Esophageal squamous cell carcinoma (ESCC) has a poor prognosis, and new therapeutic targets are required. Antibody–drug conjugates (ADCs) are a promising therapeutic modality that selectively delivers cytotoxic payloads to tumors via cell-surface antigens. Tumor-associated calcium signal transducer 2 (TROP2, TACSTD2) has shown therapeutic potential as an ADC target in several malignancies; however, its clinical significance in ESCC remains unclear. An institutional cohort of ESCC patients treated at Kindai University was retrospectively evaluated by immunohistochemistry (n=70) and RNA sequencing (n=27). TACSTD2 copy number alterations, RNA expression, and survival were analyzed using the Cancer Genome Atlas (TCGA) ESCC dataset. IHC was assessed in both resected and biopsy specimens, including metastatic lesions. Survival analyses were performed, stratifying patients by cohort-specific median TACSTD2 expression levels. Immunohistochemistry analysis demonstrated uniformly strong TROP2 expression in all evaluable primary and metastatic lesions. In the TCGA dataset, TACSTD2 mRNA expression was consistently high, irrespective of copy-number status, and was comparable to or higher than that observed in non-small cell lung cancer and breast cancer, tumor types in which TROP2-targeted ADCs are clinically active. The TACSTD2 high-expression group showed a trend toward worse overall survival in both the institutional and the TCGA cohort, whereas disease-free survival was similar. TROP2/TACSTD2 is strongly and consistently expressed in ESCC at the protein and RNA levels, despite infrequent gene amplification, supporting its feasibility as a therapeutic target. High expression shows a trend toward poorer overall survival, warranting validation in larger cohorts.
Achalasia, a rare disease, requires symptomatic self-management that can be achieved by educating patients. Pakistan continues to struggle with low health literacy, resulting in a meagre understanding of disease management, for which educational materials have shown promising improvements in knowledge and symptom resolution. This study aims to investigate the impact of educational intervention on Pakistani achalasia patients, for their disease and associated symptoms management. A prospective observational study involving 84 Pakistani achalasia patients was conducted at Center for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi. Participants received educational pamphlet covering disease information, diagnostic tests, treatment options, and dietary recommendations. Baseline data, including demographic details and health measures, were collected, followed by an educational session. One month later, follow-up assessments evaluated changes in symptoms, HRQoL, and feasibility of pamphlet. Data analysis was performed using SPSS version 25.0. The educational pamphlets significantly improved health outcomes post-follow-up. Subgroup analysis suggested that intervention was broadly effective across demographic groups, while regression analysis confirmed that pamphlet intervention was strong predictor of symptom improvement (p < 0.001) and patient satisfaction. Correlation analyses revealed that higher education levels were associated with greater improvements in both Eckardt and ASQ scores, while employment status showed weak associations with health outcomes. The educational pamphlet had a significant impact on improving symptom management and patient satisfaction with achalasia, demonstrating its effectiveness in enhancing disease understanding and self-management. Future research should focus on the long-term effects and explore additional strategies to enhance disease self-management in diverse populations.
The long-term impact of preoperative treatment on nutritional recovery after esophagectomy remains unclear. Although neoadjuvant chemotherapy (NAC) and neoadjuvant chemoradiotherapy (NACRT) followed by surgery are established strategies for advanced esophageal cancer, their differential effects on postoperative weight loss have not been well characterized. This study aimed to compare long-term nutritional outcomes between esophagectomy after induction chemotherapy and after induction chemoradiotherapy in patients with T4b esophageal cancer. We retrospectively analyzed 86 patients with T4b esophageal cancer who underwent conversion surgery after induction treatment at six institutions between 2009 and 2021. Patients were categorized into a chemotherapy group (CT group, n = 51) and a chemoradiotherapy group (CRT group, n = 35). Longitudinal changes in body weight, lymphocyte counts, serum albumin levels, and prognostic nutritional index (PNI) were evaluated up to 24 months postoperatively. Postoperative weight loss was significantly greater in the CRT group than in the CT group, particularly at 9 and 12 months postoperatively (−13.4
To compare perioperative safety and long-term functional outcomes of esophageal resection versus substitution-alone in patients with corrosive esophageal strictures refractory to endoscopic dilatation. This prospective, single-center, open-label, parallel-group, non-inferiority randomized controlled trial was conducted at a tertiary referral center in India. Patients aged 14–60 years with corrosive esophageal strictures unresponsive to serial dilatation were included. Participants were randomized in a 1:1 ratio to either esophageal resection or substitution-alone group. The primary outcome was incidence of postoperative pulmonary complications (PPC) within 30 days. Secondary outcomes included operative parameters, postoperative morbidity, mortality, and health-related quality-of-life (HRQOL) assessed using the Gastrointestinal-Quality-of-Life-Index (GIQLI). Between September 2012 and December 2023, 143 patients were randomized (resection, n=69; substitution-alone, n=74), and all were analyzed. PPC occurred in 11.6
Esophagectomy is associated with substantial morbidity and mortality, particularly in older patients. Although minimally invasive surgery (MIS) has been widely adopted, its contribution to improve operative outcomes in this population remains unclear. This study aimed to evaluate temporal trends in short-term outcomes after esophagectomy in patients aged ≥ 75 years and determine whether the increasing adoption of MIS contributed to improved operative mortality. Using the Japanese National Clinical Database, we analyzed patients aged ≥ 75 years who underwent radical esophagectomy for esophageal cancer between 2014 and 2024. The primary and secondary endpoints were operative mortality and severe postoperative complications (Clavien–Dindo grade ≥IIIa), respectively. Multivariable logistic regression analyses were performed, including sensitivity analyses additionally adjusted for MIS. Among 7,678 patients, patient complexity increased over time, with higher proportions of octogenarians, patients with American Society of Anesthesiologists Physical Status ≥ 3, and patients receiving preoperative chemotherapy. Open thoracotomy decreased from 53.1
