with non-esophagectomy was significantly better than those treated with esophagectomy. Cox proportional hazards regression model analysis showed that the risk factors affecting ECSS included race, primary site, tumor size, grade, and AJCC stage but factors affecting OS only include tumor size, grade, and AJCC stage in T1 stage patients. In the subgroup analysis, there was no difference in either ECSS or OS between the non-esophagectomy group and the esophagectomy group in T1a patients. However, in T1b patients, the OS after esophagectomy was considerably better than that of non-esophagectomy.ConclusionsNon-esophagectomy, including a variety of non-invasive procedures, is a safe and available option for patients with T1a stage esophageal cancer. For some T1b esophageal cancer patients, esophagectomy cannot be replaced at present due to its diagnostic and therapeutic effect on lymph node metastasis.

PS02.238: POSTOPERATIVE PROGNOSTIC NUTRITIONAL INDEX CAN PREDICT A LONG-TERM PROGNOSIS OF ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 189-190
Author(s):  
Jun Takahashi ◽  
Masaaki Saito ◽  
Tamotsu Obitsu ◽  
Daisuke Ishioka ◽  
Hirokazu Kiyozaki ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Conflicts Of Interest ◽  
Prognostic Nutritional Index ◽  
Pathological Stage ◽  
Radical Esophagectomy ◽  
Esophagus Cancer ◽  
Nutritional Index ◽  
Long Term Prognosis ◽  
Advanced Pathological Stage

Abstract Background Recent reports indicate the nutritional and immune status often affect the long-term prognosis of patients with cancer. The preoperative prognostic nutritional index(PNI) is used as an evaluation of the perioperative nutritional status, and it is reported that the PNI level correlates with postoperative results. However, only a handful of reports have discussed the predictive prognostic potential of postoperative PNI. The aim of this study is to clarify the correlation of postoperative PNI level and long-term prognosis of patients with esophagus cancer who underwent esophagectomy. Methods A total of 29 patients with esophageal cancer who received neoadjuvant chemotherapy followed by radical esophagectomy from January 2011 to December 2014 were retrospectively reviewed. The calculation of PNI level is as follows: 10 × serum albumin level (g/dL) + 0.005 × total lymphocyte count (/mm3). The postoperative PNI level was measured three months after radical esophagectomy. The patients were stratified by postoperative PNI level by two groups using calculated cutoff level (PNI = 43.9) by receiver operating characteristic curve. The correlation of 3-year disease-free survival (DFS) and postoperative PNI level was evaluated. Results Of the total, 25 were male and 4 were female. The median age of patients was 68 years (31–79 years). Overall, patients received 1–2 cycles of preoperative chemotherapy with 5-FU and cisplatin. Of these 29 patients, 9 (31.0%) responded to chemotherapy (8 patients had a partial response and 1 had a complete response). The median postoperative PNI level was 47.2 (38.0–58.9). Univariate analyses showed that 3-year DFS was worse in patients with low postoperative PNI level (P = 0.017), advanced pathological stage (P = 0.029) and younger age (< 70 years) (P = 0.02). Multivariate analyses showed that low postoperative PNI level[hazard ratio (HR) 0.224, 95% confidence interval (CI) 0.060–0.83, P = 0.026] and advanced pathological stage (HR 3.197, 95% CI 1.13–9.06, P = 0.029) were independent predictors of 3-year DFS. Conclusion Our findings suggest that the postoperative PNI level may be a useful marker to predict a prognosis of patients with esophagus cancer. Nutrition intervention for undernourished patients after surgery may improve prognosis of patients with esophagus cancer. Disclosure All authors have declared no conflicts of interest.

64 STATISTICAL ANALYSIS OF PROGNOSTIC FACTORS AFFECTING LONG-TERM PROGNOSIS AFTER ENDOSCOPIC TREATMENT OF ESOPHAGEAL VARICES

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
T Nishimura
Keyword(s):  
Prognostic Factors ◽  
Esophageal Varices ◽  
Endoscopic Treatment ◽  
Survival Period ◽  
Term Survival ◽  
Gastroesophageal Varices ◽  
Long Term Survival ◽  
Factors Affecting ◽  
Long Term Prognosis

Abstract   Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 260 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and June 2019. Among them, 160 successfully followed up. The patients’ characteristics were: mean age, 65.4 years (29–85); 109 men and 51 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The long-term/non-long-term survival group had a preoperative Child-Pugh score of 6.2 ± 1.1/7.4 ± 2.0 (p &lt; 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.4%/55.9% (p &lt; 0.01), significantly higher in the non-long-term group. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, p &lt; 0.05], total bilirubin value≧ 2 [HR:2.5573, p &lt; 0.05], and presence of HCC [HR:2.2450, p &lt; 0.01] were noted as significant factors. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio:0.3463, p &lt; 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices.

