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Summary The inflammation-based modified Glasgow prognostic score (mGPS) has been shown to be a prognostic factor for esophageal cancer, but its changes in relation to neoadjuvant chemotherapy (NAC) have never been discussed. The purpose of this study was to evaluate the potential prognostic role of mGPS with regard to NAC. mGPS was evaluated on the basis of admission blood samples taken before chemotherapy and before surgery. Patients with elevated C-reactive protein (CRP) serum levels (>10 mg/L) and hypoalbuminemia (

Laparoscopic partial resection of gastric gastrointestinal stromal tumors (GISTs) ≤5 cm in size is widely performed, whereas that of large GISTs (size >5 cm) is controversial because of oncologic and technical safety. Furthermore, laparoscopic resection of GISTs located at the esophagogastric junction (EGJ) is difficult because of the high risk of narrowing or/and deformity of the EGJ. In the current study we report a case of laparoscopic partial resection of a large GIST located at the EGJ. A 74-year-old female patient visited our institution complaining of epigastric discomfort. An esophagogastroduodenoscopy and an abdominal computed tomography scan revealed a 7.5 × 4.0 cm GIST at the EGJ and upper stomach. The patient underwent laparoscopic partial resection with intracorporeal suturing, without any breakage of the pseudocapsule. The defect of the esophagogastric wall after resection was closed by intracorporeal running suture. The patient's postoperative course was uneventful. To the best of our knowledge, this is the first report of laparoscopic resection of a large GIST located at the EGJ. Our technique of intracorporeal manual suturing following laparoscopic gastric resection can be a valid option for minimally invasive surgery for a large GIST located at the EGJ.

Liposarcoma of the esophagus is very rare. We experienced a huge (27.5 × 11.6 cm) liposarcoma of the esophagus. A 73-year-old man presented with severe dyspnea requiring emergency tracheal intubation. Computed tomography and esophagogastroduodenoscopy showed a large submucosal tumor arising from the esophageal entrance and extending intraluminally to the lower esophagus. We successfully performed endoscopic submucosal dissection (ESD) and esophagotomy to remove the tumor, which preserved swallowing and phonation. The final diagnosis by histopathologic and immunohistologic examination was well-differentiated liposarcoma of the esophagus. Treatment by the combination of ESD and esophagotomy can be performed even for a very large tumor. This method preserves deglutition with a lower risk of recurrent laryngeal nerve paralysis than that with esophagectomy.

Preoperative chemoradiotherapy (CRT) is widely used in the treatment of locally advanced rectal cancer (LARC). Pathological response to CRT has been shown to be a potential prognostic predictor in rectal cancer patients. The aim of this study was to determine the prognostic significance of pathological response to preoperative CRT in LARC patients. Thirty-two patients with LARC were retrospectively analyzed to determine the relationships of pathological response and clinicopathological characteristics to survival outcomes. Patients received CRT with tegafur/uracil and leucovorin. Radiotherapy was administered in fractions of 1.8 Gy/day and 5 days per week. The total dose of radiation delivered was 45 Gy. All patients underwent total mesorectal excision with lymph node dissections after CRT, and resected specimens were examined pathologically. Four patients showed pathological complete response, 14 showed good response, and 14 showed poor response. Pathological complete or good response was associated with longer survival (P = 0.041). Clinicopathological factors excluding gender were not correlated with outcome. No factor was associated with recurrence. Pathological response to preoperative CRT may be a useful prognostic predictor in patients with LARC.