Esophagus最新文献

{"title":"Benefits of neoadjuvant chemotherapy: is the prognosis of ypN0 patients after neoadjuvant chemotherapy comparable to that of pN0 patients undergoing surgery alone?","authors":"Osamu Shiraishi, Koji Tanaka, Tomoki Makino, Takahito Sugase, Takashi Kanemura, Atsushi Takeno, Keijiro Sugimura, Masaaki Motoori, Yutaka Kimura, Motohiro Hirao, Kazumasa Fujitani, Hiroshi Miyata, Masahiko Yano, Makoto Yamasaki, Yuichiro Doki, Takushi Yasuda","doi":"10.1007/s10388-025-01132-9","DOIUrl":"https://doi.org/10.1007/s10388-025-01132-9","url":null,"abstract":"<p><strong>Background: </strong>Preoperative treatment has become widely recognized for improving survival in patients with esophageal cancer. The present study aimed to compare the prognosis between patients with pathological node-negative status treated with surgery alone (SA-pN0) and those who were clinically node-positive but converted to ypN0 following neoadjuvant chemotherapy (NAC-ypN0) in cases of advanced thoracic esophageal squamous cell carcinoma (ESCC).</p><p><strong>Methods: </strong>This retrospective analysis used a multicenter database of 4849 consecutive patients who underwent treatment for esophageal cancer. Patients with clinical T2 or more advanced ESCC who underwent standard subtotal esophagectomy between 1990 and 2017 were included. The NAC-ypN0 group was compared with the SA-pN0 group in terms of patient characteristics, recurrence patterns, and survival outcomes using propensity score-matched analysis.</p><p><strong>Results: </strong>In total, 109 patients were classified as NAC-ypN0 and 137 as SA-pN0. Propensity score matching resulted in the selection of 87 patients per group. Compared with the SA-pN0 group, the NAC-ypN0 group had a significantly more advanced clinical TNM stage and underwent significantly more three-field lymphadenectomies. Pathological findings showed downstaging of the pT stage in the NAC-ypN0 group, resulting in an equivalent distribution between the two groups. Additionally, the NAC-ypN0 group had significantly lower rates of lymphatic invasion (33% vs. 56%) and venous invasion (21% vs. 52%). Recurrence rates (21% vs. 22%) and survival outcomes (5-year overall survival: 83.9% vs. 76.1%, P = 0.110) were comparable between the two groups.</p><p><strong>Conclusions: </strong>The NAC-ypN0 group demonstrated reduced lymphovascular invasion and showed a prognosis comparable to that of the SA-pN0 group.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110214","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":"Initial reduction of the primary tumor or lymph nodes: which is the better prognostic factor in patients with esophageal squamous cell carcinoma receiving neoadjuvant chemotherapy followed by surgery?","authors":"Takaomi Hagi, Osamu Shiraishi, Masuhiro Terada, Atsushi Yamada, Masashi Kohda, Tomoya Nakanishi, Yoko Hiraki, Hiroaki Kato, Atsushi Yasuda, Masayuki Shinkai, Motohiro Imano, Takushi Yasuda","doi":"10.1007/s10388-025-01128-5","DOIUrl":"https://doi.org/10.1007/s10388-025-01128-5","url":null,"abstract":"<p><strong>Background: </strong>Early response of the primary tumor (PT) to neoadjuvant chemotherapy (NAC) in patients with esophageal squamous cell carcinoma (ESCC) is considered a potential predictor of postoperative prognosis. However, the role of metastatic lymph nodes (LNs) remains poorly understood. This study aimed to compare the predictive value of early response in PT and LNs for postoperative prognosis.</p><p><strong>Methods: </strong>We enrolled 124 consecutive patients who received NAC-docetaxel, cisplatin, 5-fluorouracil (DCF) followed by surgery for ESCC between April 2010 and March 2020. Initial tumor reduction of the PT (ITR-PT) and LN (ITR-LN), defined as the percentage decrease in tumor shorter diameter after the first course of NAC-DCF, was evaluated using computed tomography. The optimal cut-off values of ITRs were determined using receiver operating characteristic curves and Cox regression models, and their relationship with recurrence-free survival (RFS) was analyzed.</p><p><strong>Results: </strong>The median ITR-PT and ITR-LN were 21.77% and -0.88%, respectively. The optimal cut-off values for predicting prognosis were approximately 10% for ITR-PT (hazard ratio [HR], 3.23; 95% confidence interval [CI], 1.84-5.64) and -10% for ITR-LN (HR, 2.20; 95% CI, 1.27-3.80). ITR-PT showed a greater impact on RFS (3-year RFS: ITR-PT ≥ 10%, 66.1%; ITR-PT < 10%, 18.4%; log-rank P < 0.001) compared with ITR-LN (3-year RFS: ITR-LN ≥ -10%, 64.1%; ITR-PT < -10%, 34.3%; log-rank P = 0.004). Multivariate analysis of RFS identified ypN, ITR-PT, and ITR-LN as independent prognostic factors.</p><p><strong>Conclusions: </strong>Both ITR-PT and ITR-LN are promising predictors of survival in patients with ESCC who underwent NAC-DCF plus surgery. ITR-PT may be a stronger prognostic factor than ITR-LN.