A238 A RETROSPECTIVE ANALYSIS OF THE LONG-TERM OUTCOMES OF PATIENTS WITH T1B ESOPHAGEAL CANCER
Bibliographic record
Abstract
Endoscopic mucosal resection is commonly performed for dysplasia/early adenocarcinoma within the setting of Barrett’s esophagus. Cancers that invade the submucosa (T1b) can be further subdivided into SM1, SM2, and SM3, depending on the depth of invasion into the submucosa. Invasive adenocarcinoma significantly increases the risk of lymph node metastasis, which is of critical importance if endoscopic treatment is the only therapy planned. Accurate prediction of lymph node status is therefore crucial in order to determine the appropriate method (surgery or endoscopic) of treatment for early lesions. This study aims to assess the long-term outcomes of patients who have had treatment for a T1b esophageal adenocarcinoma and to determine the extent of lymph node involvement as assessed through surgical specimens or long term clinical/radiological follow up. Additionally, factors associated with lymph node metastasis will be evaluated. A retrospective chart review of patients with T1b esophageal cancer between 01/05-05/17 was performed at 4 sites which deal with most of the esophageal cancers in British Columbia. Data collected includes demographics, procedure dates, indication, findings, imaging, characteristics of the cancer (depth and extent of penetration, size of lesion, differentiation, lymphovascular invasion), method of resection, and follow-up. 36 patients were found to have a T1b esophageal adenocarcinoma. 75% (27/36) of these patients received surgery to remove the cancer while 25% (9/36) received EMR. The overall rate of lymph node metastasis (LNM) for all patients was 13.8% (5/36). All of these patients went for surgery and had at least one high-risk factor (poorly differentiated, positive for lymphovascular invasion, >2cm). 56% (15/27) of patients that went for surgery received neoadjuvant therapy, including only 1 of the 5 patients with LNM. The average follow up was 777 days (range, 0 – 2660 days) for surgical patients and was 1210 days (range, 120 – 2880 days) for EMR patients. 13.8% of patients have had evidence of lymph node involvement in this group with T1b esophageal adenocarcinoma. Patients with T1b esophageal adenocarcinoma that have low risk features (well differentiated, negative for lymphovascular invasion, <2cm) can be considered for EMR as opposed to surgery. Additional data is being collected to evaluate the results in a Provincial manner and will be presented. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".