Diseases of the Esophagus最新文献

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Identification of gaps in the delivery of high-quality care of patients with eosinophilic esophagitis. 找出在为嗜酸性粒细胞食管炎患者提供优质护理方面存在的差距。
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae055
Cheikh Njie, Courtney Richman, Jeffrey Rebhun, Sudharshan Achalu, Afrin N Kamal, Fouad Otaki, David A Leiman, Priya Kathpalia
{"title":"Identification of gaps in the delivery of high-quality care of patients with eosinophilic esophagitis.","authors":"Cheikh Njie, Courtney Richman, Jeffrey Rebhun, Sudharshan Achalu, Afrin N Kamal, Fouad Otaki, David A Leiman, Priya Kathpalia","doi":"10.1093/dote/doae055","DOIUrl":"10.1093/dote/doae055","url":null,"abstract":"<p><p>Quality indicators (QIs) are standardized metrics that can be used to quantify health care delivery and identify important areas for practice improvement. Nine QIs pertaining to the diagnosis and management of eosinophilic esophagitis (EoE) were recently established. We therefore aimed to identify existing gaps in care using these QIs. This is a retrospective, multicenter study utilizing recently established EoE QIs to evaluate practice patterns among adult gastroenterologists in the diagnosis and management of EoE. Three patient cohorts of 30 patients each presenting with dysphagia, food impaction, and new diagnosis of EoE, respectively, were obtained, yielding 120 patients per site to assess for every QI. Summary statistics were reported across two main themes: diagnosis and management. Subsequent analysis of gaps in care was then performed. The domain of diagnosis of EoE (QI 1 and 2) had the most notable gap in care with only 55% of the presenting patients undergoing appropriate evaluation for EoE. The domain of management of EoE had overall higher QI fulfillment-however it also contained significant intra-category variation in care. Notably, while 79% of patients had clinical follow-up within 1 year from remission, only 54% underwent surveillance endoscopy within 2 years of remission. In contrast, 100% of patients with symptomatic strictures independent of histologic response underwent endoscopic dilation (QI 4). Management approaches for EoE are evolving and variation in care delivery exists. We identified significant gaps in both diagnosis of EoE especially amongst patients presenting with index food impaction and long term management of EoE, when retrospectively evaluating care patterns using newly established QIs. This is the first study of its kind to utilize these previously established QIs to objectively identify care gaps that exist in EoE amongst several institutions. These findings also highlight the importance of QIs and standardization of management of complex chronic diseases like EoE to help bridge these gaps and provide a framework to measure adherence to these best practices.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical mechanism of muscle mass loss during neoadjuvant chemotherapy in older patients with esophageal cancer: a prospective cohort study. 老年食管癌患者在新辅助化疗期间肌肉质量下降的临床机制:一项前瞻性队列研究。
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae096
Tsuyoshi Harada, Tetsuya Tsuji, Junya Ueno, Nobuko Konishi, Takumi Yanagisawa, Nanako HIjikata, Aiko Ishikawa, Kakeru Hashimoto, Hitoshi Kagaya, Noriatsu Tatematsu, Sadamoto Zenda, Daisuke Kotani, Takashi Kojima, Takeo Fujita
{"title":"Clinical mechanism of muscle mass loss during neoadjuvant chemotherapy in older patients with esophageal cancer: a prospective cohort study.","authors":"Tsuyoshi Harada, Tetsuya Tsuji, Junya Ueno, Nobuko Konishi, Takumi Yanagisawa, Nanako HIjikata, Aiko Ishikawa, Kakeru Hashimoto, Hitoshi Kagaya, Noriatsu Tatematsu, Sadamoto Zenda, Daisuke Kotani, Takashi Kojima, Takeo Fujita","doi":"10.1093/dote/doae096","DOIUrl":"10.1093/dote/doae096","url":null,"abstract":"<p><p>In older patients with locally advanced esophageal cancer (LAEC), loss of skeletal muscle mass during neoadjuvant chemotherapy (NAC) is associated with poor clinical outcomes. This study aimed to investigate factors associated with loss of skeletal muscle mass during NAC in older patients with LAEC. This was a single-center exploratory prospective cohort study. Consecutive patients aged ≥65 years with LAEC scheduled for curative esophagectomy after NAC were enrolled between October 2021 and December 2023. As a primary endpoint, loss of skeletal muscle mass index (ΔSMI: pre-NAC minus post-NAC value) was calculated from computed tomography images before and after NAC. Significant pre-NAC and during-NAC factors with ΔSMI were detected with a multivariate regression