Papers - NANASHIMA Atsushi
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Takeno S., Tanoue Y., Hamada R., Kawano F., Tashiro K., Wada T., Nanashima A.
Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia 25 ( 2 ) 82 - 86 2019.4
Authorship：Last author, Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
Approximately half of the patients with esophageal cancer are diagnosed at an advanced stage with inoperable disease. The technique of bypass surgery, which is one of the palliative procedures for esophageal cancer, usually requires the insertion of a drainage tube for clearing secretions from the blind remnant esophagus. Since the artificial drainage tube is sometimes problematic for the patient after discharge from the hospital, drainage tubeless (DRESS) surgery might be preferable. The authors demonstrated the utility of DRESS bypass surgery by adding esophagostomy in the right supraclavicular region in three patients with unresectable esophageal cancer with and without esophago-respiratory fistula. All patients had been able to take per-orally and discharged the hospital. Two of three patients are alive with per-oral intake at 1 year later. This DRESS bypass surgery technique, which has not hardly reported in the literature, could release the patients from the tube trouble after the discharge from the hospital and give the patients the better quality of life.
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Kurahara H., Shinchi H., Ohtsuka T., Miyasaka Y., Matsunaga T., Noshiro H., Adachi T., Eguchi S., Imamura N., Nanashima A., Sakamoto K., Nagano H., Ohta M., Inomata M., Chikamoto A., Baba H., Watanabe Y., Nishihara K., Yasunaga M., Okuda K., Natsugoe S., Nakamura M.
Langenbeck's Archives of Surgery 404 ( 2 ) 167 - 174 2019.3
Language：English Publishing type：Research paper (scientific journal) Publisher：Langenbeck's Archives of Surgery
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: Neoadjuvant therapy (NAT) is increasingly used to improve the prognosis of patients with borderline resectable pancreatic cancer (BRPC) albeit with little evidence of its advantage over upfront surgical resection. We analyzed the prognostic impact of NAT on patients with BRPC in a multicenter retrospective study. Methods: Medical data of 165 consecutive patients who underwent treatment for BRPC between January 2010 and December 2014 were collected from ten institutions. We defined BRPC according to the National Comprehensive Cancer Network guidelines, and subclassified patients according to venous invasion alone (BR-PV) and arterial invasion (BR-A). Results: The rates of NAT administration and resection were 35% and 79%, respectively. There were no significant differences in resection rates and prognoses between patients in the BR-PV and BR-A subgroups. NAT did not have a significant impact on prognosis according to intention-to-treat analysis. However, in patients who underwent surgical resection, NAT was independently associated with longer overall survival (OS). The median OS of patients who underwent resection after NAT (53.7 months) was significantly longer than that of patients who underwent upfront (17.8 months) or no resection (14.9 months). The rates of superior mesenteric or portal vein invasion, lymphatic invasion, venous invasion, and lymph node metastasis were significantly lower in patients who underwent resection after NAT than in those who underwent upfront resection despite similar baseline clinical profiles. Conclusions: Resection after NAT in patients with BRPC is associated with longer OS and lower rates of both invasion to the surrounding tissues and lymph node metastasis.
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術前診断し単孔式腹腔鏡下胆嚢摘出術を施行しえた小児胆嚢捻転症の1例 Reviewed
6. 甲斐健吾，内山周一郎，髙屋 剛，佐野浩一郎，末田秀人，七島篤志
宮崎県医師会医学会誌 43 ( 1 ) 25 - 28 2019.3
Authorship：Last author Language：Japanese Publishing type：Research paper (scientific journal)
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上腸間膜動脈塞栓症術後に発症した虚血性小腸炎に対し，小腸造影検査と術中内視鏡検査が有用だった1例
池ノ上実，田代耕盛，河野文彰，武野慎祐，中村都英，七島篤志
日本腹部救急医学会雑誌 39 ( 3 ) 515 - 518 2019.3
Authorship：Last author, Corresponding author Language：Japanese Publishing type：Research paper (scientific journal)
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Motoi F., Satoi S., Honda G., Wada K., Shinchi H., Matsumoto I., Sho M., Tsuchida A., Unno M., Kurata M., Yanagimoto H., Toyama H., Nagakawa Y., Maemura K., Mataki Y., Akahori T., Kinoshita S., Terashima H., Horiguchi A., Ohtsuka Y., Nanashima A., Kanemitsu K., Ohigashi H., Tani M., Takahara T., Shiomi H., Endo I., Suzuki H., Rikiyama T., Ikoma H., Yasunaga M., Nakamura K., Egawa S., Katayose Y., Nakagawa K., Okada K., Ottomo S.
