DescriptorName: EsophagealNeoplasms... AbstractText: Esophageal stenting is often considered to relieve dysphagia in patients with locoregionally advanced esophagealcancer... oncologic outcomes in patients undergoing chemoradiation therapy (CRT) AbstractText: The data from patients treated with curative intent CRT for locoregionally advanced esophagealcancer at the University of Utah were retrospectively analyzed.
DescriptorName: Adenocarcinoma. DescriptorName: African Americans. DescriptorName: Barrett Esophagus. DescriptorName: EsophagealNeoplasms. DescriptorName: Genetic Predisposition to Disease. DescriptorName: Humans. AbstractText: Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) are far more prevalent in European Americans than in African Americans. Hypothesizing that this racial disparity in prevalence might represent a genetic susceptibility, we used an admixture mapping approach to interrogate disease association with ...
Barrett Esophagus (4), Adenocarcinoma (3), Esophageal Neoplasms (1), more mentions
DescriptorName: Barrett Esophagus. DescriptorName: Biomarkers. DescriptorName: EsophagealNeoplasms. DescriptorName: Humans. DescriptorName: Immunohistochemistry. AbstractText: The low incidence of oesophageal adenocarcinoma (EAC) in Barrett's oesophagus (BE) patients reinforces the need for risk stratification tools to make BE surveillance more effective. Therefore, we have undertaken a systematic review and meta-analysis of published studies on immunohistochemical (IHC) biomarkers in BE to determine the ...
Esophageal Neoplasms (1), Barrett Esophagus (1), Adenocarcinoma (1), more mentions
DescriptorName: Combined Modality Therapy. DescriptorName: Disease-Free Survival. DescriptorName: EsophagealNeoplasms... AbstractText: Reports are limited regarding clinical and pretreatment features that might predict a pathological complete response (pathCR) after treatment in patients with esophagealcancer (EC... 2017 American Cancer Society Keyword: esophagealcancer. Keyword: neoadjuvant. Keyword: pathological complete response. Keyword: remission.
... have yet to assess the impact of ARB use on gastro-oesophagealcancer survival AbstractText: To investigate the association between post-diagnosis ARB use and gastro-oesophagealcancer survival AbstractText: We selected a cohort of patients with newly-diagnosed gastro-oesophagealcancer between 1998 and 2012 from English cancer registries ...
BACKGROUND: Percutaneous or surgical ablation are increasingly used worldwide in the management of atrial fibrillation. The development of atrioesophageal fistula (AEF) is among the most serious and lethal complications of atrial fibrillation ablation. We sought to characterize the clinical presentation, procedural characteristics, diagnostic investigations, and treatment outcomes of all reported cases of AEF.
METHODS AND RESULTS: Electronic searches were conducted in PubMed and Embase for English scientific literature articles. Out of 628 references, 120 cases of AEF were identified using various ablation modalities. Clinical presentation occurred between 0 and 60 days postablation (median 21 days). Fever (73%), neurological (72%), gastrointestinal (41%), and cardiac (40%) symptoms were the commonest presentations. Computed tomography of the chest was the commonest mode of diagnosis (68%), although 7 cases required repeat testing. Overall mortality was 55%, with significantly reduced mortality in patients undergoing surgical repair (33%) compared with endoscopic treatment (65%) and conservative management (97%) (adjusted odds ratio, 24.9; P<0.01, compared with surgery). Multivariable predictors of mortality include presentation with neurological symptoms (adjusted odds ratio, 16.0; P<0.001) and gastrointestinal bleed (adjusted odds ratio, 4.2; P=0.047).
CONCLUSIONS: AEF complicating atrial fibrillation ablation is associated with a high mortality. Clinicians should have a high suspicion for the development of AEF in patients presenting with infective, neurological, gastrointestinal, or cardiac symptoms within 2 months of an atrial fibrillation ablation. Investigation by contrast computed tomography of the chest with consideration of repeat testing can lead to prompt diagnosis. Surgical intervention is associated with improved survival rates.
DescriptorName: EsophagealNeoplasms... AbstractText: Palliative treatments and stents are necessary for relieving dysphagia in patients with esophagealcancer. The aim of this study was to simultaneously compare available treatments in terms of complications AbstractText: Web of Science, Medline, Scopus, Cochrane Library and Embase were searched. Statistical heterogeneity was assessed using the Chi2 test and was quantified by I2.
