scholarly journals Combination of Endoscopic Resection and Radiofrequency Ablation for the Treatment of Esophageal Squamous Cell Neoplasia With Multiple Lugol-Voiding Lesions

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhihao Chen ◽  
Lizhou Dou ◽  
Yong Liu ◽  
Yueming Zhang ◽  
Shun He ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Local Recurrence ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Medical Records ◽  
Combined Treatment ◽  
Complete Response ◽  
Esophageal Mucosa ◽  
Treatment Area ◽  
Combination Treatments

BackgroundLocal recurrence of esophageal squamous cell neoplasia (ESCN) and metachronous ESCN was associated with severe background esophageal multiple Lugol-voiding lesions (LVLs) even though the primary early ESCNs were treated with endoscopic resection (ER). The aim of this study is to explore the feasibility and effectiveness of combination treatments of ER and radiofrequency ablation (RFA) in patients with early ESCNs with synchronous multiple LVLs.MethodsA total of 329 patients with early ESCNs and synchronous multiple LVLs received ER combined with RFA from September 2010 to September 2020. Clinical and pathological features and treatment outcomes were retrospectively reviewed using medical records. Factors associated with background esophageal multiple LVLs before combined treatment were analyzed.ResultsThe proportion of complete response (CR) was 96.7% after primary RFA, while 90.3% patients achieved CR for the last endoscopic examinations regardless if inside or outside the treatment area (TA). Degeneration of background esophageal multiple LVLs occurred in 70.2% of patients. The grade of background esophageal multiple LVLs before combined treatment was closely related to gender, smoking, and drinking. The incidence of metachronous ESCNs outside the TA of ER and local recurrence in the TA of ER was 3.9% and 1.2%, respectively.ConclusionsProphylactic RFA treatment of multiple LVLs together with ER treatment of the primary ESCNs may be effective in reducing the incidence of metachronous ESCNs and local recurrence through improving the background esophageal mucosa.

Lessons from pathological analysis of recurrent early esophageal squamous cell neoplasia after complete endoscopic radiofrequency ablation

Endoscopy ◽  
2018 ◽  
Vol 50 (08) ◽  
pp. 743-750 ◽  
Author(s):  
Wen-Lun Wang ◽  
I-Wei Chang ◽  
Chien-Chuan Chen ◽  
Chi-Yang Chang ◽  
Cheng-Hao Tseng ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Local Recurrence ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Complete Response ◽  
Primary Treatment ◽  
Long Term Follow Up ◽  
Endoscopic Radiofrequency Ablation ◽  
Lost To Follow Up

Abstract Background Endoscopic radiofrequency ablation (RFA) is a treatment option for early esophageal squamous cell neoplasia (ESCN); however, long-term follow-up studies are lacking. The risks of local recurrence and “buried cancer” are also uncertain. Methods Patients with flat-type ESCN who were treated with balloon-type ± focal-type RFA were consecutively enrolled. Follow-up endoscopy was performed at 1, 3, and 6 months, and then every 6 months thereafter. Endoscopic resection was performed for persistent and recurrent ESCN, and the histopathology of resected specimens was assessed. Results A total of 35 patients were treated with RFA, of whom 30 (86 %) achieved a complete response, three were lost to follow-up, and five (14 %) developed post-RFA stenosis. Two patients had persistent ESCN and received further endoscopic resection, in which the resected specimens all revealed superficial submucosal invasive cancer. Six of the 30 patients with successful RFA (20 %) developed a total of seven episodes of local recurrence (mean size 1.4 cm) during the follow-up period (mean 40.1 months), all of which were successfully resected endoscopically without adverse events. Histological analysis of the resected specimens revealed that six (86 %) had esophageal glandular ductal involvement, all of which extended deeper than the muscularis mucosae layer. Immunohistochemistry staining for P53 and Ki67 suggested a clonal relationship between the ductal involvement and epithelial cells. None of the tumors extended out of the ductal structure; no cases of cancer buried beneath the normal neosquamous epithelium were found. Conclusions Because ductal involvement is not uncommon and may be related to recurrence, the use of RFA should be conservative and may not be the preferred primary treatment for early ESCN.

