Pretreatment Dysphagia in Esophageal Cancer Patients May Eliminate the Need for Staging by Endoscopic Ultrasonography

Ripley, R. Taylor; Sarkaria, Inderpal S.; Grosser, Rachel; Sima, Camelia S.; Bains, Manjit S.; Jones, David R.; Adusumilli, Prasad S.; Huang, James; Finley, David J.; Rusch, Valerie W.; Rizk, Nabil P.

doi:10.1016/j.athoracsur.2015.06.062

Cited by 28 publications

(18 citation statements)

References 10 publications

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“…Most patients were in stage III (60.2%), stage II accounted for 22.3%, and the figures for stage I and IV were 7.8% and 9.7%, respectively. Our results were similar to those of studies in America and China, with 56.0% and 60.8% of patients diagnosed with esophagus cancer stages III and IV [ 39 , 40 ]. Vietnam is still a developing country, and due to limited economic conditions and people’s limited awareness of cancer, patients are often not examined when early manifestations of cancer occur, and their health is only checked when the disease has become intolerable.…”

Section: Discussionsupporting

confidence: 91%

Nutritional Status and Feeding Regimen of Patients with Esophagus Cancer—A Study from Vietnam

et al. 2021

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Background: Esophagus cancer patients are at high risk of malnutrition. This study was performed to assess the nutritional status and dietary intake of newly diagnosed esophageal cancer patients in Vietnam National Cancer Hospital (NCH). Methods: A cross-sectional study was conducted on 206 early esophageal cancer inpatients after gastrostomy from September 2017 to June 2018. The chi-squared test, Fisher exact test, and Mann–Whitney test were performed. The software of the Vietnam National Institute of Nutrition was used to evaluate the dietary intake of patients. Results: All the participants were male with a mean age of 57.1 ± 8.5 years. Overall, 87.4% of patients had dysphagia. Furthermore, 82.5% and 90.8% of patients reported weight loss one and six months pre-diagnosis, respectively. Moreover, 52.9% of patients suffered from mild/moderate malnutrition and 29.6% of patients had severe malnutrition according to the Patient-Generated Subjective Global Assessment (PG-SGA). The body mass index (BMI) and mid upper arm circumference (MUAC) measurement revealed 47.6% and 50% of undernourished patients, respectively. The proportions of patients having malnutrition were 10.7%, 55.8%, and 27.2% according to albumin, prealbumin, and total lymphocyte counts, respectively. The means of energy, protein, lipid, and carbohydrate in the patients’ 24 h preoperative diets were 973.6 ± 443.0 kcal/day, 42.4 ± 21.6 g/day, 31.0 ± 15.5 g/day, and 130.0 ± 64.5 g/day. The total energy, total protein, animal protein, total lipid, and plant lipid in the dietary intake of patients were strongly correlated with age, economic classification, and PG-SGA (each p < 0.05). The total energy intake increased day by day, with the average energy intake of 1343.9 ± 521.3 kcal on the seventh day. Energy and protein response rates increased day by day and were highest at 7 days post-operation at 18.0% and 19.4%. Conclusion: Malnutrition and insufficient intake are noteworthy in esophageal cancer patients. The PG-SGA is strongly correlated with the dietary intake of patients. The results from this study will help medical staff to prevent malnutrition and improve the nutritional status of esophageal cancer inpatients. Furthermore, public awareness should be raised on recognizing weight loss as an early symptom of esophageal cancer and the utilization of preoperative assessment tools for nutritional assessment and malnutrition management.

