625 results on '"Recurrent Esophageal Carcinoma"'
Search Results
2. Clinical evaluation of oxaliplatin-loaded drug-eluting callispheres beads transarterial chemoembolization for unresectable or recurrent esophageal carcinoma
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Yonghua Bi, Jianzhuang Ren, and Xinwei Han
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Esophageal carcinoma ,Drug-eluting beads transarterial chemoembolization (DEB-TACE) ,Oxaliplatin ,CalliSpheres beads (CB) ,Transarterial chemoembolization (TACE) ,Surgery ,RD1-811 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background A majority of esophageal carcinoma patients are diagnosed at an advanced stage and are no longer suitable for surgical resection. Drug-eluting beads transarterial chemoembolization (DEB-TACE) with oxaliplatin-loaded CalliSpheres beads (CB) have been used for advanced hepatocellular carcinoma and lung cancer, but they have not been reported for the treatment of unresectable or recurrent esophageal carcinoma. Methods DEB-TACE was performed on 22 patients with unresectable or recurrent esophageal carcinoma between March 2019 and May 2022. The clinical outcomes, complications, and efficacy were retrospectively recorded and analyzed. Results A total of 39 sessions of DEB-TACE were performed in 22 patients, with a technical success rate of 92.3% and clinical success rate of 65.0%. No severe complications such as procedure-related death, esophageal rupture or paraplegia were observed. Complete response, partial response, and stable disease were observed in 14.3% (2/14), 42.9% (6/14), and 21.4% (3/14) of patients 6 months after DEB-TACE, respectively. The objective response rates were 62.5%, 42.9% and 57.1% respectively at 1-, 3-, and 6-month after DEB-TACE. Subsequent interventional treatments were administered to 12 patients, including DEB-TACE for hepatic metastasis in 3 (13.6%), esophageal stenting in 5 (22.7%), and airway stent placement in 5 (22.7%). Two patients were lost to follow up. A total of 9 patients died due to tumor progression (n = 5), pneumatic infection (n = 1), and tumor-related massive esophageal hemorrhage (n = 3). The median overall survivals were 13.9 months and 26.5 months from the first session of DEB-TACE and the diagnosis of esophageal carcinoma, respectively. Conclusions DEB-TACE with oxaliplatin-loaded CB is suggested as a safe and effective treatment of unresectable or recurrent esophageal carcinoma, and more studies are required to confirm its efficacy and safety.
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- 2024
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3. Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma
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Bi, Yonghua, Shi, Xiaonan, Ren, Jianzhuang, Yi, Mengfei, Han, Xinwei, and Song, Min
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- 2021
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4. Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma
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Yonghua Bi, Xiaonan Shi, Jianzhuang Ren, Mengfei Yi, Xinwei Han, and Min Song
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Esophageal carcinoma ,Drug-eluting beads ,Transarterial chemoembolization (TACE) ,CalliSpheres® beads ,Doxorubicin ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background The clinical outcomes of drug-eluting beads transarterial chemoembolization (DEB-TACE) with doxorubicin-loaded CalliSpheres® beads for patients with unresectable or recurrent esophageal carcinoma have not been reported. The aim of this study is to study the clinical outcomes of DEB-TACE for patients with unresectable or recurrent esophageal carcinoma. Methods This retrospective study enrolled 21 patients (15 men; mean age 68.7 ± 9.7; range 46–86 years) with unresectable or recurrent esophageal carcinoma received DEB-TACE between July 2017 and September 2020. Patient characteristic data, imaging findings, complications and DEB-TACE procedure were reviewed. The primary endpoints, disease control rate (DCR) and objective response rate (ORR), were calculated. The secondary endpoints were overall survival rate and progression-free survival (PFS). Results Twenty-two sessions of DEB-TACE were performed in 21 patients. The technical success rate was 100%; without sever adverse events or procedure-related deaths. All patients received transarterial chemotherapy infusion with raltitrexed or oxaliplatin. The median follow-up period was 3.6 months (interquartile range, IQR 1.5–9.4 months). ORR and DCR were 42.9 and 85.7%, 28.6 and 71.4%, 20.0 and 40.0% respectively at 1-, 3-, and 6-months after DEB-TACE. The median PFS was 6.0 months, and the 3-, 6- and 12-month PFS rates were 68.2%, 45.5 and 0.0%, respectively. The median overall survival was 9.4 months, and the 3-, 6- and 12-month overall survival rates were 75.5%, 55.0 and 13.8%, respectively. Conclusions To our knowledge, this is the first study reports outcomes of DEB-TACE with doxorubicin-loaded CallSpheres bead treatment in the management of patients with unresectable or recurrent esophageal carcinoma. According to our results, this is a safe and feasible treatment modality that may be considered among the options for the treatment of these patients.
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- 2021
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5. Liposomal Paclitaxel Combined Nedaplatin in Treatment of Advanced or Recurrent Esophageal Carcinoma
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Ruihua Xu, professor
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- 2016
6. Diagnostic value of surveillance 18F-fluorodeoxyglucose PET/CT for detecting recurrent esophageal carcinoma after curative treatment
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Kim, Soo Jeong, Hyun, Seung Hyup, Moon, Seung Hwan, Lee, Kyung Soo, Sun, Jong-Mu, Oh, Dongryul, Ahn, Yong Chan, Zo, Jae Il, Shim, Young Mog, and Choi, Joon Young
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- 2019
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7. Clinical outcomes of doxorubicin-eluting CalliSpheres® beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma
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Min Song, Jianzhuang Ren, Mengfei Yi, Xiaonan Shi, Yonghua Bi, and Xinwei Han
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Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,RC799-869 ,CalliSpheres beads ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Internal medicine ,medicine ,Humans ,Chemoembolization, Therapeutic ,Adverse effect ,Aged ,Retrospective Studies ,Aged, 80 and over ,CalliSpheres® beads ,Chemotherapy ,business.industry ,Liver Neoplasms ,Gastroenterology ,Drug-eluting beads ,Retrospective cohort study ,General Medicine ,Hepatology ,Middle Aged ,Transarterial chemoembolization (TACE) ,Diseases of the digestive system. Gastroenterology ,Surgery ,Oxaliplatin ,Treatment Outcome ,Esophageal carcinoma ,Doxorubicin ,030220 oncology & carcinogenesis ,Neoplasm Recurrence, Local ,business ,Raltitrexed ,medicine.drug ,Research Article - Abstract
Background The clinical outcomes of drug-eluting beads transarterial chemoembolization (DEB-TACE) with doxorubicin-loaded CalliSpheres® beads for patients with unresectable or recurrent esophageal carcinoma have not been reported. The aim of this study is to study the clinical outcomes of DEB-TACE for patients with unresectable or recurrent esophageal carcinoma. Methods This retrospective study enrolled 21 patients (15 men; mean age 68.7 ± 9.7; range 46–86 years) with unresectable or recurrent esophageal carcinoma received DEB-TACE between July 2017 and September 2020. Patient characteristic data, imaging findings, complications and DEB-TACE procedure were reviewed. The primary endpoints, disease control rate (DCR) and objective response rate (ORR), were calculated. The secondary endpoints were overall survival rate and progression-free survival (PFS). Results Twenty-two sessions of DEB-TACE were performed in 21 patients. The technical success rate was 100%; without sever adverse events or procedure-related deaths. All patients received transarterial chemotherapy infusion with raltitrexed or oxaliplatin. The median follow-up period was 3.6 months (interquartile range, IQR 1.5–9.4 months). ORR and DCR were 42.9 and 85.7%, 28.6 and 71.4%, 20.0 and 40.0% respectively at 1-, 3-, and 6-months after DEB-TACE. The median PFS was 6.0 months, and the 3-, 6- and 12-month PFS rates were 68.2%, 45.5 and 0.0%, respectively. The median overall survival was 9.4 months, and the 3-, 6- and 12-month overall survival rates were 75.5%, 55.0 and 13.8%, respectively. Conclusions To our knowledge, this is the first study reports outcomes of DEB-TACE with doxorubicin-loaded CallSpheres bead treatment in the management of patients with unresectable or recurrent esophageal carcinoma. According to our results, this is a safe and feasible treatment modality that may be considered among the options for the treatment of these patients.
