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Donato BB, Campany ME, Brady JT, Jenkins JA, Armstrong V, Butterfield R, Reck Dos Santos P, D'Cunha J. Complete pathologic response in esophageal adenocarcinoma: does it make a difference? Dis Esophagus 2024:doae068. [PMID: 39169845 DOI: 10.1093/dote/doae068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/06/2024] [Accepted: 08/08/2024] [Indexed: 08/23/2024]
Abstract
Advancements in neoadjuvant regimens for esophageal adenocarcinoma have enabled some patients to achieve complete pathologic response at time of esophagectomy. There are currently limited data detailing this trend or the implications of complete pathologic response on survival. The National Cancer Database was used to identify 16,169 patients with esophageal adenocarcinoma that received trimodal therapy including esophagectomy between 2006 and 2020. Of these, 11.4% had complete pathologic response at esophagectomy. Patient factors, staging characteristics, and survival trends were evaluated. In patients diagnosed between 2016 and 2020, the rate of complete pathologic response was 17.5%. Female sex (OR 1.295, 95% CI 1.134-1.481, p = 0.0001), Black race (OR 1.729, 95% CI 1.362-2.196, p = 0.0002), Hispanic ethnicity (OR 1.418, 95% CI 1.073-1.875, p = 0.0141), and later era of diagnosis (2016-2020 OR 2.898, 95% CI 2.508-3.349, p < 0.0001) were independent predictors of complete pathologic response. Clinical stage II disease was associated with an increased probability of complete pathologic response (OR 1.492, 95% CI 1.19-1.871) while clinical stage III disease had a decreased probability of complete pathologic response (OR 0.762, 95% CI 0.621-0.936, p < 0.0001). Complete pathologic response conveyed a strong survival benefit, with a median survival of 86.4 months (95% CI 73.9-102.1) versus 30.7 months (95% CI 29.8-31.7, p < 0.0001) in those without complete pathologic response. Four-year median survival was also higher in those with complete pathologic response (63.3%, 95% CI 60.8-66.0% vs. 39.2%, 95% CI 38.4-40.1%, p < 0.0001). In summary, complete pathologic response is associated with a profound survival advantage in patients with esophageal adenocarcinoma. Such knowledge carries implications for patient counseling, prognostication, and surveillance and demonstrates a need for improved identification of complete clinical response prior to esophagectomy.
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Affiliation(s)
- Britton B Donato
- Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
- Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Megan E Campany
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale AZ, USA
| | - Justin T Brady
- Department of Colorectal Surgery, Mayo Clinic, Phoenix, AZ, USA
| | | | | | | | | | - Jonathan D'Cunha
- Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ, USA
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Gaber CE, Shaheen NJ, Edwards JK, Sandler RS, Nichols HB, Sanoff HK, Lund JL. Trimodality Therapy vs Definitive Chemoradiation in Older Adults With Locally Advanced Esophageal Cancer. JNCI Cancer Spectr 2022; 6:pkac069. [PMID: 36205723 PMCID: PMC9623425 DOI: 10.1093/jncics/pkac069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The comparative effectiveness of trimodality therapy vs definitive chemoradiation for treating locally advanced esophageal cancer in older adults is uncertain. Existing trials lack generalizability to older adults, a population with heightened frailty. We sought to emulate a hypothetical trial comparing these treatments using real-world data. METHODS A cohort of adults aged 66-79 years diagnosed with locally advanced esophageal cancer between 2004 and 2017 was identified in the Surveillance Epidemiology and End Results-Medicare database. The clone-censor-weight method was leveraged to eliminate time-related biases when comparing outcomes between treatments. Outcomes included overall mortality, esophageal cancer-specific mortality, functional adverse events, and healthy days at home. RESULTS A total of 1240 individuals with adenocarcinomas and 661 with squamous cell carcinomas were identified. For adenocarcinomas, the standardized 5-year risk of mortality was 73.4% for trimodality therapy and 83.8% for definitive chemoradiation (relative risk [RR] = 0.88, 95% confidence interval [CI] = 0.82 to 0.95). Trimodality therapy was associated with mortality risk reduction for squamous cell carcinomas (RR = 0.87, 95% CI = 0.70 to 1.01). The 1-year incidence of functional adverse events was higher in the trimodality group (adenocarcinomas RR = 1.40, 95% CI = 1.22 to 1.65; squamous cell carcinomas RR = 1.21, 95% CI = 1.00 to 1.49). Over 5 years, trimodality therapy was associated with 160 (95% CI = 67 to 229) and 177 (95% CI = 51 to 313) additional home days in individuals with adenocarcinomas and squamous cell carcinomas, respectively. CONCLUSIONS Compared with definitive chemoradiation, trimodality therapy was associated with reduced mortality but increased risk of function-related adverse events. Discussing these tradeoffs may help optimize care plans.
