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Continuous cuff pressure control on middle-aged and elderly patients undergoing endoscopic submucosal dissection of the esophagus effect of airway injury. 对接受食道内镜黏膜下剥离术的中老年患者进行持续袖带压力控制对气道损伤的影响。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI: 10.1007/s10388-024-01061-z
Xianwei Jin, Yuewen Ding, Qiaoling Weng, Chumiao Sun, Dongbo Liu, Jia Min

Objective: Assessment of the effect of continuous cuff pressure control on airway injury in middle-aged and elderly patients undergoing endoscopic submucosal dissection (ESD).

Method: A total of 104 eligible middle-aged and elderly patients requiring esophageal ESD from July 2022-September 2023 at the First Affiliated Hospital of Nanchang University were selected and randomly divided into two groups: the group undergoing general anesthesia tracheal intubation with continuous control of cuff pressure after intubation (Group A, n = 51) and the group undergoing general anesthesia tracheal intubation with continuous monitoring without control of cuff pressure (Group B, n = 53). After endotracheal intubation in Group A, under the guidance of an automatic cuff pressure controller, the air was used to inflate the tracheal cuff until the cuff pressure was 25-30cmH2O. The cuff pressure after intubation was recorded, and then the cuff pressure parameters were directly adjusted in the range of 25-30cmH2O until tracheal extubation after the operation. After endotracheal intubation, patients in Group B inflated the tracheal cuff with clinical experience, then monitored and recorded the cuff pressure with a handheld cuff manometer and instructed the cuff not to be loosened after being connected to the handheld cuff manometer-continuous monitoring until the tracheal extubation, but without any cuff pressure regulation. The patients of the two groups performed esophageal ESD. The left recumbent position was taken before the operation, and the cuff's pressure was recorded. Then, insert the gastrointestinal endoscope to find the lesion site and perform appropriate CO2 inflation to display the diseased esophageal wall for surgical operation fully. After determining the location, the cuff pressure of the two groups was recorded when the cuff pressure was stable. After the operation, the upper gastrointestinal endoscope was removed and the cuff pressure of the two groups was recorded. Postoperative airway injury assessment was performed in both groups, and the incidence of sore throat, hoarseness, cough, and blood in sputum was recorded. The incidence of postoperative airway mucosal injury was also observed and recorded in both groups: typical, episodic congestion spots and patchy local congestion.

Result: The incidence of normal airway mucosa in Group A was higher than that in Group B (P < 0.05). In comparison, the incidence of occasional hyperemia and local plaque congestion in Group A was lower than in Group B (P < 0.05).

Conclusion: Continuous cuff pressure control during operation can reduce airway injury in patients with esophageal ESD and accelerate their early recovery after the operation.

目的评估持续袖带压力控制对中老年食管黏膜下剥离术(ESD)患者气道损伤的影响:方法:选取南昌大学第一附属医院2022年7月至2023年9月期间需要进行食管ESD的符合条件的中老年患者共104例,随机分为两组:进行全身麻醉气管插管且插管后持续控制袖带压力组(A组,n=51)和进行全身麻醉气管插管且持续监测但不控制袖带压力组(B组,n=53)。A 组气管插管后,在自动袖带压力控制器的指导下,用空气给气管袖带充气,直到袖带压力达到 25-30cmH2O 为止。记录插管后的袖带压力,然后在 25-30cmH2O 的范围内直接调整袖带压力参数,直至术后气管拔管。B 组患者在气管插管后,根据临床经验对气管袖带进行充气,然后用手持式袖带压力计对袖带压力进行监测和记录,并嘱咐袖带与手持式袖带压力计连接后不要松开--持续监测直至气管拔管,但不进行任何袖带压力调节。两组患者均进行食管 ESD。手术前取左卧位,记录袖带压力。然后,插入胃肠内窥镜寻找病变部位,并进行适当的二氧化碳充气,以充分显示病变食管壁,以便进行手术操作。确定位置后,待袖带压力稳定后记录两组的袖带压力。手术结束后,取出上消化道内窥镜,记录两组的袖带压力。对两组患者进行术后气道损伤评估,记录咽痛、声音嘶哑、咳嗽和痰中带血的发生率。还观察并记录了两组患者术后气道粘膜损伤的发生率:典型的、发作性充血点和局部斑片状充血:结果:A 组气道粘膜正常的发生率高于 B 组(P在手术过程中持续控制袖带压力可减少食管 ESD 患者的气道损伤,加快其术后早期恢复。
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引用次数: 0
Association of gastric myotomy length in peroral endoscopic myotomy (POEM) with gastro-esophageal junction distensibility measured by Endoluminal Functional Lumen Imaging Probe (EndoFLIP). 经口内镜胃肌切开术(POEM)的胃肌切开长度与腔内功能性成像探头(EndoFLIP)测量的胃食管交界处扩张性的关系。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-26 DOI: 10.1007/s10388-024-01081-9
Yusuke Fujiyoshi, Mary Raina Angeli Fujiyoshi, Kareem Khalaf, Gary R May, Christopher W Teshima

Background: Endoluminal Functional Lumen Imaging Probe (EndoFLIP) is a device that measures gastro-esophageal junction (GEJ) distensibility. However, it is not demonstrated that GEJ distensibility increases proportionally with varying gastric myotomy length in peroral endoscopic myotomy (POEM). This study aimed to investigate the association between gastric myotomy length in POEM and intraoperative EndoFLIP findings.

Methods: This single-center, retrospective cohort study included patients who underwent POEM with intraoperative EndoFLIP from December 2019 to January 2023. Using EndoFLIP, minimal balloon diameter and its distensibility index (DI) were measured pre- and post-myotomy. Primary and secondary outcomes were the post-myotomy EndoFLIP findings at 30 ml and 40 ml volume fills.