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- 2021
8. Diagnostic value of surveillance 18F-fluorodeoxyglucose PET/CT for detecting recurrent esophageal carcinoma after curative treatment
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Young Mog Shim, Dongryul Oh, Yong Chan Ahn, Seung Hwan Moon, Jong-Mu Sun, Joon Young Choi, Jae Il Zo, Seung Hyup Hyun, Kyung Soo Lee, and Soo Jeong Kim
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PET-CT ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Recurrent Esophageal Carcinoma ,General Medicine ,Esophageal cancer ,medicine.disease ,030218 nuclear medicine & medical imaging ,Fluorodeoxyglucose PET ,03 medical and health sciences ,0302 clinical medicine ,Positron emission tomography ,Curative treatment ,030220 oncology & carcinogenesis ,medicine ,Carcinoma ,Radiology, Nuclear Medicine and imaging ,Radiology ,Stage (cooking) ,business - Abstract
Esophageal carcinoma recurs within two years in approximately half of patients who receive curative treatment and is associated with poor survival. While 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a reliable method of detecting recurrent esophageal carcinoma, in most previous studies FDG PET/CT scans were performed when recurrence was suspected. The aim of this study was to evaluate FDG PET/CT as a surveillance modality to detect recurrence of esophageal carcinoma after curative treatment where clinical indications of recurrent disease are absent. A total of 782 consecutive FDG PET/CT studies from 375 patients with esophageal carcinoma after definitive treatment were reviewed. Abnormal lesions suggestive of recurrence on PET/CT scans were then evaluated. Recurrence was determined by pathologic confirmation or other clinical evidence within two months of the scan. If no clinical evidence for recurrence was found at least 6 months after the scan, the case was considered a true negative for recurrence. The diagnostic sensitivity and specificity of PET/CT for detecting recurrent esophageal carcinomas were 100% (64/64) and 94.0% (675/718), respectively. There were no significant differences in the diagnostic performance of PET/CT for detecting recurrence according to initial stage or time between PET/CT and curative treatments. Unexpected second primary cancers were detected by FDG PET/CT in seven patients. Surveillance FDG PET/CT is a useful imaging tool for detection of early recurrence or clinically unsuspected early second primary cancer in patients with curatively treated esophageal carcinoma but without clinical suspicion of recurrence.
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- 2019
9. Japan PMDA approves Merck's Keytruda in combo with chemotherapy to treat radically unresectable, advanced or recurrent esophageal carcinoma
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Merck Research Laboratories ,Medical research ,Medicine, Experimental ,Carcinoma -- Prognosis -- Care and treatment -- Development and progression ,Chemotherapy ,Cancer -- Prognosis -- Care and treatment -- Development and progression -- Chemotherapy ,Pharmaceutical industry ,Esophageal cancer -- Prognosis -- Development and progression -- Care and treatment ,Pharmaceuticals and cosmetics industries ,Keytruda (Medication) - Abstract
Merck, known as MSD outside the United States and Canada, announced that Keytruda, Merck's anti-PD-1 therapy, has been approved by the Japan Pharmaceuticals and Medical Devices Agency (PMDA) for the [...]
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- 2021
10. Prognosis and Treatment After Diagnosis of Recurrent Esophageal Carcinoma Following Esophagectomy with Curative Intent
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Parry, K., Visser, E., van Rossum, P. S. N., Mohammad, N. Haj, Ruurda, J. P., and van Hillegersberg, R.
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- 2015
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11. Enhanced radiosensitizing by sodium glycididazole in a recurrent esophageal carcinoma tumor model
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Peipei Wu, Xiaolin Li, Xiaorong Sun, Jing Liu, Ligang Xing, and Jinming Yu
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0301 basic medicine ,Radiosensitizer ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,tumor bed effect ,03 medical and health sciences ,0302 clinical medicine ,sodium glycididazole ,medicine ,Carcinoma ,Pimonidazole ,Sodium Glycididazole ,esophageal cancer ,radiosensitizer ,hypoxia ,business.industry ,Cancer ,Esophageal cancer ,medicine.disease ,Radiation therapy ,030104 developmental biology ,Oncology ,030220 oncology & carcinogenesis ,Nuclear medicine ,business ,Research Paper - Abstract
// Peipei Wu 1, 2, * , Jing Liu 1, * , Xiaorong Sun 3 , Xiaolin Li 1 , Ligang Xing 1 and Jinming Yu 1 1 Department of Radiation Oncology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academic of Medicine Science, Jinan 250117, Shandong, China 2 Department of Oncology, Jining No.1 People’s Hospital, Jining 272011, Shandong, China 3 Department of Radiology, Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academic of Medicine Science, Jinan 250117, Shandong, China * These authors have contributed equally to this work Correspondence to: Ligang Xing, email: xinglg@medmail.com.cn Keywords: esophageal cancer, sodium glycididazole, radiosensitizer, tumor bed effect, hypoxia Received: December 15, 2016 Accepted: June 05, 2017 Published: July 10, 2017 ABSTRACT Re-irradiation is challenging for esophageal cancer patients with local-regional recurrence after initial radiotherapy. The purpose of this study is to establish a recurrent esophageal tumor model and investigate radiosensitizing effects of sodium glycididazole (CMNa). Tumor models were established by pre-irradiation (0 Gy, 10 Gy or 20 Gy) to the right hind leg of the nude mice 24 hours before tumor transplantation (ECA109 human esophageal carcinoma cells). Tumor growth curves were analyzed. Hypoxic microenvironment was exhibited in tumor frozen slides stained for pimonidazole, Hoechst 33342, hematoxylin-eosin and CD34. Mice bearing primary (0 Gy pre-irradiation) and recurrent (10 Gy pre-irradiation) tumors were randomized into control (no treatment), radiation (30 Gy in 3 weekly fractionations), or radiation combined with CMNa (1 mmol/kg i.p. injected 60 min before radiation) respectively. The data showed tumors from 10 Gy and 20 Gy pre-irradiated sites grew significantly slower than those in the 0 Gy pre-irradiated group. The recurrent xenograft tumors showed increased necrotic fractions, decreased micro-vascular density, increased pimonidazole-positive fraction, and decreased Hoechst-positive fraction. In the primary xenograft tumors, CMNa adding to radiation did not lead to significant tumor growth delay than radiation alone. However, for the recurrent tumor model, the growth rate was remarkably reduced as CMNa combined with radiation as comparison with radiation alone. In conclusion, the recurrent esophageal xenograft model with tumor bed effect was successfully established characterized by slow growth, increased hypoxia fraction and decreased blood flow. Significant radiosensitization by CMNa was demonstrated in the recurrent model.
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- 2017
12. Salvage radiotherapy in patients with recurrent esophageal carcinoma
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Fakhrian, K., Gamisch, N., Schuster, T., Thamm, R., Molls, M., and Geinitz, H.
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- 2012
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13. Lymph node dissection with cervical approach as a salvage surgery for locoregional failure after definitive chemoradiotherapy in a patient with recurrent esophageal carcinoma: report of a case
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Yoshimura, Fumihiro, Sakurai, Yoichi, Furuta, Shinpei, Sunagawa, Risaburo, Inaba, Kazuki, Isogaki, Jun, Komori, Yoshiyuki, Uyama, Ichiro, and Ozawa, Soji
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- 2009
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14. Survival After Recurrent Esophageal Carcinoma Has Not Improved Over the Past 18 Years
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Blom, Rachel L., Lagarde, Sjoerd M., van Oudenaarde, Kim, Klinkenbijl, Jean H. G., Hulshof, Maarten C., van Laarhoven, Hanneke W., Bergman, Jacques J., Busch, Olivier R., and van Berge Henegouwen, Mark I.
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- 2013
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15. Prognosis and Treatment After Diagnosis of Recurrent Esophageal Carcinoma Following Esophagectomy with Curative Intent
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E. Visser, R. van Hillegersberg, K. Parry, P.S.N. Van Rossum, N. Haj Mohammad, and Jelle P. Ruurda
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Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Adenocarcinoma ,Surgical oncology ,Medicine ,Combined Modality Therapy ,Humans ,Prospective Studies ,Prospective cohort study ,Thoracic Oncology ,Survival rate ,Neoplasm Staging ,Curative intent ,business.industry ,General surgery ,Middle Aged ,medicine.disease ,Prognosis ,Esophagectomy ,Survival Rate ,Oncology ,Carcinoma, Squamous Cell ,Surgery ,Female ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Background Strategies for the treatment of recurrence after initial curative esophagectomy are increasingly being recognized. The aim of this study was to identify prognostic factors that affect survival in patients with recurrence and to evaluate treatment strategies. Methods A prospective database (2003–2013) was used to collect consecutive patients with esophageal carcinoma treated with initial curative esophagectomy. Locations, symptoms, and treatment of recurrence were registered. Post-recurrence survival was defined as the time between the first recurrence and death or last follow-up. Results Of the 335 selected patients, 171 (51 %) developed recurrence. Multivariable analysis identified distant recurrence as opposed to locoregional recurrence [hazard ratio (HR) 2.15, 95 % confidence interval (CI) 1.27–3.65; p = 0.005], more than three recurrent locations (HR 2.42, 95 % CI 1.34–4.34; p = 0.003), and treatment (HR 0.29, 95 % CI 0.20–0.44; p
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- 2015
16. United States : Mercks KEYTRUDA (pembrolizumab) Approved in Japan in Combination With Chemotherapy for First-Line Treatment of Patients With Radically Unresectable, Advanced or Recurrent Esophageal Carcinoma
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Merck Research Laboratories ,Cancer patients -- Prognosis -- Care and treatment ,Carcinoma -- Prognosis -- Care and treatment ,Chemotherapy ,Cancer -- Prognosis -- Care and treatment -- Chemotherapy ,Pharmaceutical industry ,Esophageal cancer -- Prognosis -- Care and treatment ,Business, international ,Keytruda (Medication) - Abstract
First Anti-PD-1/L1-Based Regimen Approved in Japan for First-Line Treatment of Advanced Esophageal Cancer KEYTRUDA Is Now Approved for 16 Indications in Japan Merck, known as MSD outside the United States [...]