Predictive Factor of Local Recurrence After Endoscopic Resection of Large Esophageal Squamous Cell Carcinoma

2009 ◽  
Vol 69 (5) ◽  
pp. AB122-AB123
Author(s):  
Ryu Ishihara ◽  
Yoji Takeuchi ◽  
Noriya Uedo ◽  
Hiroyasu Iishi ◽  
Koji Higashino ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Predictive Factor

Combined therapy for carcinoma of the nasopharynx: a report of 49 cases

1993 ◽  
Vol 107 (3) ◽  
pp. 201-204 ◽  
Author(s):  
Sheng Hongzheng ◽  
Jia Haixia
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Complete Response ◽  
Regional Chemotherapy ◽  
Chemotherapeutic Agents ◽  
Well Differentiated ◽  
One Year

From April, 1986 to June 1989 49 Patients (29 male, 20 female) aged 20 to 70 years old whod developed carcinomea of naospharynx (included 15 with relapses) were trated with neoadjuvant regional chemothrapy, followed by radiotherapy, or crysurgery and radiotherapy.Thirty-three of the patients had squamous cell carcinoma with poor differentiated, four with well differentiated squamous cell carcinoma were included. Tumours were treated with three moalities: (I) Induction regional chemotherapy with temporal aftery catheterization as well as superselective intra-arterial chemotherapy of the femoral artery (chemotherapeutic agents: pingyangmycinum (P), Cisplatin (D), Vomcromstine (V), Methotrexate (M) and P.D.M. programmes); (2)Liquid cryosurgery in 25 cases; (3) Radiotherapy was carried out for two weeks after crysosurgery after chemotherapy.The date showed CR (complete response—all tumour gone) and PR (partial response—more than 50 percent reduction) in 40 cases (81.6 per cent) and NR (no response—less than 50 per cent or no response) in nine cases (18.3 per cent) following regional chemotherapy. All of the patients were followed up for more than one year, and 48 of them survived (97.9 per cent). Thirty-five cases were followed up over two years and 28 of them survived (80 per cent). Twenty cases were followed up over three years, and 12 of them survived (60 per cent).The effect of regional chemotherapy and crysurgery in combined treatment for carcinoma of the nasopharynx is discussed in this paper.

scholarly journals Endoscopic resections for superficial esophageal squamous cell epithelial neoplasia: focus on histological discrepancies between biopsy and resected specimens

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lang Yang ◽  
Hua Jin ◽  
Xiao-li Xie ◽  
Yang-tian Cao ◽  
Zhen-hua Liu ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Squamous Cell ◽  
Medical Records ◽  
Intraepithelial Neoplasia ◽  
Lesion Size ◽  
Clinicopathological Parameters ◽  
Low Grade ◽  
Type B ◽  
Forceps Biopsy ◽  
Discrepancy Rate

Abstract Background Endoscopic resection has been used for high-grade intraepithelial neoplasia (HGIN) and superficial esophageal squamous cell carcinoma (ESCC) with limited risk of lymph node metastasis. However, some of these lesions cannot be accurately diagnosed based on forceps biopsy prior to treatment. In this study we aimed to investigate how to solve this histological discrepancy and avoid over- and under-treatment. Methods The medical records of patients with superficial esophageal squamous cell neoplasia who underwent endoscopic resection at our hospital from January 2012 to December 2019 were reviewed retrospectively. The histological discrepancy between the biopsy and resected specimens was calculated and its association with clinicopathological parameters was analyzed. Results A total of 137 lesions from 129 patients were included. The discrepancy rate between forceps biopsy and resected specimens was 45.3% (62/137). Histological discrepancy was associated with the histological category of the biopsy (p < 0.001). In addition, 17 of the 30 (56.7%) biopsies that was diagnosed as indefinite/negative for neoplasia or low-grade intraepithelial neoplasia were upgraded to HGIN or ESCC after resection. The upgrade was due to lesion size ≥ 10 mm (p = 0.002) and type B intrapapillary capillary loops (p < 0.001). Moreover, 34 of the 83 biopsies that were diagnosed with HGIN were upgraded to ESCC after resection, which was related to lesion size (p = 0.001), location (p = 0.018), and pink color sign (p = 0.002). Conclusions Histological discrepancy between forceps biopsy and resected specimens is common in clinical practice. Recognizing the risk factors for each histological category of biopsy may reduce these discrepancies and improve clinical management.

