INTRODUCTION:Various nutritional and inflammatory biomarkers have been proposed to predict prognosis in cancer patients. This study aimed to identify the most significant of these, along with clinical features, in gastric cancer patients who underwent gastrectomy. METHODS:We retrospectively analyzed gastric cancer patients who underwent gastrectomy. Preoperative markers included mGPS (modified Glasgow Prognostic Score), neutrophil-to-lymphocyte ratio, C-reactive protein-to-albumin ratio, prognostic nutritional index, and Controlling Nutrition Status score. Postoperative markers were CRPmax, postoperative complications, and operative procedures. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS). Survival was analyzed with the Kaplan-Meier method. Key prognostic factors were identified using stepwise univariate and multivariable Cox regression. RESULTS:360 patients were analyzed. Stepwise Cox analysis showed mGPS as the strongest preoperative predictor of OS and RFS. When including both pre- and postoperative variables, age, pathological stage, and surgical procedure were independent prognostic factors. In a model limited to modifiable factors, mGPS and postoperative complications independently predicted both OS and RFS, while surgical procedure independently predicted RFS only. CONCLUSIONS:Improving preoperative mGPS and minimizing postoperative complications may enhance survival after gastrectomy. When appropriate, stomach-preserving procedures (e.g., subtotal distal gastrectomy) should be favored over total gastrectomy.

Despite the availability of numerous perioperative prognostic indicators for advanced gastric cancer, their relative predictive accuracy has not been compared. The present study investigated the association of these indicators and postoperative chemotherapy with patient survival in advanced gastric cancer. A total of 142 patients with stage II-IV gastric cancer who underwent gastrectomy with R0/R1 resection were examined. The preoperative modified Glasgow prognostic score (mGPS), controlling nutritional status score, CRP-to-albumin ratio, prognostic nutritional index and neutrophil-to-lymphocyte ratio was calculated. Postoperative serum CRP was evaluated as the CRPmax. Postoperative chemotherapy was administered according to the Japanese Gastric Cancer Treatment Guidelines. Patients were divided into chemotherapy and no chemotherapy groups, followed by propensity score matching to adjust for background factors. The endpoints were relapse-free survival (RFS) and overall survival (OS). Prognostic factors were evaluated using the Cox proportional hazard model. The OS and RFS were found to be improved in the chemotherapy group compared with the no chemotherapy group (P<0.05) and in the low mGPS group compared with the high mGPS group (P<0.05). Stepwise regression analysis identified the mGPS as the most reliable preoperative marker for both OS and RFS. Cox analysis of the matched groups revealed that postoperative chemotherapy was an independent prognostic factor for RFS and that mGPS was an independent prognostic factor for OS. A preoperative CRP of <0.3 mg/dl and a low mGPS score were found to be independent prognostic factors for RFS in the chemotherapy group. Overall, postoperative chemotherapy was found to reduce recurrence in advanced gastric cancer, while the preoperative mGPS was a strong prognostic marker for OS. Improving the preoperative mGPS may therefore improve both OS and the effectiveness of postoperative chemotherapy, but future large-scale studies are needed.

Although early detection of pancreatic ductal adenocarcinoma (PDAC) remains challenging, health checkups may improve clinical outcomes. This retrospective study compared the clinical characteristics of PDAC cases identified during health checkups (HC cohort, 61 patients) with those diagnosed through other methods (non-HC cohort, 801 patients). Transabdominal ultrasonography was more frequently utilized in the HC cohort ( P < 0.01). Patients in the HC cohort were significantly younger ( P < 0.05), with lower CEA and CA19-9 levels and smaller tumor sizes ( P < 0.01). Notably, the HC cohort showed significantly higher proportions of stage IA and stage IIA disease and higher rates of curative surgical resection (all P < 0.01). Overall survival in the HC cohort was significantly higher than in the non-HC cohort ( P < 0.01 for log-rank test and multivariable analysis), and tumor size ≤ 20 mm was significantly associated with survival exceeding 5 years in the HC cohort ( P = 0.015). Our findings suggest that health checkups facilitate earlier diagnosis of PDAC and improve long-term prognosis. Establishing a standardized screening system using transabdominal ultrasonography, specifically optimized to detect tumors ≤ 20 mm, is essential to improving survival in patients with PDAC.