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- 2021
17. Merck's KEYTRUDA[R] (pembrolizumab) Approved in Japan in Combination With Chemotherapy for First-Line Treatment of Patients With Radically Unresectable, Advanced or Recurrent Esophageal Carcinoma
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Merck & Company Inc. ,Carboplatin ,Cancer patients -- Prognosis -- Care and treatment ,Respiratory agents ,Antineoplastic agents ,Carcinoma -- Prognosis -- Care and treatment -- Development and progression ,Chemotherapy ,Cancer -- Prognosis -- Care and treatment -- Development and progression -- Chemotherapy ,Pharmaceutical industry ,Esophageal cancer -- Prognosis -- Development and progression -- Care and treatment ,Antimitotic agents ,Business ,Business, international ,Keytruda (Medication) - Abstract
First Anti-PD-1/L1-Based Regimen Approved in Japan for First-Line Treatment of Advanced Esophageal Cancer KEYTRUDA Is Now Approved for 16 Indications in Japan KENILWORTH, N.J. -- Merck (NYSE: MRK), known as [...]
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- 2021
18. Gemcitabine and Cisplatin for Patients with Metastatic or Recurrent Esophageal Carcinoma: A Southwest Oncology Group Study
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Urba, Susan G., Chansky, Kari, vanVeldhuizen, Peter J., Pluenneke, Robert E., Benedetti, Jacqueline K., Macdonald, John S., and Abbruzzese, James L.
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- 2004
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19. Palliation of advanced/recurrent esophageal carcinoma with high-dose-rate brachytherapy
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Sharma, Vinay, Mahantshetty, Umesh, Dinshaw, Ketayun A, Deshpande, Raman, and Sharma, Sanjay
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- 2002
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20. Lymph node dissection with cervical approach as a salvage surgery for locoregional failure after definitive chemoradiotherapy in a patient with recurrent esophageal carcinoma: report of a case
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Fumihiro Yoshimura, Soji Ozawa, Shinpei Furuta, Jun Isogaki, Kazuki Inaba, Yoshiyuki Komori, Ichiro Uyama, Yoichi Sakurai, and Risaburo Sunagawa
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medicine.medical_specialty ,business.industry ,Recurrent Esophageal Carcinoma ,Gastroenterology ,Esophageal cancer ,medicine.disease ,Surgery ,Dissection ,medicine.anatomical_structure ,medicine ,Carcinoma ,Lymph ,Esophagus ,business ,Lymph node ,Chemoradiotherapy - Abstract
Salvage surgery is one important therapeutic option after locoregional failure of definitive chemoradiotherapy (dCRT) in patients with advanced or recurrent esophageal carcinoma. We have performed cervical lymph node dissection as a salvage surgery after chemoradiotherapy in a patient with recurrent esophageal carcinoma. A 54-year-old Japanese man was admitted to our hospital because of multiple lymph node metastases after endoscopic submucosal dissection (ESD) for early-stage esophageal carcinoma. The patient underwent a circumferential ESD of early-stage esophageal carcinoma in another hospital. The esophageal carcinoma, measuring 75 × 60 mm in size, was a superficial spreading type located in the middle portion of the thoracic esophagus. Histology of the resected specimen revealed a moderately to poorly differentiated squamous cell carcinoma, and the depth of invasion was limited within the mucosal layer associated with a small area being attached to the muscularis mucosae. Five months after ESD, lymph node metastases in the regions of right recurrent nerve and the left tracheobronchus were found, for which dCRT was performed. These metastatic lymph nodes disappeared in the chest CT scan images. Lymph node metastasis in the region of the right recurrent nerve then reappeared 8 months after the completion of CRT. Considering the solitary lymph node metastasis and surgical invasiveness, lymph node dissection using a cervical approach was selected as a salvage surgery. Cervical approach for the lymph node dissection in the region of right recurrent nerve may be one feasible option as a minimally invasive salvage surgery for patients with recurrent esophageal carcinoma after dCRT.
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- 2009
21. Diagnostic value of surveillance 18F-fluorodeoxyglucose PET/CT for detecting recurrent esophageal carcinoma after curative treatment.
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Kim, Soo Jeong, Hyun, Seung Hyup, Moon, Seung Hwan, Lee, Kyung Soo, Sun, Jong-Mu, Oh, Dongryul, Ahn, Yong Chan, Zo, Jae Il, Shim, Young Mog, and Choi, Joon Young
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POSITRON emission tomography computed tomography , *THERAPEUTICS , *CARCINOMA , *CLINICAL indications - Abstract
Purpose: Esophageal carcinoma recurs within two years in approximately half of patients who receive curative treatment and is associated with poor survival. While 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a reliable method of detecting recurrent esophageal carcinoma, in most previous studies FDG PET/CT scans were performed when recurrence was suspected. The aim of this study was to evaluate FDG PET/CT as a surveillance modality to detect recurrence of esophageal carcinoma after curative treatment where clinical indications of recurrent disease are absent. Methods: A total of 782 consecutive FDG PET/CT studies from 375 patients with esophageal carcinoma after definitive treatment were reviewed. Abnormal lesions suggestive of recurrence on PET/CT scans were then evaluated. Recurrence was determined by pathologic confirmation or other clinical evidence within two months of the scan. If no clinical evidence for recurrence was found at least 6 months after the scan, the case was considered a true negative for recurrence. Results: The diagnostic sensitivity and specificity of PET/CT for detecting recurrent esophageal carcinomas were 100% (64/64) and 94.0% (675/718), respectively. There were no significant differences in the diagnostic performance of PET/CT for detecting recurrence according to initial stage or time between PET/CT and curative treatments. Unexpected second primary cancers were detected by FDG PET/CT in seven patients. Conclusions: Surveillance FDG PET/CT is a useful imaging tool for detection of early recurrence or clinically unsuspected early second primary cancer in patients with curatively treated esophageal carcinoma but without clinical suspicion of recurrence. [ABSTRACT FROM AUTHOR]
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- 2019
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22. Survival after recurrent esophageal carcinoma has not improved over the past 18 years
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Jean H. G. Klinkenbijl, Kim van Oudenaarde, Jacques J. Bergman, Maarten C.C.M. Hulshof, Olivier R. Busch, Hanneke W. M. van Laarhoven, Mark I. van Berge Henegouwen, Sjoerd M. Lagarde, Rachel L. G. M. Blom, Other departments, Surgery, CCA -Cancer Center Amsterdam, Radiotherapy, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Oncology, and Gastroenterology and Hepatology
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Male ,medicine.medical_specialty ,Lung Neoplasms ,Esophageal Neoplasms ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Bone Neoplasms ,Kaplan-Meier Estimate ,Multimodal Imaging ,Translational research [ONCOL 3] ,Surgical oncology ,medicine ,Carcinoma ,Recurrent disease ,Humans ,In patient ,Neoadjuvant therapy ,Aged ,business.industry ,Liver Neoplasms ,Middle Aged ,medicine.disease ,Neoadjuvant Therapy ,Surgery ,Esophagectomy ,Oncology ,Female ,Neoplasm Recurrence, Local ,business ,Median survival - Abstract
Item does not contain fulltext BACKGROUND: Numerous patients will develop recurrent disease after esophagectomy for esophageal carcinoma (EC). In literature, survival after recurrent EC is poor with 6-8 months. In these studies, diagnostic imaging during follow-up (FU) is routinely performed. In the Netherlands, routine imaging is not part of FU and only performed on indication. The aim of this study was to determine survival after diagnosis of recurrent disease in patients after esophagectomy without routine imaging during FU. METHODS: All EC patients who underwent esophagectomy between 1993 and 2010 were included and followed for clinical evidence of recurrent EC. Location, symptoms, diagnosis, and treatment of recurrent disease were registered. Pattern of recurrence was compared between patients who underwent neoadjuvant therapy and patients who underwent surgery alone. Survival after detection of recurrence was determined in all patients and related to the year of surgery. RESULTS: A total of 493 of 1,088 patients (45 %) who underwent esophagectomy between 1993 and 2010 developed recurrent disease. Median interval between esophagectomy and recurrence was 10.5 months. Within the first 2 years after surgery, 33 % of patients developed recurrent EC. The majority of patients (51 %) were diagnosed with distant metastases. Locoregional recurrence occurred significantly less often among patients who underwent neoadjuvant therapy (6 vs 16 %, p = .017). Median survival after diagnosis of recurrent disease was 3 months. No relation was observed between the year of surgery and survival after recurrent disease (p = .931). CONCLUSIONS: Survival after recurrent EC in patients who undergo FU without routine imaging after esophagectomy is approximately 3 months and has not improved over the past 18 years. 01 augustus 2013
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- 2013
23. Locally Recurrent Esophageal Carcinoma: When is Re-Resection Indicated?
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Schipper, Paul H., Cassivi, Stephen D., Deschamps, Claude, Rice, David C., Nichols, Francis C., Allen, Mark S., and Pairolero, Peter C.
