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  • 1
    Online Resource
    Online Resource
    Postoperative Outcomes and Quality of Life After Left Thoracoabdominal Esophagogastrectomy: Contrasting Esophagogastrostomy with Esophagojejunostomy
    Springer Science and Business Media LLC ; 2023
    In:  Annals of Surgical Oncology
    Details
    In: Annals of Surgical Oncology, Springer Science and Business Media LLC
    Type of Medium: Online Resource
    ISSN: 1068-9265 , 1534-4681
    URL: Article
    DOI: 10.1245/s10434-023-13733-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2074021-9
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  • 2
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    495a PLATELET-TO-LYMPHOCYTE RATIO AS A MARKER OF DISEASE PROGNOSIS IN ESOPHAGEAL ADENOCARCINOMA
    Elsevier BV ; 2021
    In:  Gastroenterology Vol. 160, No. 6 ( 2021-05), p. S-892-
    Details
    In: Gastroenterology, Elsevier BV, Vol. 160, No. 6 ( 2021-05), p. S-892-
    Type of Medium: Online Resource
    ISSN: 0016-5085
    URL: Article
    DOI: 10.1016/S0016-5085(21)02864-X
    RVK:
    XA 44500
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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  • 3
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    Treatment selection and outcomes of locally advanced esophageal cancer in octo- and nonagenarians: Is a curative intent multimodal approach feasible?
    American Society of Clinical Oncology (ASCO) ; 2023
    In:  Journal of Clinical Oncology Vol. 41, No. 4_suppl ( 2023-02-01), p. 333-333
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 4_suppl ( 2023-02-01), p. 333-333
    Abstract: 333 Background: Neoadjuvant therapy followed by en bloc surgical resection affords the highest rates of survival from locally advanced esophageal cancer (LAEC) and represents the standard of care. However, patients of advanced age may not be offered this approach due to concerns over toxicity/tolerability. The outcomes of different treatment modalities for patients aged 80 and above with LAEC are not well described. Methods: A retrospective, single center, cohort analysis was performed on a prospectively maintained comprehensive esophageal cancer database. Between 2010-20, all patients ≥80yrs with locally advanced esophageal/GEJ cancer (cT2-4a, Nany, M0) were identified and outcomes stratified according to the following treatment categories: Neoadjuvant chemotherapy (nCT) or chemoradiotherapy (nCRT) followed by surgery; definitive CRT (dCRT); upfront surgery; palliative CT or RT; or best supportive care (BSC). Data presented as median(range). Univariate analysis used for clinicopathological data (*p 〈 0.05). Survival was compared with log rank analysis (Mantel Cox). Results: 79 patients ≥80 yrs with LAEC were identified. Median age was 83yr (80-97) and Charlson comorbidity index=7 (6-10). Most were cT3 (73%), cN- (56%) and adenocarcinoma (62%). Treatment approaches included: neoadjuvant (nCT(n=11)/nCRT(N=5)) + surgery (16/79(20%)); surgery alone (19/79 (24%)); dCRT (12/29(15%)); palliative RT or CT (24 + 3/79(34%)); BSC (5/79(6%)). Neoadjuvant consisted of nCT (FLOT=4; carbo-taxol =4; FOLFOX=2; CP+pembro=1) and nCRT (CROSS=5) and most received the intended full treatment/cycles (10/16:63%). Surgery was performed in 35 (age=82(80-96)), with major complications (grade 3-5) in 13/35 (37%) and 90-day mortality in 3/35(8.5%). Overall Survival for the entire cohort was 58% (1yr) and 19% (3yr), but highest with nCT/nCRT+surgery (94%/46%)*, followed by surgery alone (68%/39%), dCRT (58%/8%), palliative treatment (40%/4%), and BSC (0%/0%). Curative intent treatment (nCT/nCRT/surgery/dCRT) had significantly increased 1 and 3-yr survival compare to palliative treatment (76%/31% vs 34%/3.3%)*. Conclusions: Multimodal standard of care treatment, including surgical resection, of locally advanced esophageal cancer in octo/nonagenarians is feasible and safe in a subset of this high-risk population and associated with improved outcomes compared to other approaches. Age alone should not bias against curative-intent treatment in elderly patients with esophageal cancer.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2023.41.4_suppl.333
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2023
    detail.hit.zdb_id: 2005181-5
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  • 4
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    Online Resource
    Neutrophil extracellular traps in cancer progression
    Springer Science and Business Media LLC ; 2014
    In:  Cellular and Molecular Life Sciences Vol. 71, No. 21 ( 2014-11), p. 4179-4194
    Details
    In: Cellular and Molecular Life Sciences, Springer Science and Business Media LLC, Vol. 71, No. 21 ( 2014-11), p. 4179-4194
    Type of Medium: Online Resource
    ISSN: 1420-682X , 1420-9071
    URL: Article
    DOI: 10.1007/s00018-014-1683-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
    detail.hit.zdb_id: 1458497-9
