EsophagusPub Date : 2025-04-08DOI: 10.1007/s10388-025-01114-x
Heba Taher, Ahmed Amgad, Andrew Magdi, Ahmed Magdy, Hytham Esmate El Tantawi, Sherif N Kaddah, Sherifa Tawfik, Mahmoud Tarek, Khaled S Abdullateef
{"title":"Outcomes of transhiatal colon bypass with or without esophagectomy for establishing continuity after corrosive esophageal burns in pediatric patients.","authors":"Heba Taher, Ahmed Amgad, Andrew Magdi, Ahmed Magdy, Hytham Esmate El Tantawi, Sherif N Kaddah, Sherifa Tawfik, Mahmoud Tarek, Khaled S Abdullateef","doi":"10.1007/s10388-025-01114-x","DOIUrl":"https://doi.org/10.1007/s10388-025-01114-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the outcomes of transhiatal colon bypass, with or without esophagectomy, as a surgical intervention for esophageal replacement in pediatric patients with severe corrosive esophageal strictures, focusing on safety, complications, and long-term functional outcomes.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on pediatric patients who underwent transhiatal colon bypass between 2016 and 2019. The study included cases both with and without simultaneous esophagectomy. Standardized follow-up protocols were used to monitor complications, mortality, and long-term outcomes.</p><p><strong>Results: </strong>Ten pediatric patients were included, with seven undergoing esophagectomy as part of the transhiatal colon bypass. The esophagectomy group had a significantly longer operative time (6.0 ± 0.7 h vs. 5.0 ± 0.4 h, p = 0.02). Intraoperative complications included vagus nerve injury (2 cases) and one intraoperative death. Postoperative issues included pneumonia (2 cases) and anastomotic leaks (2 cases). Long-term complications included anastomotic strictures and one case of intestinal obstruction. Despite these complications, both groups showed normal growth and good functional outcomes, with no significant differences in manometric results (p = 1.00).</p><p><strong>Conclusion: </strong>Transhiatal colon bypass is a safe and effective option for esophageal replacement in pediatric patients with corrosive esophageal strictures. While esophagectomy increases surgical complexity and risks, it may be necessary in cases where the native esophagus poses long-term risks. Intraoperative assessment is crucial in deciding whether to include esophagectomy.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Multimodal therapy for oligometastases after curative esophagectomy for esophageal cancer.","authors":"Naomichi Koga, Masaru Morita, Taichiro Nagai, Ayako Iwanaga, Yuta Kasagi, Masahiko Sugiyama, Yasue Kimura, Keishi Sugimachi, Yasushi Toh","doi":"10.1007/s10388-025-01125-8","DOIUrl":"https://doi.org/10.1007/s10388-025-01125-8","url":null,"abstract":"<p><strong>Background: </strong>Oligometastases, defined as a limited metastatic disease, have been considered potential therapeutic targets of cancers. This study aimed to clarify the characteristics of oligometastatic recurrence and therapeutic strategy after curative esophagectomy for esophageal cancer.</p><p><strong>Methods: </strong>Clinical details, such as recurrence site, timing and contents of therapies for recurrence, and prognosis, were examined in 138 patients who experienced recurrence among 366 who underwent curative esophagectomy for esophageal cancer. Oligometastases were defined as three or fewer metastatic recurrence lesions within a single organ or lymph node (LN) station.</p><p><strong>Results: </strong>Oligometastases were identified in 36 patients (26%). The most common oligometastatic recurrence site was the LN (21 patients), followed by the lung (14 patients). In addition, the oligometastases group had a significantly better prognosis than the multiple metastasis group (P < 0.0001). Analysis for prognostic factors revealed that surgical resection for oligometastases had a significant prognostic impact on long-term survival after treatment for initial recurrence of esophageal cancer (P = 0.012).</p><p><strong>Conclusion: </strong>Oligometastases serve as a prognostic factor for recurrent esophageal cancer after curative esophagectomy. The surgical resection of isolated oligometastatic recurrences, particularly pulmonary and cervical node metastases, combined with chemotherapy or radiotherapy, represents a promising treatment strategy with a survival benefit in recurrent esophageal cancer.