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Affiliation(s)
- Charles E Gaber
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois-Chicago, Chicago, IL, USA
| | - Nicholas J Shaheen
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jessie K Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert S Sandler
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hanna K Sanoff
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer L Lund
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Babar L, Kosovec JE, Jahangiri V, Chowdhury N, Zheng P, Omstead AN, Salvitti MS, Smith MA, Goel A, Kelly RJ, Jobe BA, Zaidi AH. Prognostic immune markers for recurrence and survival in locally advanced esophageal adenocarcinoma. Oncotarget 2019; 10:4546-4555. [PMID: 31360303 PMCID: PMC6642049 DOI: 10.18632/oncotarget.27052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 06/14/2019] [Indexed: 01/09/2023] Open
Abstract
Treatment options and risk stratification for esophageal adenocarcinomas (EAC) currently rely on pathological criteria such as tumor staging. However, with advancement in immune modulated treatments, there is a need for accurate predictive biomarkers that will help identify high-risk patients and provide novel therapeutic targets. Hence, we analyzed as prognostic classifiers a host of histopathological parameters in conjunction with novel immune biomarkers. Specifically, gene expression levels for CXCL9, IDO1, LAG3, and TIM3 were established in treatment naïve samples. Additionally, PD-L1 and CD8 positivity was determined by immunohistochemical staining. Based on our finding, a Cox model consisting of pathological complete response (CR), LAG3, and CXCL9 provided improved predictability for disease-free survival (DFS) compared to CR alone, and it demonstrated statistical significance for predictability of recurrence (p=0.0001). Likewise, for overall survival (OS), a Cox model constituted of TIM3, CR, and IDO1 performed better than CR alone, and it demonstrated statistical significance for predictability of survival (p = 0.0004). TIM3 was identified as the best predictor for OS (HR=4.43, p=0.0023). In conclusion, given the paucity of treatment options for EAC, evaluation of these biomarkers early in the disease course will lead to better risk stratification of patients and much needed alternatives for improved therapy.
