Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two...Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two-thirds of the esophageal circumference,conventional ESD is time-consuming and has an increased risk of adverse events.Based on the submucosal tunnel conception,endoscopic submucosal tunnel dissection(ESTD)was first introduced by us to remove large SESCNs,with excellent results.Studies from different centers also reported favorable results.Compared with conventional ESD,ESTD has a more rapid dissection speed and R0 resection rate.Currently in China,ESTD for large SESCNs is an important part of the digestive endoscopic tunnel technique,as is peroral endoscopic myotomy for achalasia and submucosal tunnel endoscopic resection for submucosal tumors of the muscularis propria.However,not all patients with SESCNs are candidates for ESTD,and postoperative esophageal strictures should also be taken into consideration,especially for lesions with a circumference greater than three-quarters.In this article,we describe our experience,review the literature of ESTD,and provide detailed information on indications,standard procedures,outcomes,and complications of ESTD.展开更多
AIM: To evaluate the efficacy of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. METHODS: Between July 2007 and March 2009, 27 consecutive superficial esophageal squamous cell neop...AIM: To evaluate the efficacy of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. METHODS: Between July 2007 and March 2009, 27 consecutive superficial esophageal squamous cell neoplasms in 25 enrolled patients were treated by endoscopic submucosal dissection. The therapeutic efficacy, complications, and follow-up results were assessed. RESULTS: The mean size of the lesions was 21 ± 13 mm (range 2-55 mm); the mean size of the resection specimens was 32 ± 12 mm (range 10-70 mm). The enblock resection rate was 100% (27/27), and en block resection with tumor-free lateral/basal margins was 88.9% (24/27). Perforation occurred in 1 patient who was managed by conservative medical treatments. None of the patients developed local recurrence or distant metastasis in the follow-up period. CONCLUSION: Endoscopic submucosal dissection is applicable to superficial esophageal squamous cell neoplasms with promising results.展开更多
Background: The current treatment options of early glottic carcinoma are radiotherapy;trans laser microsurgery, and open surgery. However, the best treatment is still controversial due to lack of randomized controlled...Background: The current treatment options of early glottic carcinoma are radiotherapy;trans laser microsurgery, and open surgery. However, the best treatment is still controversial due to lack of randomized controlled trials. We aimed to evaluate the treatment results and the prognostic factors of local control of early glottic squamous cell carcinoma patients (GSCC) T1-2N0M0 treated at our institution. Material and Methods: We retrospectively studied the charts of 52 patients with early GSCC T1-T2N0M0 from 2010-2015 at the Clinical Oncology Department, Ain-Shams University. 24 patients had T1 and 28 had T2 early glottic carcinoma. The overall survival OS, local control rate, and laryngeal preservation rate were evaluated. Kaplan-Meier method, Cox proportional hazards model were used to analyze the data. Results: Median duration of follow-up was 13 months. Thirty-eight patients received radiation treatment alone (73.1%), 7.7% of the patients underwent surgery alone, and 19.2% of the patients had surgery combined with radiotherapy. Local recurrence after radiation failure developed in 6/52 patients, all had T2 disease and were salvaged by total laryngectomy. The ultimate local control rate was 88.5%, and the ultimate laryngeal preservation rate was 77.2% (40/52 patients). The median OS of the 52 patients was 13 months (range 2 - 46 months). Univariate analysis of factors associated with poor local control showed that age > 60 years was the only significant factor (P = 0.048). Conclusion: Radiotherapy achieves high local control and laryngeal preservation rates for patients with early glottic carcinoma, and is associated with a low rate of severe complications compared to surgery. Salvage surgery is feasible after radiotherapy failure.展开更多
BACKGROUND Chronic myelomonocytic leukemia(CMML),a rare clonal hematopoietic stem cell disorder characterized by myelodysplastic syndrome and myeloproliferative neoplasms,has a generally poor prognosis,and easily prog...BACKGROUND Chronic myelomonocytic leukemia(CMML),a rare clonal hematopoietic stem cell disorder characterized by myelodysplastic syndrome and myeloproliferative neoplasms,has a generally poor prognosis,and easily progresses to acute myeloid leukemia.The simultaneous incidence of hematologic malignancies and solid tumors is extremely low,and CMML coinciding with lung malignancies is even rarer.Here,we report a case of CMML,with ASXL1 and EZH2 gene mutations,combined with non-small cell lung cancer(lung squamous cell carcinoma).CASE SUMMARY A 63-year-old male,suffering from toothache accompanied by coughing,sputum,and bloody sputum for three months,was given a blood test after experiencing continuous bleeding resulting from a tooth extraction at a local hospital.Based on morphological results,the patient was diagnosed with CMML and bronchoscopy was performed in situ to confirm the diagnosis of squamous cell carcinoma in the lower lobe of the lung.After receiving azacitidine,programmed cell death protein 1,and platinum-based chemotherapy drugs,the patient developed severe myelosuppression and eventually fatal leukocyte stasis and dyspnea.CONCLUSION During the treatment and observation of CMML and be vigilant of the growth of multiple primary malignant tumors.展开更多
基金Supported by National Natural Science Foundation of China,No.81370584Military Major Projects of Clinical High-Tech Techniques,No.431EG63G
文摘Endoscopic submucosal dissection(ESD)is a wellestablished treatment for superficial esophageal squamous cell neoplasms(SESCNs)with no risk of lymphatic metastasis.However,for large SESCNs,especially when exceeding two-thirds of the esophageal circumference,conventional ESD is time-consuming and has an increased risk of adverse events.Based on the submucosal tunnel conception,endoscopic submucosal tunnel dissection(ESTD)was first introduced by us to remove large SESCNs,with excellent results.Studies from different centers also reported favorable results.Compared with conventional ESD,ESTD has a more rapid dissection speed and R0 resection rate.Currently in China,ESTD for large SESCNs is an important part of the digestive endoscopic tunnel technique,as is peroral endoscopic myotomy for achalasia and submucosal tunnel endoscopic resection for submucosal tumors of the muscularis propria.However,not all patients with SESCNs are candidates for ESTD,and postoperative esophageal strictures should also be taken into consideration,especially for lesions with a circumference greater than three-quarters.In this article,we describe our experience,review the literature of ESTD,and provide detailed information on indications,standard procedures,outcomes,and complications of ESTD.