AbstractText: Treatment decision making and planning in patients with oesophagealcancer are guided by radiological measurement of length of disease (LoD... These results highlight the continued benefit of EUS in the oesophagealcancer staging and treatment pathway Keyword: Decision making. Keyword: endosonography. Keyword: oesophagus. Keyword: positron emission tomography. Keyword: radiotherapy.
Esophageal perforation due to blunt trauma is a rare clinical condition, and the diagnosis is often difficult because patients have few specific symptoms. Delayed diagnosis may result in a fatal clinical course due to mediastinitis and subsequent sepsis. In this article, we describe a 26-year-old man with esophageal perforation due to blunt chest trauma resulting from a motor vehicle accident. Because a severe disturbance of consciousness masked the patient's trauma-induced thoracic symptoms, we required 11h to diagnose the esophageal perforation. Therefore, the patient developed septic shock due to mediastinitis. However, his subsequent clinical course was good because of prompt combined therapy involving surgical repair and medical treatment after the diagnosis.
Esophageal Perforation (6), Mediastinitis (4), Coma (2), more mentions
McMaster PLUS Selected
This article has been identified as especially clinically relevant or newsworthy by at least 3
practicing clinicians and of high scientific quality by expert researchers
as a part of the McMaster PLUS article rating service.
AbstractText: Please see Appendix 4 for a glossary of terms.The outcome of patients with esophagealcancer is generally poor. Although multimodal therapy is standard, there is conflicting evidence regarding the addition of esophagectomy to chemoradiotherapy AbstractText: To compare the effectiveness and safety of chemoradiotherapy plus surgery with that of chemoradiotherapy alone in people with nonmetastatic esophageal carcinoma AbstractText: We ...
DescriptorName: Databases, Factual. DescriptorName: EsophagealNeoplasms... The synergistically increased cancer risk between excessive amount of alcohol consumption and currently smoking or underweight individuals was observed only in the esophagealcancers AbstractText: Light drinking including even one alcoholic drink a day is associated with increased risks of esophageal, gastric and colorectal cancer.
Oncology (6), Endocrine Disorders (1), Anti-Obesity and Weight Loss (1) Colorectal Neoplasms (5), Stomach Neoplasms (2), Esophageal Neoplasms (1), more mentions
DescriptorName: Aged. DescriptorName: Digestive System Surgical Procedures. DescriptorName: EsophagealNeoplasms. DescriptorName: Female. DescriptorName: Hospitals, High-Volume. DescriptorName: Hospitals, Low-Volume. DescriptorName: Humans. DescriptorName: Male. DescriptorName: Middle Aged. DescriptorName: Outcome Assessment (Health Care. DescriptorName: Stomach Neoplasms. AbstractText: Most studies showing a volume outcome effect in resection surgery for oesophago-gastric cancer were conducted before the centralisation of clinical services.
CitationSubset: AIM. CitationSubset: IM. DescriptorName: Adrenal Cortex Hormones. DescriptorName: Behcet Syndrome. DescriptorName: EsophagealDiseases. DescriptorName: Humans. DescriptorName: Male. DescriptorName: Middle Aged. DescriptorName: Rare Diseases. DescriptorName: Treatment Outcome. DescriptorName: Ulcer. AbstractText: The fundamental pathogenesis of Behçet disease (BD) is still unclear and controversial. Many cases of oral aphthous ulcers and genital ulcers related to BD are reported; nevertheless, idiopathic giant esophageal ...
DescriptorName: Proton Pump Inhibitors. DescriptorName: Vitamin D. AbstractText: Vitamin D deficiency may increase esophagealcancer risk. Vitamin D affects genes regulating proliferation, apoptosis, and differentiation and induces the tumor suppressor 15-hydroxyprostaglandin dehydrogenase (PGDH) in other cancers. This nonrandomized interventional study assessed effects of vitamin D supplementation in Barrett's esophagus (BE.
Oncology (1) Barrett Esophagus (3), Esophageal Neoplasms (1), Vitamin D Deficiency (1), more mentions
This document represents the first position statement produced by the British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland, setting out the minimum expected standards in diagnostic upper gastrointestinal endoscopy. The need for this statement has arisen from the recognition that while technical competence can be rapidly acquired, in practice the performance of a high-quality examination is variable, with an unacceptably high rate of failure to diagnose cancer at endoscopy. The importance of detecting early neoplasia has taken on greater significance in this era of minimally invasive, organ-preserving endoscopic therapy. In this position statement we describe 38 recommendations to improve diagnostic endoscopy quality. Our goal is to emphasise practices that encourage mucosal inspection and lesion recognition, with the aim of optimising the early diagnosis of upper gastrointestinal disease and improving patient outcomes.