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Affiliation(s)
- Laila Babar
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Juliann E Kosovec
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Vida Jahangiri
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Nobel Chowdhury
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Ping Zheng
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Ashten N Omstead
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Madison S Salvitti
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Matthew A Smith
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Ajay Goel
- Beckman Research Institute, City of Hope Comprehensive Cancer Center, Monrovia, CA, USA
| | - Ronan J Kelly
- Department of Hematology and Oncology, Charles A. Sammons Cancer Center, Baylor University Medical Center, Dallas, TX, USA
| | - Blair A Jobe
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
| | - Ali H Zaidi
- Esophageal and Lung Institute, Allegheny Health Network, Pittsburgh, PA, USA
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Zhang T, Ji C, Shi R. miR-142-3p promotes pancreatic β cell survival through targeting FOXO1 in gestational diabetes mellitus. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:1529-1538. [PMID: 31933970 PMCID: PMC6947098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 02/18/2019] [Indexed: 06/10/2023]
Abstract
Gestational diabetes mellitus (GDM) is a common metabolic disease during pregnancy with serious harm. However, the pathogenesis of GDM has not been thoroughly studied. Recent reports have shown that microRNAs (miRNAs) are associated with GDM, but the mechanisms remain unclear. This study aimed to investigate the role of miR-142-3p in β cells of GDM. We established GDM mouse models by injecting streptozotocin (STZ) to extract embryonic tissue, peripheral blood and pancreas. qRT-PCR was used to detect the expression of miR-142-3p and FOXO1. 5-ethynyl-2'-deoxyuridine (EDU) staining and flow cytometry were used to measure cell proliferation and apoptosis. Western blot analysis was used to determine the expression of proliferation and apoptosis-related proteins. Dual-luciferase reporter assay was used to assess the target relationship between miR-142-3p and FOXO1. The results showed that miR-142-3p was up-regulated in embryonic tissue and peripheral blood of GDM model mice. Overexpression of miR-142-3p and knockdown of FOXO1 both promoted INS-1 cell proliferation, inhibited apoptosis, increased proliferating cell nuclear antigen (PCNA) and Bcl-2 expression, as well as reduced the expression level of p27, Bax and cleaved caspase-3. There are binding sites between miR-142-3p and FOXO1, which is miR-142-3p directly regulated FOXO1 expression. Moreover, above increases and decreases induced by miR-142-3p were attenuated by FOXO1 overexpression. In conclusion, miR-142-3p promotes the survival of pancreatic β cells through targeting FOXO1 in GDM. This study suggests that targeted regulation of miR-142-3p/FOXO1 might be a new strategy for the treatment of GDM.
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Affiliation(s)
- Tian Zhang
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University Changzhou, Jiangsu Province, China
| | - Chunhua Ji
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University Changzhou, Jiangsu Province, China
| | - Ruxia Shi
- Department of Gynecology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University Changzhou, Jiangsu Province, China
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Prediction of response after chemoradiation for esophageal cancer using a combination of dosimetry and CT radiomics. Eur Radiol 2019; 29:6080-6088. [PMID: 31028447 DOI: 10.1007/s00330-019-06193-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/29/2018] [Accepted: 03/20/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate the treatment response prediction feasibility and accuracy of an integrated model combining computed tomography (CT) radiomic features and dosimetric parameters for patients with esophageal cancer (EC) who underwent concurrent chemoradiation (CRT) using machine learning. METHODS The radiomic features and dosimetric parameters of 94 EC patients were extracted and modeled using Support Vector Classification (SVM) and Extreme Gradient Boosting algorithm (XGBoost). The 94-sample dataset was randomly divided into a 70-sample training subset and a 24-sample independent test set while keeping the class proportions intact via stratification. A receiver operating characteristic (ROC) curve was used to assess the performance of models using radiomic features alone and using combined radiomic features and dosimetric parameters. RESULTS A total of 42 radiomic features and 18 dosimetric parameters plus the patients' characteristic parameters were extracted for these 94 cases (58 responders and 36 non-responders). XGBoost plus principal component analysis (PCA) achieved an accuracy and area under the curve of 0.708 and 0.541, respectively, for models with radiomic features combined with dosimetric parameters, and 0.689 and 0.479, respectively, for radiomic features alone. Image features of GlobalMean X.333.1, Coarseness, Skewness, and GlobalStd contributed most to the model. The dosimetric parameters of gross tumor volume (GTV) homogeneity index (HI), Cord Dmax, Prescription dose, Heart-Dmean, and Heart-V50 also had a strong contribution to the model. CONCLUSIONS The model with radiomic features combined with dosimetric parameters is promising and outperforms that with radiomic features alone in predicting the treatment response of patients with EC who underwent CRT. KEY POINTS • The model with radiomic features combined with dosimetric parameters is promising in predicting the treatment response of patients with EC who underwent CRT. • The model with radiomic features combined with dosimetric parameters (prediction accuracy of 0.708 and AUC of 0.689) outperforms that with radiomic features alone (best prediction accuracy of 0.625 and AUC of 0.412). • The image features of GlobalMean X.333.1, Coarseness, Skewness, and GlobalStd contributed most to the treatment response prediction model. The dosimetric parameters of GTV HI, Cord Dmax, Prescription dose, Heart-Dmean, and Heart-V50 also had a strong contribution to the model.
