Body mass index influences long-term outcome in patients with colorectal cancer.

Background/aims: The influence of high Body Mass Index (BMI) on long-term outcome is scarcely known in patients with colorectal carcinoma.

Methodology: In the present study was analysed 356 consecutive patients with colorectal carcinoma, in order to address the impact of BMI on patients' characteristics, surgical procedures, and clinical outcomes following radical resection. Patients were divided into the following 3 categories according to BMI; high BMI group (BMI > or = 24.

Surgical treatment of superficial esophageal cancer.

Objective: The worldwide incidence of superficial esophageal cancer (SEC) is increasing. The aim of this study is to review the systematic surgical outcomes of esophagectomy for SEC.

Data Sources: Only manuscripts written in English and written between 1980 and 2003 were selected from MEDLINE.

Clinical outcomes of extended esophagectomy with three-field lymph node dissection for esophageal squamous cell carcinoma.

Objective: Opinions are conflicting about 3-field lymph node dissection (3FLND) during esophagectomy for esophageal cancer. In the current study, we sought to determine the prevalence of cervical and upper thoracic lymph node metastasis in patients with squamous cell carcinoma of the thoracic esophagus and to determine the impact of 3FLND on mortality, morbidity, survival, and recurrence rate.

Materials And Methods: Among 287 patients with squamous cell carcinoma of the thoracic esophagus seen between November 1985 and December 2001, 141 (49%) underwent extended esophagectomy with 3FLND (cervical, mediastinal, and abdominal lymph node dissection).

En-bloc esophagectomy for esophageal cancer.

Background: The operative approach for esophageal cancer varies from simple palliative resection to extended esophagectomy with 3-field lymph-node dissection or en-bloc esophagectomy (EBE) depending on tumor and patient status and surgical strategy of the surgeon. The merits and demerits of such EBE are yet to be determined.

Methods: A literature review was done regarding EBE for esophageal cancer.

Postoperative chemotherapy vs chemoradiotherapy for thoracic esophageal cancer: a prospective randomized clinical trial.

Background: Neither postoperative radiotherapy nor chemotherapy alone provided a survival benefit after curative esophagectomy for esophageal squamous carcinoma.

Material And Methods: Of 103 consecutive patients who underwent potentially curative esophagectomy for esophageal squamous carcinoma, 45 patients with advanced cancers without preoperative adjuvant treatments were prospectively randomized to two groups; postoperative chemotherapy alone (Group A, n=23) and postoperative radio/chemotherapy (Group B, n=22). In Group A, cisplatin (CDDP) (50 mg/m(2)) was given by intravenous infusion on days 1 and 15, and 5-fluorouracil (5-FU) (300 mg/m(2)) was given daily by continuous intravenous infusion for 5 weeks.

Pattern of recurrence after extended esophagectomy for squamous cell carcinoma of the esophagus.

Background/aims: To further investigate the underlying mechanism of the systemic spread of esophageal squamous cell carcinoma.

Methodology: Out of 151 patients who underwent a curative esophageal resection, 41 (27.1%) developed recurrent esophageal cancer.

Prognosis of patients with T2N0 tumors in the alimentary tract: should they be considered as early cancers?

Background: T1N0 tumor of the alimentary tract has an excellent long-term prognosis, however, the prognosis of T2N0 tumor has not been uniformly elucidated.

Material And Methods: Between February 1981 and April 2000, 75, 424 and 327 patients with node-negative esophageal, gastric and colorectal carcinomas, respectively, underwent curative resection and were included in this study. Long-term prognosis of those node-negative patients stratified by the T-stage were evaluated retrospectively.

Surgical treatment for locally advanced (T4) squamous cell carcinoma of the thoracic esophagus.

It is still difficult to decide on the treatment modalities for advanced esophageal carcinoma when the prognostic factors of T4 esophageal cancer are not fully understood. In this article, we report that among 71 patients with T4 thoracic esophageal cancer, 49 underwent esophagectomy, 9 had curative resection (R0 group), and 40 had palliative resection (R1/2 group). A total of 22 patients had palliative treatments: bypass in 5 (bypass group), gastrostomy or jejunostomy in 6 (stoma group), and radiochemotherapy alone in 11 (nonoperation group).