    SSG: 12
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  • 5
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    Abstract 1767: Peripheral blood neutrophil-to-lymphocyte ratio (NLR), a predictor of poor survival in cancer patients, was positively associated with the percentage of circulating low-density neutrophil fraction
    American Association for Cancer Research (AACR) ; 2021
    In:  Cancer Research Vol. 81, No. 13_Supplement ( 2021-07-01), p. 1767-1767
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 81, No. 13_Supplement ( 2021-07-01), p. 1767-1767
    Abstract: Low density (LDNs) and high density (HDNs) are two neutrophil subsets that can be separated through gradient centrifugation. LDNs was shown to be a tumor-promoting phenotype and high percentage of circulating LDNs was associated with poor cancer prognosis. In the last decade, it has also been suggested that neutrophil-to-lymphocyte ratio (NLR) is a marker of cancer-associated inflammation and high peripheral blood NLR was associated with poor cancer patient survival. Our study therefore aimed to i) establish the correlation between the percentage of circulating LDN fraction and blood NLR in cancer patients; ii) determine the differences between LDN and HDN protein expression; iii) compare the protein expression of neutrophils between cancer patients and healthy volunteers. Materials & methods: Peripheral blood of esophageal/gastric cancer patients with clinical stage of II-III were collected. Circulating LDNs and HDNs were isolated using differential density centrifugation, and protein expression determined by immunophenotyping of cells using 12 different markers. Immunophenotyping of neutrophils from healthy volunteers was compared with that of cancer patients using the same panel of markers. Results: The percentage of circulating LDN fraction varied between 0.2% to 40% in cancer patients with an average higher than that in healthy volunteers. LDN fraction was significantly elevated in patients with high peripheral blood NLR (NLR above 4). We observed a positive Pearson's correlation between NLR and LDN fraction in blood of cancer patients. Compared to HDNs, pro-tumor LDNs was bigger in size and exhibited a higher expression of Arginase 1 (Arg1), CD66b (CEACA-8), and CXCR2. Peripheral blood neutrophils (PBNs) in cancer patients, containing both HDN and LDN fractions, showed a lower expression of Arg1 and neutrophil elastase (NE). Conclusion: Higher percentage of circulating LDNs in patients with elevated blood NLR may explain the correlation between high NLR and poor survival in cancer patients. High Arg1 expression of LDNs compared to HDNs can contribute to LDNs pro-tumor activity. Decreased expression of Arg1 and NE in PBNs of cancer patients compared to healthy subjects could be due to the degranulation of PBNs in cancer patients. Citation Format: Ramin Rohanizadeh, Olivia Koufos, Xin Su, Ariane Brassard, Betty Giannias, France Bourdeau, Roni Rayes, Jonathan Spicer, Veena Sangwan, Swneke Bailey, Lorenzo Ferri, Jonathan Cools-Lartigue. Peripheral blood neutrophil-to-lymphocyte ratio (NLR), a predictor of poor survival in cancer patients, was positively associated with the percentage of circulating low-density neutrophil fraction [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1767.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/1538-7445.AM2021-1767
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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  • 6
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    Current Status of Management of Malignant Disease: Current Management of Esophageal Cancer
    Springer Science and Business Media LLC ; 2015
    In:  Journal of Gastrointestinal Surgery Vol. 19, No. 5 ( 2015-5), p. 964-972
    Details
    In: Journal of Gastrointestinal Surgery, Springer Science and Business Media LLC, Vol. 19, No. 5 ( 2015-5), p. 964-972
    Type of Medium: Online Resource
    ISSN: 1091-255X , 1873-4626
    URL: Article
    DOI: 10.1007/s11605-014-2701-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 2057634-1
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  • 7
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    Online Resource
    Endoscopic pyloromyotomy in minimally invasive esophagectomy: a novel approach
    Springer Science and Business Media LLC ; 2022
    In:  Surgical Endoscopy Vol. 36, No. 4 ( 2022-04), p. 2341-2348
    Details
    In: Surgical Endoscopy, Springer Science and Business Media LLC, Vol. 36, No. 4 ( 2022-04), p. 2341-2348
    Type of Medium: Online Resource
    ISSN: 0930-2794 , 1432-2218
    URL: Article
    DOI: 10.1007/s00464-021-08511-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1463171-4
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  • 8
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    The management of dysphagia in esophageal adenocarcinoma patients undergoing neoadjuvant chemotherapy: Can invasive tube feeding be avoided?