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Andreollo NA, Beraldo GDC, Alves IPF, Tercioti-Junior V, Ferrer JAP, Coelho-Neto JDS, Lopes LR. PATHOLOGIC COMPLETE RESPONSE (YPT0 YPN0) AFTER CHEMOTHERAPY AND RADIOTHERAPY NEOADJUVANT FOLLOWED BY ESOPHAGECTOMY IN THE SQUAMOUS CELL CARCINOMA OF THE ESOPHAGUS. ACTA ACUST UNITED AC 2018; 31:e1405. [PMID: 30539980 PMCID: PMC6284395 DOI: 10.1590/0102-672020180001e1405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 08/24/2018] [Indexed: 12/29/2022]
Abstract
Background: Esophageal squamous cell carcinoma is an aggressive neoplasia that requires a multidisciplinary treatment in which survival and prognosis are still not satisfactory. The complete pathologic response to neoadjuvant chemotherapy and radiotherapy is considered a good prognosis factor, and esophagectomy is indicated. Aim: Survival analysis of cases with pathologic complete response (ypT0 ypN0) to neoadjuvant chemotherapy and/or radiotherapy, submmitted to esophagectomy. Methods: Between 1983-2014, 222 esophagectomies were performed, and 177 were conducted to neoadjuvant treatment. In 34 patients the pathologic response was considered complete. Medical records of the patients were retrospectively reviewed regarding type of chemotherapy applied, amount of radiotherapy, interval between the neoadjuvant therapy and the surgery, body mass index; postoperative complications; hospital admission time and survival. Results: The average age was 55.8 years. Twenty-five patients were subjected to chemotherapy and radiotherapy, and nine to neoadjuvant radiotherapy. The total radiation dose ranged from 4400 until 5400 cGy. The chemotherapy was performed with 5FU, cisplatin, and carbotaxol, concomitantly with the radiotherapy. The esophagectomy was transmediastinal, followed by the cervical esophagogastroplasty performed on a average of 49.4 days after the neoadjuvant therapy. The hospital admission time was an average of 14.8 days. During the follow-up period, 52% of the patients submitted to radiotherapy and chemotherapy were disease-free, with 23.6% of them presenting more than five years survival. Conclusions: The neoadjuvant treatment followed by esophagectomy in patients with pathologic complete response is beneficial for the survival of patients with esophageal squamous cell carcinoma.
