Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0546837 (esophageal cancer)
 8,907 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Protein-calorie malnutrition is frequently diagnosed in patients with serious digestive conditions displaying obstructive symptoms, notably in esophageal cancer. In the present study a homogeneous group of subjects affected by esophageal cancer and candidates for elective surgery was randomly treated by one of the following oral supplements: arginine (group I), glutamine (group II), or mixed commercial amino acids (Group III-controls). The methods included nutritional measurements (biochemical and anthropometric assement), immunologic survey (skin tests), and general clinical and surgical findings, with emphasis on surgical morbidity. Body weight remained stable throughout the study, whereas serum albumin, total lymphocytes and skin tests tended to improve in all groups, with statistical confirmation for albumin in arginine-treated cases (group II). Post-operative hospitalization was numerically shorter during glutamine supplementation, and this trend was statistically significant when total morbidity was compared between the groups. It is concluded that: 1) Malnutrition and anergy were a major problem in this population, with equally severe post-operative morbidity; 2) Administration of arginine enabled serum albumin levels to improve; 3) Glutamine-treated subjects displayed reduced post-operative morbidity; 4) No side effects could be attributed to the therapy here employed.
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PMID:[Comparative study of arginine and glutamine supplements in malnourished surgical patients]. 857 93

Malnutrition is frequently associated with esophageal cancer. To maintain and improve nutrition during the stress of esophagectomy early postoperative enteral feeding was used in surgical patients. Minor complications such as jejunal tube dislodgment, metabolic derangements, and feeding-related gastrointestinal complications occurred, all of which were easily corrected. Nutritional status was maintained or improved in most patients and the actual cost compared to a calculated cost of an equinitrogenous, equicaloric parenteral solution was much less.
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PMID:Enteral feeding in esophageal surgery. 879 25

Authors have performed 266 one-stage resections and 6 reversed two-stage operations for the treatment of esophageal cancer during a 10-year-period. In six cases first a substernal bypass with colon or stomach was carried out while the tumourous esophagus was removed only 3-4 weeks later from a right thoracic approach. All six patients recovered. The reverse two-stage operation for esophageal cancer can be suggested with rare indications (pulmonary abscess, previous abdominal operations, severe malnutrition, etc.) and it is only justified when the advantage gained by increased operability and decreased morbidity and/or mortality is higher than the disadvantage ensuing from oncological, financial and patient demanding considerations.
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PMID:Reverse two-stage procedure in the surgical treatment of esophageal cancer. 1019 10

BACKGROUND: Malnutrition is common in patients with esophageal and esophagogastric cancer. Compared to patients with other digestive and extradigestive neoplasia, the highest incidence (78.9%) was found in those with esophageal cancer. Malnutrition is associated with postoperative complications, increased morbidity, and prolonged hospital stays. METHODS: The authors review the impact and causes of malnutrition in esophageal cancer patients and present strategies that can be used to preserve or restore the nutritional status in this patient population throughout treatment. RESULTS: Patients usually are unable to sustain weight on oral intake alone and require additional means of nutritional support. Several methods can be used to provide nutritional care to the esophageal cancer patient, such as diet modification, oral supplementation, and enteral or parenteral nutrition. The enteral route is preferred due to preservation of gut integrity, reduced risk of complications, and less expense. In terminally ill patients, minimal nutritional intervention may be all that is needed to achieve patient comfort. CONCLUSIONS: In order to improve clinical outcomes and the quality of life for patients with esophageal and esophagogastric cancers, the extent of malnutrition must be identified and treated.
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PMID:Nutritional Management of Patients With Esophageal and Esophagogastric Junction Cancer. 1075 36

The purpose of this study was to investigate the possible contribution of different dietary nutrients in the development of esophageal cancer (EC) in the Caspian littoral of Iran. Forty-one cases and 145 members of their households were matched for age and gender with 40 non-blood-relative controls and 130 members of their households for their nutrient intake. A standard 24-hour dietary recall questionnaire was used to estimate the daily intake of energy, protein, P, Fe, Na, K, vitamins C and A, thiamin, riboflavin, and niacin. Dietary nutrient deficiency was defined as less than 75% of the World Health Organization human nutritional requirements, except for P, Na, and K, for which the United States Recommended Dietary Allowances were followed. The results indicate the following: (1) The mean daily intake of all nutrients, except for riboflavin, was significantly lower in cases than in control subjects (P < .05); (2) with the exception of protein, riboflavin, and phosphorus, significant correlation was observed between the pattern of nutrient intake and health status of the study subjects (P < .05); and (3) dietary deficiency of niacin and phosphorus was associated significantly with the risk of EC development among case and control households (P < .01-.001), indicating that persons living in case households with dietary deficiencies of these nutrients have more than twice the risk of developing EC tumors than those living in control households. In conclusion, apparently some nutrients, such as P and niacin, may play a role in the etiology of esophageal cancer, and the status of these nutrients may be used eventually as an epidemiologic predictive marker for EC in the Caspian littoral of Iran and perhaps other regions.
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PMID:Nutrient intake and esophageal cancer in the Caspian littoral of Iran: a case-control study. 1097 93