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CANCER patients ,SURGICAL excision ,MEDICAL records ,CANCER cells - Abstract
Background: Limited locally recurrent esophageal carcinoma is rare, and little is known regarding effectiveness of re-resection. Methods: Medical records of 27 consecutive patients with locally recurrent esophageal carcinoma who underwent reoperation at our institution between February 1974 and January 2003 were analyzed. Results: The original and recurrent cancer cell types were identical in all patients. Median disease-free interval was 19.4 months (range, 2.5 to 170 months). Recurrence was at the anastomosis in 23 patients (85%), esophageal remnant in 3 (11%), and stomach in 1 (4%). Ten patients had completion gastrectomy and partial esophagectomy, and 9 had resection of the anastomosis. The remaining 8 patients were found intraoperatively to have unresectable disease and underwent biopsy only. Re-resection was complete in 15 of the 19 patients resected (79%). Four patients had microscopic cancer at the resection margins. Reconstruction was with colon in 10 patients and esophagogastrostomy in 9. There were 2 deaths (operative mortality, 7%). Complications occurred in 16 patients (59%). Arrhythmia and anastomotic leak were the most common complications and each occurred in 7 patients (26%). Factors favorably associated with survival were disease-free interval greater than 2 years (p ≤ 0.05) and complete re-resection (p ≤ 0.02). Two-, three-, and five-year survival for patients completely re-resected was 62%, 44%, and 35%, respectively. Survival for patients who had incomplete re-resections was 18% at 2 years and zero at 3 years. Conclusions: Re-resection of locally recurrent esophageal carcinoma is associated with considerable morbidity. However, long-term survival is possible in patients with a long disease-free interval or a complete re-resection. [Copyright &y& Elsevier]
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- 2005
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24. Locally Recurrent Esophageal Carcinoma: When is Re-Resection Indicated?
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David C. Rice, Paul H. Schipper, Stephen D. Cassivi, Mark S. Allen, Peter C. Pairolero, Francis C. Nichols, and Claude Deschamps
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Adult ,Male ,Reoperation ,Pulmonary and Respiratory Medicine ,Thorax ,medicine.medical_specialty ,Esophageal Neoplasms ,Recurrent Esophageal Carcinoma ,Anastomosis ,medicine ,Humans ,Aged ,Neoplasm Staging ,Esophageal disease ,business.industry ,Patient Selection ,Stomach ,Medical record ,Respiratory disease ,Cancer ,Middle Aged ,medicine.disease ,Survival Analysis ,Surgery ,Outcome and Process Assessment, Health Care ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Neoplasm Recurrence, Local ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background Limited locally recurrent esophageal carcinoma is rare, and little is known regarding effectiveness of re-resection. Methods Medical records of 27 consecutive patients with locally recurrent esophageal carcinoma who underwent reoperation at our institution between February 1974 and January 2003 were analyzed. Results The original and recurrent cancer cell types were identical in all patients. Median disease-free interval was 19.4 months (range, 2.5 to 170 months). Recurrence was at the anastomosis in 23 patients (85%), esophageal remnant in 3 (11%), and stomach in 1 (4%). Ten patients had completion gastrectomy and partial esophagectomy, and 9 had resection of the anastomosis. The remaining 8 patients were found intraoperatively to have unresectable disease and underwent biopsy only. Re-resection was complete in 15 of the 19 patients resected (79%). Four patients had microscopic cancer at the resection margins. Reconstruction was with colon in 10 patients and esophagogastrostomy in 9. There were 2 deaths (operative mortality, 7%). Complications occurred in 16 patients (59%). Arrhythmia and anastomotic leak were the most common complications and each occurred in 7 patients (26%). Factors favorably associated with survival were disease-free interval greater than 2 years ( p ≤ 0.05) and complete re-resection ( p ≤ 0.02). Two-, three-, and five-year survival for patients completely re-resected was 62%, 44%, and 35%, respectively. Survival for patients who had incomplete re-resections was 18% at 2 years and zero at 3 years. Conclusions Re-resection of locally recurrent esophageal carcinoma is associated with considerable morbidity. However, long-term survival is possible in patients with a long disease-free interval or a complete re-resection.
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- 2005
25. Survival after recurrent esophageal carcinoma has not improved over the past 18 years.
- Author
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Blom, R.L., Lagarde, S.M., Oudenaarde, K. van, Klinkenbijl, J.H.G., Hulshof, M.C.C., Laarhoven, H.W.M. van, Bergman, J.J., Busch, O.R., Berge Henegouwen, M.I. van, Blom, R.L., Lagarde, S.M., Oudenaarde, K. van, Klinkenbijl, J.H.G., Hulshof, M.C.C., Laarhoven, H.W.M. van, Bergman, J.J., Busch, O.R., and Berge Henegouwen, M.I. van
- Abstract
1 augustus 2013, Item does not contain fulltext, BACKGROUND: Numerous patients will develop recurrent disease after esophagectomy for esophageal carcinoma (EC). In literature, survival after recurrent EC is poor with 6-8 months. In these studies, diagnostic imaging during follow-up (FU) is routinely performed. In the Netherlands, routine imaging is not part of FU and only performed on indication. The aim of this study was to determine survival after diagnosis of recurrent disease in patients after esophagectomy without routine imaging during FU. METHODS: All EC patients who underwent esophagectomy between 1993 and 2010 were included and followed for clinical evidence of recurrent EC. Location, symptoms, diagnosis, and treatment of recurrent disease were registered. Pattern of recurrence was compared between patients who underwent neoadjuvant therapy and patients who underwent surgery alone. Survival after detection of recurrence was determined in all patients and related to the year of surgery. RESULTS: A total of 493 of 1,088 patients (45 %) who underwent esophagectomy between 1993 and 2010 developed recurrent disease. Median interval between esophagectomy and recurrence was 10.5 months. Within the first 2 years after surgery, 33 % of patients developed recurrent EC. The majority of patients (51 %) were diagnosed with distant metastases. Locoregional recurrence occurred significantly less often among patients who underwent neoadjuvant therapy (6 vs 16 %, p = .017). Median survival after diagnosis of recurrent disease was 3 months. No relation was observed between the year of surgery and survival after recurrent disease (p = .931). CONCLUSIONS: Survival after recurrent EC in patients who undergo FU without routine imaging after esophagectomy is approximately 3 months and has not improved over the past 18 years.
- Published
- 2013
26. Palliation of advanced/recurrent esophageal carcinoma with high-dose-rate brachytherapy
- Author
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Umesh Mahantshetty, R. K. Deshpande, Ketayun A. Dinshaw, Vinay Sharma, and Sanjay Sharma
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Palliative care ,Esophageal Neoplasms ,medicine.medical_treatment ,Brachytherapy ,Recurrent Esophageal Carcinoma ,Esophageal Diseases ,Swallowing ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Esophagus ,Survival rate ,Ulcer ,Aged ,Aged, 80 and over ,Radiation ,business.industry ,Esophageal disease ,Palliative Care ,Middle Aged ,medicine.disease ,High-Dose Rate Brachytherapy ,Deglutition ,Surgery ,Survival Rate ,medicine.anatomical_structure ,Oncology ,Esophageal Stenosis ,Female ,Neoplasm Recurrence, Local ,Deglutition Disorders ,business ,Follow-Up Studies ,Tracheoesophageal Fistula - Abstract
Purpose: The aim was to assess the improvement in swallowing status, complication rate, and overall survival. Patients and Methods: Fifty-eight patients with advanced/recurrent esophageal carcinoma were treated for palliation with high-dose-rate intraluminal brachytherapy (HDR-ILRT) with a remote afterloading microSelectron unit (192Ir source) with or without external radiation from November 1994 to May 2000 at the Tata Memorial Hospital. The mean age was 64 years. The mid-third of the esophagus was involved in 38 patients (66%). The group was comprised of 37 previously untreated patients (29 with ≤50% Karnofsky performance status and old age, 4 with metastatic disease, and 4 with second primary esophageal lesions) and 21 patients with post-treatment recurrent tumors. Thirty-eight patients (65%) received intraluminal brachytherapy alone, whereas the remaining 20 patients (35%) received a combination of external and intraluminal radiation therapy. All patients received 2 fractions of HDR-ILRT 1 week apart with 600 cGy per fraction at 1 cm off axis. Results: Overall improvement in swallowing status was seen in 22 patients (48%), and 24 (41%) maintained pretreatment swallowing status. Median dysphagia-free survival was 10 months. Overall complication rates were 30%, with stricture seen in 9 patients (15%), ulceration in 6 (10%), and tracheo-esophageal fistula in 3 patients (5%). Complication rates were higher in the post-treatment group (38%) than in the previously untreated group (27%) (p = 0.29). The median overall survival for the entire group was 7 months. Median survival was better, although not significantly, for the previously untreated cohort: 7.8 months vs. 6 months for the post-treatment group (p = 0.77). Conclusion: HDR-ILRT brachytherapy achieves good palliation with acceptable complications in advanced/recurrent esophageal carcinoma.
