Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007097 (carcinoma)
 152,788 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Esophageal carcinoma models were created by transplanting VX2 cells to rabbit esophagus endoscopically. By injecting finely divided activated charcoal into normal rabbit esophagus and tumor sites of esophageal carcinoma model, lymph flow was observed directly. Existence of lymph node metastasis was studied in detailed pathology. In 30 rabbits with upper esophageal carcinoma, lymph node metastasis was seen in 77%. Metastasis to bilateral intrathoracic paratracheal lymph node was seen in 50%, and also concentration of lymphatic flows from tumor site was seen. However, there were no metastasis and no lymph flow to abdominal lymph nodes. While, metastasis to cervical lymph nodes showed around 13%. Esophageal lymphatic flows were also seen reaching the cervical area along the esophagus. In 40 models with mid lower esophageal carcinoma, lymph node metastasis were seen in 88%. Metastasis to right and left thoracic paratracheal lymph nodes was 75% and 53%, respectively, and 25% of metastasis went to cardia lymph nodes. The lymph flows were going up and down around these lymph nodes, and reaching to lymph nodes at upper highest mediastinum or left gastric artery. The metastatic rate to the cervical lymph nodes was about 5%. There were no significant differences in lymphatic metastasis between right and left mediastinum. These findings suggest the necessity of radical dissection for both sides of the mediastinum.
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PMID:[Experimental study of lymph node metastasis in thoracic esophageal carcinoma--regarding lymph node metastasis and changes in lymphatic flow by ultrafine charcoal in rabbit esophageal carcinoma model]. 161 91

Early detection of a malignancy in reflux esophagitis should permit an effective surgical action if a causal time relation between reflux, esophagitis and carcinoma exists. In the medical literature on tumors of the esophagus associated with reflux esophagitis, it has been reported that they are adenocarcinomas in most instances. Squamous carcinomas are seldom mentioned. In a population of patients with five squamous carcinomas and 13 adenocarcinomas associated with reflux, three squamous carcinomas had developed on stage III or on a stenotic esophagitis and two squamous carcinomas were at the upper limit of a Barrett's esophagus. The 13 adenocarcinomas were associated with a Barrett's esophagus. No carcinoma was found to be associated with a low grade esophagitis. During the same time period, 224 patients were operated upon for a serious documented esophagitis (stage III, stenotic, Barrett's esophagus), including the 18 patients with carcinoma. Five hundred and thirty-four patients were operated upon for a lower grade esophagitis, with no associated carcinoma and 592 patients were operated upon for carcinoma of the esophagus. The five squamous carcinomas associated with reflux were resected and classified T1 N0. The 13 adenocarcinomas associated with reflux were resected and classified T1 N0 M0 (two patients), T2 N0 M0 (two), T3 N0 M0 (five), T3 N1 M0 (one patient), T3 N2 M0 (one) and T3 N3 M0 (two patients). Four patients with squamous carcinomas were alive after two, six, nine and 15 years. Eight patients with adenocarcinomas were alive after two years (one patient), three years (two patients), four years (three), five years (one patient) and seven years (one). Three carcinomas were diagnosed by routine endoscopy. The mean age of the patients with carcinoma associated with reflux was older than in the general carcinoma series, the relative number of females was higher and the use of alcohol and tobacco was not as frequent, but the differences were not significant. In squamous and columnar carcinomas, a long history was significant (p less than 0.001); in Barrett's esophagus, loss of weight (p less than 0.01), intestinal epithelium (p less than 0.001) and dysplasia (p less than 0.01) were also significant. In one patient, carcinoma was discovered during the follow-up evaluation of an antireflux procedure for Barrett's esophagus.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Reflux esophagitis and carcinoma. 163 35