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998517","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":"Fistula closure technique using an esophageal stent and fixation method for gastrointestinal-airway fistula after esophageal cancer surgery.","authors":"Koichi Okamoto, Yuta Sannomiya, Kazuyoshi Mitta, Akifumi Hashimoto, Hisashi Nishiki, Daisuke Kaida, Takashi Miyata, Toshikatsu Tsuji, Hideto Fujita, Noriyuki Inaki, Itasu Ninomiya, Hiroyuki Takamura","doi":"10.1007/s10388-025-01129-4","DOIUrl":"https://doi.org/10.1007/s10388-025-01129-4","url":null,"abstract":"<p><strong>Background: </strong> The occurrence of a gastrointestinal-airway fistula after esophageal cancer surgery is a serious and fatal complication that can cause severe respiratory complications. It is a pathological condition requiring prompt intervention to avoid a fatal course. Conventionally, highly invasive surgical treatment has been selected for the treatment for gastrointestinal-airway fistula, but its difficulty and mortality risk cannot be neglected. Esophageal stent placement is useful as a nonoperative management for gastrointestinal-airway fistulas, but the success rate of fistula closure is not that high. Hence, an effective method that can solve technical problems to avoid intervention-related complications and increases the success rate of fistula closure by stent placement needs to be developed. We have achieved better results with our unique ingenuity for the management of esophageal stent placement; thus, we aimed to describe the details of the management methods.</p><p><strong>Methods: </strong>Our technique used in stent placement included endoscopic insertion of the self-expandable metallic stent and the fixation of the stent with a nylon thread and a transnasal catheter on the face. With this ingenuity, it becomes possible to reduce stent migration, and an easy and quick adjustment of its position in case of stent migration can be possible.</p><p><strong>Results: </strong>We have experienced successfully cured cases with our novel technique [five of seven cases (71.4%)] with a minimum indwelling period.</p><p><strong>Conclusions: </strong>Our technique is feasible for use in the management of gastrointestinal-airway fistula after esophageal cancer surgery.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975524","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":"Detection of pathologic complete response using deep neural network-based endoscopic evaluation in patients with esophageal cancer receiving neoadjuvant chemotherapy: a nationwide multicenter retrospective study from 46 Japanese esophageal centers.","authors":"Satoru Matsuda, Tomoyuki Irino, Yuko Kitagawa, Akihiko Okamura, Shuhei Mayanagi, Eisuke Booka, Masashi Takeuchi, Junya Kitadani, Mitsuro Kanda, Tetsuya Abe, Takeo Bamba, Masaaki Iwatsuki, Takehiro Kagaya, Takanori Kurogochi, Yasuhiro Tsubosa, Hirofumi Kawakubo, Yoshihiro Kakeji, Koji Kono, Masayuki Watanabe, Hiroya Takeuchi","doi":"10.1007/s10388-025-01130-x","DOIUrl":"https://doi.org/10.1007/s10388-025-01130-x","url":null,"abstract":"<p><strong>Background: </strong>Detecting pathological complete response (pCR) preoperatively facilitated a non-surgical approach after neoadjuvant chemotherapy (NAC). We previously developed a deep neural network-based endoscopic evaluation to determine pCR preoperatively. Its quality warrants improvement with a larger data series for clinical application.</p><p><strong>Methods: </strong>This study retrospectively reviewed patients with esophageal squamous cell carcinoma (ESCC) receiving NAC at 46 Japanese esophageal centers certified by the Japan Esophageal Society. Endoscopic images after NAC were collected with clinicopathological factors and long-term outcomes. We randomly selected the same number of patients with Grades 0-1a and Grades 1b-2 based on those with pCR (Grade 3). A deep neural network was used for endoscopic image analyses. A test data set, consisting of 100 photos, was utilized for validation. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the deep neural network-based model and experienced physicians were calculated.</p><p><strong>Results: </strong>The study enrolled 1041 patients, including 354 (33%) patients with pCR, the same number of histological non-responders (Grade 0-1a/1b-2, 352 [33%]/368 [34%]). The median values of sensitivity, specificity, PPV, NPV, and accuracy for pCR detection were 80%, 90%, 89%, 82%, and 85%, respectively. The patients with pCR preoperatively demonstrated significantly better overall survival and recurrence-free survival.</p><p><strong>Conclusions: </strong>This large-scale study revealed that the deep neural network-based endoscopic evaluation after NAC identified pCR with feasible accuracy. The current artificial intelligence technology may guide an individualized treatment strategy, including a non-surgical approach, in patients with ESCC through prospective studies with careful external validation.