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

The distribution of involved nodes was analyzed in 110 patients with cancer of the thoracic esophagus undergoing systematic dissection of lymph nodes including cervical nodes. Nodal involvement was found in 75% of cases. The distribution pattern of involved nodes suggested that the esophagus is directly drained by various lymph nodes. Cancer metastasis was commonly found across a considerable longitudinal distance; even across two thirds of the esophagus. Longitudinal metastasis to lymph nodes along the recurrent laryngeal nerves (RLNs): upward metastasis, or the perigastric nodes: downward metastasis, was quite frequent. Especially, the right RLN nodes and cardiac nodes were involved in 40% of cases, respectively. In cases with a solitary involved node or with superficial cancer, such upward or downward metastasis was much more prominent than other metastasis. Surgical results varied with the number of positive nodes and the involved site. Cases with no or one positive node showed similar late results; significantly better than the result in other cases (p less than 0.05). Most of three year survivors with nodal involvement had only upward and/or downward metastasis. Perigastric involvement had less influence on the result than mediastinal involvement. Though the pattern of lymphatic extension in esophageal cancer is apparently quite singular, it seemed to be derived from the fact that the esophagus is directly drained by many widely distributed lymphatic channels which have different clinical meanings.
 ...
PMID:[Pattern of lymphatic spreading in cancer of the thoracic esophagus--analysis in cases undergoing cervical dissection]. 160 44

The most important results given by recent clinical studies concerning antireflux surgery are aimed at the avoidance of side effects. This seems to be achieved through the modification of the fundoplication (looser and shorter cuff). Up to now risk analysis in esophageal cancer was at the center of considerations; results were influenced by the patient's risk factors and surgical complications in the reconstruction. On the basis of such analyses, individual risk is now exactly predictable. Decisive prognostic factors are the complete extirpation of the tumors (R0-resection) and the nodal status (greater than 8 involved mediastinal lymph nodes). More attention is paid to the early detection of the malignant potency of the endobrachesophagus.
 ...
PMID:[Value of clinical and experimental results for general practice in esophageal surgery]. 179 17

Lymphoscintigraphy (LS) and computed tomography (CT) were used preoperatively to assess nodal involvement in 23 patients with esophageal cancer. LS predicted nodal involvement with a high sensitivity and low specificity since false positives were frequent while in contrast, CT predicted it with high specificity and low sensitivity. The combination of LS and CT improved sensitivity by up to 87 per cent but not specificity. The positive image of nodes in LS was associated with malignant cell involvement and/or reactive changes in the nodes, especially sinus histiocytosis and germinal center hyperplasia. When cervical nodes were involved, bilateral images of lymph flows were often lost and by using the images of lymph flow as well as those of the nodes, the combination predicted cervical nodal involvement with a sensitivity of 83 per cent and a specificity of 86 per cent. Thus, the combination of LS and CT is beneficial for preoperatively estimating cervical nodal involvement in esophageal cancer.
 ...
PMID:Preoperative assessment of cervical lymph node involvement in esophageal cancer. 205 59

Lymph node metastases in the thoraco-cervical transitional region (TCTR) and its ultrasonic detection were evaluated in 64 patients with thoracic esophageal cancer, who received radical esophagectomy with modified neck dissection. Lymph node metastases in TCTR were found in 19 of 64 cases (29.7%). Nodal metastases in the supraclavicular region were found in similar incidence of 23.4% (15 of 64 cases). Lymph nodes in both regions were infiltrated in 8 cases. Direct metastases to supraclavicular region and metastases in single region of TCTR were indicated in 4 cases equally. The degree of lymph node metastases of 11 patients suffered from middle intra-thoracic esophageal (Im) cancer with nodal involvement in TCTR were divided into three groups, two cases of n2, one of n3 and eight of n4, according to the Guide Lines. Convex type probe excelled in description of TCTR. Swollen lymph nodes were detected in 12 out of 19 cases with metastases by preoperative ultrasound using this probe (sensitivity of 63.2%). Forty-four of 45 cases without metastases were diagnosed as such (specificity of 97.8%). The partition of TCTR in the Guide Lines should be reconsidered for better evaluation of the results on lymph node metastases in this region.
 ...
PMID:[Lymph node metastases in the thoraco-cervical transitional region in thoracic esophageal cancer--with ultrasonic detection and a comment on the guide lines]. 266 29