During the period 1971 and 1990, 500 patients underwent resection for carcinoma of the esophagus, 51 of whom had an associated Barrett's esophagus. Of these, 49 had adenocarcinoma and two had squamous cell carcinoma. Barrett's carcinoma accounted for 23.7 percent of the surgically treated adenocarcinomas during this period. Reflux symptoms were present in 13 patients preoperatively. Tumors developed in four patients who had undergone previous antireflux operation and in two patients on the surveillance program. By postresection staging, 18 patients had stage II tumors and 33 patients had stages III and IV tumors. Stage and length of the tumor were the only prognostic determinants. The overall 90 day hospital mortality rate was 17.6 percent. The hospital mortality rate before 1986 was 22.9 percent, but decreased to 6.3 percent in the last five years. The one, two and five year survival rates were 45.9, 25.0 and 13.6 percent, respectively. The five year survival rate was significantly greater for patients with stage II (25 percent) than for patients with stages III and IV (4.5 percent) (p less than 0.05) and for tumor length less than 6 centimeters (21 percent) than for tumors greater than 6 centimeters (zero percent; p less than 0.001).
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PMID:Carcinoma arising in Barrett's esophagus. 163 41

The gastric bypass of the excluded esophagus in the palliative treatment of carcinoma of the esophagus carries a considerable mortality. One of the most significant events that contributes to this mortality is the disruption of the distal closure of the excluded esophagus. In order to avoid this, a distal-end esophagostomy accompanying the gastric bypass procedure was created in six patients with advanced carcinoma of the upper and middle third of the esophagus. This distal esophagostomy is carried out by extrapleural dissection and is developed to the back, at the level of the eighth rib, just lateral and adjacent to the spinal muscles. Operative survival of all these sick patients proves this to be a safe operation that avoids the fatal complication described.
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PMID:Distal-end esophagostomy of the excluded esophagus in the palliation of upper and mid-esophageal carcinoma. 168 57

Transhiatal blunt esophagectomy has been reported as a safe and effective procedure for the palliation of carcinoma of the esophagus. Avoidance of a thoracotomy eliminates the morbidity associated with this procedure, and creation of a cervical esophagogastric anastomosis avoids the catastrophic sequelae of an intrathoracic anastomotic leak. Moreover, use of the procedure for palliation does not preclude excellent 1-year survival rates. We report early results in five consecutive patients with esophageal carcinoma who underwent transhiatal blunt esophagectomy. Five patients had 22 complications, including one with a fascial dehiscence, pyloroplasty leak, and localized mediastinal abscess requiring a second laparotomy. One patient died in the hospital postoperatively of massive aspiration pneumonitis. Our results compare favorably with those reported in the literature. We believe that transhiatal blunt esophagectomy avoids the morbidity and mortality of a thoracotomy and an intrathoracic anastomosis, yet remains a major gastrointestinal operative procedure with all of its attendant risks.
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PMID:Transhiatal blunt esophagectomy for carcinoma of the esophagus. 169 Jan 92

One hundred forty patients with carcinoma of the esophagus treated over a 12-year period at Queens Hospital Center were reviewed. Comparable numbers of patients were assigned at random to radiation therapy alone, surgical treatment with radiation, or treatment with combinations of radiation and chemotherapy pre- or postoperatively. Surgical mortality (survival 1 month or less) was 9 patients of 34, or approximately 26%. Mean survival including the early deaths was 7.5 months. Deaths were primarily due to respiratory tract complications, either alone or in combination, with three cases of anastomotic leaks, sepsis, inanition, and progressing carcinoma. Fifty-two patients received radiation therapy alone. Although there were only six deaths (10%) within the first month of treatment, average survival was 8.4 months, only marginally greater than those treated by surgery. Of 13 patients treated with combined radiation and chemotherapy, no deaths occurred within the first month of treatment, but the average survival was only 6.5 months. Of nine patients treated with chemotherapy alone, no deaths occurred within the first month of treatment, but mean survival of this small group was only 4.9 months. Efficacy of chemotherapy and radiation therapy as definitive, adjuvant, or palliative therapy, in spite of recent somewhat optimistic reports, remains to be proven. Exploratory surgery should be retained as an essential staging and therapeutic modality in those patients in whom definite evidence establishing inoperability is lacking; ie, tumor fixation to vital structures, distant metastases, and other medical contraindications to surgery. Endoscopic instrumentation with the yttrium aluminum garnet laser appears to have a future as preliminary to surgery or definitive (palliative) management of obstructing esophageal carcinoma.
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PMID:Carcinoma of the esophagus seen in a 12-year period at Queens Hospital Center. 169 95