model. Statistical significance was considered as two-tailed P <0.05. A total of 69 patients were analyzed. The mean age was 72.9 years, and 53 (77%) were male. Mean SMI before and after NAC was 43.1 and 40.9 cm2/m2, and mean ΔSMI was 2.2 cm2/m2. In multivariate analysis, ΔSMI was associated with increased sitting time during NAC (per 1 min/day, adjusted coefficient 0.007, 95% confidence interval [CI] 0.001 to 0.013, P = 0.016), decreased Geriatric Nutritional Risk Index during NAC (per 1 score, adjusted coefficient -0.146, 95% CI -0.213 to -0.013, P = 0.002), and worsening decreased appetite during NAC (vs. no worsening, adjusted coefficient 1.571, 95% CI 0.279 to 2.862, P = 0.018). It was hypothesized that the inactivity-related mechanism and malnutrition-related mechanism are important for skeletal muscle mass loss during NAC in older patients with LAEC.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Central ligation or partial preservation of the right gastric artery does not seem to affect conduit or anastomotic perfusion during robot-assisted resection of gastroesophageal junction cancer: a randomized clinical trial. 胃食管连接部癌机器人辅助切除术中,胃右动脉的中央结扎或部分保留似乎不会影响导管或吻合口的灌注:一项随机临床试验。
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae102
Jens Thomas Fredrik Osterkamp, Nikolaj Nerup, Morten Bo S Svendsen, Rune B Strandby, Lars Bo Svendsen, Eske K Aasvang, Henrik Vad, Astrid Plamboeck, Michael P Achiam
{"title":"Central ligation or partial preservation of the right gastric artery does not seem to affect conduit or anastomotic perfusion during robot-assisted resection of gastroesophageal junction cancer: a randomized clinical trial.","authors":"Jens Thomas Fredrik Osterkamp, Nikolaj Nerup, Morten Bo S Svendsen, Rune B Strandby, Lars Bo Svendsen, Eske K Aasvang, Henrik Vad, Astrid Plamboeck, Michael P Achiam","doi":"10.1093/dote/doae102","DOIUrl":"10.1093/dote/doae102","url":null,"abstract":"<p><p>The gastric conduit can be created with partial preservation or a central ligation of the right gastric artery. Central ligation may facilitate complete removal of lymph node (LN) station 3; however, whether this influences conduit and anastomotic perfusion is unknown. Hence this study investigated whether a central ligation of the right gastric artery would affect conduit or anastomotic perfusion compared with partial preservation (local standard) during robot-assisted resection of gastroesophageal junction cancer. Patients scheduled for robot-assisted resection of gastroesophageal junction cancer were randomized to either central ligation or partial preservation of the right gastric artery. Perfusion was assessed using quantified indocyanine green angiography: before gastric mobilization, after conduit formation, and after anastomosis. Hemodynamic variables during surgery and surgical outcomes were recorded. We included 70 patients between June 2020 and October 2021, of whom 5 were excluded from the final analysis. The two patient groups did not differ in conduit (0.07 [interquartile range (IQR), 0.05-0.08] vs. 0.07 u [IQR, 0.05-0.08], P = 0.86) or anastomotic perfusion (0.08 [standard deviation (SD), ±0.02] vs. 0.08 u [SD, ±0.02], P = 0.21), nor did they differ in intraoperative blood loss, anastomotic leaks, postoperative complications, or 1-year survival. However, more LNs were resected in the central ligation group (36 [IQR, 30-44] vs. 28 [IQR, 23-43], P = 0.02). Introducing a central ligation of the right gastric artery did not seem to affect conduit or anastomotic perfusion, compared with partial preservation. However, significantly more LNs were resected.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of intraoperative recurrent laryngeal nerve monitoring on minimally invasive esophagectomy outcomes for esophageal cancer: a meta-analysis of case-control studies. 术中喉返神经监测对食管癌微创食管切除术预后的影响:病例对照研究的荟萃分析
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae116
Rayner Peyser Cardoso, Lokesh Agarwal, Swizel Ann Cardoso, Ayushi Agarwal, Vaibhav Varshney, Subhash Soni, B Selvakumar, Peeyush Varshney