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post-endoscopy esophageal squamous cell carcinoma with invasion of the muscularis mucosa or deeper detected in surveillance endoscopy after esophageal endoscopic resection.","authors":"Daiki Kitagawa, Ryu Ishihara, Shunsuke Yoshii, Yuya Asada, Tomoya Ueda, Atsuko Kizawa, Takehiro Ninomiya, Yuki Okubo, Yushi Kawakami, Yasuhiro Tani, Minoru Kato, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Tomoki Michida, Yasuhiro Fujiwara","doi":"10.1007/s10388-025-01124-9","DOIUrl":"https://doi.org/10.1007/s10388-025-01124-9","url":null,"abstract":"<p><strong>Background: </strong>Surveillance endoscopy is recommended after endoscopic resection of esophageal squamous cell carcinomas (ESCCs). However, surveillance endoscopy sometimes detects advanced subsequent ESCCs with invasion of the muscularis mucosa (MM) or deeper. We aimed to clarify the clinicopathological features of these advanced subsequent ESCCs.</p><p><strong>Methods: </strong>This single-center retrospective study identified subsequent ESCCs detected during surveillance endoscopy. ESCCs that invaded the MM or deeper and were detected within 24 months after the previous endoscopy were defined as post-endoscopy esophageal advanced lesions (PEEALs), while the first ESCC detected in the patient was defined as the primary lesion. Study 1 compared the clinicopathological characteristics of PEEALs versus non-advanced lesions. Study 2 compared the endoscopic features of pT1a-MM PEEALs versus pT1a-MM primary lesions.</p><p><strong>Results: </strong>A total of 307 subsequent ESCCs were analyzed in Study 1. Of these, 20 were PEEALs and 287 were non-advanced lesions (pT1a-EP/LPM). The median intervals from the previous endoscopy for PEEALs and non-advanced lesions were 6.1 months and 6.7 months, respectively (P = 0.283). The morphological feature of marginal elevation was seen in 60% of PEEALs. In Study 2, 15 pT1a-MM PEEALs were compared with 149 pT1a-MM primary lesions. Compared with primary lesions, pT1a-MM PEEALs were smaller (median 10 mm vs. 30 mm, P < 0.001) and had a higher prevalence of marginal elevation morphology (53.3% vs. 10.1%, P < 0.001).</p><p><strong>Conclusions: </strong>The specific feature of PEEALs was marginal elevation. Surveillance endoscopy with careful observation for these lesions is recommended after endoscopic resection of ESCCs.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preoperative inspiratory muscle training preserved diaphragmatic excursion after esophagectomy: a randomized-controlled trial.","authors":"Hiroki Mizusawa, Yuji Higashimoto, Osamu Shiraishi, Masashi Shiraishi, Ryuji Sugiya, Masaya Noguchi, Kengo Kanki, Tamotsu Kimura, Akira Ishikawa, Takushi Yasuda","doi":"10.1007/s10388-025-01123-w","DOIUrl":"https://doi.org/10.1007/s10388-025-01123-w","url":null,"abstract":"<p><strong>Background: </strong>Preoperative inspiratory muscle training (IMT) enhances diaphragmatic excursion (DE) in patients with esophageal cancer; however, the postoperative effects of IMT on DE have not yet been evaluated. This study aimed to investigate the effect of preoperative IMT on perioperative diaphragmatic function as measured by DE, inspiratory muscle strength, lung function, and exercise tolerance.</p><p><strong>Methods: </strong>This was a parallel, randomized-controlled trial. Patients with thoracic or abdominal esophageal cancer scheduled for esophagectomy were randomized into either the incentive spirometry (IS) or IMT group. Each intervention was performed during preoperative neoadjuvant chemotherapy (NAC). The primary outcome was the DE, and the secondary outcomes were maximal inspiratory pressure (MIP), lung function, and exercise tolerance, which were measured before and 1-3 months after esophagectomy.</p><p><strong>Results: </strong>Thirty-two patients were included in the analysis. The DE in the IMT group (n = 15) increased from baseline to pre-operation, and the rate of change was significantly greater than that in the IS group (n = 17). Although the DE and MIP decreased in both groups after esophagectomy, the decline in the DE after esophagectomy was significantly lower in the IMT group than that in the IS group (p < 0.05). Furthermore, significant differences in DE persisted at least until 3 months post-esophagectomy, whereas MIP did not differ significantly at any time point. Pulmonary function and exercise tolerance were not significantly different between the two groups.</p><p><strong>Conclusions: </strong>The IMT before esophagectomy enhanced diaphragmatic function, which was preserved for more than 3 months after esophagectomy.