Results: The study included 44 patients (mean age 53.1 years, 50% female). Chicago classification included achalasia type I (39%), II (41%), III (9%), hypercontractile esophagus (2%), and EGJOO (9%). The mean esophageal myotomy length was 7.5 ± 2.2 cm and gastric myotomy was 2.1 ± 0.6 cm. Simple linear regression analyses indicated that for each 1 cm increase in gastric myotomy length, the DI at 30 ml volume fill was estimated to increase by 2.0 mm2/mmHg (p < 0.05, R2 = 0.41), the minimal diameter at 30 ml volume fill was estimated to increase by 2.4 mm (p < 0.05, R2 = 0.48), and the minimal diameter at 40 ml volume fill was estimated to increase by 1.3 mm (p < 0.05, R2 = 0.09).

Conclusions: This study demonstrates a significant linear relationship between gastric myotomy length and GEJ distensibility measured by EndoFLIP during POEM. These findings may be useful in clinical practice by enabling EndoFLIP to help calibrate a desired gastric myotomy length to achieve optimal DI and minimal diameter.

背景:腔内功能成像探头(EndoFLIP)是一种测量胃食管交界处(GEJ)扩张性的设备。然而,在经口内镜胃肌切开术(POEM)中,胃食管连接部扩张性随胃肌切开长度的变化而成正比增加的现象并未得到证实。本研究旨在调查 POEM 中胃肌切除术长度与术中 EndoFLIP 结果之间的关联:这项单中心、回顾性队列研究纳入了2019年12月至2023年1月期间接受POEM并进行术中EndoFLIP的患者。使用 EndoFLIP 测量了肌瘤切除术前后的最小球囊直径及其扩张性指数(DI)。主要和次要结果是肌瘤切除术后 30 毫升和 40 毫升容量填充时的 EndoFLIP 结果:研究包括 44 名患者(平均年龄 53.1 岁,50% 为女性)。芝加哥分型包括贲门失弛缓症 I 型(39%)、II 型(41%)、III 型(9%)、食管过度收缩型(2%)和 EGJOO 型(9%)。食管肌切术的平均长度为 7.5 ± 2.2 厘米,胃肌切术为 2.1 ± 0.6 厘米。简单线性回归分析表明,胃肌切开长度每增加 1 厘米,30 毫升容量填充时的 DI 估计会增加 2.0 mm2/mmHg(p 2 = 0.41),30 毫升容量填充时的最小直径估计会增加 2.4 mm(p 2 = 0.48),40 毫升容量填充时的最小直径估计会增加 1.3 mm(p 2 = 0.09):本研究表明,在 POEM 期间,胃肌切开长度与 EndoFLIP 测量的胃食管扩张性之间存在明显的线性关系。这些发现在临床实践中可能很有用,因为 EndoFLIP 可以帮助校准所需的胃肌切除术长度,以达到最佳的胃肠径和最小直径。
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引用次数: 0
Endoscopic program with a scoring system for surveillance of metachronous esophageal cell carcinoma for older patients considering risk factors after endoscopic resection. 考虑到内镜切除术后的风险因素,采用评分系统监测老年食管细胞癌的内镜方案。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-09 DOI: 10.1007/s10388-024-01077-5
Sakiko Naito, Masakatsu Fukuzawa, Hirokazu Shinohara, Yasuyuki Kagawa, Akira Madarame, Yohei Koyama, Hayato Yamaguchi, Yoshiya Yamauchi, Takao Itoi

Background: This study evaluated the association between the risk factors and prognosis for metachronous esophageal squamous cell carcinoma (ESCC) after endoscopic resection (ER) of esophageal cancer in older patients.

Methods: We conducted a retrospective observational study of 127 patients with ESCC who underwent ER from 2015 to 2020. Patients were classified as non-older (≤ 64 years), early older (65-74 years), and late older (≥ 75 years). We analyzed factors associated with poor overall survival and metachronous ESCC after ER using multivariate Cox regression analysis. A metachronous ESCC prediction scoring system was examined to validate the surveillance endoscopy program.

Results: Body mass index (BMI) and Charlson Comorbidity Index (CCI) were significant risk factors for poor overall survival in the multivariate analysis (p = 0.050 and p = 0.037, respectively). Multivariate analysis revealed that age of < 64 years, Lugol-voiding lesions (grade B/C), and head and neck cancer were significantly related to metachronous ESCC (p = 0.035, p = 0.035, and p = 0.014, respectively). In the development cohort, BMI < 18.5 kg/m2, CCI > 2, age < 64 years, Lugol-voiding lesions (grade B/C), and head and neck cancer were significantly related to metachronous ESCC, and each case was assigned 1 point. Patients were classified into low (0, 1, and 2) and high (> 3) score groups based on total scores. According to Kaplan-Meier curves, the 3-year overall survival was significantly lower in the high-score group than in the low-score group (91.5% vs. 100%, p = 0.012).

Conclusions: We proposed an endoscopic surveillance scoring system for metachronous ESCC considering BMI and CCI in older patients.

研究背景本研究评估了老年食管癌内镜下切除术(ER)后发生食管鳞癌(ESCC)的风险因素与预后之间的关联:我们对2015年至2020年期间接受内镜切除术的127例ESCC患者进行了回顾性观察研究。患者被分为非老年患者(≤64岁)、早期老年患者(65-74岁)和晚期老年患者(≥75岁)。我们采用多变量考克斯回归分析法分析了ER后总生存率差和并发ESCC的相关因素。为了验证监测内镜检查项目,我们还研究了一种近端ESCC预测评分系统:结果:在多变量分析中,体重指数(BMI)和夏尔森综合症指数(CCI)是总生存率低的重要风险因素(p = 0.050 和 p = 0.037)。多变量分析显示,年龄为 2 岁、CCI>2 岁、年龄为 3 岁)为基于总分的评分组。根据 Kaplan-Meier 曲线,高分组的 3 年总生存率明显低于低分组(91.5% vs. 100%,p = 0.012):结论:我们提出了一种内镜监测评分系统,用于监测老年患者中考虑到 BMI 和 CCI 的远期 ESCC。
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引用次数: 0
Comparison of proton-based definitive chemoradiotherapy and surgery-based therapy for esophageal squamous cell carcinoma: a multi-center retrospective Japanese cohort study. 以质子为基础的食管细胞癌确定性化放疗与手术治疗的比较:一项多中心回顾性日本队列研究。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-06-06 DOI: 10.1007/s10388-024-01068-6
Koichi Ogawa, Hitoshi Ishikawa, Takeshi Toyozumi, Kazuhiro Noma, Koji Kono, Hidehiro Hojo, Hiroyasu Tamamura, Yusuke Azami, Toshiki Ishida, Yoshihiro Nabeya, Hiromitsu Iwata, Masayuki Araya, Sunao Tokumaru, Kazushi Maruo, Tatsuya Oda, Hisahiro Matsubara