scholarly journals Real-time virtual sonography-assisted radiofrequency ablation in liver tumors with conspicuous or inconspicuous images or peritumoral landmarks under ultrasonography

2021 ◽  
Author(s):  
Hsin-Chih Huang ◽  
L. B. Gatchalian ◽  
Yi-Chung Hsieh ◽  
Wei-Ting Chen ◽  
Chen-Chun Lin ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Liver Metastasis ◽  
Local Recurrence ◽  
Real Time ◽  
Liver Tumors ◽  
Complete Response ◽  
Recurrence Rates ◽  
Cross Sectional ◽  
Multiple Switching

Abstract Objectives The objectives of this study were to determine the primary technique effectiveness (PTE), to compare the complete response and local recurrence rates between conspicuous and inconspicuous tumors using single and switching electrodes of real-time virtual sonography (RVS)-assisted radiofrequency ablation (RFA) in conspicuous and inconspicuous hepatic tumors under conventional ultrasonography (US). Subjects and method We compared the complete ablation of inconspicuous tumors with and without anatomical landmark (N = 54) with conspicuous liver tumors (N = 272). Conventional US imaging was done initially, and then these images were fused with CT or MRI arterial-venous-wash-out cross-sectional studies and synchronized with real-time US images. Results RVS-assisted RFA was technically feasible in all patients. The PTE rate after the first ablation was 94% (245/261) for conspicuous tumors, 88% (7/8) in inconspicuous tumors with landmark, and 78% (36/46) in inconspicuous tumors without landmark. The complete response (p = 0.1912 vs. p = 0.4776) and local recurrence rate (p = 0.1557 vs. p = 0.7982) were comparable in conspicuous tumors of both HCC and liver metastasis group when single or multiple switching was used. The cumulative local recurrence in the conspicuous and inconspicuous tumors of the HCC group (p = 0.9999) was almost parallel after 12 (10% vs. 4%) and 24 (13% vs. 4%) months of follow-up. In the liver metastasis group, the cumulative local recurrence for conspicuous tumors (p = 0.9564) was nearly equal after 12 and 24 months of monitoring (24% vs. 27%) while no recurrence was incurred for the inconspicuous tumors. Conclusion RVS-assisted RFA is an effective tool for the treatment of conspicuous and inconspicuous HCC and hepatic metastasis.

Local recurrence of large squamous-cell carcinoma of the esophagus after endoscopic resection

2008 ◽  
Vol 67 (6) ◽  
pp. 799-804 ◽  
Author(s):  
Ryu Ishihara ◽  
Hiroyasu Iishi ◽  
Yoji Takeuchi ◽  
Motohiko Kato ◽  
Sachiko Yamamoto ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Cell Carcinoma ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Carcinoma Of The Esophagus

scholarly journals Aspirin enhances the therapeutic efficacy of cisplatin in oesophageal squamous cell carcinoma by inhibition of putative cancer stem cells

2021 ◽  
Author(s):  
Zhigeng Zou ◽  
Wei Zheng ◽  
Hongjun Fan ◽  
Guodong Deng ◽  
Shih-Hsin Lu ◽  
...  
Keyword(s):  
Stem Cells ◽  
Squamous Cell Carcinoma ◽  
Cancer Stem Cells ◽  
Cell Carcinoma ◽  
Cell Lines ◽  
Squamous Cell ◽  
High Throughput Sequencing ◽  
Combined Treatment ◽  
Oesophageal Squamous Cell Carcinoma