Although early detection of pancreatic ductal adenocarcinoma (PDAC) remains challenging, health checkups may improve clinical outcomes. This retrospective study compared the clinical characteristics of PDAC cases identified during health checkups (HC cohort, 61 patients) with those diagnosed through other methods (non-HC cohort, 801 patients). Transabdominal ultrasonography was more frequently used in the HC cohort (P < 0.01). Patients in the HC cohort were significantly younger (P < 0.05), had lower carcinoembryonic antigen and carbohydrate antigen 19 − 9 levels, and had smaller tumor sizes (P < 0.01). Notably, the HC cohort showed significantly higher proportions of stage IA and stage IIA disease and higher rates of curative surgical resection (all P < 0.01). Overall patient survival in the HC cohort was significantly higher than in the non-HC cohort (P < 0.01 for the log-rank test and multivariable analysis), with a tumor size ≤ 20 mm significantly associated with survival exceeding 5 years in the HC cohort (P = 0.015). Our findings suggest that health checkups can facilitate earlier PDAC diagnosis and improve long-term prognosis. Thus, standardizing PDAC screening during health checkups, specifically to detect early-stage tumors (≤ 20 mm), could potentially contribute to improving long-term outcomes.

Background/Aim: Appendiceal gastrointestinal stromal tumors (GISTs) are exceptionally rare neoplasms. Case Report: We report a case of a 68-year-old man who presented with recurrent right lower quadrant abdominal pain. Ultrasonography revealed a 10×4 mm hypoechoic submucosal tumor adjacent to the appendiceal orifice. Contrast-enhanced computed tomography demonstrated a delayed-enhancing appendiceal lesion without regional lymphadenopathy. Laparoscopic appendectomy was performed. Histopathological examination revealed an 8-mm tumor composed of spindle-shaped cells arising from the muscularis propria of the appendix. Immunohistochemical analysis showed positivity for c-kit and CD34, leading to a diagnosis of very low-risk appendiceal GIST. Conclusion: This case highlights the diagnostic challenges posed by this extremely rare entity and contributes additional long-term outcome data to the limited literature on appendiceal GISTs. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, most frequently arising in the stomach (approximately 60%) and small intestine (approximately 30%) (1). In contrast, GISTs originating from the appendix are exceedingly rare, accounting for approximately 0.1% of all GISTs (2). Owing to their rarity and small size, appendiceal GISTs are often discovered incidentally and may present diagnostic challenges. Herein, we report a rare case of appendiceal GIST detected preoperatively and successfully treated by laparoscopic appendectomy, with long-term recurrence-free survival.

Background/Aim: Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision is the standard treatment for advanced low rectal cancer; however, long-term oncological outcomes vary widely, and reliable prognostic biomarkers remain limited. Carcinoembryonic antigen (CEA) is commonly used in colorectal cancer management, but the prognostic value of post-CRT CEA levels has not been fully clarified. This study aimed to identify clinically relevant prognostic factors for recurrence and survival, with particular focus on pre- and post-CRT CEA levels. Patients and Methods: A retrospective review was conducted of 41 consecutive patients with advanced low rectal cancer (Rb, cT3/4 or N1/2 and no lateral lymph node metastasis) who underwent long-course preoperative CRT followed by radical surgery. CRT consisted of 45 Gy in 25 fractions with concurrent tegafur/uracil, followed by total mesorectal excision 8-10 weeks after CRT completion. Clinicopathological factors were analyzed in relation to recurrence, disease-free survival (DFS), and overall survival (OS). Results: With a median follow-up of 69.3 months, recurrence occurred in 16 patients. Five-year DFS and OS rates were 59.4% and 73.2%, respectively. Univariate analysis identified postoperative complications, pathological complete response, and pre- and post-CRT CEA levels as significant factors associated with recurrence. Multivariate analysis demonstrated that post-CRT CEA was the only independent prognostic factor. Receiver operating characteristic analysis identified a post-CRT CEA cut-off value of 3.9 ng/ml. Patients with lower post-CRT CEA showed significantly better DFS and OS. Conclusion: Post-CRT CEA is a valuable prognostic biomarker for recurrence and survival in advanced low rectal cancer, and patients with elevated post-CRT CEA may benefit from additional consolidation chemotherapy.