    American Society of Clinical Oncology (ASCO) ; 2013
    In:  Journal of Clinical Oncology Vol. 31, No. 15_suppl ( 2013-05-20), p. e15034-e15034
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. e15034-e15034
    Abstract: e15034 Background: Neoadjuvant chemotherapy is an accepted standard for locally advanced esophago-gastric adenocarcinoma. However the dysphagia frequently associated with this condition may interfere with patient tolerance of neoadjuvant chemotherapy. Surgical or endoscopic invasive tube feeding (ITF), including stents, is a commonly employed strategy to maintain nutritional support however it can cause significant morbidity in its own right. We sought to determine if an approach of careful dietary counseling and fast-tracked neoadjuvant chemotherapy can obviate the need for ITF. Methods: Pts undergoing neoadjuvant chemotherapy (DCF or ECF Q3 weeks x3 or FLOT Q2weeks x4) for locally advanced (cT3 and/or N+) esophageal or EGJ adenocarcinoma at a single institution from 3/07-9/12 were identified from a prospective database. All received dietary counseling and were closely monitored for signs/ symptoms of malnutrition with serial (baseline/pre-surgery) Body Mass Index (BMI), albumin, dysphagia scores (DS: 0 best - 4 worse), and quality of life (FACT-E). We assessed the response of dysphagia and nutritional status to neoadjuvant treatment and the need for ITF. Data presented as median (Interquartile Range) or median (±SD), paired t-test or Wilcoxon signed ranks test determined significance (*p=0.05). Results: Of 130 patients undergoing neoadjuvant chemotherapy 78 had dysphagia scores of 2 or greater, most of whom received DCF (91%). Overall the dysphagia improved in 75/78 (96%) from a DS of 3 (2-4) to 0 (0-1)*. This was associated with an increase in FACT-E QoL scores (117±23 to 140±20)*. Weight (Kg)(70±22:69±24), BMI (24.5±8 to 23.9±7), and Albumin (40±5 to 37±4) were maintained. Only one patient required a stent, and none a jejunostomy, or gastrostomy. Conclusions: Appropriately timed neoadjuvant chemotherapy with a highly effective regimen rapidly restores normal swallowing, maintains nutritional status, and obviates the need for stenting or invasive tube feeding in patients with significant dysphagia from esophageal adenocarcinoma.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/jco.2013.31.15_suppl.e15034
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2013
    detail.hit.zdb_id: 2005181-5
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  • 9
    Online Resource
    Online Resource
    Synchronous pulmonary and esophageal cancers: Is combined esophagectomy and anatomic lung resection appropriate?
