The Experts below are selected from a list of 174 Experts worldwide ranked by ideXlab platform
Nimish Vakil - One of the best experts on this subject based on the ideXlab platform.
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a controlled trial of an expansile metal stent for palliation of esophageal obstruction due to Inoperable Cancer
The New England Journal of Medicine, 1993Co-Authors: Klaus Knyrim, Hansjoachim Wagner, Norbert Bethge, Michael Keymling, Nimish VakilAbstract:Background Esophageal obstruction due to Cancer can produce debilitating dysphagia. Rapid palliation is usually possible with endoscopic placement of a plastic esophageal prosthesis, but this device has a high rate of complications. A new alternative is a metal-mesh stent that collapses to 3 mm in diameter at placement but can then expand up to 16 mm. Methods Patients with esophageal carcinoma (39 patients) or malignant extrinsic obstruction (3 patients) were randomly assigned to treatment with either a plastic prosthesis (16 mm in diameter) or an expansile metal-mesh stent. The patients were evaluated every six weeks until death. The degree of palliation was expressed as a dysphagia score and a Karnofsky performance score. Results Complications were significantly less frequent with the metal stents than with the plastic prostheses (no complications vs. nine; P<0.001). The dysphagia and Karnofsky scores improved significantly and to a similar degree in both treatment groups. The most common causes of recu...
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A Controlled Trial of an Expansile Metal Stent for Palliation of Esophageal Obstruction Due to Inoperable Cancer
The New England Journal of Medicine, 1993Co-Authors: Klaus Knyrim, Hansjoachim Wagner, Norbert Bethge, Michael Keymling, Nimish VakilAbstract:Background Esophageal obstruction due to Cancer can produce debilitating dysphagia. Rapid palliation is usually possible with endoscopic placement of a plastic esophageal prosthesis, but this device has a high rate of complications. A new alternative is a metal-mesh stent that collapses to 3 mm in diameter at placement but can then expand up to 16 mm. Methods Patients with esophageal carcinoma (39 patients) or malignant extrinsic obstruction (3 patients) were randomly assigned to treatment with either a plastic prosthesis (16 mm in diameter) or an expansile metal-mesh stent. The patients were evaluated every six weeks until death. The degree of palliation was expressed as a dysphagia score and a Karnofsky performance score. Results Complications were significantly less frequent with the metal stents than with the plastic prostheses (no complications vs. nine; P
Klaus Knyrim - One of the best experts on this subject based on the ideXlab platform.
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a controlled trial of an expansile metal stent for palliation of esophageal obstruction due to Inoperable Cancer
The New England Journal of Medicine, 1993Co-Authors: Klaus Knyrim, Hansjoachim Wagner, Norbert Bethge, Michael Keymling, Nimish VakilAbstract:Background Esophageal obstruction due to Cancer can produce debilitating dysphagia. Rapid palliation is usually possible with endoscopic placement of a plastic esophageal prosthesis, but this device has a high rate of complications. A new alternative is a metal-mesh stent that collapses to 3 mm in diameter at placement but can then expand up to 16 mm. Methods Patients with esophageal carcinoma (39 patients) or malignant extrinsic obstruction (3 patients) were randomly assigned to treatment with either a plastic prosthesis (16 mm in diameter) or an expansile metal-mesh stent. The patients were evaluated every six weeks until death. The degree of palliation was expressed as a dysphagia score and a Karnofsky performance score. Results Complications were significantly less frequent with the metal stents than with the plastic prostheses (no complications vs. nine; P<0.001). The dysphagia and Karnofsky scores improved significantly and to a similar degree in both treatment groups. The most common causes of recu...
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A Controlled Trial of an Expansile Metal Stent for Palliation of Esophageal Obstruction Due to Inoperable Cancer
The New England Journal of Medicine, 1993Co-Authors: Klaus Knyrim, Hansjoachim Wagner, Norbert Bethge, Michael Keymling, Nimish VakilAbstract:Background Esophageal obstruction due to Cancer can produce debilitating dysphagia. Rapid palliation is usually possible with endoscopic placement of a plastic esophageal prosthesis, but this device has a high rate of complications. A new alternative is a metal-mesh stent that collapses to 3 mm in diameter at placement but can then expand up to 16 mm. Methods Patients with esophageal carcinoma (39 patients) or malignant extrinsic obstruction (3 patients) were randomly assigned to treatment with either a plastic prosthesis (16 mm in diameter) or an expansile metal-mesh stent. The patients were evaluated every six weeks until death. The degree of palliation was expressed as a dysphagia score and a Karnofsky performance score. Results Complications were significantly less frequent with the metal stents than with the plastic prostheses (no complications vs. nine; P
Claus Belka - One of the best experts on this subject based on the ideXlab platform.