{"title":"Impact of intraoperative recurrent laryngeal nerve monitoring on minimally invasive esophagectomy outcomes for esophageal cancer: a meta-analysis of case-control studies.","authors":"Rayner Peyser Cardoso, Lokesh Agarwal, Swizel Ann Cardoso, Ayushi Agarwal, Vaibhav Varshney, Subhash Soni, B Selvakumar, Peeyush Varshney","doi":"10.1093/dote/doae116","DOIUrl":"10.1093/dote/doae116","url":null,"abstract":"<p><p>Esophagectomy and lymphadenectomy for esophageal cancer carry an inherent risk of recurrent laryngeal nerve (RLN) injury. Intraoperative nerve monitoring (IONM) may help prevent RLN damage, though evidence on its effectiveness is still limited. This systematic review and meta-analysis (SRMA) evaluate the feasibility and efficacy of IONM during minimally invasive esophagectomy (MIE) for esophageal cancer. This SRMA followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines, with a registered protocol on PROSPERO (CRD42022367916). Two independent authors conducted a comprehensive literature search across multiple databases, screening studies on MIE for esophageal cancer using IONM. Case-control studies were included, focusing on the RLN palsy (RLNP) rate as the primary outcome. A total of 11 studies involving 1907 patients (IONM group: 752 patients; non-IONM group: 1155 patients) were included in the SRMA. IONM significantly reduced the incidence of RLNP (OR = 0.47, P < 0.001). Length of hospital stay (LOHS) and lower respiratory tract infection (LRTI) rates were significantly reduced with IONM use. No significant differences were observed in anastomotic leak, chylothorax, total number of lymph nodes dissected, operation time, aspiration rates, or intraoperative blood loss. The pooled sensitivity and specificity of IONM for detecting RLN injury were 83.3% and 81%, respectively. IONM during MIE significantly reduces the incidence of RLNP, postoperative LRTI, and shortens the LOHS, without adding operative risks. Further research is needed to evaluate its long-term survival benefits and cost-effectiveness.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of benralizumab on histopathology and inflammatory signatures in a clinical cohort of eosinophilic esophagitis. 苯拉利珠单抗对嗜酸性粒细胞食管炎临床队列中组织病理学和炎症特征的影响
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doae031
Ashley L Pyne, Amiko M Uchida, Mark W Hazel, Chris J Stubben, Joy W Chang, Dominique D Bailey, Nirmala Gonsalves, Kristina Allen-Brady, Kathryn A Peterson, Maria A Pletneva
{"title":"Effect of benralizumab on histopathology and inflammatory signatures in a clinical cohort of eosinophilic esophagitis.","authors":"Ashley L Pyne, Amiko M Uchida, Mark W Hazel, Chris J Stubben, Joy W Chang, Dominique D Bailey, Nirmala Gonsalves, Kristina Allen-Brady, Kathryn A Peterson, Maria A Pletneva","doi":"10.1093/dote/doae031","DOIUrl":"10.1093/dote/doae031","url":null,"abstract":"<p><p>A preliminary report from the recent phase 3 trial of benralizumab, a monoclonal antibody that binds to interleukin-5 receptor alpha (IL5Rα), in patients with EoE revealed that medication use led to tissue eosinophil eradication but did not meet the clinical endpoint of symptom resolution. Here, we characterized the clinical, endoscopic, histologic, and transcriptional changes in patients with active EoE following benralizumab treatment. We retrospectively examined patients with EoE treated with benralizumab at the University of Utah (n = 11) and reviewed reported clinical symptoms, circulating and tissue eosinophilia, and endoscopic and histologic scores. Gene expression profiles from available esophageal tissue from benralizumab-treated patients were compared to those from patients with remission EoE (n = 5), active EoE (n = 10), and controls (n = 22). Benralizumab treatment resulted in partial symptom improvement and significant reduction in tissue eosinophilia, and endoscopic and histologic disease scoring (P < 0.01). Histologic score reductions were driven by eosinophil feature scores, while scores for epithelial features (basal cell hyperplasia and dilated intercellular spaces) were similar to those in active EoE. The gene signatures in benralizumab-treated patients mimicked those of active EoE (e.g. upregulation of POSTN, CDH26, CCL26, and downregulation of DSG1). RNA profiles and pathways support histologic findings of impaired epithelial function that persists despite benralizumab treatment. In conclusion, despite eosinophil eradication, patients treated with benralizumab had persistent epithelial injury at the histologic and transcriptional level. In this cohort, benralizumab therapy failed to eradicate inflammation and epithelial dysfunction showing that interleukin-5 receptor alpha blockade monotherapy is insufficient to control EoE.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survival outcomes of robot-assisted transmediastinal esophagectomy in patients with esophageal squamous cell carcinoma. 机器人辅助经纵隔食管切除术治疗食管鳞状细胞癌患者的生存结局。
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doaf007
Koichi Yagi, Susumu Aikou, Shoh Yajima, Masayuki Urabe, Yasuyohi Sato, Yasuhiro Okumura, Takashi Mitsui, Masato Nishida, Yukinori Yamagata, Hiroharu Yamashita, Sachiyo Nomura, Kazuhiko Mori, Yasuyuki Seto