BackgroundImmune dysregulation and excessive inflammatory responses can lead to hemophagocytic syndrome (HPS) involving autologous blood cell phagocytosis, with fatal outcomes occurring in some cases. This case report describes an 80-year-old man who was simultaneously diagnosed with diffuse large B-cell lymphoma (DLBCL) and rectal cancer and developed HPS during neoadjuvant chemotherapy for the latter.Case descriptionTreatment for DLBCL was initiated first, and six courses of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy were administered, which led to a clinical complete response of the lymphoma lesions. Following the completion of DLBCL treatment, preoperative chemoradiotherapy with tegafur–uracil/leucovorin (UFT/UZEL) was initiated for rectal cancer. On Day 18, a fever of 38.3 °C developed. Blood tests conducted on Day 24 revealed Grade 4 neutropenia and Grade 4 thrombocytopenia. Granulocyte colony-stimulating factor (G-CSF) preparation, antibiotic therapy, and recombinant human soluble thrombomodulin (rTM) were initiated as disseminated intravascular coagulopathy (DIC) therapy. A poor therapeutic response was achieved, and acute respiratory distress syndrome (ARDS) developed on Day 34. Imaging of the biopsied bone marrow confirmed that hemophagocytosis by macrophages was occurring. The patient was ultimately diagnosed with HPS. Epstein–Barr virus (EBV) and cytomegalovirus (CMV) infections were identified, and treatment to combat the infections was initiated; however, the patient passed away on Day 37.ConclusionIt is important to consider the possibility of HPS, and diagnosis and treatment initiation should occur in a timely manner when fever of an unknown origin and decreased blood cell counts are observed during malignant disease treatment.

Colorectal cancers (CRCs) include stroma-dominant tumors with desmoplasia and differentiated, gland-forming tumors with little stroma. We asked whether this difference reflects stromal abundance alone or also involves a distinct cancer cell state. HEST-1K sections were classified as M-type (stroma-dominant; five patient/tissue units) or D-type (differentiated and cancer cell-dominant; seven units). Prespecified EMT/pEMT, ECM/integrin, YAP/TAZ-TEAD, and DTP/persister gene sets were examined across spatial, bulk, and single-cell datasets and patient-derived malignant ascites cultures. M-type tumors contained broader CAF-rich compartments and higher activity of all four programs in EPCAM/KRT-high regions, including epithelial-dense tumor cores. Activity was greatest near CAF-rich areas. In GSE39582, EMT/pEMT, ECM/integrin, DTP/persister, and invasive epithelial programs were independently associated with recurrence. Ascites-derived cultures from stroma-dominant tumors showed higher ECM/integrin and survival programs. Independent institutional analyses supported the public data findings: focused real-time PCR showed higher MAPK/TGF-beta-related gene expression in M-type-derived than in D-type-derived ascites cells, and IHC showed stronger epithelial CD44v6 expression in M-type primary tumors and metastatic lymph node lesions. CAF co-culture increased VIM-promoter activity. These findings characterize stroma-dominant CRC as a spatially organized ecosystem in which a CAF-rich compartment is associated with stress-adapted cancer cell programs. Its poor prognosis may therefore involve not only stromal abundance but also a morphology-associated cancer cell state detectable after dissemination.

A male in his 60s who presented for evaluation of markedly elevated serum CA19-9 levels. Imaging studies revealed a carcinoma located in the pancreatic tail. He was diagnosed with resectable pancreatic tail cancer(Pt, TS2[35 mm], T3, S1, RP1, PV1[PVsp], A1[Asp], PL0, OO1[gastric invasion], N0, M0 cStage ⅡA). Neoadjuvant chemotherapy with gemcitabine +S-1 was administered, resulting in a partial response according to RECIST criteria. The patient subsequently underwent distal pancreatectomy, local gastrectomy, and partial left adrenalectomy. Histopathological examination confirmed pancreatic tail carcinoma:Pt, well-differentiated, TS2(30 mm), ypT3, ypS1, ypRP1, ypPV0, ypA0, ypPL1(PLspa), ypOO1(gastric invasion), ypN1a, M0, ypStage ⅡB, R0 resection, Grade 1b. Notably, there was no evidence of direct adrenal invasion. Postoperative adjuvant chemotherapy with S-1 was administered. One year after surgery, contrast-enhanced CT and PET-CT revealed enlargement of the left adrenal gland with abnormal FDG uptake(SUVmax 6.5). EUS-FNA confirmed adrenal metastasis from pancreatic cancer. The patient underwent chemoradiotherapy consisting of 60 Gy in 30 fractions combined with gemcitabine+nab-paclitaxel. Serum CA19-9 normalized, and FDG uptake on PET-CT resolved. Subsequently, a left adrenalectomy was performed. Histopathological evaluation revealed no viable cancer cells, showing only post-treatment changes, consistent with a pathological complete response(Grade 4). The postoperative course was uneventful, and at 6 months post-adrenalectomy, the patient remains recurrence-free without further adjuvant therapy.