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Long-Term Outcome of Mitomycin C- and 5-FU-Based Primary Radiochemotherapy for Esophageal Cancer
Strahlentherapie und Onkologie, 2010Co-Authors: Maria Wolf, Franz Zehentmayr, Maximilian Niyazi, Ute Ganswindt, Wolfgang Haimerl, Michael Schmidt, Dieter Hölzel, Claus BelkaAbstract:Background and Purpose: For definitive radiochemotherapy, 5-fluorouracil/cisplatin protocols have been considered the standard of care for esophageal carcinoma over the last 2 decades. By contrast, most patients treated at the University Hospital, LMU Munich, Germany, received 5-fluorouracil/mitomycin C. The objective of this retrospective analysis was to determine the value of 5-fluorouracil/mitomycin-C-based therapy. Patients and Methods: Tumor stage, treatment received, and outcome data of patients treated for esophageal Cancer between 1982 and 2007 were collected; endpoint of the analysis was overall survival. Results: 298 patients with Inoperable Cancer of the esophagus were identified (16.8% adenocarcinoma, 77.5% squamous cell carcinoma). At diagnosis, 61.7% (184/298) had UICC stage III–IV, 54.4% (162/298) positive lymph nodes, and 26.5% (79/298) metastatic disease. 74.5% of all patients (222/298) received radiation doses between 55 and 65 Gy, 65.8% (196/298) were subjected to concomitant chemotherapy. The median follow-up period (patients alive) was 4.1 years. A significant increase of overall survival (p < 0.0001) in the radiochemotherapy versus the radiotherapy-alone group was observed. 52% (102/196) in the 5-fluorouracil/ mitomycin C group had tumor stages comparable to the RTOG 85-01 study cohort (T1–3 N0–1 M0). The median survival in this subgroup was 18.2 months, 3- and 5-year survival rates were 22.7% (21/102) and 15.0% (13/102), respectively. Conclusion: Despite being nominally inferior to platinum-based radiochemotherapy, the overall survival rates are in a similar range. Thus, the mitomycin-C-based radiochemotherapy approach may considered to be as effective as the standard therapy. However, there is no randomized trial available in order to prove the equality. Hintergrund und Ziel: Radiochemotherapie mit 5-Fluorouracil und Cisplatin gilt seit 2 Jahrzehnten als Standard fur die primare Behandlung des Osophaguskarzinoms. Im Gegensatz dazu erhielten die meisten Patienten, die im Klinikum der LMU Munchen behandelt wurden, eine definitive Radiochemotherapie mit 5-Fluorouracil und Mitomycin C. Retrospektiv wurde gepruft, zu welchen Ergebnissen das angewandte Regime im Vergleich zur Standardtherapie fuhrte. Patienten und Methodik: Retrospektiv wurden Tumorstadium, Therapieform und das Outcome der Patienten mit Osophaguskarzinom, die zwischen 1982 und 2007 behandelt wurden, erhoben (Tabelle 1). Primarer Endpunkt war das Gesamtuberleben (Abbildungen 1a bis 1c). Ergebnisse: 298 Patienten (16,8% Adenokarzinome [50/298], 77,5% Plattenepithelkarzinome [231/298]) wurden primar behandelt. Bei Diagnosestellung wiesen 61,7% (184/298) UICC-Stadien III–IV, 54,4% (162/298) einen positiven Lymphknotenstatus sowie 26,5% (79/298) Fernmetastasen auf. 74,5% aller Patienten (222/298) erhielten eine Bestrahlungsdosis zwischen 55 und 65 Gy. 65,8% (196/298) bekamen parallel dazu eine Chemotherapie. Der mediane Nachbeobachtungszeitraum betrug 4,1 Jahre. Es zeigte sich ein signifikant langeres Uberleben in der Radiochemotherapiegruppe im Vergleich zur Radiotherapiegruppe (p < 0,0001). 102/196 Patienten (52%) in der Radiochemotherapiegruppe hatten Tumorstadium T1–3 N0–1 M0, entsprechend der RTOG-85-01-Kohorte. In dieser Subgruppe zeigten sich ein medianes Uberleben von 18,2 Monaten und Uberlebensraten von 22,7% (21/102) bzw. 15,0% (13/102) nach 3 respektive 5 Jahren (Tabellen 2 und 4). Schlussfolgerung: Obwohl in diesem unselektionierten Kollektiv der Standardtherapie mit Cisplatin/5-Fluorouracil nominell unterlegen, sind die Uberlebensraten in einem vergleichbaren Bereich (Tabelle 3). Eine Radiochemotherapie mit 5-Fluorouracil und Mitomycin C scheint ahnlich effektiv wie die Standardtherapie zu sein. Allerdings gibt es keine randomisierte Studie, um dies zu beweisen.