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985157","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":"Exploring predictive biomarkers of efficacy and survival with nivolumab treatment for unresectable/recurrent esophageal squamous cell carcinoma.","authors":"Shigeto Nakai, Tomoki Makino, Kota Momose, Kotaro Yamashita, Koji Tanaka, Hiroshi Miyata, Sachiko Yamamoto, Masaaki Motoori, Yutaka Kimura, Ryohei Kawabata, Motohiro Hirao, Jin Matsuyama, Yusuke Akamaru, Hitomi Morihara, Azumi Ueyama, Yukinori Kurokawa, Eiichi Morii, Hisashi Wada, Hidetoshi Eguchi, Yuichiro Doki","doi":"10.1007/s10388-025-01120-z","DOIUrl":"https://doi.org/10.1007/s10388-025-01120-z","url":null,"abstract":"<p><strong>Background: </strong>Programmed cell death protein-1 (PD-1) blockade has improved survival for patients with esophageal squamous cell carcinoma (ESCC), but response rates are low. Biomarkers to predict who will benefit from PD-1 blockade are urgently needed.</p><p><strong>Methods: </strong>This multicenter study involved 250 patients with recurrent/unresectable advanced ESCC receiving nivolumab as second- or later-line therapy. We assessed tumor-infiltrating T lymphocytes (TILs) and tertiary lymphoid structure (TLS) density using immunohistochemistry and hematoxylin/eosin staining in surgical specimens and pre-nivolumab endoscopic biopsies.</p><p><strong>Results: </strong>In surgical specimens, clinical response (vs. non-response) to nivolumab correlated significantly with CD8⁺ lymphocyte count (160 vs. 95.2 cells/field, P = 0.0494), CD8/Foxp3 ratio (6.52 vs. 2.72, P = 0.0053), and TLS density (0.21/mm² vs. 0.10/mm², P = 0.0005). In terms of overall survival, multivariate analysis identified CD8/Foxp3 ratio (hazard ratio [HR] = 1.83, P = 0.0050) and TLS density (HR = 1.67, P = 0.0171 as independent prognostic parameters in surgical specimens. Similarly, in endoscopic biopsies, clinical response (vs. non-response) to nivolumab correlated significantly with CD8⁺ counts (254 cells/mm² vs. 124 cells/mm², P = 0.0344), CCR8⁺ lymphocyte count (62.6 cells/mm² vs. 140 cells/mm², P = 0.0355), CD8/Foxp3 ratio (2.09 vs. 0.89, P = 0.040), and CD8/CCR8 ratio (2.34 vs. 0.89, P = 0.0020). Multivariate analysis also identified CD8/CCR8 ratio in endoscopic biopsies (HR = 1.66, P = 0.0313) as an independent prognostic parameter.</p><p><strong>Conclusions: </strong>CD8⁺ and CCR8⁺ cell counts, CD8/Foxp3 and CD8/CCR8 ratios, and TLS density may be predictive biomarkers of therapeutic efficacy and survival with PD-1 blockade for ESCC.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988818","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":"Evaluating the discrepancies between evidence-based and community standard practices in the endoscopic examination of Barrett's esophagus: a nationwide survey in Japan.","authors":"Yugo Iwaya, Katsunori Iijima, Takuto Hikichi, Yuji Amano, Masaki Endo, Kenichi Goda, Tomoaki Suga, Makoto Yamasaki, Masashi Kawamura, Fumisato Sasaki, Koji Tanaka, Ken Namikawa, Manabu Muto, Hiroya Takeuchi, Ryu Ishihara","doi":"10.1007/s10388-025-01127-6","DOIUrl":"https://doi.org/10.1007/s10388-025-01127-6","url":null,"abstract":"<p><strong>Background: </strong>Barrett's esophagus (BE) is a known precursor of esophageal adenocarcinoma (EAC). EAC is comparatively rare in Japan compared to Western countries, where BE management guidelines have been well established based on robust evidence. This study evaluated for gaps between evidence-based medicine (EBM) and real-world clinical practice for BE management in Japan and examined endoscopist adherence to Japanese and Western guidelines.</p><p><strong>Methods: </strong>A nationwide survey consisting of 19 questions was conducted among Japanese endoscopists to assess their diagnostic and surveillance practices for BE. Descriptive statistics and multivariate logistic regression analysis were employed to interpret key data.</p><p><strong>Results: </strong>Responses from 804 endoscopists revealed significant differences between Western guidelines and Japanese practices. Local adherence to standardized inspection times was 7.6%, and 30.7% of endoscopists used the Prague classification. Biopsies for BE diagnosis and random biopsies following the Seattle protocol were rarely performed. For long-segment BE, 51.4% of respondents reported using magnifying endoscopy. Regarding ultra-short-segment BE (USSBE), opinions were divided on whether it should be diagnosed as BE and if patients should be informed of its diagnosis. Approximately 40% of respondents advocated annual surveillance for USSBE, with a general tendency to recommend closer follow-up regardless of BE length as compared with Western guidelines.