Clinicopathological factors predicting R0 resection and long-term survival after esophagectomy in patients with T4 esophageal cancer undergoing induction chemotherapy or chemoradiotherapy

Karimata, Hiroyuki; Shimoji, Hideaki; Nishimaki, Tadashi

doi:10.1007/s00595-014-0980-7

Cited by 21 publications

(13 citation statements)

References 16 publications

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“…Based on these results, SOCS1 gene therapy may represent a new treatment for ESCC by inducing a variety of antitumor mechanism. For locally advanced ESCC that has invaded adjacent indispensable organs, although chemoradiotherapy is reported to be the first treatment choice, local disease control may be difficult to achieve in some cases . Our findings demonstrate that SOCS1 gene therapy might be facilitated by administering in multiple sites of the tumor using endoscopy.…”

Section: Discussionmentioning

confidence: 86%

“…Moreover, although multidisciplinary treatment with a focus on radiation therapy is also performed as an important treatment option for patients with T4 tumor, almost 50% of patients develop a locoregional recurrence after chemoradiotherapy . Additionally, salvage surgery after radiation therapy may cause serious problems, such as increased risk of surgery‐related adverse events and mortality . Therefore, new regional approaches that can improve the prognosis of patients with locally advanced ESCC are needed.…”

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confidence: 99%

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Suppressor of cytokine signaling-1 gene therapy induces potent antitumor effect in patient-derived esophageal squamous cell carcinoma xenograft mice

et al. 2017

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Chronic inflammation is involved in cancer growth in esophageal squamous cell carcinoma (ESCC), which is a highly refractory cancer with poor prognosis. This study investigated the antitumor effect and mechanisms of SOCS1 gene therapy for ESCC. Patients with ESCC showed epigenetics silencing of SOCS1 gene by methylation in the CpG islands. We infected 10 ESCC cells with an adenovirus-expressing SOCS1 (AdSOCS1) to examine the antitumor effect and mechanism of SOCS1 overexpression. SOCS1 overexpression markedly decreased the proliferation of all ESCC cell lines and induced apoptosis. Also, SOCS1 inhibited the proliferation of ESCC cells via multiple signaling pathways including Janus kinase (JAK)/signal transducer and activator of transcription (STAT) and focal adhesion kinase (FAK)/p44/42 mitogen-activated protein kinase (p44/42 MAPK). Additionally, we established two xenograft mouse models in which TE14 ESCC cells or ESCC patient-derived tissues (PDX) were subcutaneously implanted. Mice were intra-tumorally injected with AdSOCS1 or control adenovirus vector (AdLacZ). In mice, tumor volumes and tumor weights were significantly lower in mice treated with AdSOCS1 than that with AdLacZ as similar mechanism to the in vitro findings. The Ki-67 index of tumors treated with AdSOCS1 was significantly lower than that with AdLacZ, and SOCS1 gene therapy induced apoptosis. These findings demonstrated that overexpression of SOCS1 has a potent antitumor effect against ESCC both in vitro and in vivo including PDX mice. SOCS1 gene therapy may be a promising approach for the treatment of ESCC.

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Section: Discussionmentioning

confidence: 86%

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confidence: 99%

Suppressor of cytokine signaling-1 gene therapy induces potent antitumor effect in patient-derived esophageal squamous cell carcinoma xenograft mice

et al. 2017

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“…Five of 28 patients underwent esophagectomy via right thoracotomy and 23 underwent TE. Primary tumor presenting as a bulky mass convexly compressing neighboring organs with an indistinct soft density layer bordering the tumor on computed tomography (CT) was regarded as initially unresectable T4 tumor . In addition, tumors were diagnosed as clinical T4 if they extended into the lumen or caused a deformity of the tracheobronchus or if they were attached to the aorta at a contact angle of ≥90° in over three slices .…”

Section: Methodsmentioning

confidence: 99%

Safety of thoracoscopic esophagectomy after induction chemotherapy for locally advanced unresectable esophageal squamous cell carcinoma