Esophageal cancer patients surviving 6 years after esophagectomy.

Background: Esophageal cancer is one of the most malignant tumors, with a dismal prognosis in spite of recent advances in early diagnosis and extended lymphadenectomy. These patients need to be stratified according to prognostic variables for precise identification of high-risk group.

Material And Methods: Seventy-six patients with esophageal carcinoma were uniformly treated with curative intent between 1980 and 1992 with at least 6 years follow-up.

Expression and prognostic significance of S100A2 protein in squamous cell carcinoma of the esophagus.

The purpose of this study was to evaluate the expression of S100A2 Ca2+-binding protein and its prognostic significance in the management of squamous cell carcinoma of the esophagus. Changes in cytosolic Ca2+ concentration control a wide range of cellular responses including cellular apoptosis. Intracellular S100 Ca2+-binding proteins are key molecules in transducing Ca2+ signaling.

Expression and prognostic significance of PTEN product protein in patients with esophageal squamous cell carcinoma.

Background: PTEN is a candidate tumor-suppressor gene in a variety of malignant tumors. The prognostic importance of PTEN product protein (PTEN) and its correlation with clinicopathologic characteristics have yet to be delineated in patients with esophageal carcinoma.

Methods: Specimens from 97 patients with esophageal squamous cell carcinoma were used for the immunohistochemical evaluation of PTEN expression.

Periarterial papaverine application improves intraoperative kidney function during laparoscopic donor nephrectomy.

Background: Laparoscopic donor nephrectomy decreases disincentives to donation frequently associated with the disadvantages of open surgery. However, concerns have been raised regarding graft quality, since the incidence of delayed graft function is higher when compared with open procedures. This may be caused by amelioration of kidney perfusion due to the elevated intraabdominal pressure and to a mechanically induced renal angiospasm during donation.

Clinicopathologic factors correlated with number of metastatic lymph nodes in oesophageal cancer.

Background: The number of metastatic lymph nodes is applied to the staging system of gastric cancer and colorectal cancer. However, it has not been evaluated in oesophageal cancer.

Patients And Methods: Of 258 patients with primary squamous cell carcinoma of the thoracic oesophagus between February 1981 and December 1999, 160 underwent three-field oesophagectomy with a curative intent.

Dukes' classification as a useful staging system in resectable squamous cell carcinoma of the esophagus.

Dukes' classification for colorectal cancer is simple and has been widely used as a valuable prognostic indicator. It has been used as an assessment of gastric cancer, but it has not been evaluated for esophageal cancer. Of 251 patients with primary squamous cell carcinoma of the thoracic esophagus between February 1981 and April 1999, 155 patients underwent esophagectomy with a curative intent.

Prognostic factors in node-negative squamous cell carcinoma of the thoracic esophagus.

Background: Among several clinicopathological factors influencing the outcome of patients with esophageal carcinoma, the presence or absence of lymph node metastasis is the most important. Prognostic indicators, however, in patients without lymph node involvement have not been fully understood.

Materials And Methods: Out of 247 patients with primary squamous cell carcinoma of the thoracic esophagus between February 1981 and December 1998, 154 patients (62.

Prognosis of T4 gastric carcinoma patients: an appraisal of aggressive surgical treatment.

Background And Objectives: Despite precipitous drop in the incidence of gastric carcinoma in Japan, it is still one of the leading causes of death associated with malignant disease. Once the contiguous organs are involved the prognosis becomes dismal. Prognostic factors governing the survival of patients with T4 gastric carcinoma remain unclear.

Esophageal resection in elderly esophageal carcinoma patients: improvement in postoperative complications.

Background: Advanced age is considered to be a relative contraindication for radical esophagectomy with a three-field lymph node dissection.

Methods: Preoperative risks, postoperative morbidity and mortality, and long-term survival in 55 elderly patients (> or =70 years) who had undergone extensive esophagectomy for esophageal carcinoma were compared with those of 149 younger patients (<70 years).