</p><p><strong>Conclusions: </strong>This survey highlighted several incongruities between EBM and real-world practices for BE, as well as differences between Western and Japanese approaches. Bridging these gaps will require generating more Japan-specific evidence, refining guidelines, and then promoting their dissemination to harmonize best BE practices with international standards and Japanese clinical settings.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975745","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":"Treatment strategies and long-term outcomes for patients with oligometastasis in esophageal squamous cell carcinoma after radical esophagectomy.","authors":"Hirotaka Ishida, Yusuke Taniyama, Chiaki Sato, Hiroshi Okamoto, Yohei Ozawa, Ryohei Ando, Jun Takahashi, Michiaki Unno, Takashi Kamei","doi":"10.1007/s10388-025-01126-7","DOIUrl":"https://doi.org/10.1007/s10388-025-01126-7","url":null,"abstract":"<p><strong>Background: </strong>Advancements in esophageal cancer treatment have not substantially reduced the high recurrence rate and poor survival outcomes following esophagectomy; however, patients with oligometastasis may benefit from aggressive local treatments.</p><p><strong>Methods: </strong>We performed curative esophagectomy in 714 patients with esophageal squamous cell carcinoma between 2007 and 2022. In total, 206 patients with recurrent lesions were enrolled in this study. Oligometastasis was defined as ≤ 5 lesions in a single organ or lymph node station. Treatments included surgery, chemoradiotherapy (CRT), chemotherapy, and radiotherapy. Disease-specific survival (DSS) was defined as the time from the initial recurrence to disease-related death or the last observation.</p><p><strong>Results: </strong>Among the patients, 109 had oligometastasis, most commonly in the lymph nodes (N = 84), followed by the lung (N = 8) and liver (N = 7). The DSS rate in patients with oligometastasis (5-year DSS: 37.5%) was significantly higher than that in patients with multiple metastases (3.3%) (P < 0.001). Metastatic lesions are more likely to be oligometastatic when a disease-free interval (DFI) is prolonged. In the oligometastasis cohort, surgery or CRT was associated with significantly improved survival outcomes, particularly among patients with a DFI of less than 9 months. The selection of treatment modalities was significantly influenced by the patient's performance status (PS), with better PS being associated with a greater likelihood of receiving surgery or CRT.</p><p><strong>Conclusion: </strong>Aggressive local treatment should be considered for oligometastasis after esophagectomy to improve long-term survival. A good PS after esophagectomy is crucial for the effective treatment of oligometastatic lesions.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973763","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":"Risk factors for upper extremity deep vein thrombosis after esophagectomy for esophageal cancer in retrosternal reconstruction.","authors":"Yusuke Ogawa, Yu Ohkura, Masaki Ueno, Kentoku Fujisawa, Hayato Shimoyama, Shusuke Haruta, Harushi Udagawa","doi":"10.1007/s10388-025-01122-x","DOIUrl":"https://doi.org/10.1007/s10388-025-01122-x","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity deep vein thrombosis (UEDVT) is a fatal postoperative complication that can cause pulmonary embolism (PE). There have been few reports on the relationship between esophageal cancer and UEDVT. The aim of this study is to analyze the risk factors for UEDVT in esophageal cancer.</p><p><strong>Methods: </strong>Seventy-five cases of thoracic esophageal cancer who underwent one-stage curative resection and reconstructive surgery from May 2019 to June 2022 were included. The stomach or ileocolon was selected as the reconstructive graft. All cases requiring chemotherapy were treated with a peripheral central venous catheter (PICC). To evaluate the width of the retrosternal space, the retrosternal ratio and the cross-sectional area of the graft intestine were measured at the level of the left brachiocephalic vein.</p><p><strong>Results: </strong>UEDVT was observed in 11 patients (14.7%) and occurred only with gastric tube reconstruction (p = 0.02). The width of the retrosternal space was significantly different between the UEDVT and non-UEDVT groups (p = 0.002). The cross-sectional area of reconstructive organ was larger in the stomach than in the ileocolon (p < 0.01). Patients with a history of PICC insertion from the left side had a higher incidence of UEDVT (p = 0.025).</p><p><strong>Conclusions: </strong>In esophagectomy, gastric tube reconstruction, a retrosternal ratio less than 0.16, and history of PICC insertion from the left side are risk factors for UEDVT.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987977","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":"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}