144 cases of the superficial esophageal cancer, of which invasion was limited to the submucosa, have been resected for the last 23 years. 94 cases (65%) were early cancer, and 50 cases (35%) were superficial cancer with metastasis. The 5-year survival rate of early cancer cases was 65%, otherwise, that of superficial cancer cases with metastasis was 24%. There was a significant difference between these two groups. As for the depth of cancerous invasion, the 5-year survival rate of mucosal cancer cases was 100%. That of submucosal cancer cases was 70% even in cases without nodal involvement. Analyzing the cancerous depth of the superficial cancer and its nodal involvement and its vascular invasion, the lymph node metastasis and the vascular invasion were not observed in 90% of mucosal cancer cases, otherwise these were negative only in 30% of submucosal cancer cases. So to obtain the remarkable improvement of the long term results of esophageal cancer, the diagnosis and the treatment of mucosal cancer of the esophagus are essential. The endoscopic examination have come to play a large role for the diagnosis of mucosal cancer of the esophagus. Moreover, the endoscopic dyeing with Lugol's solution is important in the diagnosis of flat type of esophageal lesions, that is mucosal cancer and epithelial cancer. At present time, the treatment of early esophageal cancer is in principle surgery. And the operative mortality was low, 1.4%. However, the non-invasive treatments; endoscopic LASER therapy, radiation, endoscopic strip-biopsy etc., will be performed more frequently in minute mucosal cancer.
 ...
PMID:[Diagnosis and surgical treatment of early esophageal cancer]. 269 50

Correlation between nuclear DNA content of tumor cells and survival, pathologic findings, as well as family history of patients was studied using paraffin-embedded materials from 85 cases of esophageal cancer and 52 cases of colorectal cancer. Nuclei were isolated from paraffin sections by the method of Hedley et al. and stained with propidium iodide. DNA index was calculated using nuclear DNA content of lymphocyte from the same patients as the external standard. Distribution of DNA indices showed a single peak in esophageal cancer, while it was bimodal in colorectal cancers. In esophageal cancers, although there was a significant correlation between survival and depth of invasion or nodal involvement, there was a very weak correlation between survival and DNA aneuploidy. Only for advanced cases, the patients who had tumors with diploidy or low ploid aneuploidy lived significantly longer than those with high ploid aneuploidy. On the other hand, in regard to colorectal cancers, the patients who had tumors with diploidy survived significantly longer than those with aneuploidy. Furthermore, patients who showed higher degree of aneuploidy tended to have poorer prognosis. There were no correlations between DNA ploidy and histologic type, depth of invasion, nodal metastasis, stage or family history of cancer.
 ...
PMID:[Flow cytometric analysis of DNA ploidy in esophageal and colorectal cancers--in relation to prognosis, pathologic findings, or family history of cancer]. 281 39

Most complementary investigations assessing the resectability of esophageal carcinoma are not very accurate. In approximately half of the patients who undergo surgery, the surgeon discovers unknown growth extension of the tumor. The aim of this study was to define the place of CT scan in the assessment of esophageal cancer. A prospective study concerning 54 cases of squamous cell carcinoma was conducted during 18 months. We consecutively tested the sensitivity and the specificity of information supplied by a CGR 10000 CT scan. The reading was done by the same radiologist who was unaware of the other preoperative findings. All cases of carcinoma were proved histologically. The characteristics of the tumor itself were accurately described by CT scan. Tracheobronchial spread was correctly assessed in 96.2 p. 100 of cases; specificity was 100 p. 100. On the contrary, the sensitivity of the nodal involvement was weak (less than 55 p. 100) for the abdominal as well as the mediastinal areas. Moreover, CT scan identified 48 out of 49 patients without metastases. The results of this study did not allow to determine the value of signs of tumoral spread to the aorta, pericardium, and intra-abdominal regions and therefore CT scan can not be used to determine invasion of the pleural or peritoneal serosa. These results suggest that: a) CT scan alone is not sufficient in the assessment of patients for surgery, b) CT scan facilitates the choice of operative strategy, c) oncologic classification of non operative carcinoma, correct fields of radiation therapy, and follow-up of malignancy through chemotherapy are improved.
 ...
PMID:[Value of x-ray computed tomography in cancer of the esophagus. Prospective and blind study]. 335 Feb 46