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lymph-node ratio as a risk factor for recurrence following neoadjuvant docetaxel, cisplatin, and 5-fluorouracil therapy for locally advanced esophageal squamous cell carcinoma.","authors":"Mikako Tamba, Akihiko Okamura, Hiroki Osumi, Yu Imamura, Jun Kanamori, Mariko Ogura, Shota Fukuoka, Koichiro Yoshino, Shohei Udagawa, Takeru Wakatsuki, Eiji Shinozaki, Masayuki Watanabe, Kensei Yamaguchi, Keisho Chin, Akira Ooki","doi":"10.1007/s10388-024-01103-6","DOIUrl":"10.1007/s10388-024-01103-6","url":null,"abstract":"<p><strong>Background and purpose: </strong>It remains unclear whether the lymph-node ratio (LNR) is a relevant factor for the risk of recurrence following neoadjuvant chemotherapy (nCT) with docetaxel, cisplatin, and 5-fluorouracil (DCF), which is a new standard of care for locally advanced esophageal squamous cell carcinoma (ESCC) in Japan. This study aimed to evaluate the clinical utility of LNR as a risk factor for recurrence.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 75 patients who underwent nCT-DCF followed by curative surgery for resectable ESCC. The cut-off for the LNR was determined using receiver-operating characteristic curve analysis for recurrence.</p><p><strong>Results: </strong>A higher LNR was observed in 34 (45.3%) patients. At a median follow-up of 19.2 months, the median disease-free survival (DFS)/recurrence-free survival (RFS) rate was not reached in patients with a lower LNR and was 8.0 months in those with a higher LNR (P < 0.01). The estimated 1-year DFS/RFS rate was 47.8% and 100% for patients with a higher LNR and lower LNR, respectively. LNR remained a risk factor, even when stratified by non-pathological complete response, the presence of positive ypN, or ypStage III. In those with a higher LNR, the median DFS/RFS was 18.3 versus 8.0 months with and without adjuvant nivolumab treatment, respectively.</p><p><strong>Conclusions: </strong>Higher LNR indicates a more aggressive phenotype with worse DFS/RFS rates and increased recurrence following nCT-DCF treatment and curative surgery for ESCC.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"166-176"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A purely laparoscopic approach can reduce the incidence of postoperative pneumonia in esophageal cancer patients undergoing esophagectomy.","authors":"Yoshiro Yukawa, Kotaro Yamashita, Kota Momose, Takuro Saito, Koji Tanaka, Tomoki Makino, Kazuyoshi Yamamoto, Tsuyoshi Takahashi, Yukinori Kurokawa, Ryohei Kawabata, Atsushi Takeno, Kiyokazu Nakajima, Hidetoshi Eguchi, Yuichiro Doki","doi":"10.1007/s10388-025-01110-1","DOIUrl":"10.1007/s10388-025-01110-1","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive esophagectomy for esophageal cancer has become increasingly common to reduce postoperative pneumonia. However, the usefulness of pure laparoscopic abdominal manipulation without an upper abdominal incision remains unclear.</p><p><strong>Methods: </strong>We evaluated the utility of pure laparoscopic surgery (LAP) vs. hand-assisted laparoscopic surgery (HALS) in esophagectomy. A total of 344 consecutive patients who underwent curative esophagectomy for esophageal cancer from 2019 to 2023 were enrolled; 235 patients were treated with HALS and 109 with LAP. The peri- and postoperative outcomes were compared between the two groups using a propensity score-matched analysis.</p><p><strong>Results: </strong>Propensity score matching was used to compare 92 patients each in the HALS and LAP groups. Clinicopathological characteristics did not differ between the two groups. The incidence of postoperative pneumonia was significantly higher in the HALS group than in the LAP group (30% vs. 11%, respectively; P = 0.001). Multivariate logistic analysis showed that HALS was independently associated with postoperative pneumonia (odds ratio 3.82, P = 0.002), along with older age and male sex.</p><p><strong>Conclusions: </strong>LAP may reduce the incidence of postoperative pneumonia in esophageal cancer patients who undergo esophagectomy.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"157-165"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EsophagusPub Date : 2025-04-01Epub Date: 2025-01-23DOI: 10.1007/s10388-024-01105-4
Chien-Huai Chuang, Jhe-Cyuan Guo, Ken Kato, Chih-Hung Hsu