Epidemiological studies have shown that an increased risk of esophageal cancer is associated with the chronic consumption of alcoholic beverages, although alcohol itself is not a carcinogen in animal models. Reactive oxygen species produced by the metabolism of ethanol or by chronic inflammation may play an important role in the carcinogenic process. In this study, we analyzed one type of oxidative DNA damage, 8-hydroxyguanine (8-OH-Gua), and its repair activity in the esophagus as indicators of cellular oxidative stress in rats given long-term ethanol and an autoclaved diet (nutrition-deficient diet). Three-week-old male Sprague-Dawley rats were fed an ethanol beverage whose concentration was increased from 12 to 70% over 20 weeks. When the concentration reached 50%, the diet of one group was changed from the regular diet to an autoclaved diet. At the feeding periods of 20, 25, 30, and 35 weeks, the rats were sacrificed and the 8-OH-Gua levels and repair activities within the esophagi were measured. After 30 weeks of ethanol- and autoclaved diet-feeding, significant increases of 8-OH-Gua and its repair activity were observed in the esophagi, but not in those of the ethanol- and normal diet-fed rats. This result indicates that the combined effects of long-term ethanol consumption and nutritional deficiency may be involved in inducing oxidative stress in the rat esophagus.
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PMID:Increase in 8-hydroxyguanine and its repair activity in the esophagi of rats given long-term ethanol and nutrition-deficient diet. 1105 Apr 66

Esophageal cancer remains one of the leading causes of cancer death worldwide. Patients generally present with progressive dysphagia, malnutrition, and weight loss. The diagnosis commonly involves radiologic studies and conventional esophagogastroduodenoscopy. Advances in endoscopic evaluation have allowed early detection of premalignant and malignant lesions. These techniques include chromoscopy, which can be performed in conjunction with high-resolution/magnification endoscopy, and fluorescent endoscopy. Such techniques as endoscopic ultrasound with dedicated echoendoscopes or high-frequency probes, positron emission tomography, optical coherence tomography, endoscopic magnetic resonance imaging, and tactile sensing may complement conventional imaging by CT to enhance staging accuracy. Because the majority of patients present with incurable disease at the time of diagnosis, nonsurgical approaches to their management have evolved. These include endoscopic mucosal resection, stenting, tumor ablation, and palliative chemoradiotherapy. The ablative techniques include argon plasma coagulator therapy, laser, and photodynamic therapy. For patients with early malignancies of the esophagus who are not surgical candidates, such techniques may be used with curative intent.
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PMID:Nonsurgical approaches to esophageal malignancy. 1273 43

The malnourished cancer patients are at a higher risk of morbidity and mortality, when undergoing major surgical treatments. In comparison with patients affected with other cancers, the highest occurrence of malnutrition (78.9%) was found in those with esophageal cancer and is related with post-operative complications. The Authors review the impact of peri-operative nutritional support on outcomes in esophageal cancer patients undergoing surgery, and produce strategies that can be used to preserve or restore the nutritional condition in patients throughout treatment. Several methods may be used to provide nutritional care, such as oral supplementation, and enteral or parenteral nutrition. The enteral option is to be preferred, due to preservation of intestinal integrity, reduced risk of complications, and lesser expenses. The prevention or correction of nutrient depletion in several malnourished esophageal cancer patients remarkably reduce or eliminate malnutrition-related morbidity and mortality, therefore the level of malnutrition must be identified and treated.
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PMID:[Treatment of the esophageal cancer: the impact of peri-operative parenteral nutrition]. 1672 93

The incidence of esophageal cancer has increased dramatically in the Western population in the last two decades. Many of these patients tend to present late in the disease course with symptoms of dysphagia and malnutrition. Thus a majority of patients at presentation may require palliation of their symptoms. Lung cancer is the most common cause of cancer related mortality in the United States. Similar to esophageal cancer, many patients present in advanced stages where surgical resection for cure may not be an option. Endobronchial obstruction from both primary and metastatic neoplasm causes significant morbidity. The modalities, which are currently available for palliation of symptoms include surgery, photodynamic therapy, dilation, external beam radiation, stents, Nd:YAG laser therapy, and brachytherapy. Each of these modalities has their specific advantages and drawbacks. In this article, we discuss the role of photodynamic therapy in the palliation of esophageal and lung cancer.
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PMID:Role of photodynamic therapy in unresectable esophageal and lung cancer. 1678 24

Esophagectomy for carcinoma of the esophagus is associated with significant mortality and morbidity. Patients with esophageal cancer have frequently obstruction with dysphagia and they often develop malnutrition. In addition, patients can suffer from chronic aspiration leading to a poor preoperative respiratory status. Thorough preoperative evaluation is essential for assessing the operative risk in the individual patient. Respiratory and cardiac problems are the most common complications and assessment of surgical risk, preoperative performance status, particularly with regard to pulmonary and cardiac risk, is likely to be the most important factor. Clinical findings are more predictive of pulmonary complications than results of testing. Cardiac risk is evaluated according to the American College of Cardiology (ACC)/American Heart Association guidelines. With the identification of risk factors, patients undergoing esophageal surgery could be stratified. Appropriate preoperative risk-reduction strategies can be used to decrease morbidity and mortality rates associated with esophagectomy for cancer.
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PMID:Preoperative anesthetic evaluation and preparation in patients requiring esophageal surgery for cancer. 1679 11


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