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Section: Discussionsupporting

confidence: 91%

Nutritional Status and Feeding Regimen of Patients with Esophagus Cancer—A Study from Vietnam

et al. 2021

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“…1 Most of the patients are diagnosed at advanced clinical stages. 2,3 Concerning advanced stage neoplasms, neoplasm circumferential involvement or even complete esophageal lumen obstruction are common, leading to intense dysphagia, weight loss, and malnutrition.…”

Section: Abstract: Esophageal Neoplasms -Neoadjuvant Therapy -Prognosismentioning

confidence: 99%

Variables Associated to Pathologic Complete Response, Overall Survival and Disease-Free Survival in the Neoadjuvant Setting for Esophageal Cancer: A Retrospective Cohort Analysis

Takeda

Viyuela

Cruz

et al. 2018

International Surgery

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Objective: The aim of the study was to evaluate prognostic factors during neoadjuvant therapy that can predict pathologic complete response (pCR), overall survival (OS), or disease-free survival (DFS). Summary of background data:Variables that can predict tumor response to neoadjuvant therapy are required for esophageal cancer management.Methods: A retrospective cohort was performed with esophageal cancer patients submitted to neoadjuvant therapy. pCR, OS, and DFS were evaluated. Logistic regression was used to evaluate prognostic factors. This study covered 140 patients, 94 squamous cell carcinomas (SCC), and 44 adenocarcinomas. SCC is more often associated with pCR (compared to adenocarcinoma, OR: 8.07, 95% CI: 2.91-22.38); it has higher probability of DFS (HR for death or recurrence was 0.6, 95% CI: 0.37-0.98); and a higher probability of OS (HR for death was 0.59, 95% CI: 0.35-1). Gender, age, grade of cellular differentiation, chemotherapy regimen, and neoplasm circumferential involvement before neoadjuvant therapy are variables that are unrelated to DFS. Relief of dysphagia, and weight gain were also unrelated to the outcomes. In the multivariate analysis, the weight loss during neoadjuvant therapy was related to higher risk for recurrence or death (HR 1.02, 95% CI: 1-

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“…The majority of patients (about 60%) have advanced cancer when diagnosed, as early EC are frequently asymptomatic[ 14 , 15 ]. Five-year relative survival rates for localized, regional, and distant stages of all types of esophageal cancers are currently estimated at 40%, 21%, and 4%, respectively[ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Is endoscopic ultrasound examination necessary in the management of esophageal cancer?

DaVee

Ajani

Lee

2017

WJG

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Despite substantial efforts at early diagnosis, accurate staging and advanced treatments, esophageal cancer (EC) continues to be an ominous disease worldwide. Risk factors for esophageal carcinomas include obesity, gastroesophageal reflux disease, hard-alcohol use and tobacco smoking. Five-year survival rates have improved from 5% to 20% since the 1970s, the result of advances in diagnostic staging and treatment. As the most sensitive test for locoregional staging of EC, endoscopic ultrasound (EUS) influences the development of an optimal oncologic treatment plan for a significant minority of patients with early cancers, which appropriately balances the risks and benefits of surgery, chemotherapy and radiation. EUS is costly, and may not be available at all centers. Thus, the yield of EUS needs to be thoughtfully considered for each patient. Localized intramucosal cancers occasionally require endoscopic resection (ER) for histologic staging or treatment; EUS evaluation may detect suspicious lymph nodes prior to exposing the patient to the risks of ER. Although positron emission tomography (PET) has been increasingly utilized in staging EC, it may be unnecessary for clinical staging of early, localized EC and carries the risk of false-positive metastasis (over staging). In EC patients with evidence of advanced disease, EUS or PET may be used to define the radiotherapy field. Multimodality staging with EUS, cross-sectional imaging and histopathologic analysis of ER, remains the standard-of-care in the evaluation of early esophageal cancers. Herein, published data regarding use of EUS for intramucosal, local, regional and metastatic esophageal cancers are reviewed. An algorithm to illustrate the current use of EUS at The University of Texas MD Anderson Cancer Center is presented.

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Pretreatment Dysphagia in Esophageal Cancer Patients May Eliminate the Need for Staging by Endoscopic Ultrasonography

Cited by 28 publications

References 10 publications

Nutritional Status and Feeding Regimen of Patients with Esophagus Cancer—A Study from Vietnam

Nutritional Status and Feeding Regimen of Patients with Esophagus Cancer—A Study from Vietnam

Variables Associated to Pathologic Complete Response, Overall Survival and Disease-Free Survival in the Neoadjuvant Setting for Esophageal Cancer: A Retrospective Cohort Analysis

Is endoscopic ultrasound examination necessary in the management of esophageal cancer?

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