Background: Proton-based, definitive chemoradiotherapy (P-CRT) for esophageal squamous cell carcinoma (ESCC) previously showed comparable survival outcomes with the surgery-based therapy, i.e., neoadjuvant chemotherapy followed by esophagectomy (NAC-S), in a single-institutional study. This study aimed to validate this message in a Japanese multicenter study.

Methods: Eleven Japanese esophageal cancer specialty hospitals have participated. A total of 518 cases with clinical Stage I-IVA ESCC between 2010 and 2019, including 168 P-CRT and 350 NAC-S patients, were enrolled and long-term outcomes were evaluated. Propensity-score weighting analyses with overlap weighting for confounding adjustment were used.

Results: The 3-year overall survival (OS) of the P-CRT group was equivalent to the NAC-S group (74.8% vs. 72.7%, hazard ratio [HR]: 0.87, 95% confidence interval [CI]: 0.61-1.25). Although, the 3-year P-CRT group progression-free survival (PFS) was inferior to the NAC-S group (51.4% vs. 59.6%, HR 1.39, 95% CI 1.04-1.85), the progression P-CRT group cases showed better survival than the NAC-S group (HR 0.58, 95% CI 0.38-0.88), largely because of salvage surgery or endoscopic submucosal dissection for local progression. The survival advantage of P-CRT over NAC-S was more pronounced in the cT1-2 (HR 0.61, 95% CI 0.29-1.26) and cStage I-II (HR 0.50, 95% CI 0.24-1.07) subgroups, although this trend was not evident in other populations, such as cT3-4 and cStage III-IVA.

Conclusions: Proton-based CRT for ESCC showed equivalent OS to surgery-based therapy. Especially for patients with cT1-2 and cStage I-II disease, proton-based CRT has the potential to serve as a first-line treatment.

背景:基于质子的食管鳞状细胞癌(ESCC)确定性化放疗(P-CRT)与基于手术的治疗(即食管切除术(NAC-S)后的新辅助化疗)的生存率相当。本研究旨在通过日本多中心研究验证这一观点:方法:11 家日本食管癌专科医院参与了研究。方法:11 家日本食管癌专科医院参与了这项研究,共纳入了 2010 年至 2019 年期间的 518 例临床 I-IVA 期 ESCC 患者,其中包括 168 例 P-CRT 患者和 350 例 NAC-S 患者,并对其长期预后进行了评估。采用倾向分数加权分析和重叠加权进行混杂因素调整:结果:P-CRT组的3年总生存率(OS)与NAC-S组相当(74.8% vs. 72.7%,危险比[HR]:0.87,95% 置信区间 [CI]:0.61-1.25):0.61-1.25).虽然P-CRT组的3年无进展生存期(PFS)不如NAC-S组(51.4% vs. 59.6%,HR 1.39,95% CI 1.04-1.85),但P-CRT组病例的进展生存期优于NAC-S组(HR 0.58,95% CI 0.38-0.88),这主要是因为局部进展时进行了挽救手术或内镜粘膜下剥离术。与NAC-S相比,P-CRT的生存优势在cT1-2(HR 0.61,95% CI 0.29-1.26)和c分期I-II(HR 0.50,95% CI 0.24-1.07)亚组中更为明显,但这一趋势在cT3-4和c分期III-IVA等其他人群中并不明显:结论:基于质子的CRT治疗ESCC的OS与手术治疗相当。结论:质子CRT治疗ESCC的OS与手术治疗相当,尤其是对于cT1-2和c分期为I-II的患者,质子CRT有可能成为一线治疗方法。
{"title":"Comparison of proton-based definitive chemoradiotherapy and surgery-based therapy for esophageal squamous cell carcinoma: a multi-center retrospective Japanese cohort study.","authors":"Koichi Ogawa, Hitoshi Ishikawa, Takeshi Toyozumi, Kazuhiro Noma, Koji Kono, Hidehiro Hojo, Hiroyasu Tamamura, Yusuke Azami, Toshiki Ishida, Yoshihiro Nabeya, Hiromitsu Iwata, Masayuki Araya, Sunao Tokumaru, Kazushi Maruo, Tatsuya Oda, Hisahiro Matsubara","doi":"10.1007/s10388-024-01068-6","DOIUrl":"10.1007/s10388-024-01068-6","url":null,"abstract":"<p><strong>Background: </strong>Proton-based, definitive chemoradiotherapy (P-CRT) for esophageal squamous cell carcinoma (ESCC) previously showed comparable survival outcomes with the surgery-based therapy, i.e., neoadjuvant chemotherapy followed by esophagectomy (NAC-S), in a single-institutional study. This study aimed to validate this message in a Japanese multicenter study.</p><p><strong>Methods: </strong>Eleven Japanese esophageal cancer specialty hospitals have participated. A total of 518 cases with clinical Stage I-IVA ESCC between 2010 and 2019, including 168 P-CRT and 350 NAC-S patients, were enrolled and long-term outcomes were evaluated. Propensity-score weighting analyses with overlap weighting for confounding adjustment were used.</p><p><strong>Results: </strong>The 3-year overall survival (OS) of the P-CRT group was equivalent to the NAC-S group (74.8% vs. 72.7%, hazard ratio [HR]: 0.87, 95% confidence interval [CI]: 0.61-1.25). Although, the 3-year P-CRT group progression-free survival (PFS) was inferior to the NAC-S group (51.4% vs. 59.6%, HR 1.39, 95% CI 1.04-1.85), the progression P-CRT group cases showed better survival than the NAC-S group (HR 0.58, 95% CI 0.38-0.88), largely because of salvage surgery or endoscopic submucosal dissection for local progression. The survival advantage of P-CRT over NAC-S was more pronounced in the cT1-2 (HR 0.61, 95% CI 0.29-1.26) and cStage I-II (HR 0.50, 95% CI 0.24-1.07) subgroups, although this trend was not evident in other populations, such as cT3-4 and cStage III-IVA.</p><p><strong>Conclusions: </strong>Proton-based CRT for ESCC showed equivalent OS to surgery-based therapy. Especially for patients with cT1-2 and cStage I-II disease, proton-based CRT has the potential to serve as a first-line treatment.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"484-494"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A phase 3, randomized, double-blind, multicenter, placebo-controlled study of S-588410, a five-peptide cancer vaccine as an adjuvant therapy after curative resection in patients with esophageal squamous cell carcinoma. 食管鳞状细胞癌患者根治性切除术后将五胜肽癌症疫苗 S-588410 作为辅助疗法的 3 期随机、双盲、多中心、安慰剂对照研究。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-11 DOI: 10.1007/s10388-024-01072-w
Tomoki Makino, Hiroshi Miyata, Takushi Yasuda, Yuko Kitagawa, Kei Muro, Jae-Hyun Park, Tetsuro Hikichi, Takahiro Hasegawa, Kenji Igarashi, Motofumi Iguchi, Yasuhide Masaoka, Masahiko Yano, Yuichiro Doki