Surgical treatment of esophageal cancer is largely palliative. To clarify the indication it is necessary to assess the effectiveness of the palliation in relief of dysphagia and the operative risks. In a retrospective study we analyzed the perioperative morbidity and follow-up in 25 patients with carcinoma of the esophagus treated between 1984 and 1988 (5 years). With combined anesthesia, early extubation and intensive pulmonary therapy, no perioperative respiratory insufficiency was observed. Perioperative mortality was 0%. An anastomotic leak in 2 patients with a cervical anastomosis was healed in both cases by conservative management. On hospital discharge all patients were able to eat normally. 13 patients died after 1 year on average (4 months to 3 years). 12 patients are alive 6 months to 4 years after operation, 10 of them without symptoms. Our results show that with optimal perioperative management of esophageal carcinoma low morbidity is possible and good palliation of dysphagia is feasible.
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PMID:[Surgery in esophageal carcinoma: risks and results]. 169 22

A case of primary carcinoma of the esophagus is presented that consisted of poorly differentiated small-cell carcinoma. The patient underwent endoscopic treatment, first with an Nd:YAG laser and, finally, with bougienage and the insertion of a prosthesis in order to relieve dysphagia and improve the nutritional status and quality of life. Even though it is generally uncommon for laser therapy to be chosen as a primary mode of treatment, the results obtained should permit to overcome this lack of confidence in the choice of laser treatment for small-cell carcinoma of the esophagus.
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PMID:Small-cell carcinoma of the esophagus. Treatment by endoscopy. 169 67

In a group of 245 cases of primary carcinoma of the esophagus the authors found three cases of adenoid cystic carcinoma (ACC). Clinical and pathologic data of those patients (one female and two male; age range, 49-74 years) were analyzed. Tumors were localized in the middle third of the esophagus. One patient lived 15 months after surgery. Another is a case of early ACC who has been living 4.5 years after surgery and is without specific symptoms. The third patient had not had surgery and died 13 months after the onset of dysphagia. An autopsy showed only a locally invasive tumor growing into the surroundings of the esophagus, and regional lymph node metastases without distant parenchymal metastases. These findings support pathologic and biologic similarities between ACC of the esophagus and ACC of the salivary glands. There are synchronous tumors of the esophagus and the vital localization which makes the prognosis of ACC of the esophagus worse than ACC of the salivary glands.
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PMID:Adenoid cystic carcinoma of the esophagus. A clinicopathologic study of three cases. 170 15

Although endoscopic laser therapy is effective for symptom palliation in esophageal cancer, few studies have investigated its effect on survival. We previously reported a 300% improvement in survival in 10 patients with squamous-cell carcinoma of the esophagus after endoscopic Nd:YAG laser energy. We now report a study to determine if the survival advantage persisted after treating an additional 26 patients. Thirty-six patients with squamous-cell carcinoma of the esophagus treated with endoscopic laser therapy were compared to 20 controls identified by our hospital Tumor Registry. There was no difference between the groups with respect to age, sex, race, location of tumor, or clinical stage. More control patients (25%) had previously undergone surgery than laser patients (0%) (p less than 0.05). Survival analysis demonstrated a significant improvement in overall survival (p less than 0.05), with an improvement in median survival from 5.7 to 9.7 months (p less than 0.05). One-year survival was 38% in laser patients, compared to 20% in control patients. Our experience continues to demonstrate that endoscopic laser therapy is effective in prolonging life as well as palliating the symptoms of patients with squamous-cell esophageal carcinoma.
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PMID:The effect of endoscopic laser therapy on survival in patients with squamous-cell carcinoma of the esophagus. Further experience. 170 55


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