Results: Elderly patients had worse preoperative cardiopulmonary function and had more frequent postoperative cardiopulmonary complications compared with younger patients (p < 0.

Spontaneous apoptosis in advanced esophageal carcinoma: its relation to Fas expression.

The prognostic importance of spontaneous apoptosis and its correlation with clinicopathological characteristics and Fas expression have yet to be delineated in esophageal carcinoma. Specimens from 65 patients with advanced squamous cell carcinoma of the esophagus were used for immunohistochemical evaluation of Fas, proliferating cell nuclear antigen, and apoptosis. The mean apoptotic index (AI) of 65 tumors was 1.

Esophageal cancer with cirrhosis of the liver: results of esophagectomy in 18 consecutive patients.

Background: Patients with cirrhosis of the liver sometimes are candidates for esophagectomy with extensive lymphadenectomy.

Materials And Methods: Of 271 patients with primary esophageal carcinoma, 19 patients (7.0%) had pathologically proven cirrhosis of the liver.

Prognostic significance of Fas and Fas ligand system-associated apoptosis in gastric cancer.

Background: Previous studies indicate that gastric carcinomas express Fas ligand and down-regulate Fas to escape from the host immune attack; however, the prognostic importance of Fas/FasL expression in this tumor is yet to be evaluated.

Methods: Specimens from 87 gastric carcinoma patients of different stages treated in a defined period with curative intent were evaluated for apoptosis, Fas, FasL, and CD8 expression using an immunohistochemical method.

Results: The percentage of terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL)-positive apoptotic cells expressed as apoptotic index (AI) was higher in 43 patients when the cut-off value was set at the median value.

Esophageal cancer with distant lymph node metastasis: prognostic significance of metastatic lymph node ratio.

The cervical and celiac lymph node metastases are defined as distant metastasis (Mlym) from thoracic esophageal carcinoma by TNM (primary tumor, regional lymph nodes, and distant metastasis) classification. The prognostic factors, however, of such distant node metastases are not fully understood. Of 85 patients with node-positive thoracic esophageal carcinoma who were treated with the same modalities of treatment, 31 (37%) had Mlym.

A tailored perioperative blood transfusion might avoid undue recurrences in gastric carcinoma patients.

In a large retrospective study, the prognostic significance of blood transfusion (BT) and type of blood product transfused were searched in 640 curatively resected gastric carcinoma patients. Out of 640 patients, 222 (34.7%) received BT and the incidence of BT was reduced from 45% in the early period to 21% in the most recent period.

Cyclooxygenase-2 expression correlates with tumor neovascularization and prognosis in human colorectal carcinoma patients.

The role of cyclooxygenase-2 (COX-2) in tumor neovascularization of human colorectal carcinoma is yet to be delineated. One hundred colorectal carcinoma specimens were evaluated for COX-2 expression and CD34-stained microvessel density (MVD) by immunohistochemical methods. The relationships between COX-2 expression and clinicopathological feature of the patients, MVD, and survival time were analyzed.

Impact of screening survey of gastric cancer on clinicopathological features and survival: retrospective study at a single institution.

Background: Detection of gastric cancer in an early stage is important to improve the prognosis of patients with gastric cancer. This study compared the clinicopathologic characteristics and surgical results in patients with asymptomatic gastric cancer detected by a screening program with those of patients with symptomatic cancer. The efficacy of 2 screening methods (barium meal and endoscopy) was also compared.

Prognostic factors after extended esophagectomy for squamous cell carcinoma of the thoracic esophagus.

Backgrounds And Objectives: In Japan, extended esophagectomy with extensive lymphadenectomy has become the standard surgical procedure for carcinoma of the thoracic esophagus. Although mortality and morbidity rates after such extensive esophagectomy have been acceptable, the long-term outcomes are not necessarily satisfactory.

Methods: Among 235 patients with primary squamous cell carcinoma of the thoracic esophagus between June 1981 and March 1998, 143 patients (60.