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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

At diagnosis, nearly 50% of patients with carcinoma of the esophagus have a metastatic disease. Less than 60% of patients with locoregional disease can undergo a curative resection. Surgical principles include a wide resection of the primary tumor, including resection margins of 5 cm or more, plus regional lymphadenectomy. Radiotherapy alone can be considered for palliation in patients with locoregional disease who are medically unsuitable for surgery and in patients with contraindication for chemotherapy. The median length of survival is approximately 12 months. Effectiveness of chemoradiotherapy has been studied in randomized trials in patients with locoregional carcinoma (stage I-III). Chemoradiotherapy should include 50 to 60 Gy of radiotherapy plus concurrent chemotherapy with 5-fluorouracil (5-FU) plus cisplatin. Chemoradiotherapy is now an established alternative to surgical therapy (predominantly in patients with squamous cell carcinoma). In patients treated with chemoradiotherapy, a follow up endoscopy of the upper gastrointestinal tract 4 to 6 weeks after its completion is recommended. If a complete remission can be confirmed, patients are observed or offered esophagectomy. Patients with unresectable (T4) carcinoma can be treated with radiotherapy plus concurrent chemotherapy and those with adenocarcinoma of the distal esophagus with positive nodes should receive adjuvant postoperative radiotherapy and chemotherapy with 5-FU plus cisplatin.
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PMID:[Review of combined chemoradiotherapy in the treatment of esophageal carcinoma]. 1292 45

Carcinoma of the esophagus must be staged accurately before a treatment plan is initiated, and imaging studies play a major role in this process. Imaging for esophageal carcinoma involves evaluation of the locoregional extent of the tumor and distant metastatic disease. A CT scan of the chest and upper abdomen provides the most comprehensive information about esophageal carcinoma; however, accurate assessment of the depth of primary tumor invasion and lymph node status remains limited, even with newer generation scanners. Endoscopic US is a user-dependent modality that has emerged as a highly accurate technique in experienced hands to evaluate the depth of penetration of esophageal tumors, but its ability to detect metastatic lymph nodes is less impressive, leading some investigators to perform confirmatory needle aspiration of suspicious nodes. FDG-PET is a physiologic examination that is the subject of intense investigation in patients who have esophageal carcinoma. Preliminary studies have suggested that FDG-PET can detect otherwise radiographically occult distant metastatic disease in these patients, and changes in FDG uptake might correlate with the response to therapy. These findings need to be confirmed in larger studies. More sophisticated technology continues to be developed for imaging carcinoma of the esophagus, which will more than likely affect staging algorithms in the future.
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PMID:Imaging for esophageal tumors. 1538 9

We report on visible laryngeal changes after radiotherapy. In this study, three women and two men aged 50-64 years were involved. In three cases, the primary tumor was a carcinoma of the thyroid gland and in one case a carcinoma of the esophagus. Due to dysplasia of the vocal folds, one patient underwent primary radiotherapy. Endoscopy was performed 4 to 22 years after radiotherapy. The larynx was examined by video-laryngoscopy and stroboscopy. We found a characteristic pattern of the vocal folds in all patients: bright white vocal fold surface, ectasia of capillaries and increased angiogenesis. We only found this pattern in patients after radiotherapy. In our opinion, these findings are late sequelae of radiotherapy. The picture of laryngitis due to radiotherapy can be distinguished from chronic laryngitis of other etiology using these criteria.
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PMID:[Bright white vocal folds and capillary ectasias. Late sequelae after radiotherapy]. 1652 9