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Affiliation(s)
- Nelson Adami Andreollo
- Digestive Diseases Surgical Unit and Gastrocenter, Department of Surgery, School of Medical Sciences, State University of Campinas - UNICAMP , Campinas, SP, Brazil
| | - Giovanni de Carvalho Beraldo
- Digestive Diseases Surgical Unit and Gastrocenter, Department of Surgery, School of Medical Sciences, State University of Campinas - UNICAMP , Campinas, SP, Brazil
| | - Iuri Pedreira Filardi Alves
- Digestive Diseases Surgical Unit and Gastrocenter, Department of Surgery, School of Medical Sciences, State University of Campinas - UNICAMP , Campinas, SP, Brazil
| | - Valdir Tercioti-Junior
- Digestive Diseases Surgical Unit and Gastrocenter, Department of Surgery, School of Medical Sciences, State University of Campinas - UNICAMP , Campinas, SP, Brazil
| | - José Antonio Possato Ferrer
- Digestive Diseases Surgical Unit and Gastrocenter, Department of Surgery, School of Medical Sciences, State University of Campinas - UNICAMP , Campinas, SP, Brazil
| | - João de Souza Coelho-Neto
- Digestive Diseases Surgical Unit and Gastrocenter, Department of Surgery, School of Medical Sciences, State University of Campinas - UNICAMP , Campinas, SP, Brazil
| | - Luiz Roberto Lopes
- Digestive Diseases Surgical Unit and Gastrocenter, Department of Surgery, School of Medical Sciences, State University of Campinas - UNICAMP , Campinas, SP, Brazil
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Involving the microRNA Targetome in Esophageal-Cancer Development and Behavior. Cancers (Basel) 2018; 10:cancers10100381. [PMID: 30322005 PMCID: PMC6210990 DOI: 10.3390/cancers10100381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 02/07/2023] Open
Abstract
Esophageal cancer (EC) is the eighth most common and sixth leading cause of cancer-related mortality in the world. Despite breakthroughs in EC diagnosis and treatment, patients with complete pathologic response after being submitted to chemoradiotherapy are still submitted to surgery, despite its high morbidity. Single-nucleotide polymorphisms (SNPs) in miRNA, miRNA-binding sites, and in its biogenesis pathway genes can alter miRNA expression patterns, thereby influencing cancer risk and prognosis. In this review, we systematized the information available regarding the impact of these miR-SNPs in EC development and prognosis. We found 34 miR-SNPs that were associated with EC risk. Despite the promising applicability of these miR-SNPs as disease biomarkers, they still lack validation in non-Asian populations. Moreover, there should be more pathway-based approaches to evaluate the cumulative effect of multiple unfavorable genotypes and, consequently, identify miR-SNPs signatures capable of predicting EC therapy response and prognosis.
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8
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Imai T, Abe T, Uemura N, Yoshida K, Shimizu Y. Immediate extubation after esophagectomy with three-field lymphadenectomy enables early ambulation in patients with thoracic esophageal cancer. Esophagus 2018; 15:165-172. [PMID: 29951981 DOI: 10.1007/s10388-018-0608-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 03/06/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND We retrospectively compared the effects of immediate extubation (IE) in the operating room with those of overnight mechanical ventilation (MV) after radical transthoracic esophagectomy with 3-field lymphadenectomy in patients with thoracic esophageal cancer. METHODS A total of 96 patients were evaluated. 48 patients were extubated in the operating room after surgery (IE group). The other 48 patients were extubated on the following morning (MV group). The propensity score-matching method was used to assemble a well-balanced cohort. Clinical and postoperative outcomes were investigated in each group. We also compared postoperative laboratory parameters between groups. RESULTS The rate of ambulation on postoperative day (POD) 1 was significantly higher in the IE group compared with that in the MV group (50 vs 19%, respectively, p = 0.003). Moreover, the rate of catecholamine use in the ICU was significantly lower in the IE group compared with that in the MV group (15 vs 65%, respectively, p < 0.001). With regard to postoperative respiratory management, there were no significant differences between groups. The length of ICU stay after esophagectomy was significantly shorter in the IE group compared with that in the MV group (p = 0.01), whereas the length of postoperative hospital stay was similar between groups (p = 0.265). There were also no significant differences in the incidence of postoperative complications. CONCLUSIONS IE in the operating room is not only safe and feasible, even after transthoracic esophagectomy with radical 3-field lymphadenectomy, but also contributes to decrease in catecholamine use, to increase in ambulation on POD 1 and to shorten the ICU stay.