Background: S-588410, a cancer peptide vaccine (CPV), comprises five HLA-A*24:02-restricted peptides from five cancer-testis antigens. In a phase 2 study, S-588410 was well-tolerated and exhibited antitumor efficacy in patients with urothelial cancer. Therefore, we aimed to evaluate the efficacy, immune response, and safety of S-588410 in patients with completely resected esophageal squamous cell carcinoma (ESCC).

Methods: This phase 3 study involved patients with HLA-A*24:02-positive and lymph node metastasis-positive ESCC who received neoadjuvant therapy followed by curative resection. After randomization, patients were administered S-588410 and placebo (both emulsified with Montanide™ ISA 51VG) subcutaneously. The primary endpoint was relapse-free survival (RFS). The secondary endpoints were overall survival (OS), cytotoxic T-lymphocyte (CTL) induction, and safety. Statistical significance was tested using the one-sided weighted log-rank test with the Fleming-Harrington class of weights.

Results: A total of 276 patients were randomized (N = 138/group). The median RFS was 84.3 and 84.1 weeks in the S-588410 and placebo groups, respectively (P = 0.8156), whereas the median OS was 236.3 weeks and not reached, respectively (P = 0.6533). CTL induction was observed in 132/134 (98.5%) patients who received S-588410 within 12 weeks. Injection site reactions (137/140 patients [97.9%]) were the most frequent treatment-emergent adverse events in the S-588410 group. Prolonged survival was observed in S-588410-treated patients with upper thoracic ESCC, grade 3 injection-site reactions, or high CTL intensity.

Conclusions: S-588410 induced immune response and had acceptable safety but failed to reach the primary endpoint. A high CTL induction rate and intensity may be critical for prolonging survival during future CPV development.

背景:S-588410是一种癌症多肽疫苗(CPV),由来自五种癌症睾丸抗原的五种HLA-A*24:02限制性多肽组成。在一项 2 期研究中,S-588410 对尿道癌患者的耐受性良好,并显示出抗肿瘤疗效。因此,我们旨在评估S-588410对完全切除的食管鳞状细胞癌(ESCC)患者的疗效、免疫反应和安全性:这项3期研究涉及HLA-A*24:02阳性和淋巴结转移阳性的ESCC患者,他们都接受了新辅助治疗,然后进行了根治性切除。随机分组后,患者皮下注射S-588410和安慰剂(均用蒙泰尼™ ISA 51VG乳化)。主要终点是无复发生存期(RFS)。次要终点为总生存期(OS)、细胞毒性T淋巴细胞(CTL)诱导和安全性。统计显著性采用单侧加权对数-秩检验和弗莱明-哈灵顿类加权检验:共有 276 名患者接受了随机治疗(N = 138/组)。S-588410组和安慰剂组的中位RFS分别为84.3周和84.1周(P = 0.8156),而中位OS分别为236.3周和未达到(P = 0.6533)。在 12 周内接受 S-588410 治疗的 132/134 例(98.5%)患者中观察到 CTL 诱导。注射部位反应(137/140 例患者 [97.9%])是 S-588410 组最常见的治疗突发不良事件。在接受S-588410治疗的上胸部ESCC、3级注射部位反应或CTL强度高的患者中,观察到生存期延长:结论:S-588410能诱导免疫反应,安全性可接受,但未能达到主要终点。在未来的 CPV 开发过程中,高 CTL 诱导率和高强度可能是延长生存期的关键。
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引用次数: 0
Validation of the cutoff values for the number of metastatic lymph nodes for esophageal cancer staging: a multi-institutional analysis of 655 patients in Japan. 食管癌分期中转移淋巴结数量临界值的验证:对日本 655 名患者的多机构分析。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-24 DOI: 10.1007/s10388-024-01084-6
Koji Tanaka, Takeo Fujita, Yasuaki Nakajima, Akihiko Okamura, Kenro Kawada, Masayuki Watanabe, Yuichiro Doki

Background: The number of metastatic lymph nodes (LNs) is an important prognostic factor for esophageal cancer, and N staging is important for prognostic stratification. The optimal cutoff values for clinical (cN) and pathologic N (pN) staging should be reconsidered following advances in neoadjuvant therapy.

Methods: The study included 655 patients who underwent esophagectomy between January 2014 and December 2016 in four high-volume centers in Japan. Optimal cutoff values for the number of metastatic LNs in cN and pN staging were examined using X-tile, and their prognostic performance was validated using the Kaplan-Meier method.