The aim of this study was to assess whether the sentinel node concept could be applicable to clinically early carcinoma of the esophagus. We studied ten consecutive cT1N0 patients who underwent radical esophagectomy with regional lymph node dissection. On the day before surgery, 99m-Tc tin colloid was injected endoscopically around the primary tumor. Lymphoscintigraphy was also performed about three hours after injection. Immediately after surgery, the radioactivity of all dissected lymph nodes was measured with a hand-held gamma probe. The radioactivity and the metastatic status assessed by routine histopathologic examination were compared. A total of six patients had hot spots detected by lymphoscintigraphy, of which the detection rate was 60% (6 of 10). The ex vivo hot node detection rate was 90% (9 of 10). Three patients were found to have metastatic nodes. In one patient, sentinel node mapping failed to identify any hot spot or hot node. In the other two patients, the metastatic nodes did not correspond to hot nodes. The accuracy of hot node status was 77.8% (7 of 9), and the false-negative rate was 100% (2 of 2). The present study showed that radio-guided sentinel node detection is insufficiently reliable at present due to the high false-negative rate and low accuracy.
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PMID:Radio-guided sentinel node mapping in patients with superficial esophageal carcinoma: feasibility study. 1757 23

Primary small-cell carcinoma of the esophagus is a rare tumor that disseminates early and has a uniformly poor prognosis if untreated. We report on a patient with esophageal small-cell carcinoma treated with combination chemotherapy following surgical resection. A 48-year-old female had an ulcerated tumor in the distal part of the esophagus, which was microscopically diagnosed as esophageal small-cell carcinoma. Computed tomography (CT) of the chest and abdomen showed no lymphadenopathy or distant metastatic disease. Chemotherapy plus radiation therapy was planned but the patient refused the proposed treatment due to socieconomic reasons. Subsequently, subtotal esophagectomy with lymphadenectomy (3 periesophageal nodes) was performed in another hospital. The histopathologic diagnosis of the primary tumor was small-cell carcinoma and the resected lymph nodes also contained metastatic deposits. On the second postoperative month she was admitted with hepatic metastases. Combination chemotherapy with etoposide 120 mg/m(2)/day on days 1 to 3, and cisplatin 75mg/ m(2)/day on day 1, given intravenously (i.v.) every 3 weeks was started. After 3 courses, the patient achieved complete remission. Esophageal small-cell carcinoma is an aggressive tumor. Patients with disseminated disease should receive combination chemotherapy along with symptomatic treatment.
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PMID:Small cell carcinoma of the esophagus: report of a case with review of the literature. 1757 83

The value of (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the detection of carcinoma of unknown primary (CUP) differs among the studies. This study aimed to evaluate the role of (18)F-FDG PET/CT in CUP. Fifty-one patients (19 women, 32 men) with metastasis confirmed by histopathology from an unknown primary tumor were included in this study. Patients received 370 MBq of (18)F-FDG intravenously, and PET/CT was performed at 60 minutes after injection. Primary tumor sites were detected in 5 of 51 patients (9.6%): in 2 patients with carcinoma of the lung, in 1 patient with carcinoma of the gallbladder, in 1 patient with carcinoma of the esophagus, and in 1 patient with carcinoma of the stomach. No primary tumor was discovered in the remaining 46 patients (90.4%) during the follow-up. The sensitivity, specificity, and accuracy of (18)F-FDG PET/CT were 100%, 80.4%, and 82.4%. The positive and negative predictive values were 35.7 and 100%, respectively. Based on the data presented, (18)F-FDG PET/CT has a clinical implicative value in detecting the primary tumor of CUP. PET/CT can be useful to rule out the possibility of detecting the primary tumor during the follow-up.
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PMID:Clinical implication of (18)F-FDG PET/CT in carcinoma of unknown primary. 2127 63

A 56-year-old man with advanced esophageal carcinoma and lymph node swelling of abdomen (cStage III) underwent neoadjuvant chemotherapy (NAC) with 5-FU/CDDP. The side effect was stomatitis of grade 2. Primary tumor and lymph node swelling revealed remarkable effectiveness after 2 courses of NAC. Esophageal carcinoma was not found by endoscopy. Reduction of the lymph node was slight, however, radical resection of the esophageal carcinoma was performed. Pathologic examination of resected specimens revealed no malignant cells in the esophagus, and no metastasis of lymph node (Effect grade 3). Thus, we found NAC to be markedly effective for primary tumor and lymph nodes of esophageal carcinoma, and a radical operation was performed.
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PMID:[A curative resected case of pathological complete response of esophageal carcinoma treated with 5-FU/CDDP as neoadjuvant chemotherapy]. 2136 66


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