Effective postoperative pain management is crucial after minimally invasive hepatectomy (MIH) to promote recovery, and multimodal analgesia strategies are used to reduce opioid requirements and improve outcomes. Acetaminophen is commonly included as part of multimodal therapies for postoperative pain management. However, the safety and efficacy of acetaminophen for postoperative analgesia in MIH remains unestablished due to its hepatic metabolism. This study aimed to evaluate the safety and efficacy of routine intravenous acetaminophen administration following MIH. The data of consecutive 50 patients who had undergone MIH were retrospectively analyzed. Regarding postoperative analgesia, patients were allocated to either the opioid-alone cohort (Cohort O) or opioid with routine intravenous acetaminophen cohort (Cohort A). Analgesic efficacy was evaluated using the numerical rating scale (NRS) over the first 2 postoperative days. The sum of opioid rescue doses and frequency of postoperative nausea and vomiting (PONV) were assessed. Analgesic safety was determined by monitoring prolonged elevated transaminase levels. Postoperatively, no significant differences in the hepatic and renal functions and systemic inflammatory markers were observed between the two cohorts. On both postoperative day 1 and day 2, Cohort A showed significantly lower NRS scores than Cohort O. Notably, almost all patients in Cohort A did not require any rescue opioid doses, resulting in a significantly reduced median rescue dose (6 versus 0 doses, p = 0.0017). Even when opioid doses were reduced due to PONV, Cohort A continued to exhibit significantly lower NRS scores. Multimodal analgesia comprising routine intravenous acetaminophen administration could be safe and effective after minimally invasive hepatectomy, without adverse effects regarding hepatic function.

Artificial intelligence(AI)is transforming cancer medicine across three key domains. First, AI enables the conversion of unstructured visual data-such as pathology slides and radiological images-into structured, quantifiable formats. This improves diagnostic reproducibility and allows for automated tumor detection, classification, and prognostication with accuracy comparable to or exceeding that of specialists. Second, AI facilitates high‒dimensional analysis of omics data, including RNA sequencing and DNA methylation profiles. Machine learning models can uncover latent molecular patterns, predict splicing abnormalities, and identify dependency genes, enabling more refined molecular classification and novel therapeutic target identification. Third, multimodal AI integrates heterogeneous data types-images, genomics, and clinical text-into unified analytical frameworks. This allows for non‒invasive prediction of molecular alterations, treatment responsiveness assessment, and outcome prediction. Integration with large language models(LLMs)further enhances interpretability and enables cross‒modal reasoning in clinical decision‒making contexts. Together, these 3 layers of AI application-image structuring, omics analysis, and multimodal integration-form the foundation for a next‒generation approach to cancer care. AI does not merely automate existing tasks but offers new pathways to understanding cancer's origins, molecular essence, and progression trajectories‒bringing the vision of true precision oncology closer to clinical reality.

Colorectal cancer with gut-associated lymphoid tissue (GALT) carcinoma histopathology is particularly rare in very elderly patients. GALT is characterized by submucosal localization and prominent lymphoid infiltration with germinal center formation within tumor-infiltrating lymphocytes. This study aims to report a case of colorectal cancer with GALT carcinoma histopathology in a very elderly patient and to provide a comprehensive literature review. In this case, a 90-year-old female presented with an irregularly elevated tumor in the sigmoid colon, diagnosed via colonoscopy. Computed tomography revealed no lymph node or distant metastases. The patient underwent laparoscopy-assisted sigmoid colon resection with D3 dissection. Histopathological examination revealed well-differentiated adenocarcinoma in the submucosal layer with partial invasion into the muscle layer. Lymphocytes, along with lymph follicles, proliferated compressively in the stroma surrounding the tumor glands. Immunohistochemical analysis showed lost expression of mismatch repair proteins, MLH1 and PMS2, consistent with the tumor immunohistochemistry profile. B cells (CD20- and CD79a-positive) were generally distributed in and around the lymph follicles, while T cells (CD3-positive) were primarily located between the lymph follicles. This case highlights the rare histopathology of GALT carcinoma in colorectal cancer and underscores the importance of considering such diagnoses in elderly patients with colorectal tumors.