Abstract Background Cancer stem cells (CSCs) are related to the patient’s prognosis, recurrence and therapy resistance in oesophageal squamous cell carcinoma (ESCC). Although increasing evidence suggests that aspirin (acetylsalicylic acid, ASA) could lower the incidence and improve the prognosis of ESCC, the mechanism(s) remains to be fully understood. Methods We investigated the role of ASA in chemotherapy/chemoprevention in human ESCC cell lines and an N-nitrosomethylbenzylamine-induced rat ESCC carcinogenesis model. The effects of combined treatment with ASA/cisplatin on ESCC cell lines were examined in vitro and in vivo. Sphere-forming cells enriched with putative CSCs (pCSCs) were used to investigate the effect of ASA in CSCs. Assay for Transposase-Accessible Chromatin with high-throughput sequencing (ATAC-seq) was performed to determine the alterations in chromatin accessibility caused by ASA in ESCC cells. Results ASA inhibits the CSC properties and enhances cisplatin treatment in human ESCC cells. ATAC-seq indicates that ASA treatment results in remarkable epigenetic alterations on chromatin in ESCC cells, especially their pCSCs, through the modification of histone acetylation levels. The epigenetic changes activate Bim expression and promote cell death in CSCs of ESCC. Furthermore, ASA prevents the carcinogenesis of NMBzA-induced ESCC in the rat model. Conclusions ASA could be a potential chemotherapeutic adjuvant and chemopreventive drug for ESCC treatment.

scholarly journals Post-Neoadjuvant Surveillance and Surgery as Needed Compared with Post-Neoadjuvant Surgery on Principle in Multimodal Treatment for Esophageal Cancer: A Scoping Review

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 429
Author(s):  
Julian Hipp ◽  
Blin Nagavci ◽  
Claudia Schmoor ◽  
Joerg Meerpohl ◽  
Jens Hoeppner ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Local Recurrence ◽  
Scoping Review ◽  
Multimodal Treatment ◽  
Neoadjuvant Treatment ◽  
Complete Response ◽  
Diagnostic Methods ◽  
Cochrane Library ◽  
Randomized Controlled

Background: A substantial fraction of patients with esophageal cancer show post-neoadjuvant pathological complete response (pCR). Principal esophagectomy after neoadjuvant treatment is the standard of care for all patients, although surveillance and surgery as needed in case of local recurrence may be a treatment alternative for patients with complete response (CR). Methods: We performed a scoping review to describe key characteristics of relevant clinical studies including adults with non-metastatic esophageal cancer receiving multimodal treatment. Until September 2020, relevant studies were identified through systematic searches in the bibliographic databases Medline, Web of Science, Cochrane Library, Science Direct, ClinicalTrials, the German study register, and the WHO registry platform. Results: In total, three completed randomized controlled trials (RCTs, with 468 participants), three planned/ongoing RCTs (with a planned sample size of 752 participants), one non-randomized controlled study (NRS, with 53 participants), ten retrospective cohort studies (with 2228 participants), and one survey on patients’ preferences (with 100 participants) were identified. All studies applied neoadjuvant chemoradiation protocols. None of the studies examined neoadjuvant chemotherapeutic protocols. Studies investigated patient populations with esophageal squamous cell carcinoma, adenocarcinoma, and mixed cohorts. Important outcomes reported were overall, disease-free and local recurrence-free survival. Limitations of the currently available study pool include heterogeneous chemoradiation protocols, a lack of modern neoadjuvant treatment protocols in RCTs, short follow-up times, the use of heterogeneous diagnostic methods, and different definitions of clinical CR. Conclusion: Although post-neoadjuvant surveillance and surgery as needed compared with post-neoadjuvant surgery on principle has been investigated within different study designs, the currently available results are based on a wide variation of diagnostic tools to identify patients with pCR, short follow-up times, small sample sizes, and variations in therapeutic procedures. A thoroughly planned RCT considering the limitations in the currently available literature will be of great importance to provide patients with CR with the best and less harmful treatment.

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