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Related Concept Videos

Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

98
Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
98
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

154
Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
154
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Clinical T2 N0 M0 Esophageal Cancer: Identifying Predictive Factors Of Upstaging.
  1. Home
  3. Research Domains
  5. Biomedical And Clinical Sciences
  7. Oncology And Carcinogenesis
  9. Predictive And Prognostic Markers
  11. Clinical T2 N0 M0 Esophageal Cancer: Identifying Predictive Factors Of Upstaging.

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Clinical T2 N0 M0 Esophageal Cancer: Identifying Predictive Factors of Upstaging.

Sadia Tasnim1, Siva Raja1, Eugene H Blackstone1

  • 1Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.

The Annals of Thoracic Surgery
|February 2, 2024

View abstract on PubMed

Summary
This summary is machine-generated.

Clinical T2 N0 M0 esophageal cancer staging is often inaccurate. Dysphagia and high tumor SUVmax predict advanced disease, suggesting these patients may benefit from neoadjuvant therapy.

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Area of Science:

  • Oncology
  • Medical Imaging

Background:

  • Clinical staging of esophageal cancer (cT2 N0 M0) is challenging due to frequent understaging.
  • Understaged patients may miss crucial neoadjuvant therapy benefits.
  • Identifying preoperative predictors of advanced disease is vital for accurate esophageal cancer management.

Purpose of the Study:

  • To identify preoperative factors predicting advanced-stage esophageal cancer in patients initially staged as cT2 N0 M0.
  • To improve treatment decisions by accurately assessing disease extent before surgery.

Main Methods:

  • Retrospective analysis of 60 patients with cT2 N0 M0 esophageal cancer who underwent esophagectomy.
  • Evaluation of radiologic, clinical, and endoscopic factors as preoperative markers.
  • Utilized Fisher exact, Wilcoxon rank sum, and random forest classification for analysis.

Main Results:

  • Only 13% of patients had actual pathologic T2 N0 M0 disease; 60% were upstaged.
  • Upstaging occurred due to T stage (19%), N stage (39%), or both (42%).
  • Dysphagia and high tumor maximum standardized uptake value (SUVmax ≥5) predicted upstaging (75% combined predictive value).

Conclusions:

  • Dysphagia and high tumor SUVmax are significant predictors of advanced esophageal cancer in the cT2 N0 M0 group.
  • These findings suggest considering neoadjuvant therapy for patients presenting with these predictive factors.
  • Improved preoperative assessment can optimize treatment strategies for esophageal cancer.