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Background: There are few reports on the associations between lymph node (LN) status, determined by preoperative 18F‐fluorodeoxyglucose‐positron emission tomography (FDG‐PET), and prognosis in patients with locally advanced esophageal squamous cell carcinoma (ESCC) who underwent esophagectomy post‐neoadjuvant chemotherapy (NCT). Additionally, details on the diagnostic performance of LN metastasis determination based on pathological examination versus FDG‐PET have not been reported. In this study, we aimed to evaluate the associations among LN status using FDG‐PET, LN status based on pathological examination, and prognosis in patients with locally advanced ESCC who underwent esophagectomy post‐NCT. Methods: We reviewed the data of 124 consecutive patients with ESCC who underwent esophagectomy with R0 resection post‐NCT between December 2008 and August 2022 and were evaluated pre‐ and post‐NCT using FDG‐PET. The associations among LN status using FDG‐PET, LN status based on pathological examination, and prognosis were assessed. Results: Station‐by‐station analysis of PET‐positive LNs pre‐ and post‐NCT correlated significantly with pathological LN metastases (sensitivity, specificity, and accuracy pre‐ and post‐NCT: 51.6%, 96.0%, and 92.1%; and 28.2%, 99.5%, and 93.1%, respectively; both p < 0.0001). Using univariate and multivariate analyses, LN status determined using PET post‐NCT was a significant independent predictor of both recurrence‐free survival and overall survival. Conclusion: The LN status assessed using FDG‐PET post‐NCT was significantly associated with the pathological LN status and prognosis in patients with ESCC who underwent esophagectomy post‐NCT. Therefore, FDG‐PET is a useful diagnostic tool for preoperatively predicting pathological LN metastasis and survival in these patients and could provide valuable information for selecting individualized treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Pathological lymph node metastasis (LNM) following multimodal therapy is an important indicator of poor prognosis in patients with esophageal cancer. However, a significant number of patients without LNM are still at high risk for recurrence. Methods: We assessed prognostic factors in 143 patients without pathological LNM who were diagnosed with locally advanced esophageal squamous cell carcinoma (ESCC) and underwent neoadjuvant chemotherapy (NAC) or chemoradiotherapy (NACRT), followed by surgery. Results: Using univariate and multivariate analyses of recurrence‐free survival, carcinoembryonic antigen (CEA) levels (hazard ratio [HR]: 2.17, 95% confidence interval [CI]: 1.12–4.23, and p = 0.02) and neutrophil‐to‐lymphocyte ratio (NLR) (HR: 1.22, 95% CI: 1.04–1.43, and p = 0.02) were significant independent covariates. Furthermore, pretherapeutic LNM (HR: 1.94, 95% CI: 1.003–3.76, and p = 0.049), NACRT (HR: 3.29, 95% CI: 1.30–8.33, and p = 0.01), poorly differentiated tumors (HR: 2.52, 95% CI: 1.28–4.98, and p = 0.01), and lymphovascular invasion (LVI) (HR: 2.78, 95% CI: 1.27–6.09, and p = 0.01) were also significant independent covariates. The recurrence rates among patients with 0/1, 2, 3, and 4/5 poor prognostic factors were significantly different (5.0%, 25.0%, 35.7%, and 53.8%, respectively; p = 0.001); the survival rates were stratified among these prognostic groups. Conclusions: Pretherapeutic CEA and NLR levels, pretherapeutic LNM, NACRT, poorly differentiated tumors, and LVI were significantly correlated with survivals in patients without pathological LNM after neoadjuvant therapy and surgery. Postoperative therapy should be considered in patients with ESCC with several indicators of recurrence, even in those without pathological LNM who underwent surgery following neoadjuvant therapy. [ABSTRACT FROM AUTHOR]

Overwork-related cerebrovascular and cardiovascular diseases (CCVDs), and mental disorders, including suicide (OCCMS) is a major problem worldwide. In Japan, OCCMS is known as Karoshi (death from overwork), which has become a social problem since the 1980s, and various countermeasures have been implemented to combat it. This study details the status of workers' compensation for OCCMS in Japan from FY2010 to FY2020 and outlines efforts to prevent OCCMS. During the study period, 2,928 and 5,099 cases of CCVDs, and mental disorders including suicide, respectively, were approved for workers' compensation. The number of cases per million employees was remarkably high for the transport and postal services by industry and in transport or machine operation workers by occupation. Policies since 2014 have included stress check measures for promoting worker self-check, prevention of harassment and promotion of gender fairness in the workplace, and regulation of overtime work. Meanwhile, the Research Center for Overwork-Related Disorders of the National Institute of Occupational Safety and Health, Japan, has conducted a wide range of research, including analysis of workers' compensation cases and public service accidents, surveys, experiments, and on-site interventions, on the effects of long working hours and interwork intervals. Although national statistics demonstrate an expansion of the working population and a decrease in working hours, continued efforts are required to realize workplaces that are comfortable to work in. Research on current conditions and countermeasures by industry and occupation, the prevalence of the interwork interval schedule, and measures for accommodating diverse work styles are immediate challenges. [ABSTRACT FROM AUTHOR]

This study investigates the effects of foreign return-oriented shareholders and domestic relational shareholders of Japanese companies on the earnings management behavior of their invested firms when stock option pay is adopted. We theorize that foreign shareholders seek short-term returns and do not engage in close monitoring due to an information disadvantage while domestic shareholders prevent managerial behavior that distorts information disclosure. Our findings show that managers of firms that use stock option pay engage in earnings management to increase their private financial benefits and meet capital markets' expectations, which allows them to enhance their own reputation. However, this managerial behavior is contingent on the firm's ownership structure. Our results show that while foreign shareholders enhance the positive impact of stock options on earning management, domestic shareholders and affiliated directors mitigate this positive effect. Our empirical analyses support the argument that ownership heterogeneity is a key determinant of managerial propensity to engage in earnings management when Japanese firms adopt stock option pay. [ABSTRACT FROM AUTHOR]