    American Society of Clinical Oncology (ASCO) ; 2020
    In:  Journal of Clinical Oncology Vol. 38, No. 4_suppl ( 2020-02-01), p. 341-341
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 38, No. 4_suppl ( 2020-02-01), p. 341-341
    Abstract: 341 Background: Resection is the best treatment for both esophagus and lung cancer, however, concerns that a combined resection of synchronous lung/esophagus tumors might be associated with higher morbidity may preclude surgical therapy. We sought to review a multi-institutional experience on combined esophagus/lung cancer resections. Methods: Patients undergoing esophagectomy and those with concurrent anatomic resection for bronchogenic carcinoma between 1997-2018 at three high-volume North American centers were identified from prospectively collected databases. Combined resection cases (E+L) were matched in a 1:3 ratio to patients who underwent esophagectomy alone (E), based on age, sex, stage, neoadjuvant therapy, procedure (2/3hole), and approach (MIE/open). Patient demographics, tumour characteristics, and post-operative outcomes were compared. Statistical analysis was performed using unpaired t-test or Wilcoxon sum-rank test for continuous variables and Fisher’s exact test for categorical data. Statistical significance was defined as p 〈 0.05. Results: Of over 2500 patients undergoing esophagectomy, synchronous anatomic lung resection was performed in 20; 4 were excluded due to incomplete data (n = 16). Matching yielded 48 patients and 4 duplicates were removed (n = 44); there were no significant differences in patient demographics, neoadjuvant therapy, clinical stage, or procedure. Anatomic resection consisted of lobectomy (16/20), segmentectomy (3/20) and pneumonectomy (1/20), combined with 2-hole (14/20), 3-hole (4/20), or left thoraco-abdominal (2/20) esophagectomy. The proportion of patients with any complication in E+L was 50%, and 66% in E (p = 0.42). Pulmonary complications were 19% and 27% in the respective groups (p = 0.74). Mortality did not differ (E+L = 0/16:E = 1/44)NS. The median length of stay for both groups was similar (E+L = 10.5 days(IQR 5.7): E = 10.0 days (IQR 8.7))NS. Conclusions: Patients with synchronous localized lung and esophageal cancer, although rare, should not be biased towards non-surgery therapy, as the morbidity associated with combined esophagectomy and anatomic lung resection does not differ significantly from esophagectomy alone.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2020.38.4_suppl.341
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2020
    detail.hit.zdb_id: 2005181-5
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  • 10
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    177. BULKY LYMPHADENOPATHY IN ESOPHAGEAL CANCER: ASSESSING PATHOLOGICAL AND SURVIVAL OUTCOMES AFTER TREATMENT WITH CURATIVE INTENT
    Oxford University Press (OUP) ; 2023
    In:  Diseases of the Esophagus Vol. 36, No. Supplement_2 ( 2023-08-30)
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 36, No. Supplement_2 ( 2023-08-30)
    Abstract: Whilst pre-treatment bulky regional lymphadenopathy is associated with poor survival outcomes in gastric adenocarcinoma, the impact this may have on survival in the setting of esophageal adenocarcinoma has not been described. The aim of this study was to explore the relationship between bulky regional lymphadenopathy found at diagnosis and survival outcomes in patients with esophageal adenocarcinoma treated with neoadjuvant chemotherapy and en bloc esophagogastrectomy. Methods A single center, retrospective review of a prospectively maintained upper GI cancer surgical database was performed between 01/2012 and 12/2020. Patients with adenocarcinoma of the esophagus/esophagogastric junction (cT2–3, Nany, M0) treated with neoadjuvant docetaxel based chemotherapy and transthoracic en bloc esophagogastrectomy were identified. Pretreatment CT scans were reviewed and patients stratified according to whether bulky periesophageal or periceliac lymph nodes were present. This was defined as periceliac or periesophageal lymphadenopathy & gt;2 cm in its long axis. Once stratified by the presence of bulky lymphadenopathy, overall survival (OS) was compared and a Cox multivariate regression model calculated. Results Of the 975 patients identified, 225 met the inclusion criteria. cT3/4 and cN+ was found in 169/225 (75%) and 154/225 (73%) respectively. Forty-eight patients (21%) were allocated to the bulky lymphadenopathy group. Among them, ypT status was similar, ypN3 disease more common (18/48,38% vs 39/177,20%, p = 0.025) with a trend towards pathological complete response (5/48,10% vs 7/177,4%, p = 0.086). OS was worse among patients with bulky regional lymphadenopathy (32.6 vs 50 months, p = 0.012). Along with poor differentiation (HR 1.8,95% CI 1.0–2.9, p = 0.034) and ypN+ (HR 1.9,95% CI 1.1–3.6, p = 0.032), bulky lymphadenopathy was independently associated with an increased risk of death (HR 1.7,1.0–2.9,p = 0.048). Conclusion Pre-treatment bulky regional lymphadenopathy is a poor prognostic sign despite multimodal treatment with docetaxel based systemic neoadjuvant therapy and en bloc resection. Identification of alternative treatment strategies may help improve survival outcomes among this specific group of patients.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doad052.043
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2004949-3
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