- Published
- 2002
27. Advanced and Recurrent Esophageal Carcinoma: Combination Chemotherapy with Etoposide, Leucovorin, 5-Fluorouracil, and Cisplatin
- Author
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Ohwada, Susumu, primary, Iino, Yuichi, additional, Nakamura, Seiji, additional, Tanahashi, Yoshihumi, additional, Kawashima, Yoshiyuki, additional, Miyamoto, Yukio, additional, and Morishita, Yasuo, additional
- Published
- 1993
- Full Text
- View/download PDF
28. Self-expandable Metallic Stents for Patients with Recurrent Esophageal Carcinoma After Failure of Primary Chemoradiotherapy
- Author
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Muto, Manabu, Ohtsu, Atsushi, Miyata, Yoshinori, Shioyama, Yasukazu, Boku, Narikazu, and Yoshida, Shigeaki
- Published
- 2001
29. Complete regression of recurrent esophageal carcinoma with reduced expression of glutathione S-transferase-π by treatment with continuous infusion of 5-fluorouracil and low-dose cisplatin infusion
- Author
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O. Takaishi, Tetsuo Arakawa, Takashi Fukuda, Toshio Watanabe, Yuko Hamaguchi, Harushi Osugi, Michio Kato, Yasuhiro Fujiwara, Kazunari Tominaga, Kazuhide Higuchi, Shinji Chono, Tetsuo Kuroki, and Motohiro Imano
- Subjects
Antimetabolites, Antineoplastic ,Pathology ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Antineoplastic Agents ,Gastroenterology ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Carcinoma ,Humans ,Medicine ,Esophagus ,Infusion Pumps ,Glutathione Transferase ,Cisplatin ,Chemotherapy ,Dose-Response Relationship, Drug ,Hepatology ,business.industry ,Esophageal disease ,Middle Aged ,medicine.disease ,Isoenzymes ,Radiation therapy ,medicine.anatomical_structure ,Glutathione S-Transferase pi ,Fluorouracil ,Female ,Neoplasm Recurrence, Local ,Tomography, X-Ray Computed ,business ,medicine.drug - Abstract
The mortality rate of recurrent esophageal carcinoma remains high because of its resistance to chemotherapy and radiation therapy. We present a patient with recurrent esophageal carcinoma, which dramatically disappeared after treatment with the combination of continuous infusion of 5-fluorouracil and low-dose cis-Diamminedichloroplatinum-II (cisplatin) infusion (FP therapy). Furthermore, we immunohistologically found that glutathione S-transferases (GST)-pi, a marker of resistance to cisplatin, was faintly expressed both in the endoscopical biopsy specimens of recurrent tumor and in the resected specimens of esophageal carcinoma and metastatic lymph nodes. FP therapy was suggested to be effective for recurrent esophageal carcinoma. Immunostaining for GST-pi might be a prospective marker for the sensitivity of esophageal carcinoma to FP therapy, particularly cisplatin.
- Published
- 1999
30. Thermoradiotherapy for Recurrent Esophageal Carcinoma
- Author
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Satoshi Nomoto, Hajime Imada, Katsuya Yahara, Takayuki Ohguri, Yukunori Korogi, Tomoaki Morioka, and Fumio Kato
- Subjects
Oncology ,Hyperthermia ,medicine.medical_specialty ,Chemotherapy ,business.industry ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,External irradiation ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,Internal medicine ,medicine ,Combined therapy ,Radiology ,Esophagus ,business ,Survival analysis - Published
- 2004
31. Gemcitabine and Cisplatin for Patients with Metastatic or Recurrent Esophageal Carcinoma: A Southwest Oncology Group Study
- Author
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University of Michigan Medical Center, Ann Arbor, MI, U.S.A., Southwest Oncology Group Statistical Center, Seattle, WA, U.S.A, University of Kansas Medical Center, Kansas City, MO, Kansas City Community Clinical Oncology Program, Kansas City, MO, St Vincent's Comprehensive Cancer Center, New York, NY, U.S.A, MD Anderson Cancer Center, Houston, TX, U.S.A, Ann Arbor, Urba, Susan G., Chansky, Kari, Van Veldhuizen, Peter J., Pluenneke, Robert E., Benedetti, Jacqueline K., Macdonald, John S., Abbruzzese, James L., University of Michigan Medical Center, Ann Arbor, MI, U.S.A., Southwest Oncology Group Statistical Center, Seattle, WA, U.S.A, University of Kansas Medical Center, Kansas City, MO, Kansas City Community Clinical Oncology Program, Kansas City, MO, St Vincent's Comprehensive Cancer Center, New York, NY, U.S.A, MD Anderson Cancer Center, Houston, TX, U.S.A, Ann Arbor, Urba, Susan G., Chansky, Kari, Van Veldhuizen, Peter J., Pluenneke, Robert E., Benedetti, Jacqueline K., Macdonald, John S., and Abbruzzese, James L.
- Abstract
Purpose : Experimental data, both in vivo and in vitro, suggest that the combination of gemcitabine and cisplatin acts synergistically. Within the Southwest Oncology Group, we designed a Phase II trial to test this chemotherapy combination for patients with esophageal cancer. Experimental design : Patients with metastatic or recurrent esophageal cancer were treated with gemcitabine 1000???mg/m 2 on days 1, 8, and 15, and cisplatin 100???mg/m 2 on day 15. Cycles were repeated every 28 days. The statistical endpoint was overall survival. Results : Sixty-four eligible patients were accrued from 37 institutions. Twenty-six percent of patients had prior chemotherapy. The treatment was generally well-tolerated, with the most common toxicity being neutropenia in 31% of patients. All 64 patients have died. Survival at 3 months was 81%, and at 1 year was 20%. Median survival was 7.3 months. Conclusions : This regimen is tolerable palliative option for patients with metastatic esophageal cancer.
- Published
- 2006
32. Comparison of CT and MRI for the diagnosis recurrent esophageal carcinoma after operation
- Author
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Kantarc, M., Polat, P., Alper, F., Eroğlu, A., Eren, S., Okur, A., and Onbaş, O.
- Published
- 2004
33. Salvage radiotherapy in patients with recurrent esophageal carcinoma
- Author
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Khashayar Fakhrian, Michael Molls, Hans Geinitz, Tibor Schuster, N. Gamisch, and Reinhard Thamm
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Anastomosis ,Gastroenterology ,Internal medicine ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Esophagus ,Aged ,Salvage Therapy ,business.industry ,Middle Aged ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,Treatment Outcome ,Toxicity ,Cohort ,Adenocarcinoma ,Female ,Neoplasm Recurrence, Local ,business - Abstract
The feasibility and effectiveness of radiotherapy in the management of recurrent esophageal carcinoma (REC) is reported. A consecutive cohort of 54 patients with rcT1-4, rcN0-1, or cM0 recurrent esophageal carcinoma (69% squamous cell carcinoma, 31% adenocarcinoma) was treated between 1988 and 2010. The initial treatment for these patients was definitive radiochemotherapy, surgery alone, or neoadjuvant radiochemotherapy + surgical resection in 8 (15%), 33 (61%), and 13 (24%) patients, respectively. The median time to recurrence from initial treatment was 19 months (range 4–79 months). The site of the recurrence was anastomotic or local, nodal, or both in 63%, 30%, and 7% of patients, respectively. Salvage radio(chemo)therapy was carried out with a median dose of 45 Gy (range 30–68 Gy). Median follow-up time for surviving patients from the start of R(C)T was 38 months (range 10–105 months). Relief of symptoms was achieved in 19 of 28 symptomatic patients (68%). The median survival time was 12 months (95% confidence interval (CI) 7–17 months) and the median recurrence-free interval was 8 months (95% CI 4–12 months). The survival rates at 1, 2, and 3 years were 55 ± 7%, 29 ± 6%, and 19 ± 5%, respectively. The recurrence-free survival rates at 1, 2, and 3 years were 44 ± 7%, 22 ± 6%, and 15 ± 5%, respectively. A radiation dose ≥ 45 Gy and conformal RT were associated with a better prognosis. RT is feasible and effective in the management of recurrent esophageal carcinoma, especially for relief of symptoms. Toxicity is in an acceptable range. The outcome of REC is poor; however, long-term survival of patients with recurrent esophageal carcinoma after radiochemotherpy might be possible, even with a previous history of radiotherapy in the initial treatment. If re-irradiation of esophageal carcinoma is contemplated, three-dimensional conformal techniques and a minimum total dose of 45 Gy are recommended.
- Published
- 2011
34. Recurrent esophageal carcinoma after esophagectomy with three-field lymph node dissection
- Author
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Hoichi Kato, Hiroshi Watanabe, Hiroyasu Igaki, Atsushi Ochiai, Yuji Tachimori, and Yukihiro Nakanishi
- Subjects
Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Recurrence ,Carcinoma ,Humans ,Medicine ,Neoplasm Metastasis ,Esophagus ,Lymph node ,Survival rate ,Aged ,business.industry ,Esophageal disease ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Esophagectomy ,Survival Rate ,medicine.anatomical_structure ,Oncology ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Lymph Node Excision ,Female ,Lymphadenectomy ,Lymph Nodes ,business - Abstract
To evaluate the effect of the extended lymphadenectomy for thoracic esophageal carcinoma, the pattern of recurrence in the 50 patients with pT3 tumors who underwent esophagectomy with cervical, mediastinal, and abdominal lymph node dissection (3-F) (group A) was compared with that of 100 patients at pT3 who underwent esophagectomy without upper mediastinal and cervical lymphadenectomy (2-F) (group B). The cumulative 5-year survival rate for 115 patients who underwent 3-F was 50.9%. Cumulative 5-year survival rates for patients in groups A and B were 36.8% and 22.0%, respectively. The survival curve for group A was significantly better than group B (P = 0.02332). Lymphatic recurrence was noted less frequently in group A (8/23) than in group B (31/49) (χ2 = 5.1149), whereas the rate of hematogenous recurrence was similar. Extension of the field of lymph node dissection reduced the lymph node recurrence in patients with thoracic esophageal carcinoma, which may have positively affected patient survival. © 1996 Wiley-Liss, Inc.