{"title":"Exploring novel immunotherapy in advanced esophageal squamous cell carcinoma: Is targeting TIGIT an answer?","authors":"Chien-Huai Chuang, Jhe-Cyuan Guo, Ken Kato, Chih-Hung Hsu","doi":"10.1007/s10388-024-01105-4","DOIUrl":"10.1007/s10388-024-01105-4","url":null,"abstract":"<p><p>Esophageal squamous cell carcinoma (ESCC) is a prevalent and highly lethal malignancy in Asia. Recent advancements in immune checkpoint inhibitors (ICIs) have markedly transformed the systemic therapy landscape for ESCC. Anti-PD-1-based combination with chemotherapy or with ipilimumab, an anti-CTLA-4 antibody, have been established as the new standard first-line treatments for patients with advanced ESCC. Moreover, anti-PD-1 monotherapy has demonstrated improved efficacy and survival compared with second-line chemotherapy in previously treated patients with ESCC. Novel ICIs targeting other immune checkpoints also show potential for enhancing anticancer therapy in advanced ESCC.The TIGIT/PVR pathway represents a new immune checkpoint. Preclinical studies have indicated that the dual blockade of TIGIT and PD-1 can enhance antitumor immune responses. Clinical trials have reported that combining anti-TIGIT with anti-PD-1/PD-L1 antibodies elicited clinical responses in patients with advanced ESCC. In the first-line systemic therapy setting, combinations of dual ICIs targeting TIGIT and PD-1/PD-L1 plus platinum-based chemotherapy have demonstrated acceptable toxicity profiles and promising antitumor activity in several phase II trials and one phase III study. However, the role of adding an anti-TIGIT antibody to the current standard of anti-PD-1/PD-L1 plus platinum-based chemotherapy in first-line therapy for advanced ESCC remains to be fully determined, necessitating further clinical trials. Ongoing studies are also investigating the role of anti-TIGIT, with or without anti-PD-1/PD-L1, in locoregional ESCC. Additional research is essential to optimize the potential of anti-TIGIT therapy in ESCC and other malignancies by identifying predictive biomarkers, determining optimal antibody types, and gaining key mechanistic insights.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"139-147"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
EsophagusPub Date : 2025-04-01Epub Date: 2025-02-05DOI: 10.1007/s10388-025-01111-0
Seyeon Jeon, Boram Park, Seong Yong Park, Yeong Jeong Jeon, Junghee Lee, Jong Ho Cho, Hong Kwan Kim, Yong Soo Choi, Young Mog Shim
{"title":"Comparison and validation of the Japanese classification 12th edition and American joint committee on cancer 8th edition on intrathoracic esophageal squamous cell carcinoma.","authors":"Seyeon Jeon, Boram Park, Seong Yong Park, Yeong Jeong Jeon, Junghee Lee, Jong Ho Cho, Hong Kwan Kim, Yong Soo Choi, Young Mog Shim","doi":"10.1007/s10388-025-01111-0","DOIUrl":"10.1007/s10388-025-01111-0","url":null,"abstract":"<p><strong>Background: </strong>The American Joint Committee on Cancer (AJCC) 8th edition and Japanese classification 12th edition can be applied for esophageal cancer staging. This retrospective study aimed to compare these two staging systems in patients with surgically treated esophageal squamous cell carcinoma (ESCC).</p><p><strong>Methods: </strong>We retrospectively reviewed 2,853 patients who underwent esophagectomy and lymphadenectomy from 1994 to 2020. Patients were divided into the upfront (n = 2156) and neoadjuvant (n = 697) groups.</p><p><strong>Results: </strong>The mean age of the patients was 63.5 ± 8.2 years with a median follow-up of 7.6 years. Comparing both staging systems showed that patients were more likely to be staged lower by the Japanese classification. Survival curves for overall survival (OS) and disease-free survival in the upfront group were well separated in the two staging systems (p < 0.01), and the HR for survival significantly increased as the stage increased. In the neoadjuvant group, there were crossovers of survival curves between stages II and III in the AJCC, and crossovers between stages I and II, and stages III and IV in the Japanese classification. The HR for OS demonstrated less statistical differences in the neoadjuvant group.</p><p><strong>Conclusion: </strong>The AJCC 8th edition and Japanese classification 12th edition predicted survival well for patients received the upfront surgery, whereas both showed crossovers of survival curves for patients undergoing neoadjuvant therapy. More accurate staging systems for patients with ESCC who received neoadjuvant therapy and surgery are needed.