In Japan, the proportion of elderly gastric cancer patients is increasing. Although surgery in patients aged ≥ 80 years is relatively safe, postoperative pneumonia often occurs, reducing quality of life and being fatal. We retrospectively investigated the risk factors for pneumonia after gastrectomy in elderly patients at our hospital. Between 2010 and 2019, 113 patients aged ≥ 80 years underwent gastrectomy for gastric cancer at our hospital. Of these, 88 patients were retrospectively investigated, excluding 25 patients who did not receive sufficient postoperative follow-up. The diagnosis of pneumonia was based on chest CT findings. Univariate and multivariate analyzes for risk factors of pneumonia were performed using the Cox proportional hazards model. The patients were aged 80–93 years (median 83 years) and consisted of 63 males and 25 females. The surgical procedures included distal gastrectomy in 54, total gastrectomy in 25, proximal gastrectomy in two, and local resection in seven. Postoperative pneumonia was observed in 38 patients. Seventeen of them died from pneumonia. The time to onset of pneumonia was 0.2-144.6 months (median 12.0 months), and the median observation period for patients without pneumonia was 38.8 months. Multivariate analysis revealed that age, Geriatric Nutritional Risk Index, respiratory history, and extent of gastrectomy (total vs. distal: hazard ratio 3.91, 95

A male in his 70s underwent laparoscopic-assisted high anterior resection and D2 lymph node dissection for rectal cancer (pT3, pN1a, M0, fStage ⅢB)3 years ago. Postoperative adjuvant chemotherapy was not administered due to diabetic nephropathy. Three years post-surgery, plain CT and PET-CT revealed recurrent liver metastasis at the bifurcation of the anterior and posterior liver segments. Right hepatic lobectomy was planned following portal vein embolization, as his ICG R15 was 18.9%, indicating insufficient residual liver volume after resection. To avoid frequent contrast-enhanced CT scans due to low renal function, 4D flow-MRI was performed before portal vein embolization and on the third day post-embolization to measure portal blood flow velocity and volume. These measurements were applied to the estimated residual liver volume formula to predict the residual liver volume 28 days later. The predicted residual liver volume on the 28th day was 469 mL(64%), and CT volumetry performed on the same day showed a volume of 471 mL. Right hepatic lobectomy was performed without worsening liver or kidney function. This case report demonstrates that using 4D flow-MRI can accurately predict the residual liver volume after portal vein embolization, enabling safe curative resection in patients for whom contrast-enhanced CT is challenging due to renal impairment.

With the aging of society, the number of cases with colorectal cancer aged 90 and over is increasing. We retrospectively reviewed short-term outcomes of laparoscopic surgery performed at our hospital from January 2019 to August 2024. Thirteen patients were included. Primary tumor locations were C/A/T/D/S/R=3/4/1/1/3/1. Pathological stages were Stage 1/2/3/4=3/2/6/2. All patients underwent primary tumor resection, with D2 lymphadenectomy in 2 cases and D3 in 11. Stoma creation was performed in 2 cases;anastomosis was performed in 11. Postoperative complications of Clavien-Dindo Grade ≥Ⅲ occurred in 2 patients. The median postoperative hospital stay was 20 days(range 9-56 days). All patients returned to their preoperative living conditions without becoming bedridden. We conclude that laparoscopic surgery allows safe recovery even in super-elderly patients.

ABSTRACT Aim The clinical characteristics of colonic diverticular perforation are poorly understood. We aimed to clarify the clinical characteristics of colonic diverticular perforation. Methods Patients who underwent surgery for colonic diverticular perforation from 2011 to 2021 were retrospectively evaluated. The patients were divided into right‐ and left‐sided colon cohorts according to their perforation location. Results Of 1129 patients with gastrointestinal perforation, 138 had colonic diverticular perforation. The sigmoid colon was the most common perforation site. The patients were categorized into right‐sided (20 patients) and left‐sided (118 patients) colon cohorts. The number of patients with colonic diverticular perforation increased with age, as did the proportion of left‐sided perforations. The left‐sided cohort had significantly higher mean age, hemoglobin, and serum albumin levels than the right‐sided cohort. The blood urea nitrogen and serum creatinine levels were significantly lower in the right‐sided cohort. The proportion of patients with colostomy, the proportion of patients with postoperative complications, and the length of intensive care unit stay during hospitalization were significantly longer in the left‐sided cohort. The left‐sided cohort also had a considerably longer mean hospital stay and higher mean hospitalization costs than the right‐sided colon cohort. An age of ≥ 75 years tended to be associated with a prolonged hospital stay and high hospitalization costs in the left‐sided colon cohort. Conclusions The patients' conditions, length of hospital stay, and hospitalization costs were significantly worse in the left‐ than right‐sided colon cohort. The clinical characteristics differed according to the location of the diverticular perforation.