{"title":"Survival outcomes of robot-assisted transmediastinal esophagectomy in patients with esophageal squamous cell carcinoma.","authors":"Koichi Yagi, Susumu Aikou, Shoh Yajima, Masayuki Urabe, Yasuyohi Sato, Yasuhiro Okumura, Takashi Mitsui, Masato Nishida, Yukinori Yamagata, Hiroharu Yamashita, Sachiyo Nomura, Kazuhiko Mori, Yasuyuki Seto","doi":"10.1093/dote/doaf007","DOIUrl":"https://doi.org/10.1093/dote/doaf007","url":null,"abstract":"<p><p>We developed a robot-assisted transmediastinal esophagectomy (RATME) to reduce the surgical invasiveness of open transthoracic esophagectomy (oTTE). However, the long-term survival outcomes of patients who undergo RATME remain unclear. Patients who underwent RATME for esophageal squamous cell carcinoma (ESCC) between January 2012 and April 2020 were enrolled. Overall survival (OS), relapse-free survival (RFS), and ESCC cause-specific survival (CSS) were analyzed according to clinical stage. Survivals were compared between patients who underwent the RATME and oTTE using propensity score matching analysis. One hundred and twenty-seven patients who underwent RATME were included in the analysis. The 3- and 5-year OS rates were 96.2 and 92.1% for cStage I RATME group, 84.8 and 82.3% for cStage II, and 61.8 and 61.8% for cStage III, respectively. The 3- and 5-year RFS rates were 94.3 and 84.3% for cStageI, 71.7 and 69.3% for cStage II, and 5 48.2 and 48.2% for cStage III, respectively. Survival analysis using 74 paired patients showed that the RATME group had better OS and RFS than the oTTE group (p = 0.0028 and p = 0.016, respectively), but equivalent CSS (p = 0.078). The OS of the RATME group stratified by clinical stage was equivalent to that of the comprehensive registry data from Japan, and showed better OS and RFS than the oTTE group, indicating that RATME radicality is guaranteed with regard to long-term survival.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Feasibility and safety of interventional radiology-guided biopsy for esophageal stenosis. 介入放射引导下食管狭窄活检的可行性和安全性。
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doaf005
Gang Zhou, Xiaolong Ding, Meng Wang, Yalin Tong, Yaozhen Ma, Meipan Yin, Chunxia Li, Gang Wu
{"title":"Feasibility and safety of interventional radiology-guided biopsy for esophageal stenosis.","authors":"Gang Zhou, Xiaolong Ding, Meng Wang, Yalin Tong, Yaozhen Ma, Meipan Yin, Chunxia Li, Gang Wu","doi":"10.1093/dote/doaf005","DOIUrl":"https://doi.org/10.1093/dote/doaf005","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic clamp biopsy is generally performed to confirm the pathological diagnosis of esophageal stenosis. However, it might be challenging in patients with severe esophageal stenosis. Hence, we aimed to investigate the feasibility and safety of interventional radiology-guided clamp biopsy under fluoroscopy for diagnosing esophageal stenosis.</p><p><strong>Methods: </strong>The clinical data of 81 patients aged 39-89 (mean age 67.4 ± 10.5) years with esophageal stenosis whose pathological tissues were obtained by interventional radiology-guided forceps biopsy at our treatment center were retrospectively analyzed; 35.8% (29/81) patients had esophageal space-occupying stenosis and 64.2% (52/81) had esophagogastric anastomotic stenosis. The detection rate of esophageal stenosis, and operation-related complications were analyzed.</p><p><strong>Results: </strong>About 75.3% (61/81) patients could not tolerate or refused endoscopic examination; the remaining 24.7% (20/81) underwent endoscopic examination, but their pathological specimens could not be obtained through the stenosis segment. The technical success rate of interventional radiology-guided clamp biopsy was 100%, and the mean duration of operation was 7.8 ± 4.2 minutes. No serious operation-related complications were observed. Histological examination showed that 35.8% (29/81) patients had malignant tumor and 64.2% (52/81) had benign tumor. Interventional radiology-guided biopsy had a better detection rate compared with gastroscopic biopsy (P < 0.001, χ2 = 64.64).</p><p><strong>Conclusion: </strong>Interventional radiology-guided clamp biopsy is a new esophageal biopsy technique that is minimally invasive, safe, and rapid, with a low rate of missed diagnosis and low requirements regarding the patients' condition. Thus, it is a complementary or auxiliary diagnostic method in cases where the traditional endoscopic approach fails.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A preliminary investigation of blood cell counts for esophageal cancer screening: differentiating esophageal cancer from gastroesophageal reflux disease. 血细胞计数在食管癌筛查中的初步研究:鉴别食管癌与胃食管反流病