RATIONALE: Giant fibrovascular polyps (GFVPs) found in the hypopharynx are exceedingly rare. These are benign tumors which are identified by CT or MRI and usually treated based on symptoms. Even more rarely, pathology may identify one of these masses as an atypical lipomatous tumor (ALT). This paper will present a case of an ALT of the hypopharynx that was originally classified as a GFVP, highlighting the difficulty in distinguishing between them and the importance of making the correct diagnosis.
PATIENT CONCERNS: An 84-year-old man presented to the emergency department with a 6-month history of a pedunculated hypopharyngeal growth, dysphagia, and intermittent dyspnea.
DIAGNOSES: The mass was characterized as a GFVP by barium swallow and MRI.
INTERVENTIONS: The hypopharyngeal mass was resected for obstructive symptoms and to confirm the diagnosis. Final pathology found the mass to be more consistent with an atypical lipomatous tumor (ALT).
OUTCOMES: The patient's dysphagia and dyspnea resolved. He was free of recurrence at 22 months postoperative.
LESSONS: Both GFVPs and ALTs are very rarely found in the hypopharynx but can be easily misclassified as one another. Imaging is useful to initially characterize the mass, but to definitively differentiate between them, pathological analysis is necessary. Although they are rare, it is important to consider both possibilities on the differential for hypopharyngeal masses. Further, accurate analysis is essential to distinguish between them because their definitive management and follow-up is different.
Neoplasms (4), Deglutition Disorders (3), Dyspnea (3), more mentions
A multicenter retrospective study.The purpose of this study was to explore risk factors of dysphagia after anterior cervical surgery and factors affecting rehabilitation of dysphagia 2 years after surgery.Patients who underwent anterior cervical surgery at 3 centers from January 2010 to January 2013 were included. The possible factors included 3 aspects: demographic variables-age, sex, body mass index (BMI): hypertension, diabetes, heart disease, smoking, alcohol use, diagnose (cervical spondylotic myelopathy or ossification of posterior longitudinal ligament), preoperative visual analogue scale (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA), surgical-related variables-surgical option (ACDF, ACCF, ACCDF, or Zero profile), operation time, blood loss, operative level, superior fusion segment, incision length, angle of C2 to C7, height of C2 to C7, cervical circumference, cervical circumference/height of C2 to C7.The results of our study indicated that the rate of dysphagia at 0, 3, 6, 12, and 24 months after surgery was 20%, 5.4%, 2.4%, 1.1%, and 0.4%, respectively. Our results showed that age (58.8 years old), BMI (27.3 kg/m), course of disease (11.6 months), operation time (103.2 min), blood loss (151.6 mL), incision length (9.1 cm), cervical circumference (46.8 cm), angle of C2 to C7 (15.3°), cervical circumference/height of C2 to C7 (4.8), preoperative VAS (7.5), and ODI (0.6) in dysphagia group were significantly higher than those (52.0, 24.6, 8.6, 88.2, 121.6, 8.6, 42.3, 12.6, 3.7, 5.6, and 0.4, respectively) in nondysphagia group; however, height of C2 to C7 (9.9 vs 11.7 cm) and preoperative JOA (8.3 vs 10.7) had opposite trend between 2 groups. We could also infer that female, smoking, diabetes, ossification of posterior longitudinal ligament, ACCDF, multilevel surgery, and superior fusion segment including C2 to C3 or C6 to C7 were the risk factors for dysphagia after surgery immediately. However, till 2 years after surgery, only 2 risk factors, smoking and diabetes, could slow rehabilitation of dysphagia.Many factors could significantly increase rate of dysphagia after anterior cervical surgery. Operation time as a vital factor markedly increases immediate postoperative dysphagia and smoking, as the most important factor, lower recovery of dysphagia. Further study is needed to prove if these factors could influence dysphagia.
Endocrine Disorders (4), Cardiovascular Diseases (3), Anti-Obesity and Weight Loss (2) Deglutition Disorders (12), Diabetes Mellitus (4), Ossification of Posterior Longitudinal Ligament (2), more mentions