Results: The cutoff values were 1, 2, and 3 for cN staging and 1, 3, and 7 for pN staging. Prognosis was significantly better in patients with cN0 than in those with modified (m)-cN1 (p = 0.0211). However, prognosis was not significantly different among the patients with m-cN1, m-cN2, and m-cN3 disease. Prognosis was significantly different among the patients with pN0, pN1, pN2, and pN3 disease (pN0 vs pN1, p < 0.0001; pN1 vs pN2, p < 0.0001; pN2 vs pN3, p < 0.0001). In patients who received preoperative neoadjuvant therapy, prognosis, which was not significantly different among the patients with cN0, m-cN1, m-cN2, and m-cN3 disease (cN0 vs m-cN1, p = 0.5675; m-cN1 vs m-cN2, p = 0.4425; m-cN2 vs m-cN3, p = 0.7111), was significantly different among the patients with pN0, pN1, pN2, and pN3 disease (pN0 vs pN1, p = 0.0025; pN1 vs pN2, p = 0.0046; pN2 vs pN3, p = 0.0104).

Conclusions: cN has no prognostic impact in patients who underwent preoperative treatment followed by esophagectomy, despite the optimization of cN classification. The conventional TNM8th pN classification is useful for predicting prognosis even for patients who have undergone preoperative treatment. The conventional cutoffs for metastatic LNs in the International Union against Cancer tumor node metastasis staging system are valid and can be effectively used in clinical practice.

背景:转移淋巴结(LN)的数量是食管癌的一个重要预后因素,N分期对预后分层非常重要。随着新辅助疗法的发展,临床(cN)和病理 N(pN)分期的最佳临界值应重新考虑:该研究纳入了2014年1月至2016年12月期间在日本四家大医院接受食管切除术的655名患者。使用X-tile检验了cN和pN分期中转移性LN数量的最佳临界值,并使用Kaplan-Meier方法验证了其预后性能:结果:cN分期的临界值为1、2和3,pN分期的临界值为1、3和7。cN0患者的预后明显优于改良(m)-cN1患者(p = 0.0211)。然而,m-cN1、m-cN2 和 m-cN3 患者的预后无明显差异。pN0、pN1、pN2 和 pN3 患者的预后有明显差异(pN0 vs pN1,p 结论:尽管对 cN 分类进行了优化,但 cN 对接受术前治疗和食管切除术的患者的预后没有影响。传统的 TNM8th pN 分类即使对接受过术前治疗的患者也有助于预测预后。国际抗癌联盟肿瘤结节转移分期系统中转移性 LN 的常规临界值是有效的,可在临床实践中有效使用。
{"title":"Validation of the cutoff values for the number of metastatic lymph nodes for esophageal cancer staging: a multi-institutional analysis of 655 patients in Japan.","authors":"Koji Tanaka, Takeo Fujita, Yasuaki Nakajima, Akihiko Okamura, Kenro Kawada, Masayuki Watanabe, Yuichiro Doki","doi":"10.1007/s10388-024-01084-6","DOIUrl":"10.1007/s10388-024-01084-6","url":null,"abstract":"<p><strong>Background: </strong>The number of metastatic lymph nodes (LNs) is an important prognostic factor for esophageal cancer, and N staging is important for prognostic stratification. The optimal cutoff values for clinical (cN) and pathologic N (pN) staging should be reconsidered following advances in neoadjuvant therapy.</p><p><strong>Methods: </strong>The study included 655 patients who underwent esophagectomy between January 2014 and December 2016 in four high-volume centers in Japan. Optimal cutoff values for the number of metastatic LNs in cN and pN staging were examined using X-tile, and their prognostic performance was validated using the Kaplan-Meier method.</p><p><strong>Results: </strong>The cutoff values were 1, 2, and 3 for cN staging and 1, 3, and 7 for pN staging. Prognosis was significantly better in patients with cN0 than in those with modified (m)-cN1 (p = 0.0211). However, prognosis was not significantly different among the patients with m-cN1, m-cN2, and m-cN3 disease. Prognosis was significantly different among the patients with pN0, pN1, pN2, and pN3 disease (pN0 vs pN1, p < 0.0001; pN1 vs pN2, p < 0.0001; pN2 vs pN3, p < 0.0001). In patients who received preoperative neoadjuvant therapy, prognosis, which was not significantly different among the patients with cN0, m-cN1, m-cN2, and m-cN3 disease (cN0 vs m-cN1, p = 0.5675; m-cN1 vs m-cN2, p = 0.4425; m-cN2 vs m-cN3, p = 0.7111), was significantly different among the patients with pN0, pN1, pN2, and pN3 disease (pN0 vs pN1, p = 0.0025; pN1 vs pN2, p = 0.0046; pN2 vs pN3, p = 0.0104).</p><p><strong>Conclusions: </strong>cN has no prognostic impact in patients who underwent preoperative treatment followed by esophagectomy, despite the optimization of cN classification. The conventional TNM8th pN classification is useful for predicting prognosis even for patients who have undergone preoperative treatment. The conventional cutoffs for metastatic LNs in the International Union against Cancer tumor node metastasis staging system are valid and can be effectively used in clinical practice.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"464-471"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of definitive carbon-ion radiotherapy for cT1bN0M0 esophageal squamous cell carcinoma. cT1bN0M0食管鳞状细胞癌的最终碳离子放射治疗效果。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-05-30 DOI: 10.1007/s10388-024-01067-7
Tetsuro Isozaki, Hitoshi Ishikawa, Shigeru Yamada, Yoshihiro Nabeya, Keiko Minashi, Kentaro Murakami, Hisahiro Matsubara

Background: A recent phase I/II study determined the optimal dose of definitive carbon-ion radiotherapy (CIRT) for cT1bN0M0 esophageal cancer. This study aimed to further confirm the efficacy and feasibility of the recommended dose fractionation of CIRT with long-term follow-up results in a larger sample size.