Background As gastric cancer patients aged ≥ 85 years have a short life expectancy and often die from other diseases such as pneumonia, indications for surgery are controversial. In this study, we retrospectively analyzed the prognostic factors of elderly patients with gastric cancer who are candidates for curative gastrectomy. Methods Among 114 patients aged ≥ 85 years with gastric cancer at our hospital between 2010 and 2019, prognostic factors were examined using the Cox proportional hazards model in 76 patients excluding those with cStage IVB or endoscopic submucosal dissection. We also analyzed the factors of pneumonia death. Results cStage was I/IIA/IIB/III/IVA in 37/6/14/14/5 patients, respectively. Treatment included distal gastrectomy in 28 patients, total gastrectomy in 6, local resection in 9, others in 3, and no surgery in 30. In univariate analyses of overall survival, Eastern Cooperative Oncology Group Performance Status, physiological score of Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM), Onodera's prognostic nutritional index, cStage, and treatment were prognostic factors. In a multivariate analysis, POSSUM physiological score, cStage, treatment method {no surgery vs distal gastrectomy: hazard ratio (HR) 5.78, 95% confidence interval (CI) 2.33–14.3}, (total gastrectomy vs distal gastrectomy: HR 4.26, 95% CI 1.22–14.9) were independent prognostic factors. In univariate analyses of pneumonia-specific survival, treatment (total gastrectomy vs distal gastrectomy: HR 6.98, 95% CI 1.18–41.3) was the only prognostic factor. Conclusions The prognosis of distal gastrectomy was better than that of non-surgery even in patients aged ≥ 85 years. However, total gastrectomy was considered to be avoidable due to the high rate of postoperative pneumonia death.

A woman in her sixties with portosystemic shunt and hepatic encephalopathy underwent open mesenteric vein ligation, resulting in improved portal flow and blood ammonia. In this case, 4D flow MRI was a valuable diagnostic and follow-up tool, visualizing and quantifying physiological portal hemodynamics with features distinct from those of contrast-enhanced CT and digital subtraction angiography. Our case study highlights the value of 4D flow MRI for managing portosystemic shunts.

Objective Esophageal cancer is a gastrointestinal cancer with a poor prognosis. However, it is curable and can be treated endoscopically if it is detected at an early stage. The objective of this study was to identify the factors that contribute to early detection. Methods From April 2011 to December 2019, we retrospectively investigated consecutive patients diagnosed with esophageal squamous cell carcinoma (ESCC) through upper gastrointestinal endoscopy at two hospitals of Kawasaki Medical University based on medical records. The factors contributing to the early detection of ESCC were investigated by comparing patients with ESCC with those undergoing health checkups in whom no organic lesions were found in the upper gastrointestinal tract on endoscopy (controls). Patients Factors contributing to early detection were examined in 402 ESCC cases and 391 sex- and age-matched controls, and early and advanced cancers were compared along with the risk factors for ESCC. Results A multivariate analysis showed that alcohol consumption and smoking, concomitant cancer of other organs, and a low body mass index (BMI) were factors associated with ESCC (odds ratio [OR], 4.65; 95% confidence interval [CI], 2.880-7.520, OR, 3.63; 95% CI, 2.380-5.540, OR, 2.09; 95% CI, 1.330-3.270, OR, 6.38; 95% CI, 3.780-10.800), whereas dyslipidemia was significantly less common in patients with ESCC (OR, 0.545; 95% CI, 0.348-0.853). Comparing early and advanced cancers, a history of endoscopic screening was the only factor involved in early detection (OR, 7.93; 95% CI, 4.480-14.000). Conclusion The factors associated with ESCC include alcohol consumption, smoking, concomitant cancer of other organs, and a low BMI. Endoscopy in subjects with these factors may therefore be recommended for the early detection of ESCC.