- Published
- 1996
35. Recurrent esophageal carcinoma: CT evaluation after esophagectomy
- Author
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Isaac R. Francis, James G. Carlisle, Barry H. Gross, Mark B. Orringer, James F. Smick, and Leslie E. Quint
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Esophageal Neoplasms ,Pleural effusion ,Biopsy ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Adenocarcinoma ,Sensitivity and Specificity ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Esophagus ,Lymph node ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Stomach ,Middle Aged ,medicine.disease ,Primary tumor ,Pleural Effusion, Malignant ,Surgery ,Esophagectomy ,medicine.anatomical_structure ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Female ,Lymph Nodes ,Radiology ,Neoplasm Recurrence, Local ,Tomography, X-Ray Computed ,business - Abstract
Computed tomographic (CT) scans were retrospectively reviewed for evidence of (a) intragastric soft-tissue mass or gastric wall thickening, (b) extragastric soft-tissue mass or mediastinal lymph node enlargement (local-regional disease), (c) abdominal lymph node enlargement, and (d) metastatic disease to distant organs.Fifty-eight patients with a clinical suspicion of recurrent esophageal carcinoma underwent CT. The thoracic level of local-regional recurrence was compared with the level of the primary tumor.Proof of recurrence status was obtained in 52 of 58 patients. Of the 58 patients, 36 (62%) had CT findings of recurrence, 16 (28%) had no CT findings of recurrence, and six (10%) had CT findings questionable for recurrence. CT accuracy for determining recurrence status was 87%. There was no correlation between the level of primary tumor and that of recurrence.At CT, tumor recurrences were most commonly seen as some combination of local-regional disease, distant metastases, and abdominal lymph node enlargement. CT findings isolated to one region were seen only occasionally.
- Published
- 1993
36. Enhanced radiosensitizing by sodium glycididazole in a recurrent esophageal carcinoma tumor model.
- Author
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Wu P, Liu J, Sun X, Li X, Xing L, and Yu J
- Abstract
Re-irradiation is challenging for esophageal cancer patients with local-regional recurrence after initial radiotherapy. The purpose of this study is to establish a recurrent esophageal tumor model and investigate radiosensitizing effects of sodium glycididazole (CMNa). Tumor models were established by pre-irradiation (0 Gy, 10 Gy or 20 Gy) to the right hind leg of the nude mice 24 hours before tumor transplantation (ECA109 human esophageal carcinoma cells). Tumor growth curves were analyzed. Hypoxic microenvironment was exhibited in tumor frozen slides stained for pimonidazole, Hoechst 33342, hematoxylin-eosin and CD34. Mice bearing primary (0 Gy pre-irradiation) and recurrent (10 Gy pre-irradiation) tumors were randomized into control (no treatment), radiation (30 Gy in 3 weekly fractionations), or radiation combined with CMNa (1 mmol/kg i.p . injected 60 min before radiation) respectively. The data showed tumors from 10 Gy and 20 Gy pre-irradiated sites grew significantly slower than those in the 0 Gy pre-irradiated group. The recurrent xenograft tumors showed increased necrotic fractions, decreased micro-vascular density, increased pimonidazole-positive fraction, and decreased Hoechst-positive fraction. In the primary xenograft tumors, CMNa adding to radiation did not lead to significant tumor growth delay than radiation alone. However, for the recurrent tumor model, the growth rate was remarkably reduced as CMNa combined with radiation as comparison with radiation alone. In conclusion, the recurrent esophageal xenograft model with tumor bed effect was successfully established characterized by slow growth, increased hypoxia fraction and decreased blood flow. Significant radiosensitization by CMNa was demonstrated in the recurrent model., Competing Interests: CONFLICTS OF INTEREST The authors declare no conflicts of interest.
- Published
- 2017
- Full Text
- View/download PDF
37. A Case of Recurrent Esophageal Carcinoma in the Remnant Esophagus which was Resected Six Years after the Operation for Thoracic Esophageal Carcinoma
- Author
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Akira Tangoku, Hiroyuki Uchisako, Masayuki Nakamura, Hiroshi Kusanagi, Takashi Suzuki, Takuo Murakami, and Hiroto Hayashi
- Subjects
medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,General surgery ,Recurrent Esophageal Carcinoma ,Gastroenterology ,medicine ,Carcinoma ,Surgery ,Radiology ,Esophagus ,medicine.disease ,business - Abstract
われわれは胸部食道癌切除後6年3か月経過して発見された遺残食道再発と思われる1例を経験したので報告する.症例は52歳男性で, 6年3か月前に当科にて胸部食道癌に対して右開胸.開腹胸部食道全摘, 胸壁前食道胃吻合を施行されている.術後経過は良好であり, 近医にて経過観察されていたが, 再び嚥下困難が生じるようになった.上部消化管造影および内視鏡検査にて吻合部付近の狭窄が指摘され, 精査目的で当科再入院となった.前回の摘出標本の病理組織学的検討より遺残食道再発と思われた.頸部食道切除および胃管上部部分切除, 両側頸部郭清を行い, 手術用顕微鏡を用いた血管吻合法を併用して遊離空腸を用いて再建した.術後経過は良好で, 再手術後4年経過したが再発の兆候を認めていない.
- Published
- 1992
38. Self-expandable metallic stents for patients with recurrent esophageal carcinoma after failure of primary chemoradiotherapy
- Author
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Atsushi Ohtsu, Manabu Muto, Shigeaki Yoshida, Yoshinori Miyata, Narikazu Boku, and Yasukazu Shioyama
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Esophageal Neoplasms ,Fever ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Pain ,Self-expandable metallic stent ,Carcinoma ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Refractory Carcinoma ,Treatment Failure ,Esophagus ,Esophageal Obstruction ,Aged ,Morphine ,business.industry ,Stent ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Analgesics, Opioid ,Mediastinitis ,medicine.anatomical_structure ,Oncology ,Female ,Stents ,Neoplasm Recurrence, Local ,business ,Respiratory Insufficiency ,Chemoradiotherapy - Abstract
Background Recent advances in chemoradiotherapy for esophageal carcinoma have resulted in improved survival rates. However, there are few options for recurrent dysphagia due to refractory carcinoma after failure of primary chemoradiotherapy. The aim of this study was to evaluate the safety and efficacy of self-expandable metallic stent placement for patients with recurrent esophageal carcinoma where definitive chemoradiotherapy has failed. Methods Thirteen consecutive patients with recurrent squamous cell carcinoma of the esophagus, in whom self-expandable metallic stents were placed after failure of primary chemoradiotherapy, were studied retrospectively. All patients had esophageal obstruction or malignant fistula. Results The oral alimentation status of nine of 13 patients (69%) improved after successful placement of the stent. Following placement of the stent, fever (>38 degrees C) and severe chest pain occurred in 85% (11/13) of the patients. In all patients examined, C-reactive protein was elevated within 1 week of the operation. Esophageal perforation occurred in three patients. Stent-related mediastinitis and pneumonia developed in six (46%) and three (23%) patients, respectively. Seven of the 13 patients (54%) died of stent-related pulmonary complications. Conclusion Although the placement of a self-expandable metallic stent for patients with recurrent esophageal carcinoma after failure of chemoradiotherapy improved their oral alimentation status, we found that this treatment increases the risk of life-threatening pulmonary complications.
- Published
- 2001
39. Comparison of CT and MRI for the diagnosis recurrent esophageal carcinoma after operation
- Author
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Fatih Alper, Suat Eren, A. Eroǧlu, Adnan Okur, Omer Onbas, Mecit Kantarci, and Pinar Polat
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Esophageal Neoplasms ,Pleural effusion ,Recurrent Esophageal Carcinoma ,Pericardial effusion ,Risk Assessment ,Sensitivity and Specificity ,Metastasis ,Cohort Studies ,Predictive Value of Tests ,medicine ,Humans ,Esophagus ,Child ,Neoplasm Staging ,Probability ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Bone metastasis ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Primary tumor ,Magnetic Resonance Imaging ,Survival Analysis ,Esophagectomy ,medicine.anatomical_structure ,Female ,Radiology ,Neoplasm Recurrence, Local ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Despite an increase in radical surgery for esophageal carcinoma, many patients continue to develop recurrent disease. Some reports have suggested that recurrent tumors should be treated aggressively with a combination of chemotherapy and radiotherapy. The aim of this study was to assess the comparative utility of computed tomography (CT) and magnetic resonance imaging (MRI) for the evaluation of recurrence after curative resection of cancer of the esophagus and gastroesophageal junction. To maximize survival benefit, detection of tumor recurrence as early and accurately as possible is important. Twenty-three patients who developed recurrent tumors after curative transthoracic esophagogastrectomy for esophageal carcinoma were analyzed retrospectively. The CT and MRI findings were correlated with pathology or with endoscopic and clinical follow-up. Primary tumor recurrence was detected at the anastomosis side in 19 patients (intraluminal mass in 13 and as diffuse or focal wall thickening in six). Distant recurrence was seen in the liver (n = 5), lung (n = 4), bone (n = 3), abdominal lymph node (n = 4), pleural effusion (n = 2) and pericardial effusion (n = 1). CT and MRI were found equal in showing the intraluminal mass, liver metastasis, pleural and pericardial effusion. Thickening of esophageal wall was demonstrated in nine patients using CT, but only seven of these tumor recurrences were confirmed by MRI, the remaining two were related to secondary fibrosis. Both CT and MRI showed diffuse gastric wall thickening determined as false tumor recurrence due to severe gastritis in one case. There were two (50%) false negatives for lung metastasis in MRI and one bone metastasis (33%) false negative in CT. CT was found superior in the demonstration of lung metastasis and MRI was superior in the evaluation of wall thickening and bone metastasis.