Akiyama

Iwaya

Endo

et al. 2019

Asian J Endoscop Surgery

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Introduction Recent studies have reported that induction chemotherapy with docetaxel plus cisplatin and 5‐fluorouracil (DCF) is an effective treatment for unresectable, locally advanced esophageal cancer. The aim of this study was to investigate the safety and feasibility of thoracoscopic esophagectomy (TE) after DCF for initially unresectable esophageal squamous cell carcinoma (ESCC). Methods Twenty‐three patients with initially unresectable T4 thoracic ESCC underwent TE after induction DCF. Results The neighboring organs with tumors were the tracheobronchus in nine patients, thoracic aorta in 13, and pericardium and diaphragm in three each (concurrent overlapping invasion occurred in five patients). The mean total operation time was 556.3 ± 107.2 minutes, and the mean time of the thoracic procedure was 258.9 ± 83.9 minutes. The mean total blood loss was 166.2 ± 117.8 mL, and the loss during the thoracic procedure was 33.5 ± 24.6 mL. All patients achieved complete R0 resection under TE. No conversions to open thoracotomy were performed. The postoperative morbidity rate was 34.8%. The postoperative hospital stay was 24.3 (range, 13‐38) days. Five patients had recurrence: four had distant metastasis (lung, two; liver, three; and one with overlap), and one had mediastinal lymph node recurrence. No local recurrence was noted at the site of the primary T4 tumor. Conclusions TE was safely performed in 23 patients after DCF therapy for locally advanced unresectable ESCC. Induction DCF, followed by TE, could be an alternative treatment for unresectable T4 ESCC.

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“…The poor results of dCRT in unresectable cT4 tumors and the morbidity of salvage surgery following dCRT have led to the hypothesis that planned surgery after induction CRT may be a reasonable alternative. In this regard, recent studies have shown that it is feasible to perform a radical resection, while preserving vital organs (trachea and aorta), in patients with tumor response to induction treatment . However, radical esophagectomy after induction therapy in these patients has been associated with a higher risk of in‐hospital mortality .…”

Section: Stage‐directed Individualized Therapymentioning

confidence: 99%

“…However, radical esophagectomy after induction therapy in these patients has been associated with a higher risk of in‐hospital mortality . Nonetheless, reported R0 resection rates range between 61% and 88% . As this is a rather new strategy, identifying prognostic indicators for R0 resections could contribute to a better selection of appropriate candidates for esophagectomy after induction therapy in patients with initially unresectable cT4 tumors, although secondary radical esophagectomy after induction therapy has been associated with a higher risk of in‐hospital mortality …”

Section: Stage‐directed Individualized Therapymentioning

confidence: 99%

Stage‐directed individualized therapy in esophageal cancer

Goense

Rossum

Kandioler

et al. 2016

Annals of the New York Academy of Sciences

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Esophageal cancer is the eighth most common cancer worldwide, and the incidence of esophageal carcinoma is rapidly increasing. With the advent of new staging and treatment techniques, esophageal cancer can now be managed through various strategies. A good understanding of the advances and limitations of new staging techniques and how these can guide in individualizing treatment is important to improve outcomes for esophageal cancer patients. This paper outlines the recent progress in staging and treatment of esophageal cancer, with particularly attention to endoscopic techniques for early-stage esophageal cancer, multimodality treatment for locally advanced esophageal cancer, assessment of response to neoadjuvant treatment, and the role of cervical lymph node dissection. Furthermore, advances in robot-assisted surgical techniques and postoperative recovery protocols that may further improve outcomes after esophagectomy are discussed.

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Clinicopathological factors predicting R0 resection and long-term survival after esophagectomy in patients with T4 esophageal cancer undergoing induction chemotherapy or chemoradiotherapy

Cited by 21 publications

References 16 publications

Suppressor of cytokine signaling-1 gene therapy induces potent antitumor effect in patient-derived esophageal squamous cell carcinoma xenograft mice

Suppressor of cytokine signaling-1 gene therapy induces potent antitumor effect in patient-derived esophageal squamous cell carcinoma xenograft mice

Safety of thoracoscopic esophagectomy after induction chemotherapy for locally advanced unresectable esophageal squamous cell carcinoma

Stage‐directed individualized therapy in esophageal cancer

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