Methods: This single center retrospective study evaluated patients with cT1bN0M0 esophageal squamous cell carcinoma treated with the recommended dose fractionation of 50.4 Gy relative biological effectiveness in 12 fractions, between 2012 and 2022.

Results: Thirty-eight patients underwent CIRT at our hospital. Although eight (21.1%) patients were older than 80 years, 15 (39.5%) had high surgical risk, and seven (18.4%) were at high risk for chemotherapy, all patients underwent CIRT as scheduled. Grade 3 esophagitis occurred in eight (21.1%) patients and grade 3 pneumonia in one (2.6%) patient in this study, but no grade 4 adverse events occurred. The only grade 3 late adverse event was pneumonia in one patient (2.6%). The 5-year overall survival rate, local control rate, and disease-free survival rates were 76.6% (95% CI, 90.9-62.4), 74.9% (95% CI, 90.7-59.0), and 66.4% (95% CI, 83.3-49.5), respectively. Additionally, post CIRT recurrence was as follows: seven (18.4%) patients had recurrence in another part of the esophagus, three (7.9%) in the primary site, three (7.9%) in lymph nodes outside the irradiated area, and one (2.6%) patient had liver metastasis.

Conclusions: Our study demonstrates that CIRT using the recommended dose fractionation is feasible and effective for cT1bN0M0 esophageal squamous cell carcinoma.

背景:最近的一项I/II期研究确定了cT1bN0M0食管癌确定性碳离子放疗(CIRT)的最佳剂量。本研究旨在通过更大样本量的长期随访结果,进一步证实碳离子放疗推荐剂量分次的有效性和可行性:这项单中心回顾性研究评估了2012年至2022年间接受推荐剂量分次治疗的cT1bN0M0食管鳞状细胞癌患者,推荐剂量分次为50.4 Gy,相对生物效应为12次:我院有 38 名患者接受了 CIRT 治疗。虽然有 8 名(21.1%)患者年龄超过 80 岁,15 名(39.5%)患者手术风险高,7 名(18.4%)患者化疗风险高,但所有患者都按计划接受了 CIRT 治疗。在这项研究中,8 名患者(21.1%)发生了 3 级食管炎,1 名患者(2.6%)发生了 3 级肺炎,但没有发生 4 级不良事件。唯一的 3 级晚期不良事件是一名患者(2.6%)的肺炎。5年总生存率、局部控制率和无病生存率分别为76.6%(95% CI,90.9-62.4)、74.9%(95% CI,90.7-59.0)和66.4%(95% CI,83.3-49.5)。此外,CIRT术后复发情况如下:7例(18.4%)患者在食管其他部位复发,3例(7.9%)在原发部位复发,3例(7.9%)在照射区域外的淋巴结复发,1例(2.6%)患者出现肝转移:我们的研究表明,采用推荐剂量分次进行 CIRT 治疗 cT1bN0M0 食管鳞癌是可行且有效的。
{"title":"Outcomes of definitive carbon-ion radiotherapy for cT1bN0M0 esophageal squamous cell carcinoma.","authors":"Tetsuro Isozaki, Hitoshi Ishikawa, Shigeru Yamada, Yoshihiro Nabeya, Keiko Minashi, Kentaro Murakami, Hisahiro Matsubara","doi":"10.1007/s10388-024-01067-7","DOIUrl":"10.1007/s10388-024-01067-7","url":null,"abstract":"<p><strong>Background: </strong>A recent phase I/II study determined the optimal dose of definitive carbon-ion radiotherapy (CIRT) for cT1bN0M0 esophageal cancer. This study aimed to further confirm the efficacy and feasibility of the recommended dose fractionation of CIRT with long-term follow-up results in a larger sample size.</p><p><strong>Methods: </strong>This single center retrospective study evaluated patients with cT1bN0M0 esophageal squamous cell carcinoma treated with the recommended dose fractionation of 50.4 Gy relative biological effectiveness in 12 fractions, between 2012 and 2022.</p><p><strong>Results: </strong>Thirty-eight patients underwent CIRT at our hospital. Although eight (21.1%) patients were older than 80 years, 15 (39.5%) had high surgical risk, and seven (18.4%) were at high risk for chemotherapy, all patients underwent CIRT as scheduled. Grade 3 esophagitis occurred in eight (21.1%) patients and grade 3 pneumonia in one (2.6%) patient in this study, but no grade 4 adverse events occurred. The only grade 3 late adverse event was pneumonia in one patient (2.6%). The 5-year overall survival rate, local control rate, and disease-free survival rates were 76.6% (95% CI, 90.9-62.4), 74.9% (95% CI, 90.7-59.0), and 66.4% (95% CI, 83.3-49.5), respectively. Additionally, post CIRT recurrence was as follows: seven (18.4%) patients had recurrence in another part of the esophagus, three (7.9%) in the primary site, three (7.9%) in lymph nodes outside the irradiated area, and one (2.6%) patient had liver metastasis.</p><p><strong>Conclusions: </strong>Our study demonstrates that CIRT using the recommended dose fractionation is feasible and effective for cT1bN0M0 esophageal squamous cell carcinoma.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"523-529"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcome research on esophagectomy analyzed using nationwide databases in Japan: evidences generated from real-world data. 利用日本全国数据库分析食管切除术的结果研究:从真实世界数据中获得的证据。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-19 DOI: 10.1007/s10388-024-01080-w
Yoshihiro Kakeji, Hiroyuki Yamamoto, Masayuki Watanabe, Koji Kono, Hideki Ueno, Yuichiro Doki, Yuko Kitagawa, Hiroya Takeuchi, Ken Shirabe, Yasuyuki Seto