- Published
- 2004
40. Gemcitabine and cisplatin for patients with metastatic or recurrent esophageal carcinoma: a Southwest Oncology Group Study
- Author
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Kari Chansky, James L. Abbruzzese, Jacqueline Benedetti, John S. Macdonald, Susan G. Urba, Robert E Pluenneke, and Peter J. Vanveldhuizen
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Esophageal Neoplasms ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Neutropenia ,Adenocarcinoma ,Deoxycytidine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Carcinoma ,Humans ,Pharmacology (medical) ,Survival rate ,Aged ,Pharmacology ,Chemotherapy ,business.industry ,Esophageal cancer ,Middle Aged ,medicine.disease ,Gemcitabine ,Survival Rate ,Regimen ,Carcinoma, Squamous Cell ,Female ,Cisplatin ,Neoplasm Recurrence, Local ,business ,medicine.drug - Abstract
Purpose: Experimental data, both in vivo and in vitro, suggest that the combination of gemcitabine and cisplatin acts synergistically. Within the Southwest Oncology Group, we designed a Phase II trial to test this chemotherapy combination for patients with esophageal cancer. Experimental design: Patients with metastatic or recurrent esophageal cancer were treated with gemcitabine 1000 mg/m2 on days 1, 8, and 15, and cisplatin 100 mg/m2 on day 15. Cycles were repeated every 28 days. The statistical endpoint was overall survival. Results: Sixty-four eligible patients were accrued from 37 institutions. Twenty-six percent of patients had prior chemotherapy. The treatment was generally well-tolerated, with the most common toxicity being neutropenia in 31% of patients. All 64 patients have died. Survival at 3 months was 81%, and at 1 year was 20%. Median survival was 7.3 months. Conclusions: This regimen is tolerable palliative option for patients with metastatic esophageal cancer.
- Published
- 2004
41. Therapeutic effects of re-radiotherapy combined with S-1 in treatment of recurrent esophageal carcinoma
- Author
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Jing Wu, Xin Wang, Yonggang Shi, Hao Gu, and Ruitai Fan
- Subjects
Radiation therapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Therapeutic effect ,medicine ,Radiology ,business - Published
- 2014
42. Salvage Treatment in Locoregional Recurrent Esophageal Carcinoma (EC) Using Intensity Modulated Radiation Therapy - Helical Tomotherapy (IMRT-HT)
- Author
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Salvatore Tumolo, Roberto Innocente, A. De Paoli, Ettore Bidoli, Marco Trovo, Carlo Gobitti, Gianmaria Miolo, Tanja Baresic, Davide Adriano Santeufemia, and Giovanni Boz
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Chemotherapy ,Radiation ,business.industry ,medicine.medical_treatment ,Recurrent Esophageal Carcinoma ,Esophageal cancer ,Neutropenia ,medicine.disease ,Tomotherapy ,Oxaliplatin ,Internal medicine ,medicine ,Carcinoma ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,Pneumonitis ,medicine.drug - Abstract
Purpose/Objectives: Patients with locally advanced esophageal carcinoma are recommended to undergo treatment with radiation and chemotherapy, which may be followed by surgery in appropriate operative candidates. Radiation has traditionally been delivered with 3D conformal radiation therapy (3D CRT). This study is evaluating early outcomes and acute and late toxicity in patients treated with Intensity Modulated Radiation Therapy (IMRT) with concurrent chemotherapy. Materials/Methods: This is a retrospective review of 17 patients with esophageal carcinoma treated with IMRT and chemotherapy from 2008 2010. Pathology includes squamous cell and adenocarcinomas. Tumor sites include middle thoracic, lower thoracic and GE junction. Initial clinical stages are TX-T3, N0-3, and M0-1. All patients received at least one cycle of concurrent 5-fluorouracil with either cisplatin or oxaliplatin. IMRT dose was 50.4 Gy in 28 fractions prescribed to a target volume which included the tumor and regional lymphatics. All IMRT plans utilized coplanar beams in a 7-9 beam arrangement. Results: Median follow-up is 9 months (range, 4-20). Median patient age is 72 (range, 55-87). Sixteen patients received 50.4 Gy via an IMRT plan, and one received 25.2 Gy. Trimodality treatment was completed in 11 patients (65%). Surgery was either esophagogastrectomy or minimally invasive esophagectomy. Of the 11 patients who proceeded to surgery, 3 (27%) had a pathologic complete response, 7 (64%) had a partial response (PR) and 1 patient (9%) had stable disease. Of the 6 patients who received chemotherapy and IMRT alone, 2 patients had a clinical PR, 1 had disease progression, and 3 did not have follow-up data available. In the initial 17 patients, there were no local or regional recurrences, though 2 patients developed distant metastases. Twelve patients are alive at last follow-up. Of the 5 deaths, 2 were due to esophageal cancer, 1 from radiation complications, 1 from chemotherapy complications, and 1 from surgical complications. Acute CTCAE V4.0 grade 3 toxicities from concurrent chemotherapy and IMRT developed in the following patients: 2 esophagitis, 1 fatigue, 1 nausea/vomiting, 4 dehydration, 1 anemia, 1 thrombocytopenia and 5 neutropenia. Patients with grade 4 toxicities included 1 thrombocytopenia and 1 neutropenia. Four patients developed late grade 3 esophageal strictures. There was one grade 4 cardiac complication, and one grade 5 pleuro-esophageal fistula. There were no cases of radiation pneumonitis or ulcers. Conclusions: IMRT is a feasible treatment modality, which may be equally efficacious to 3D CRT for the treatment of esophageal carcinoma, and may offer fewer treatment complications, including a lower incidence of pneumonitis. Author Disclosure: K.V. Kowalchik: None. G. Kim: None. E. Johnson: None. N. Paryani: None. S. Ko: None.
- Published
- 2012
43. Therapeutic effects of re-radiotherapy combined with S-1 in treatment of recurrent esophageal carcinoma
- Author
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Gu, Hao, primary, Wang, Xin, additional, Wu, Jing, additional, Fan, Rui-Tai, additional, and Shi, Yong-Gang, additional
- Published
- 2014
- Full Text
- View/download PDF
44. Survival after recurrent esophageal carcinoma has not improved over the past 18 years
- Abstract
BACKGROUND: Numerous patients will develop recurrent disease after esophagectomy for esophageal carcinoma (EC). In literature, survival after recurrent EC is poor with 6-8 months. In these studies, diagnostic imaging during follow-up (FU) is routinely performed. In the Netherlands, routine imaging is not part of FU and only performed on indication. The aim of this study was to determine survival after diagnosis of recurrent disease in patients after esophagectomy without routine imaging during FU. METHODS: All EC patients who underwent esophagectomy between 1993 and 2010 were included and followed for clinical evidence of recurrent EC. Location, symptoms, diagnosis, and treatment of recurrent disease were registered. Pattern of recurrence was compared between patients who underwent neoadjuvant therapy and patients who underwent surgery alone. Survival after detection of recurrence was determined in all patients and related to the year of surgery. RESULTS: A total of 493 of 1,088 patients (45 %) who underwent esophagectomy between 1993 and 2010 developed recurrent disease. Median interval between esophagectomy and recurrence was 10.5 months. Within the first 2 years after surgery, 33 % of patients developed recurrent EC. The majority of patients (51 %) were diagnosed with distant metastases. Locoregional recurrence occurred significantly less often among patients who underwent neoadjuvant therapy (6 vs 16 %, p = .017). Median survival after diagnosis of recurrent disease was 3 months. No relation was observed between the year of surgery and survival after recurrent disease (p = .931). CONCLUSIONS: Survival after recurrent EC in patients who undergo FU without routine imaging after esophagectomy is approximately 3 months and has not improved over the past 18 years.