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doaf025
Binrui Luo, Yang Yang, Yuanshuai Huang
{"title":"A preliminary investigation of blood cell counts for esophageal cancer screening: differentiating esophageal cancer from gastroesophageal reflux disease.","authors":"Binrui Luo, Yang Yang, Yuanshuai Huang","doi":"10.1093/dote/doaf025","DOIUrl":"https://doi.org/10.1093/dote/doaf025","url":null,"abstract":"<p><p>Esophageal Cancer (EC) ranks as the eleventh most prevalent malignancy globally and the seventh leading cause of cancer-related mortality. There is growing evidence to suggest that blood routine parameters have diagnostic and prognostic value in oncology. This study was designed to analyze whether there are any significant differences in complete blood count (CBC) parameters between patients with EC, patients with gastroesophageal reflux disease (GERD), and healthy controls (HC). We retrospectively analyzed selected blood parameters from 209 HC, 209 patients diagnosed with EC, and 198 patients suffering from GERD. We found significant differences in platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) among the EC, GERD, and HC groups. Of note, PDW and LMR exhibited significant differences specifically between the EC and GERD groups. In conclusion, the LMR holds diagnostic significance and can differentiate patients with EC from those with GERD. The integration of hematological parameters and clinical manifestations serves as a guiding principle for both medical practitioners and patients in determining the necessity for upper gastrointestinal endoscopy, thereby potentially enhancing the early detection rate of EC.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 2","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of treatment methods and survival in esophageal neuroendocrine carcinoma population of Surveillance, Epidemiology, and End Results database: a retrospective cohort study. 食道神经内分泌癌监测、流行病学和最终结果数据库中治疗方法与生存率的关系:一项回顾性队列研究。
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2025-01-07 DOI: 10.1093/dote/doaf008
T Yang, P Yang, H Li, M Sun, J Zhang, Y Li, B Zhu
{"title":"Association of treatment methods and survival in esophageal neuroendocrine carcinoma population of Surveillance, Epidemiology, and End Results database: a retrospective cohort study.","authors":"T Yang, P Yang, H Li, M Sun, J Zhang, Y Li, B Zhu","doi":"10.1093/dote/doaf008","DOIUrl":"https://doi.org/10.1093/dote/doaf008","url":null,"abstract":"<p><p>Esophageal neuroendocrine carcinoma (ENEC) is an uncommon and highly aggressive tumor with an obscure etiology. Thus, this study aimed to investigate the best treatment option for patients with ENEC. This study identified patients with ENEC from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2021. Clinicopathological characteristics were analyzed using descriptive statistics, and prognostic factors were determined through Cox regression analysis. Kaplan-Meier survival analysis was used to assess five-year overall survival (OS). Patients were divided into a combined radiotherapy and chemotherapy group and a surgery group based on treatment modality. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. A total of 604 participants were included; univariate and multivariate analyses indicated that ENEC patients with localized or regional disease had significantly higher survival rates (HR = 0.38, 95% CI 0.29-0.51, P < 0.001 and HR = 0.56, 95% CI 0.44-0.71, P < 0.001) than those with distant metastases. The combination of radiotherapy and chemotherapy (HR = 0.34, 95% CI 0.25-0.46, P < 0.001) and surgical treatment (HR = 0.43, 95% CI 0.31-0.59, P < 0.001) significantly improved survival. Kaplan-Meier analysis showed significant differences in OS among treatments (P < 0.0001), with the combination therapy and surgery groups having similar rates of 7.04% and 8.77%, respectively, and outperforming other methods. The combination therapy group maintained the best survival rate over time. The synergistic application of radiotherapy and chemotherapy has markedly enhanced the five-year survival rate of patients with ENEC, offering invaluable insights for clinical management strategies.</p>","PeriodicalId":54277,"journal":{"name":"Diseases of the Esophagus","volume":"38 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: In Memoriam Professor Dr. Jörg Rüdiger Siewert. 纠正:纪念教授博士Jörg rdiger Siewert。
IF 2.6 3区 医学
Diseases of the Esophagus Pub Date : 2024-12-21 DOI: 10.1093/dote/doae119
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