Esophagectomy for esophageal cancer is a highly invasive gastrointestinal surgical procedure. The National Clinical Database (NCD) of Japan, initiated in 2011, has compiled real-world data on esophagectomy, one of nine major gastroenterological surgeries. This review examines outcomes after esophagectomy analyzed using the Japanese big databases. Certification systems by the Japanese Society of Gastroenterological Surgery (JSGS) and the Japan Esophageal Society (JES) have shown that institutional certification has a greater impact on short-term surgical outcomes than surgeon certification. Minimally invasive esophagectomy has emerged as a viable alternative to open esophagectomy, although careful patient selection is crucial, especially for elderly patients with advanced tumors. The NCD has significantly contributed to the assessment and enhancement of surgical quality and short-term outcomes, while studies based on Comprehensive Registry of Esophageal Cancer in Japan (CRECJ) have provided data on patient characteristics, treatments, and long-term outcomes. The JES has conducted various questionnaire-based retrospective clinical reviews in collaboration with authorized institutions certified by JES. The Diagnosis Procedure Combination (DPC) database provides administrative claims data including itemized prices for surgical, pharmaceutical, laboratory, and other inpatient services. Analyzing these nationwide databases can offer precise insights into surgical quality for esophageal cancer, potentially leading to improved treatment outcomes.

食管癌食管切除术是一种高创胃肠外科手术。日本国家临床数据库(NCD)于 2011 年启动,汇编了九大胃肠外科手术之一食管切除术的真实数据。本综述利用日本大型数据库分析了食管切除术后的疗效。日本胃肠外科学会(JSGS)和日本食管外科学会(JES)的认证体系表明,机构认证比外科医生认证对短期手术效果的影响更大。微创食管切除术已成为开放式食管切除术的可行替代方案,但谨慎选择患者至关重要,尤其是晚期肿瘤的老年患者。NCD 为评估和提高手术质量和短期疗效做出了重大贡献,而基于日本食管癌综合登记处(CRECJ)的研究则提供了有关患者特征、治疗方法和长期疗效的数据。JES 与获得 JES 认证的授权机构合作,开展了各种基于调查问卷的回顾性临床审查。诊断程序组合(DPC)数据库提供行政报销数据,包括手术、药品、化验和其他住院服务的明细价格。通过分析这些全国性数据库,可以准确了解食管癌的手术质量,从而改善治疗效果。
{"title":"Outcome research on esophagectomy analyzed using nationwide databases in Japan: evidences generated from real-world data.","authors":"Yoshihiro Kakeji, Hiroyuki Yamamoto, Masayuki Watanabe, Koji Kono, Hideki Ueno, Yuichiro Doki, Yuko Kitagawa, Hiroya Takeuchi, Ken Shirabe, Yasuyuki Seto","doi":"10.1007/s10388-024-01080-w","DOIUrl":"10.1007/s10388-024-01080-w","url":null,"abstract":"<p><p>Esophagectomy for esophageal cancer is a highly invasive gastrointestinal surgical procedure. The National Clinical Database (NCD) of Japan, initiated in 2011, has compiled real-world data on esophagectomy, one of nine major gastroenterological surgeries. This review examines outcomes after esophagectomy analyzed using the Japanese big databases. Certification systems by the Japanese Society of Gastroenterological Surgery (JSGS) and the Japan Esophageal Society (JES) have shown that institutional certification has a greater impact on short-term surgical outcomes than surgeon certification. Minimally invasive esophagectomy has emerged as a viable alternative to open esophagectomy, although careful patient selection is crucial, especially for elderly patients with advanced tumors. The NCD has significantly contributed to the assessment and enhancement of surgical quality and short-term outcomes, while studies based on Comprehensive Registry of Esophageal Cancer in Japan (CRECJ) have provided data on patient characteristics, treatments, and long-term outcomes. The JES has conducted various questionnaire-based retrospective clinical reviews in collaboration with authorized institutions certified by JES. The Diagnosis Procedure Combination (DPC) database provides administrative claims data including itemized prices for surgical, pharmaceutical, laboratory, and other inpatient services. Analyzing these nationwide databases can offer precise insights into surgical quality for esophageal cancer, potentially leading to improved treatment outcomes.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"411-418"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of time to postoperative recurrence on the prognosis of patients with esophageal cancer post recurrence: exploratory analysis of OGSG 1003. 术后复发时间对复发后食管癌患者预后的影响:OGSG 1003 的探索性分析。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI: 10.1007/s10388-024-01070-y
Soshi Hori, Makoto Yamasaki, Nobuyuki Yamamoto, Takashi Harino, Kota Momose, Kotaro Yamashita, Koji Tanaka, Keijiro Sugimura, Tomoki Makino, Atsushi Takeno, Osamu Shiraishi, Masaaki Motoori, Hiroshi Miyata, Yutaka Kimura, Motohiro Hirao, Takushi Yasuda, Masahiko Yano, Yuichiro Doki

Background: The association between recurrence timing and prognosis in patients with locally advanced resectable esophageal cancer undergoing neoadjuvant chemotherapy (NAC) followed by esophagectomy remains unclear. This study aimed to clarify this association using multicenter prospective clinical trial data.

Methods: Among 162 patients enrolled in a NAC phase II study comparing the efficacy of cisplatin and fluorouracil plus docetaxel with cisplatin and fluorouracil plus adriamycin, 64 patients with recurrence after R0 resection were included in this study. We evaluated the association between recurrence timing and overall survival after recurrence (OSr), along with clinicopathological factors associated with recurrence timing and OSr.

Results: Among 64 patients, 46 (71.9%) and 59 (92.2%) experienced recurrence within 1 and 2 years after surgery, respectively. Groups based on recurrence timing, including ≤ 6, 6-12, and > 12 months, had median OSr of 3.6, 13.9, and 13.4 months, respectively. The prognosis was significantly poorer for patients with recurrence ≤ 6 months after surgery than for other patients (P < 0.001). Multivariate analysis revealed pathological lymph node staging as an independent factor associated with early recurrence (odds ratio: 3.46, 95% confidence interval: 1.47-8.02, P = 0.0045). On the other hand, multivariate analysis for factors associated with OSr revealed pT (hazard ratio [HR]: 1.91, 95%CI 1.26-2.88, P = 0.0022), early recurrence (HR: 6.88, 95%CI 2.68-17.6, P < 0.001), and treatment after recurrence, with both local treatment (HR: 0.47, 95%CI 0.22-0.98, P = 0.043) and chemotherapy (HR: 0.25, 95%CI 0.11-0.58, P = 0.0011) as independent prognostic factors.