Journal of Gastroenterology 54 ( 2 ) 194 - 203 2019.2
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Journal of Gastroenterology
© 2018, Japanese Society of Gastroenterology. Background: Neoadjuvant chemotherapy (NAC) represents a promising alternative to pancreatic ductal adenocarcinoma (PDAC) planned resection, but the survival impact remains undefined. To assess the feasibility and survival outcomes of NAC with gemcitabine and S1 (GS) for PDAC planned resection by prospective study. Methods: Patients with resectable or borderline resectable PDAC received 2 cycles of NAC-GS and were offered curative resection followed by gemcitabine adjuvant. The primary endpoint was 2-year overall survival (OS). Adverse events during NAC, radiological and tumor marker responses, resection rate, and surgical safety were evaluated as secondary endpoints (UMIN000004148). Results: We enrolled 104 patients between 2010 and 2012, with 101 patients treated using NAC-GS as the full analysis set (FAS). Of the 101 patients, 88% received the planned 2 cycles of NAC. Grade 3 neutropenia was common (35%). Radiological partial response and decreased carbohydrate antigen 19-9 concentration (> 50% decrease) were noted in 13% and 41%, respectively. R0/1 resections with M0 were performed in 65 patients without surgical mortality. Of the 65 patients, 44 received planned gemcitabine adjuvant for 6 months as the on-protocol cohort. The primary endpoint for the 2-year OS rate was 55.9% in the FAS (n = 101) and 74.6% in the on-protocol cohort (n = 44). Conclusions: NAC-GS was feasible and actively prolonged survival following PDAC planned resection. Randomized control trials are needed to further clarify the survival benefit of NAC-GS in addition to surgery followed by adjuvant therapy.
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Yukinori Tanoue, Atsushi Nanashima, Koichi Yano, Yoshirou Fujii, Masahide Hiyoshi, Naoya Imamura, Takeomi Hamada, Makoto Ikenoue, Takashi Wada, Yoichi Mizutani, Toshinori Hirai.
Nuclear Medicine Communications 40 ( 2 ) 145 - 152 2019.2
Language：English Publishing type：Research paper (scientific journal) Publisher：Nuclear Medicine Communications
© 2018 Wolters Kluwer Health, Inc. All rights reserved. Background The relationship between posthepatectomy complications and liver functional parameters was preliminary reported in a pilot study. The present study sequentially evaluated the clinical significance of maximal removal rate of technetium- 99m -galactosyl human serum albumin (GSAR max ) in the future remnant liver (rGSAR max ) in patients to predict posthepatectomy complications. Methods Between 2010 and August 2017, GSAR max , rGSAR max , their difference (Dif), and the rGSAR max to GSAR max ratio were examined in 247 additional patients who underwent hepatectomy for liver and biliary diseases. Hepatectomy-related postoperative complications (i.e. long-term ascites, intra-abdominal infection, and hepatic failure) occurred in 73 (29.6%) patients. Results The median and mean preoperative GSAR max values were 0.477 and 0.498±0.166 mg/min, respectively; rGSAR max values were 0.341 and 0.366±0.145 mg/min, respectively; Dif values were 0.105 and 0.132±0.111 mg/min, respectively; and the rGSAR max to GSAR max ratio values were 0.774 and 0.746±0.177, respectively. Among these, the GSAR max and rGSAR max values were significantly correlated with the liver functional parameters ICGR15, LHL15, HH15, prothrombin activity, serum hyaluronic acid level, and platelet count (all P<0.01). The rGSAR max values were significantly lower in patients with long-term ascites (P<0.05), and the predictive cutoff values of rGSAR max were 0.290 mg/min; however, the multivariate logistic regression analysis showed that rGSAR max was not independently related to long-term ascites. Conclusion When accompanied by other functional liver reserve parameters, rGSAR max seemed to be an alternative liver functional parameter related to ascites.