PS02.098: LONG-TERM OUTCOMES OF ADDITIONAL THERAPY FOLLOWING ENDOSCOPIC RESECTION FOR T1B-SM ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 148-149
Author(s):  
Tsuyoshi Tanaka ◽  
Masaki Ueno ◽  
Toshiro Iizuka ◽  
Shu Hoteya ◽  
Shusuke Haruta ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Lymphatic Invasion ◽  
Additional Treatment ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Risk Factors For Recurrence ◽  
Recurrent Patterns

Abstract Background Esophagectomy is the standard treatment strategy for superficial esophageal cancer diagnosed as pT1b(sm) following endoscopic resection (EMR/ESD). However, chemoradiotherapy (CRT) is expected to be an alternative treatment option. This study retrospectively compared the long-term outcomes of surgery and CRT as additional treatments for EMR/ESD pT1b esophageal cancer. Methods In a retrospective single-center study, the data of 83 consecutive patients who underwent EMR/ESD and were diagnosed with pT1b(sm) from January 2002 to December 2013 were collected, and additional treatment was administered to 59 of these patients (26 surgery and 33 CRT). Long-term outcomes, recurrent patterns, and risk factors for recurrence were analyzed. Results Median patient age was 63 (range, 43–79) years, and male/female ratio was 54:5. Tumor characteristics were as follows: location, Ce/Ut/Mt/Lt/Ae/EG = 1/6/32/13/3/4; median size, 25 (range, 5–88) mm; depth, sm1/sm2 = 18/41; vascular invasion (ly, v), + / − = 37/22; and cut end (HM, VM), + or × / − = 17/42. Sex, Charlson comorbidity index, tumor size, macroscopic type, cut end, and resection state were not different between the two groups. Meanwhile, age, tumor location, histological type, tumor depth, and vascular invasion were different between the two groups. The 5-year survival rates (relapse-free survival rate; RFS) were 92.3% (92.3%; RFS) and 80.3% (70.4%; RFS) in the surgery and CRT groups, respectively. The surgery group was significantly superior to the CRT group in terms of RFS (P = 0.042). All tumor recurrence was observed in the CRT group (P = 0.030). Recurrent patterns were as follows: hematogenous metastases (lung, bone, and adrenal gland) in three patients and lymph node metastases (four regional and an extra-regional) in four patients. In multivariate analysis, tumor size (P = 0.048) and lymphatic invasion (P = 0.032) were revealed as significant risk factors for recurrence in the CRT group. Conclusion Surgery is recommended as the additional treatment for ESD/EMR-pT1b esophageal cancer for better recurrent-free survival. Although CRT could be an acceptable treatment choice, the indication should be carefully decided, particularly in cases with large tumor size or lymphatic invasion. Disclosure All authors have declared no conflicts of interest.

scholarly journals Anti-NMDAR encephalitis

2019 ◽  
Vol 7 (1) ◽  
pp. e633 ◽  
Author(s):  
Xiaolu Xu ◽  
Qiang Lu ◽  
Yan Huang ◽  
Siyuan Fan ◽  
Lixin Zhou ◽  
...  
Keyword(s):  
Ovarian Teratoma ◽  
Long Term Outcomes ◽  
First Line ◽  
Factors Affecting ◽  
First Line Therapy ◽  
Nmdar Encephalitis ◽  
Clinical Presentations ◽  
Long Term Prognosis

ObjectiveTo describe the detailed clinical characteristics, immunotherapy, and long-term outcomes of patients with anti-NMDA receptor (NMDAR) encephalitis in China.MethodsA single-center, prospective study. Patients who met the diagnostic criteria were enrolled from 2011 to 2017 and followed up. The clinical features, treatment, and long-term outcomes were collected prospectively. Factors affecting the long-term prognosis were analyzed.ResultsThe study included 220 patients. The most common clinical presentations were psychosis (82.7%) and seizures (80.9%). Of the patients, 19.5% had an underlying neoplasm; of which ovarian teratoma was 100% of tumors in females and only one male had lung cancer. Most patients (99.5%) received first-line therapy (glucocorticoids, IV immunoglobulin, or plasmapheresis alone or combined), and only 7.3% received second-line immunotherapy (rituximab, cyclophosphamide alone, or combined). Long-term immunotherapy (mycophenolate mofetil or azathioprine >1 year) was administered to 53.2% of patients. During the first 12 months, 207 (94.1%) patients experienced improvement, and 5 (2.3%) died, whereas 38 (17.3%) experienced relapses. At 12-month follow-up, 92.7% had favorable clinical outcomes (modified Rankin Scale score ≤2).ConclusionsPatients in China present with psychosis and seizure frequently but have a low percentage of underlying neoplasms. Re-enforced first-line immunotherapy is effective in managing anti-NMDAR encephalitis in the acute phase. Although relapse is relatively common, with combined first-line and long-term immunotherapy, most patients reached favorable outcomes.

Prognostic factors for medium- and long-term survival of esophageal cancer patients in the Netherlands

2013 ◽  
Vol 109 (5) ◽  
pp. 465-471 ◽  
Author(s):  
Pauline Bus ◽  
Valery E. Lemmens ◽  
Martijn G. van Oijen ◽  
Geert-Jan Creemers ◽  
Grard A. Nieuwenhuijzen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
The Netherlands ◽  
Cancer Patients ◽  
Term Survival ◽  
Long Term Survival
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