Shcherbakov Am - One of the best experts on this subject based on the ideXlab platform.
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Use of endoscopic surgery and combined radiotherapy for Inoperable Cancer of the esophagus
Voprosy onkologii, 2020Co-Authors: Shcherbakov Am, Kanaev Sv, Shulepov AvAbstract:: A comparative evaluation of the efficacy of combined radiotherapy (112 - group 1) carried out in conjunction with a battery of procedures of endoscopic surgery plus combined radiotherapy (76 - group 2) for Inoperable Cancer of the esophagus was conducted in 118 patients. Maximum local regression was reported in group 2 (77.6%) as compared with only 33.9% in group 1. Relatively longer relapse-free period (133 days) and lower residual growth incidence (44.6%) were in group 2, too, as compared with 107 days and 63.5% in group 1. Mean survival duration was nearly identical in both groups - ca.15 months. Similarly, survival rates in groups 2 and 1 were: 69.2 and 58.8% (year 1), 22.2 and 22.3% (year 2), and 11.3 and 12.9% (year 3), respectively. It was concluded that combinations of endoscopic surgery and combined radiotherapy for Inoperable Cancer of the esophagus improved immediate results and reduced the rates of residual tumor incidence. However, no significant differences in mean duration or rates of survival were observed.
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Results of endoscopic recanalization for Inoperable Cancer of the esophagus
Voprosy onkologii, 2020Co-Authors: Shcherbakov AmAbstract:: Patients with Inoperable Cancer of the esophagus were followed up for 1-3 years after a course of palliative endoscopic destruction of tumor. Residual growth occurred in 88.1% with an average stabilization period of 47 days. Among the unfavorable prognostic factors were partial decomposition of tumor, squamous-cell pattern, size of more than 9 cm, circular extension through the esophagus and stage III stenosis. With the aid of newly-developed methods of outpatient endoscopic destruction, 94.2% could eat throughout their survival period. Mean survival time was 5.6 months or 7.3 months in metastasis-free cases.
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An experience with stenting the esophagus in patients with Inoperable Cancer
Vestnik khirurgii imeni I. I. Grekova, 2020Co-Authors: Shcherbakov AmAbstract:: An experience with treatment of 21 patients with Inoperable Cancer of the esophagus allowed determination of indications and contraindications, development of the method and technique of endoscopic implantation of a domestic meshed self-expanding stent. The complications resulting from the process of mounting and the stent itself are analyzed. The methods of eliminating the complications are shown. The immediate and nearest results of endoprosthesing are assessed. Recommendations are given concerned with the cases of ingrowth of tumor into the stent.
K. Fischerman - One of the best experts on this subject based on the ideXlab platform.
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Palliation of oesophagogastric neoplasms with Nd:YAG laser treatment.
Scandinavian Journal of Gastroenterology, 1990Co-Authors: Svend Schulze, K. FischermanAbstract:The palliative effect of endoscopic Nd:YAG laser treatment of malignant strictures of the oesophagus and cardia was prospectively evaluated in 30 patients. Most (n = 28) were primarily treated for dysphagia, and swallowing was improved in 21 and normalized in 14 of these patients. Two patients were successfully treated for bleeding. Six patients developed complications (including two perforations), and four of these were fatal. The median survival was 4 months (range, 17 days to 14 months). It is concluded that in a great number of patients with Inoperable Cancer of the oesophagus and cardia, laser treatment is better than other palliative procedures.