文摘AIM: To evaluate the efficacy of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. METHODS: Between July 2007 and March 2009, 27 consecutive superficial esophageal squamous cell neoplasms in 25 enrolled patients were treated by endoscopic submucosal dissection. The therapeutic efficacy, complications, and follow-up results were assessed. RESULTS: The mean size of the lesions was 21 ± 13 mm (range 2-55 mm); the mean size of the resection specimens was 32 ± 12 mm (range 10-70 mm). The enblock resection rate was 100% (27/27), and en block resection with tumor-free lateral/basal margins was 88.9% (24/27). Perforation occurred in 1 patient who was managed by conservative medical treatments. None of the patients developed local recurrence or distant metastasis in the follow-up period. CONCLUSION: Endoscopic submucosal dissection is applicable to superficial esophageal squamous cell neoplasms with promising results.
文摘Background: The current treatment options of early glottic carcinoma are radiotherapy;trans laser microsurgery, and open surgery. However, the best treatment is still controversial due to lack of randomized controlled trials. We aimed to evaluate the treatment results and the prognostic factors of local control of early glottic squamous cell carcinoma patients (GSCC) T1-2N0M0 treated at our institution. Material and Methods: We retrospectively studied the charts of 52 patients with early GSCC T1-T2N0M0 from 2010-2015 at the Clinical Oncology Department, Ain-Shams University. 24 patients had T1 and 28 had T2 early glottic carcinoma. The overall survival OS, local control rate, and laryngeal preservation rate were evaluated. Kaplan-Meier method, Cox proportional hazards model were used to analyze the data. Results: Median duration of follow-up was 13 months. Thirty-eight patients received radiation treatment alone (73.1%), 7.7% of the patients underwent surgery alone, and 19.2% of the patients had surgery combined with radiotherapy. Local recurrence after radiation failure developed in 6/52 patients, all had T2 disease and were salvaged by total laryngectomy. The ultimate local control rate was 88.5%, and the ultimate laryngeal preservation rate was 77.2% (40/52 patients). The median OS of the 52 patients was 13 months (range 2 - 46 months). Univariate analysis of factors associated with poor local control showed that age > 60 years was the only significant factor (P = 0.048). Conclusion: Radiotherapy achieves high local control and laryngeal preservation rates for patients with early glottic carcinoma, and is associated with a low rate of severe complications compared to surgery. Salvage surgery is feasible after radiotherapy failure.
文摘BACKGROUND Chronic myelomonocytic leukemia(CMML),a rare clonal hematopoietic stem cell disorder characterized by myelodysplastic syndrome and myeloproliferative neoplasms,has a generally poor prognosis,and easily progresses to acute myeloid leukemia.The simultaneous incidence of hematologic malignancies and solid tumors is extremely low,and CMML coinciding with lung malignancies is even rarer.Here,we report a case of CMML,with ASXL1 and EZH2 gene mutations,combined with non-small cell lung cancer(lung squamous cell carcinoma).CASE SUMMARY A 63-year-old male,suffering from toothache accompanied by coughing,sputum,and bloody sputum for three months,was given a blood test after experiencing continuous bleeding resulting from a tooth extraction at a local hospital.Based on morphological results,the patient was diagnosed with CMML and bronchoscopy was performed in situ to confirm the diagnosis of squamous cell carcinoma in the lower lobe of the lung.After receiving azacitidine,programmed cell death protein 1,and platinum-based chemotherapy drugs,the patient developed severe myelosuppression and eventually fatal leukocyte stasis and dyspnea.CONCLUSION During the treatment and observation of CMML and be vigilant of the growth of multiple primary malignant tumors.