- Published
- 2013
45. [A case report of complete obstruction of the left main bronchus caused by recurrent esophageal carcinoma with pulmonary embolism of right lung after surgery for esophageal cancer]
- Author
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Mamoru, Uemura, Masahiko, Yano, Kentaro, Kishi, Ko, Takachi, Isao, Miyashiro, Shingo, Noura, Hidetoshi, Eguchi, Terumasa, Yamada, Masayuki, Ohue, Hiroaki, Ohigashi, Yo, Sasaki, Osamu, Ishikawa, and Imaoka, Shingi
- Subjects
Airway Obstruction ,Postoperative Complications ,Esophageal Neoplasms ,Humans ,Bronchial Diseases ,Female ,Stents ,Laser Therapy ,Middle Aged ,Neoplasm Recurrence, Local ,Pulmonary Embolism ,Respiratory Insufficiency ,Urokinase-Type Plasminogen Activator - Abstract
A 54-year-old woman complained of dyspnea, due to complete obstruction of the left main bronchus caused by recurrent esophageal carcinoma, was transferred to our department about two months after curative resection (with preoperative chemotherapy for T4 cancer) in July 2004. She suddenly developed a severe shortness of breath with anxiety, and arterial blood gas analysis revealed a PaO2 of 25 mmHg (FiO2 1.0). The presence of pulmonary embolism was diagnosed by pulmonary perfusion scintigraphy. Thrombolytic therapy with urokinase was started to keep the air way. Fogarty catheter and bronchoscopic Nd-YAG laser treatment was performed. After that, an expandable metallic stent (EMS) was placed at the site of obstruction without any troubles, and there was a striking improvement in her condition of respiration and atelectasis. The radiation therapy was initiated and completed safely. The tumor lesion had disappeared on CT scan after the radiation therapy (a total dose of 50 Gy). We experienced a case that could be rescued from an advanced respiratory failure caused by one side air way obstruction and another side's blood circulation disorder.
- Published
- 2005
46. Findings in the Area of Esophageal Cancer Reported from Shandong Cancer Hospital (Enhanced radiosensitizing by sodium glycididazole in a recurrent esophageal carcinoma tumor model)
- Subjects
Recurrence (Disease) -- Research -- Analysis -- Models ,Tumors -- Research -- Analysis -- Models ,Radiotherapy -- Analysis -- Models ,Esophageal cancer -- Research -- Analysis -- Models ,Health - Abstract
2017 AUG 18 (NewsRx) -- By a News Reporter-Staff News Editor at Health & Medicine Week -- Current study results on Oncology - Esophageal Cancer have been published. According to [...]
- Published
- 2017
47. [A case report of complete obstruction of the left main bronchus caused by recurrent esophageal carcinoma with pulmonary embolism of right lung after surgery for esophageal cancer].
- Author
-
Uemura M, Yano M, Kishi K, Takachi K, Miyashiro I, Noura S, Eguchi H, Yamada T, Ohue M, Ohigashi H, Sasaki Y, Ishikawa O, and Shingi I
- Subjects
- Airway Obstruction therapy, Bronchial Diseases therapy, Esophageal Neoplasms surgery, Female, Humans, Laser Therapy, Middle Aged, Neoplasm Recurrence, Local, Postoperative Complications, Respiratory Insufficiency etiology, Respiratory Insufficiency therapy, Stents, Urokinase-Type Plasminogen Activator therapeutic use, Airway Obstruction etiology, Bronchial Diseases etiology, Esophageal Neoplasms complications, Pulmonary Embolism etiology
- Abstract
A 54-year-old woman complained of dyspnea, due to complete obstruction of the left main bronchus caused by recurrent esophageal carcinoma, was transferred to our department about two months after curative resection (with preoperative chemotherapy for T4 cancer) in July 2004. She suddenly developed a severe shortness of breath with anxiety, and arterial blood gas analysis revealed a PaO2 of 25 mmHg (FiO2 1.0). The presence of pulmonary embolism was diagnosed by pulmonary perfusion scintigraphy. Thrombolytic therapy with urokinase was started to keep the air way. Fogarty catheter and bronchoscopic Nd-YAG laser treatment was performed. After that, an expandable metallic stent (EMS) was placed at the site of obstruction without any troubles, and there was a striking improvement in her condition of respiration and atelectasis. The radiation therapy was initiated and completed safely. The tumor lesion had disappeared on CT scan after the radiation therapy (a total dose of 50 Gy). We experienced a case that could be rescued from an advanced respiratory failure caused by one side air way obstruction and another side's blood circulation disorder.
- Published
- 2005
48. Salvage Treatment in Locoregional Recurrent Esophageal Carcinoma (EC) Using Intensity Modulated Radiation Therapy - Helical Tomotherapy (IMRT-HT)
- Author
-
Innocente, R., primary, Santeufemia, D., additional, Miolo, G., additional, Gobitti, C., additional, Trovò, M.G., additional, Tumolo, S., additional, Bidoli, E., additional, Baresic, T., additional, Boz, G., additional, and De Paoli, A., additional
- Published
- 2012
- Full Text
- View/download PDF
49. Comparison of CT and MRI for the diagnosis recurrent esophageal carcinoma after operation.
- Author
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Kantarci M, Polat P, Alper F, Eroglu A, Eren S, Okur A, and Onbaş O
- Subjects
- Adolescent, Adult, Child, Cohort Studies, Esophageal Neoplasms diagnosis, Esophagectomy methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local surgery, Neoplasm Staging, Predictive Value of Tests, Probability, Retrospective Studies, Risk Assessment, Sensitivity and Specificity, Survival Analysis, Esophageal Neoplasms surgery, Magnetic Resonance Imaging, Neoplasm Recurrence, Local diagnosis, Tomography, X-Ray Computed
- Abstract
Despite an increase in radical surgery for esophageal carcinoma, many patients continue to develop recurrent disease. Some reports have suggested that recurrent tumors should be treated aggressively with a combination of chemotherapy and radiotherapy. The aim of this study was to assess the comparative utility of computed tomography (CT) and magnetic resonance imaging (MRI) for the evaluation of recurrence after curative resection of cancer of the esophagus and gastroesophageal junction. To maximize survival benefit, detection of tumor recurrence as early and accurately as possible is important. Twenty-three patients who developed recurrent tumors after curative transthoracic esophagogastrectomy for esophageal carcinoma were analyzed retrospectively. The CT and MRI findings were correlated with pathology or with endoscopic and clinical follow-up. Primary tumor recurrence was detected at the anastomosis side in 19 patients (intraluminal mass in 13 and as diffuse or focal wall thickening in six). Distant recurrence was seen in the liver (n = 5), lung (n = 4), bone (n = 3), abdominal lymph node (n = 4), pleural effusion (n = 2) and pericardial effusion (n = 1). CT and MRI were found equal in showing the intraluminal mass, liver metastasis, pleural and pericardial effusion. Thickening of esophageal wall was demonstrated in nine patients using CT, but only seven of these tumor recurrences were confirmed by MRI, the remaining two were related to secondary fibrosis. Both CT and MRI showed diffuse gastric wall thickening determined as false tumor recurrence due to severe gastritis in one case. There were two (50%) false negatives for lung metastasis in MRI and one bone metastasis (33%) false negative in CT. CT was found superior in the demonstration of lung metastasis and MRI was superior in the evaluation of wall thickening and bone metastasis., (Copyright 2004 ISDE)
- Published
- 2004
- Full Text
- View/download PDF
50. Comparison of CT and MRI for the diagnosis recurrent esophageal carcinoma after operation.
- Author
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Kantarei, M., Polat, P., Alper, F., Ero&gcaron;lu, A., Eren, S., Okur, A., and Onbaş, O.
- Subjects
- *
DIAGNOSIS of esophageal cancer , *MAGNETIC resonance imaging , *TUMORS , *DRUG therapy , *PLEURAL effusions , *CANCER treatment , *METASTASIS , *ESOPHAGEAL surgery - Abstract
Despite an increase in radical surgery for esophageal carcinoma, many patients continue to develop recurrent disease. Some reports have suggested that recurrent tumors should be treated aggressively with a combination of chemotherapy and radiotherapy. The aim of this study was to assess the comparative utility of computed tomography (CT) and magnetic resonance imaging (MRI) for the evaluation of recurrence after curative resection of cancer of the esophagus and gastroesophageal junction. To maximize survival benefit, detection of tumor recurrence as early and accurately as possible is important. Twenty-three patients who developed recurrent tumors after curative transthoracic esophagogastrectomy for esophageal carcinoma were analyzed retrospectively. The CT and MRI findings were correlated with pathology or with endoscopic and clinical follow-up. Primary tumor recurrence was detected at the anastomosis side in 19 patients (intraluminal mass in 13 and as diffuse or focal wall thickening in six). Distant recurrence was seen in the liver ( n = 5), lung ( n = 4), bone ( n = 3), abdominal lymph node ( n = 4), pleural effusion ( n = 2) and pericardial effusion ( n = 1). CT and MRI were found equal in showing the intraluminal mass, liver metastasis, pleural and pericardial effusion. Thickening of esophageal wall was demonstrated in nine patients using CT, but only seven of these tumor recurrences were confirmed by MRI, the remaining two were related to secondary fibrosis. Both CT and MRI showed diffuse gastric wall thickening determined as false tumor recurrence due to severe gastritis in one case. There were two (50%) false negatives for lung metastasis in MRI and one bone metastasis (33%) false negative in CT. CT was found superior in the demonstration of lung metastasis and MRI was superior in the evaluation of wall thickening and bone metastasis. [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
- View/download PDF
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