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Esophagus - Cancer

July 28, 2014
This study tracked changes in management for and outcomes of T1a and T1b esophageal cancer using data from the National Cancer Data Base.  Endoscopic resection increased nearly 3-fold to 53% for T1a lesions during the interval, and increased nearly 3-fold to 21% for T1b cancers.  Nodal involvement was predicted by T status, tumor size >2cm, and tu
July 12, 2014
This single institution study evaluated differences in 30-day and 90-day mortality after esophagectomy in nearly 1300 patients.  30-day mortality was 2.9%, hospital mortalit was 5.1%, and 90-day mortality was 7%.  Late deaths were related to surgery (particularly the occurrence of anastomotic leakage), sudden death, and recurrent cancer.  The sensiti
July 12, 2014
A risk model of mortality associated with esophagectomy in Japan was developed using variables identified in the ACS NSQIP program.  30-day and overall surgical mortality rates were 1.2% and 3.4%, and the morbidity rate was 42%.  Morbidity was higher after minimally invasive esophagectomy.  Mortality was related to difficulty with ADLs, recent smokin
July 12, 2014
This editorial, authored by a number of presidents/leaders of prominent medical societies, laments a recent position paper of the ESMO espousing medical oncologists as the natural team leaders of multidisciplinary oncologic care.  It cautions other cancer specialists not to abandon their roles as advocates for their cancer patients.
July 1, 2014
In this randomized trial involving195 pts from 30 centers, pts underwent chemoradiotherapy followed by surgery or surgery alone for stage I or II esophageal cancer.  The median follow-up was 94 months.  80% of pts had clinical stage II disease.  R0 resection rate and 3-year survival were similar between the groups.  Induction therapy was associated w
June 22, 2014
This prospective study evaluated the relationship of inflammatory gene polymorphisms and postoperative pneumonia after esophagectomy in 120 pts.  One genotype for IL-10 was significantly associated with reduced postoperative serum IL-10 levels and an increased rate of postoperative pneumonia.  IL-10 polymorphism was an independent predictor of pneumo
May 28, 2014
  Extracapsular spread of cancer cells is associated with poorer outcome compared to intracapsular limitation in positive lymphnodes in patients with adenocarcinoma of the oesophagus and gastro-oesophageal junction. This finding is not reflected by the current tumour staging system.  
May 27, 2014
This metanalysis identified 26 eligible studies that assess the predictive value of PET for survival after induction therapy.  Complete metabolic response was associated with a 50% decrease in mortality and in tumor recurrence compared to no response.   
May 21, 2014
The PORTICO trial has opened to evaluate the Portico Transcatheter Aortic Valve System.  This prospective multicenter trial involving up to 40 sites will randomize pts to Portico vs another TAVR valve in the US. 
February 15, 2014
Pts surviving esophagectomy longer than 10 years were queried as to QOL. Alimentary comfort rating was 9 out of 10. 33% experienced diarrhea, dumping, or regurgitation. 15% had aspiration requiring hospital care. Mean weight loss was 26 lbs. Median GI QOL score was 2.9 out of 4.

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