• Endoscopic mucosal dissection
• Endoscopic mucosal resection
• Esophageal cancer
• Radiofrequency ablation

• Humans
• Endoscopic Mucosal Resection/methods
• Esophageal Neoplasms/surgery
• Esophageal Neoplasms/pathology
• Neoplasm Staging
• Stomach Neoplasms/surgery
• Stomach Neoplasms/pathology
• Endoscopy, Gastrointestinal

• Benign stricture
• Endoscopic dilatation
• Endoscopic stent
• Oesophageal stricture
• Refractory stricture
• Self-expanding metal stent
• Stricturotomy

• Humans
• Esophageal Stenosis/therapy
• Esophageal Stenosis/surgery
• Esophageal Stenosis/etiology
• Esophagoscopy/instrumentation
• Dilatation/methods
• Stents
• Deglutition Disorders/etiology
• Deglutition Disorders/therapy
• Deglutition Disorders/physiopathology
• Deglutition Disorders/surgery
• Palliative Care
• Esophageal Neoplasms/complications
• Esophageal Neoplasms/surgery
• Esophageal Neoplasms/therapy
• Treatment Outcome
• Algorithms

• Barrett's and adenocarcinoma
• Endoscopic ultrasonography
• Esophageal cancer
• Malignant strictures
• RFA and ablative methods

• cryoablation
• esophagus
• squamous cell carcinoma

• Adenocarcinoma/pathology
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Esophagoscopy/adverse effects
• Humans
• Neoplasm Staging
• Salvage Therapy

• Barrett’s esophagus
• Cryotherapy
• Esophageal cancer
• Gastric antral vascular ectasia
• Palliative therapy

• dysphagia
• esophageal adenocarcinoma
• esophageal squamous cell carcinoma
• esophageal stent

• Early esophageal cancer
• Esophagectomy
• RAMIE
• Robotic-assisted esophagectomy

• Adenocarcinoma/diagnosis
• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Aftercare/methods
• Carcinoma, Squamous Cell/diagnosis
• Carcinoma, Squamous Cell/pathology
• Carcinoma, Squamous Cell/surgery
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Esophagectomy/methods
• Humans
• Neoplasm Staging
• Postoperative Care/methods
• Robotic Surgical Procedures/methods
• Treatment Outcome

This study is designed to investigate the clinical value of systemic chemotherapy combined with bronchoscopic interventional cryotherapy in the treatment of lung cancer.

A total of 412 lung cancer patients admitted to Cangzhou People’s Hospital from March 2018 to March 2020 were collected and divided into test group and control group based on their treatment schedules. The test group received systemic chemotherapy combined with bronchoscopic interventional cryotherapy, while the control group received systemic chemotherapy alone. Tumor objective response rate (ORR), disease control rate (DCR), serum tumor marker levels, serum matrix metalloproteinase (MMP) content, T cell subset level, survival time and adverse reactions of the two groups were observed.

The ORR and DCR of the test group were better than those of the control group, while those of the non-small cell lung cancer (NSCLC) patients in the test group were better than patients with small-cell lung cancer (SCLC) (P <  0.05). There was no significant difference in serum tumor marker levels, MMP content and T cell subset level between the two groups before treatment. After treatment, the serum tumor marker levels along with serum MMP-2, MMP-9 and CD8⁺ levels in the test group decreased more remarkably, while CD4⁺ and CD4⁺/CD8⁺ levels increased more significantly than those in the control group (P <  0.05). The serum MMP-2 and MMP-9 of NSCLC patients in the test group decreased more remarkably than those of SCLC patients, while there was no significant difference in CD8⁺, CD4⁺ and CD4⁺/CD8⁺. The progression-free survival and overall survival of the test group were obviously longer than those of the control group. The same trend was observed in NSCLC patients compared with SCLC patients in the test group (P <  0.05).

Systemic chemotherapy combined with bronchoscopic interventional cryotherapy for lung cancer has good clinical efficacy and safety, and can be widely used in clinical practice.

• Bronchoscope
• Interventional cryotherapy
• Lung cancer
• Systemic chemotherapy

The use of endoscopic spray cryotherapy to manage pathological conditions of the esophagus has become increasingly common. This mucosal ablation technique is believed to carry a lower risk of bleeding than other modalities. A 71-year-old woman and a 64-year-old man with portal hypertension and varices were diagnosed with invasive esophageal adenocarcinoma during routine variceal surveillance. Staging by endoscopic ultrasound and computed tomography was uT1N0M0 in both patients. They each underwent mucosal ablation using liquid nitrogen cryosprays with no adverse events. Both cancers completely resolved with 2 treatments, and neither patient has shown recurrence of neoplasia during follow-up observations for up to 2 years.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. The most common location of GIST is the stomach; however, occurrences of GIST in the esophagus are also possible albeit rare. Although the current standard of care for gastric and intestinal GIST involves surgery and tyrosine kinase inhibitors, this case report focuses on the potential of treating esophageal GIST through a novel means of cryoablation therapy.

