[Assessment of esophageal cancer with remote metastases treated with multidisciplinary therapy].

We present three cases of patients diagnosed with esophageal cancer with distant metastases. We conducted chemotherapy, radiotherapy, RFA, and operation for main tumor and lymph node, lung, brain metastasis. They were for a long-term survival with multidisciplinary therapy. The longest survival time was about three years. We discussed our cases in light of review of the literature.

p12CDK2-AP1 is associated with tumor progression and a poor prognosis in esophageal squamous cell carcinoma.

p12 CDK2-associating protein 1 (p12CDK2-AP1) is a growth suppressor that negatively regulates cyclin-dependent kinase 2 (CDK2) activities. In addition, p12CDK2-AP1 has also been shown to interfere in DNA replication. A reduction of p12CDK2-AP1 expression is known to be a negative prognostic indicator in patients with oral squamous cell carcinoma. To elucidate the role of p12CDK2-AP1 expression in esophageal squamous cell carcinoma (ESCC), we immunohistochemically examined the expression of p12CDK2-AP1 protein in 120 resected ESCC specimens and determined its association with the clinicopathological characteristics and prognosis. Of the 120 ESCCs, 79 (65.8%) showed positive staining (>or=25% of cancer cells showing p12CDK2-AP1 expression), while 41 (34.2%) lacked the staining (<25% of cancer cells showing p12CDK2-AP1 expression). Negative staining for p12CDK2-AP1 was found to be significantly associated with advanced lesions [depth of tumor (P=0.001), lymph node metastasis (P<0.001), pathological stage (P<0.0001) and venous invasion (P<0.0001)], and a poor prognosis (disease-free survival and overall survival: log-rank P<0.05). The rate of lymph node metastasis in patients with p12CDK2-AP1 negative-T1 ESCC was significantly higher than that in patients with p12CDK2-AP1 positive one (P<0.05). These results suggest the down-regulation of p12CDK2-AP1 to be related to tumor aggressiveness and a poor prognosis in patients with ESCC.

[Local ablation therapy combined with liver resection for multiple hepatocellular carcinomas].

In patients with multiple hepatocellular carcinomas (HCCs), a liver resection for the main tumor may be performed in combination with local ablation therapy for satellite lesions. Of 63 multiple HCC patients without radiological vascular invasions, 27 were treated with liver resection alone and the other 36 treated with the combination of liver resection and local ablation therapy. No significant differences were found in both groups with regard to age, gender, BMI, etiology of hepatitis, liver damage grade, tumor number, size of the main tumor and size of satellite lesion. In the liver resection group, 11 hemihepatectomies, 12 sectionectomies and 4 partial hepatectomies were performed. In the combination therapy group, 8 hemihepatecomies, 17 sectionectomies and 11 partial hepatectomies were performed. No significant differences were found in both groups with respect to bleeding, transfusion, disease-free survival rate, and survival rate. In the combination therapy group, a resected liver volume was significantly lower (p = 0.003) and an operation time was shorter (p = 0.009). It appears to indicate that the combination of liver resection and local ablation therapy can be useful for multiple HCCs.