Advanced esophageal carcinoma

Lerut, Toni; Leyn, Paul De; Coosemans, Willy; Raemdonck, Dirk Van; Cuypers, P.H.; Cleynenbreughel, B Van

doi:10.1007/bf00316818

Cited by 59 publications

(28 citation statements)

References 46 publications

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“…The reported incidence of stage T4 is 12%-34% [24][25][26][27] among thoracic esophageal cancer and the depth of invasion is usually diagnosed by computed tomography (CT) or endoscopic ultrasonography (EUS). However, it is often difficult to obtain an accurate preoperative diagnosis of organ invasion.…”

Section: Commentsmentioning

confidence: 99%

Treatment of T4 Esophageal Cancer. Definitive Chemo-Radiotherapy vs Chemo-Radiotherapy Followed by Surgery

Makino

Doki

2011

ATCS

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The outcome of patients with T4 esophageal cancer, defined as a tumor that invades neighboring structures (e.g., aorta, trachea, bronchus, and lung), is extremely poor. Despite recent advances in surgical techniques, these tumors are usually considered inoperable. Two distinct therapeutic options are currently available for T4 esophageal cancers: chemo-radiotherapy followed by surgery (CRT-S), which comprises esophagectomy following down-staging of the tumor by CRT, and definitive chemo-radiotherapy (D-CRT), which is designed to avoid esophagectomy by using maximum doses of irradiation. CRT-S is superior to D-CRT with respect to local control and short-term survival although CRT-S is associated with relatively higher perioperative mortality and morbidity. On the other hand, it is sometimes difficult to achieve local control with D-CRT and the treatment often results in fistula formation, though a complete response to CRT is often associated with better prognosis. Admittedly, the difference in the survival rate between the two modalities is marginal at long-term follow-up due to operative morbidity and inadequate control of distant metastasis in CRT-S. Changes in perioperative management and intensive systemic chemotherapy may enhance the outcome. Randomized controlled trials involving large population samples are needed to define the standard treatment for T4 esophageal cancer.

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Section: Commentsmentioning

confidence: 99%

Treatment of T4 Esophageal Cancer. Definitive Chemo-Radiotherapy vs Chemo-Radiotherapy Followed by Surgery

Makino

Doki

2011

ATCS

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“…Identification of lymph node metastases on histopathological examination is the single most important prognostic factor in oesophageal cancer [1][2][3][4][5][6][7][8][9][10]. The overall 5-year survival rate after surgical resection is between 70% and 92% for patients without nodal involvement, but only 18% to 47% for patients with lymph node metastasis [8,10].…”

Section: Introductionmentioning

confidence: 99%

“…The overall 5-year survival rate after surgical resection is between 70% and 92% for patients without nodal involvement, but only 18% to 47% for patients with lymph node metastasis [8,10]. It is an accurate predictor of disease-free survival and can be used to identify patients who may require adjuvant chemotherapy or chemoradiotherapy to treat systemic metastases developing after primary resection [10,11].…”

Section: Introductionmentioning

confidence: 99%

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

Kayani

Zacharakis

Ahmed

et al. 2011

European Journal of Surgical Oncology (EJSO)

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Oesophageal cancer is the seventh most common cause of cancer-related death in the developed world and the incidence of oesophageal adenocarcinoma is now the fastest growing of any gastrointestinal cancer. Lymph node involvement is the single most important prognostic factor in oesophageal cancer. Imaging to determine the extent of lymph node involvement and plan treatment often requires a combination of modalities to avoid under-staging. The seventh edition of the staging system released by the International Union Against Cancer (IUCC) has stratified lymph node involvement according to the number of lymph nodes involved and redefined its groupings for location of metastatic lymph node involvement. This review discusses the prognostic and treatment implications of these modifications and explores micrometastatic lymph node involvement, capsular infiltration and lymph node ratio as possible additions to the staging system.

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“…Early detection is especially important in esophageal squamous cell carcinoma (ESCC) which has an especially poor prognosis among alimentary tract cancers, the 5-year survival rate being 20–30% [1,2,3,4]. Advances in endoscopy and the introduction of iodine staining have increased the detection rate of superficial esophageal cancer in Japan [5], but determining whether or not unstained or understained areas are neoplastic remains problematic.…”

Section: Introductionmentioning

confidence: 99%

p53 Mutation Analysis of Low-Grade Dysplasia and High-Grade Dysplasia/Carcinoma in situ of the Esophagus Using Laser Capture Microdissection

Kobayashi

Kawachi²,

Takizawa³

et al. 2006

Oncology

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Objectives: The aim of this study was to determine the prevalence and to analyze the characteristics of p53 point mutation in esophageal intraepithelial lesions. Methods: p53 immunohistochemical and genetic analyses were performed on histopathologically and morphometrically diagnosed lesions. Laser capture microdissection samples were used for increased accuracy. Results: Of the 70 lesions studied, 21 were high-grade dysplasia/carcinoma in situ (HGD/CIS), 21 low-grade dysplasia (LGD), 16 reactive atypical epithelia (RAE) and 12 normal epithelia (NE).Immunohistochemical staining showed p53 protein accumulation in 86% (18/21) of HGD/CIS, 81% (17/21) of LGD, and in none of RAE and NE. p53 point mutation was detected in 71% (15/21) of HGD/CIS, 67% (14/21) of LGD, but in none of RAE and NE. Of HGD/CIS and LGD with p53 protein accumulation, similar percentages had mutations: 83% (15/18) and 82% (14/17), respectively. Of lesions with mutations, 72% (21/29) had mutations at hot spots such as codons 238, 248, 273 and 282. Conclusions: p53 point mutation prevalent in HGD/CIS was also present in a large number of LGD. This is strong evidence that LGD is a neoplastic lesion and that p53 point mutation is deeply involved in esophageal carcinogenesis.

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Advanced esophageal carcinoma

Cited by 59 publications

References 46 publications

Treatment of T4 Esophageal Cancer. Definitive Chemo-Radiotherapy vs Chemo-Radiotherapy Followed by Surgery

Treatment of T4 Esophageal Cancer. Definitive Chemo-Radiotherapy vs Chemo-Radiotherapy Followed by Surgery

Lymph node metastases and prognosis in oesophageal carcinoma – A systematic review

p53 Mutation Analysis of Low-Grade Dysplasia and High-Grade Dysplasia/Carcinoma in situ of the Esophagus Using Laser Capture Microdissection

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