• Barrett's esophagus
• Catheter ablation
• Cryotherapy
• Endoscopy
• Esophageal neoplasm
• Esophagoscopy
• Metaplasia
• Precancerous conditions

Endoscopic cryotherapy is a relatively new thermal ablative modality used for the treatment of neoplastic lesions of the esophagus. It relies on cycles of rapid cooling and thawing to induce tissue destruction with a cryogen (liquid nitrogen or carbon dioxide) leading to intra and extra-cellular damage. Surgical treatment was once considered the standard therapeutic intervention for neoplastic diseases of the esophagus and is associated with considerable rates of morbidity and mortality. Several trials that evaluated cryotherapy in Barrett’s esophagus (BE) associated neoplasia showed reasonable efficacy rates and safety profile. Cryotherapy has also found applications in the treatment of esophageal cancer, both for curative and palliative intent. Cryotherapy has also shown promising results as salvage therapy in cases refractory to radiofrequency ablation treatment. Cryoballoon focal ablation using liquid nitrogen is a novel mode of cryogen delivery which has been used for the treatment of BE with dysplasia and squamous cell carcinoma. Most common side effects of cryotherapy reported in the literature include mild chest discomfort, esophageal strictures and bleeding. In conclusion, cryotherapy is an effective and safe method for the treatment of esophageal neoplastic processes, ranging from early stages of low grade dysplasia to esophageal cancer.

• Esophageal cancer
• Barrett’s esophagus
• Palliative therapy
• Cryotherapy

• Barrett Esophagus/pathology
• Barrett Esophagus/surgery
• Cryosurgery/adverse effects
• Cryosurgery/methods
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/prevention & control
• Esophageal Neoplasms/surgery
• Esophagoscopy/adverse effects
• Esophagoscopy/methods
• Esophagus/diagnostic imaging
• Esophagus/pathology
• Humans
• Nitrogen/administration & dosage
• Palliative Care/methods
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Precancerous Conditions/pathology
• Precancerous Conditions/surgery
• Salvage Therapy/adverse effects
• Salvage Therapy/methods
• Treatment Outcome

Esophageal carcinoma is a highly lethal cancer associated with high morbidity and mortality. Esophageal squamous cell carcinoma and esophageal adenocarcinoma are the two distinct histological types. There has been significant progress in endoscopic diagnosis and treatment of early stages of cancer using resection and ablation techniques, as shown in several trials in the recent past. Earlier detection of esophageal cancer and advances in treatment modalities have lead to improvement in the 5-year survival from 5% to about 20% in the past decade. Endoscopic eradication therapy is the preferred modality of treatment in cancer limited to mucosal layer of the esophagus as there is very low risk of lymph node metastasis, leading to high cure rates, low risk of recurrence and with few adverse effects. The most common adverse events seen are strictures, bleeding and rarely perforation which can be endoscopically managed. In patients with recurrent advanced disease or invasive tumor, esophagectomy with lymph node dissection remains the mainstay of treatment. There is debate on post-endoscopic surveillance with some studies suggesting closer follow up with upper endoscopy every 6 mo for the first 1-2 years and then annually for the 3 years while others recommending the appropriate action only if symptoms or other abnormalities develop. Overall, the field of endoscopic therapy is still evolving and focus should be placed on careful patient selection using a multidisciplinary approach.

• Endoscopic mucosal resection
• Endoscopic submucosal dissection
• Radiofrequency ablation
• Argon plasma coagulation
• Esophageal cancer
• Photodynamic therapy
• Cryotherapy

• Adenocarcinoma/diagnosis
• Adenocarcinoma/mortality
• Adenocarcinoma/pathology
• Adenocarcinoma/surgery
• Endoscopic Mucosal Resection/adverse effects
• Endoscopic Mucosal Resection/instrumentation
• Endoscopic Mucosal Resection/methods
• Esophageal Mucosa/diagnostic imaging
• Esophageal Mucosa/pathology
• Esophageal Mucosa/surgery
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/mortality
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Esophageal Squamous Cell Carcinoma/diagnosis
• Esophageal Squamous Cell Carcinoma/mortality
• Esophageal Squamous Cell Carcinoma/pathology
• Esophageal Squamous Cell Carcinoma/surgery
• Esophagectomy/adverse effects
• Esophagectomy/instrumentation
• Esophagectomy/methods
• Esophagoscopy/adverse effects
• Esophagoscopy/instrumentation
• Esophagoscopy/methods
• Humans
• Neoplasm Staging
• Patient Selection
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Survival Rate
• Treatment Outcome

Since the 1920s the gold standard for treating cancer has been surgery, which is typically preceded or followed with chemotherapy and/or radiation, a process that perhaps contributes to the destruction of a patient’s immune defense system. Cryosurgery ablation of a solid tumor is mechanistically similar to a vaccination where hundreds of unique antigens from a heterogeneous population of tumor cells derived from the invading cancer are released. However, releasing tumor-derived self-antigens into circulation may not be sufficient enough to overcome the checkpoint escape mechanisms some cancers have evolved to avoid immune responses. The potentiated immune response caused by blocking tumor checkpoints designed to prevent programmed cell death may be the optimal treatment method for the immune system to recognize these new circulating cryoablated self-antigens. Preclinical and clinical evidence exists for the complementary roles for Cytotoxic T-lymphocyte-associated protein (CTLA-4) and PD-1 antagonists in regulating adaptive immunity, demonstrating that combination immunotherapy followed by cryosurgery provides a more targeted immune response to distant lesions, a phenomenon known as the abscopal effect. We propose that when the host’s immune system has been “primed” with combined anti-CTLA-4 and anti-PD-1 adjuvants prior to cryosurgery, the preserved cryoablated tumor antigens will be presented and processed by the host’s immune system resulting in a robust cytotoxic CD8⁺ T-cell response. Based on recent investigations and well-described biochemical mechanisms presented herein, a polyvalent autoinoculation of many tumor-specific antigens, derived from a heterogeneous population of tumor cancer cells, would present to an unhindered yet pre-sensitized immune system yielding a superior advantage in locating, recognizing, and destroying tumor cells throughout the body.

• abscopal effect
• anti-CTLA-4
• anti-PD1
• autoinoculation
• cancer immunity
• cryoablation
• immunotherapy
• self-antigens