Conclusion: Patients with advanced esophageal cancer experiencing recurrence within 6 months after esophagectomy following NAC have an extremely poor prognosis, suggesting that an advanced pN stage is associated with early recurrence.

背景:接受新辅助化疗(NAC)后再进行食管切除术的局部晚期可切除食管癌患者的复发时间与预后之间的关系仍不清楚。本研究旨在利用多中心前瞻性临床试验数据澄清这种关联:在一项比较顺铂和氟尿嘧啶加多西他赛与顺铂和氟尿嘧啶加阿霉素疗效的新辅助化疗 II 期研究的 162 例患者中,64 例 R0 切除术后复发的患者被纳入本研究。我们评估了复发时间与复发后总生存期(OSr)之间的关系,以及与复发时间和OSr相关的临床病理因素:结果:64 名患者中,分别有 46 人(71.9%)和 59 人(92.2%)在术后 1 年和 2 年内复发。根据复发时间分组,包括≤6个月、6-12个月和>12个月,中位OSr分别为3.6个月、13.9个月和13.4个月。术后≤6个月复发患者的预后明显差于其他患者(P 结论:术后≤6个月复发患者的预后明显差于其他患者:食管切除术后 6 个月内复发的晚期食管癌患者预后极差,这表明晚期 pN 分期与早期复发有关。
{"title":"The impact of time to postoperative recurrence on the prognosis of patients with esophageal cancer post recurrence: exploratory analysis of OGSG 1003.","authors":"Soshi Hori, Makoto Yamasaki, Nobuyuki Yamamoto, Takashi Harino, Kota Momose, Kotaro Yamashita, Koji Tanaka, Keijiro Sugimura, Tomoki Makino, Atsushi Takeno, Osamu Shiraishi, Masaaki Motoori, Hiroshi Miyata, Yutaka Kimura, Motohiro Hirao, Takushi Yasuda, Masahiko Yano, Yuichiro Doki","doi":"10.1007/s10388-024-01070-y","DOIUrl":"10.1007/s10388-024-01070-y","url":null,"abstract":"<p><strong>Background: </strong>The association between recurrence timing and prognosis in patients with locally advanced resectable esophageal cancer undergoing neoadjuvant chemotherapy (NAC) followed by esophagectomy remains unclear. This study aimed to clarify this association using multicenter prospective clinical trial data.</p><p><strong>Methods: </strong>Among 162 patients enrolled in a NAC phase II study comparing the efficacy of cisplatin and fluorouracil plus docetaxel with cisplatin and fluorouracil plus adriamycin, 64 patients with recurrence after R0 resection were included in this study. We evaluated the association between recurrence timing and overall survival after recurrence (OSr), along with clinicopathological factors associated with recurrence timing and OSr.</p><p><strong>Results: </strong>Among 64 patients, 46 (71.9%) and 59 (92.2%) experienced recurrence within 1 and 2 years after surgery, respectively. Groups based on recurrence timing, including ≤ 6, 6-12, and > 12 months, had median OSr of 3.6, 13.9, and 13.4 months, respectively. The prognosis was significantly poorer for patients with recurrence ≤ 6 months after surgery than for other patients (P < 0.001). Multivariate analysis revealed pathological lymph node staging as an independent factor associated with early recurrence (odds ratio: 3.46, 95% confidence interval: 1.47-8.02, P = 0.0045). On the other hand, multivariate analysis for factors associated with OSr revealed pT (hazard ratio [HR]: 1.91, 95%CI 1.26-2.88, P = 0.0022), early recurrence (HR: 6.88, 95%CI 2.68-17.6, P < 0.001), and treatment after recurrence, with both local treatment (HR: 0.47, 95%CI 0.22-0.98, P = 0.043) and chemotherapy (HR: 0.25, 95%CI 0.11-0.58, P = 0.0011) as independent prognostic factors.</p><p><strong>Conclusion: </strong>Patients with advanced esophageal cancer experiencing recurrence within 6 months after esophagectomy following NAC have an extremely poor prognosis, suggesting that an advanced pN stage is associated with early recurrence.</p>","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"472-483"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Comparison of proton-based Definitive chemoradiotherapy and surgery-based therapy for esophageal squamous cell carcinoma: a multi-center retrospective Japanese cohort study. 更正:基于质子的食管鳞状细胞癌确定性化放疗与手术治疗的比较:日本多中心回顾性队列研究。
IF 2.2 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-10-01 DOI: 10.1007/s10388-024-01071-x
Koichi Ogawa, Hitoshi Ishikawa, Takeshi Toyozumi, Kazuhiro Noma, Koji Kono, Hidehiro Hojo, Hiroyasu Tamamura, Yusuke Azami, Toshiki Ishida, Yoshihiro Nabeya, Hiromitsu Iwata, Masayuki Araya, Sunao Tokumaru, Kazushi Maruo, Tatsuya Oda, Hisahiro Matsubara
{"title":"Correction: Comparison of proton-based Definitive chemoradiotherapy and surgery-based therapy for esophageal squamous cell carcinoma: a multi-center retrospective Japanese cohort study.","authors":"Koichi Ogawa, Hitoshi Ishikawa, Takeshi Toyozumi, Kazuhiro Noma, Koji Kono, Hidehiro Hojo, Hiroyasu Tamamura, Yusuke Azami, Toshiki Ishida, Yoshihiro Nabeya, Hiromitsu Iwata, Masayuki Araya, Sunao Tokumaru, Kazushi Maruo, Tatsuya Oda, Hisahiro Matsubara","doi":"10.1007/s10388-024-01071-x","DOIUrl":"10.1007/s10388-024-01071-x","url":null,"abstract":"","PeriodicalId":11918,"journal":{"name":"Esophagus","volume":" ","pages":"495"},"PeriodicalIF":2.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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