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"215-227"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Low skeletal muscle mass contributes to the prognosis of patients with superficial esophageal cancer treated with definitive chemoradiotherapy.","authors":"Kentaro Nakagawa, Yoshito Hayashi, Yujiro Adachi, Ayaka Tajiri, Hiromu Fukuda, Eiji Kimura, Ryotaro Uema, Hirotsugu Saiki, Minoru Kato, Takanori Inoue, Takeo Yoshihara, Shunsuke Yoshii, Yoshiki Tsujii, Tetsuo Takehara","doi":"10.1007/s10388-025-01109-8","DOIUrl":"10.1007/s10388-025-01109-8","url":null,"abstract":"<p><strong>Background: </strong>Herein, we aimed to examine the relationship between sarcopenia, neutrophil-lymphocyte ratio (NLR), Charlson comorbidity index (CCI), and prognostic nutritional index (PNI) in patients with superficial esophageal carcinoma who underwent definitive chemoradiotherapy (CRT).</p><p><strong>Methods: </strong>We retrospectively analyzed 100 patients (87 males) diagnosed with cT1N0M0 esophageal squamous cell carcinoma. The included patients underwent CRT as an initial treatment. Muscle mass was assessed using the psoas muscle index (PMI). All patients received concurrent chemotherapy (5-fluorouracil plus cisplatin/nedaplatin) and radiotherapy (60 Gy). The duration of follow-up (median range) was 78 (2.5-197) months. During the follow-up period, 23 recurrences occurred, along with 37 deaths (11 deaths from esophageal cancer; only one treatment-related death).</p><p><strong>Results: </strong>The 5-year survival rate was 78.0%. The median (range) PMI was 6.55 (3.90-10.9) and 4.62 (2.28-6.60) cm<sup>2</sup>/m<sup>2</sup> in males and females, respectively. The PNI was 46.6 (36.2-60.4), NLR was 2.45 (0.61-18.1), and CCI was 0 (0-10). Patients were divided into low PMI (sarcopenia) and high PMI (non-sarcopenia) groups. In the univariate survival time analysis, the low PMI group had a significant hazard ratio (HR) of 2.70 (p = 0.0049), the low Geriatric Nutritional Risk Index (GNRI) group had an HR of 2.30 (p = 0.0161), and the CCI ≥ 1 group had an HR of 2.19 (p = 0.0199). According to the multivariate analysis using these three factors and age (≥ 65 years), PMI was an independent prognostic factor (HR, 2.23; p = 0.0313).</p><p><strong>Conclusions: </strong>PMI is a notable predictor of prognosis in patients undergoing CRT for T1N0M0 esophageal cancer.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"198-206"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Activation of the tumor cell-intrinsic STING pathway induced by Fusobacterium nucleatum is associated with poor prognosis in esophageal cancer patients.","authors":"Shotaro Nakajima, Katsuharu Saito, Satoshi Fukai, Mei Sakuma, Akira Matsuishi, Ryo Kanoda, Yuya Maruyama, Hiroya Suzuki, Hirokazu Okayama, Motonobu Saito, Kosaku Mimura, Azuma Nirei, Tomohiro Kikuchi, Hiroyuki Hanayama, Zenichiro Saze, Tomoyuki Momma, Kyoko Nishiyama, Tatsuo Suzutani, Koji Kono","doi":"10.1007/s10388-025-01112-z","DOIUrl":"10.1007/s10388-025-01112-z","url":null,"abstract":"<p><strong>Background: </strong>Intratumoral Fusobacterium nucleatum (Fn) infection is closely associated with poor prognosis in esophageal cancer (EC) due to its impact on the tumor microenvironment (TME). The tumor cell-intrinsic cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway is critical for regulating immune cell activation in the TME. However, the link between intratumoral Fn infection and the activation of the cGAS-STING pathway in tumor cells, as well as its effects on EC progression, remains largely unknown.</p><p><strong>Methods: </strong>In the present study, we investigated the impact of intratumoral Fn infection on the activation of the tumor cell-intrinsic cGAS-STING pathway and EC progression by analyzing our own EC cohort and performing in vitro experiments using co-cultures of EC-cell lines and Fn.</p><p><strong>Results: </strong>The expression of tumor cell-intrinsic STING was significantly associated with worse prognosis in Fn-high EC patients. Exposure to Fn significantly activated the STING pathway in EC cells. RNA-seq analysis revealed that exposure to Fn markedly activated cytokine-chemokine-related signaling pathways and induced the expression of several cytokines and chemokines in STING-expressing EC cells. Among the differentially expressed cytokine and chemokine genes in EC cells co-cultured with Fn, analysis of TCGA datasets demonstrated that the expression of CCL20, CXCL10, and CSF2 may be associated with poor prognosis in EC patients.</p><p><strong>Conclusion: </strong>We revealed that the activation of the STING signaling pathway and the subsequent expression of cytokines and chemokines in EC cells induced by Fn infection may be closely associated with poor prognosis in EC patients.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"239-249"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}