"Blunt" transhiatal esophagectomy was performed in 23 selected patients. Nineteen had squamous carcinoma of the esophagus (upper third, 1; middle third, 12; distal third, 6), and 2 had adenocarcinoma of the distal esophagus. The other 2 patients had severe lye strictures. Resection with reconstruction was performed in one stage. Esophagogastric continuity was restored using the stomach in the posterior mediastinal position in 20 patients and in the substernal position in 2. The colon in the posterior mediastinal position was used in 1 patient with a lye stricture. Transmural tumor extension or cervical or celiac nodal metastases or both were present in 18 of 21 patients with carcinoma. There was 1 hospital death due to pericardial tamponade. Morbidity included a transient cervical anastomotic leak in 3 patients, one temporary and three permanent unilateral recurrent laryngeal nerve palsies, one intraoperative splenic injury, and severe hemorrhage requiring sternotomy for control in 1 patient. Pulmonary complications occurred in 4 patients: aspiration pneumonia (1) and moderate atelectasis (3). Three patients have died (11, 12, and 17 months postoperatively) in the group with cancer, with follow-up time of 3 to 30 months (mean, 15 months). Transhiatal blunt esophagectomy is a safe and effective procedure in many patients with either esophageal cancer or extensive, benign esophageal strictures.
 ...
PMID:Transhiatal (blunt) esophagectomy for malignant and benign esophageal disease: clinical experience and technique. 405 15

Twenty-seven patients with squamous esophageal cancer underwent small volume, low-dose, concentrated radiotherapy followed by esophageal resection whenever possible (esophagectomy for tumors of the thoracic esophagus and esophagogastrectomy for tumors of the lower esophagus). Curative resectability was 70% (19/27) with 4 operative deaths (21%). Recurrence rate was 66% after a mean period of 16 months, and the failure pathway was nodal in 53% of the cases. Historical comparison of the data suggests that preoperative irradiation increases the curative resectability rate without changing the early recurrence rate or failure pathway. Tumors with deeper invasion of the esophageal wall, which benefit by preoperative irradiation, are probably related to greater nodal diffusion, which is partly outside of the volume that may be resected or irradiated.
 ...
PMID:Preoperative irradiation and surgery for esophageal cancer: causes of failure. 676 86

To formulate a rational approach for the surgical treatment of patients with superficial esophageal cancer (SEC), tumor spread was clinicopathologically studied in 89 patients with SEC. There were 31 mucosal and 58 submucosal tumors. Lymph node metastases were not found in any of those with a mucosal tumor, while one or more lymph nodes were positive for cancer in 41.4% of those with a submucosal tumor. Furthermore, cancer metastasized to extramediastinal nodes, including cervical and abdominal nodes, in 14 patients, accounting for 58.3% of those with nodal metastasis. The 5-year survival rate was 100% and there were no recurrences after esophagectomy in those with a mucosal tumor, whereas the survival rate of those with a submucosal tumor was 64.3% at 5 years (p < 0.01). Based on the different biological behavior of mucosal and submucosal esophageal cancer, we conclude that mucosal tumors may be adequately treated by any type of local resection but submucosal tumors require a subtotal esophagectomy with systematic lymphadenectomy involving the cervical, mediastinal, and abdominal nodes for cure.
 ...
PMID:Tumor spread in superficial esophageal cancer: histopathologic basis for rational surgical treatment. 810 15


1 2 3 4 5 6 7 8 9 10 Next >>