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Affiliation(s)
- Takeharu Imai
- The Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
- The Department of Surgical Oncology, Gifu University, Graduate School of Medicine, Gifu, 501-1194, Japan
| | - Tetsuya Abe
- The Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
| | - Norihisa Uemura
- The Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
| | - Kazuhiro Yoshida
- The Department of Surgical Oncology, Gifu University, Graduate School of Medicine, Gifu, 501-1194, Japan
| | - Yasuhiro Shimizu
- The Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan
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Rasmussen SR, Nielsen RV, Fenger AS, Siemsen M, Ravn HB. Postoperative complications and survival after surgical resection of esophageal squamous cell carcinoma. J Thorac Dis 2018; 10:4052-4060. [PMID: 30174848 DOI: 10.21037/jtd.2018.07.04] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Resection of esophageal squamous cell carcinoma (SCC) is associated with a frequent occurrence of postoperative complications. Previously, the impact of complications on long-term survival has been explored primarily in mixed squamous cell and adenocarcinoma (AC) populations with conflicting results. In the present study, the influence of postoperative complications on survival following open esophageal resection was investigated exclusively in a western population with SCC. Methods In a retrospective observational study, all patients undergoing open surgical resection for esophageal SCC at our centre between February 2010 and December 2015 were consecutively included. Pre- and perioperative clinical information, mortality and complications were registered. Results In the study cohort, 133 patients were enrolled. Eighty-nine patients (67%) experienced one or more postoperative complications. The estimated 5-year survival on the entire population was 57%. Patients without complications had a long-term survival of 52%, whereas in patients with one or more complications survival was reduced to 30% (log rank P=0.039). Cox regression analysis revealed that postoperative complications were associated with an increased mortality risk with an adjusted hazard ratio (HR) of 2.02 (95% CI: 1.1-3.7, P=0.025), specifically sepsis/septic shock and anastomotic leakage significantly reduced long-term survival. Conclusions We found an improved 5-year survival in patients undergoing surgical resection for SCC compared to previous studies with mixed populations, despite a more frequent occurrence of complications. The presence of postoperative complications significantly reduced the long-term survival with 42%.
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Affiliation(s)
- Sebastian Roed Rasmussen
- Department of Thoracic Anaesthesiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Vibeke Nielsen
- Department of Thoracic Anaesthesiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Anne-Sophie Fenger
- Department of Thoracic Anaesthesiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mette Siemsen
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Hanne Berg Ravn
- Department of Thoracic Anaesthesiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Zhang J, Li S, Shang Z, Lin S, Gao P, Zhang Y, Hou S, Mo S, Cao W, Dong Z, Hu T, Chen P. Targeting the overexpressed ROC1 induces G2 cell cycle arrest and apoptosis in esophageal cancer cells. Oncotarget 2018; 8:29125-29137. [PMID: 28418860 PMCID: PMC5438718 DOI: 10.18632/oncotarget.16250] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 02/20/2017] [Indexed: 01/17/2023] Open
Abstract
Recent reports showed that regulator of Cullins-1 (ROC1) play an important role in tumor progression in a tumor-specific manner. However, the role and mechanism of ROC1 in esophageal cancer remains elusive. Here we demonstrated that ROC1 was overexpressed in esophageal squamous cell carcinomas, which was positive associated with poor prognosis of esophageal cancer patients. ROC1 knockdown significantly inhibited the growth of esophageal cancer cells in vitro and in vivo. Mechanistically, ROC1 silencing induced G2 cell cycle arrest and triggered apoptosis by accumulating the pro-apoptotic protein NOXA. Consistently, the downregulation of NOXA expression via siRNA substantially attenuated apoptosis induced by ROC1 silencing. These findings suggest that ROC1 is an appealing drug target for esophageal cancer.
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Affiliation(s)
- Jingyang Zhang
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Shuo Li
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Zhaoyang Shang
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Shan Lin
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Peng Gao
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Yi Zhang
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Shuaiheng Hou
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Saijun Mo
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Wenbo Cao
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Ziming Dong
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Tao Hu
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
| | - Ping Chen
- College of Basic Medical Sciences, Zhengzhou University, Collaborative Innovation Center of Henan Province for Cancer Chemoprevention, Zhengzhou, 450001, China
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