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Risk factors for hepatic insufficiency after major hepatectomy in non-cirrhotic patients. Reviewed
Fujii Y, Nanashima A, Hiyoshi M, Imamura N, Yano K, Hamada T
Asian journal of surgery 42 ( 1 ) 251 - 255 2019.1
Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)
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Higuchi K., Nanashima A., Hiyoshi M., Imamura N., Yano K., Hamada T., Tsuchimochi Y., Wada T., Tsuchiya K., Kawano F., Ikeda T., Takeno S.
Case Reports in Gastroenterology 13 ( 1 ) 140 - 143 2019
Language：English Publishing type：Research paper (scientific journal) Publisher：Case Reports in Gastroenterology
© 2019 The Author(s). Published by S. Karger AG, Basel. The indocyanine green test is a reliable liver function examination before major hepatectomy, and anaphylaxis is rarely a concern. A 65-year-old male patient without epigastralgia was diagnosed with a 2.2-cm intrahepatic cholangiocarcinoma. He had no history of allergic reactions. Some liver dysfunction was indicated by the laboratory data; however, there was no marked obstructive jaundice and the liver functional reserve was maintained by technetium-99m galactosyl serum albumin. The indocyanine green test was routinely performed, but the patient immediately demonstrated severe anaphylaxis due to indocyanine green administration. He had cardiorespiratory arrest, but recovered after immediate resuscitation. Although acute renal and respiratory failure was significant, the patient recovered at day 10 after the event, and his liver function and other organ functions were improved. Then, the scheduled left hepatectomy with caudate and extrahepatic duct resection was successfully performed without issues. The patient exhibited no allergic response against the administration of antibiotics or other drugs and the postoperative course was uneventful. The patient was discharged on day 17. The tumor was diagnosed as stage III intrahepatic cholangiocarcinoma and R0 resection was accomplished. Preoperative management, including the liver functional loading test, should be carefully carried out before major hepatectomy.
DOI： 10.1159/000499181
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Aortoesophageal fistula: review of trends in the last decade Reviewed
Takeno S., Ishii H., Nanashima A., Nakamura K.
Surgery Today 50 ( 12 ) 1551 - 1559 2019
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Surgery Today
© 2019, Springer Nature Singapore Pte Ltd. We reviewed articles on aortoesophageal fistula (AEF) published between January, 2009 and December, 2018. Postoperative aortic disease was the most common cause of AEF, followed by primary aortic aneurysm, bone ingestion, and thoracic cancer. Thoracic endovascular aortic repair (TEVAR) was the most common initial therapy for primary aortic disease, rather than graft replacement. Secondary AEF developed between 1 and 268 months, and between 1 and 11 months after the initial therapy for aortic disease and thoracic cancer, respectively. TEVAR trended to be preferred over surgery for aortic lesions because of its minimal invasiveness and certified hemostasis. In contrast, esophagectomy was preferred for esophageal lesions to remove the infectious source. A combination of surgery for the aorta (TEVAR, graft replacement or repair) and esophagus (esophagectomy, esophageal stent or repair) was usually adopted. Each graft replacement or esophagectomy was associated with a favorable prognosis for aortic or esophageal surgery, and the combination of graft replacement and esophagectomy generally improved the prognosis remarkably. Antibiotic therapy was given to 65 patients, with 20 receiving multiple antibiotics aimed at strong effects and the type of antibiotic described as broad-spectrum in 29 patients. Meropenem, vancomycin, and fluconazole were the most popular antibiotics used to prevent graft or stent infection. In conclusion, graft replacement and esophagectomy can achieve a favorable prognosis for patients with AEF, but strong, broad-spectrum antibiotic therapy might be required to prevent sepsis after surgery.
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Hamada T., Nanashima A., Hiyoshi M., Ikenoue M., Imamura N., Yano K., Fujii Y., Kubota Y., Ban T., Kawakami H., Sato Y.
International Journal of Surgery Case Reports 42 274 - 279 2018.12
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports
© 2018 Introduction This is a case report on the advances in preoperative endoscopic-guided fine-needle-aspiration (FNA) diagnosis for pancreatic carcinoma to achieve a curative operation even in patients who have a history of total gastrectomy. Case presentation A 65-year-old man, who underwent total gastrectomy for gastric cancer 13 years ago, had discomfort in the left lateral abdomen. A 3-cm hypovascular mass accompanying a large distal pseudocyst in the pancreatic tail was observed on computed tomography. Endoscopic ultrasonography via elevation of the jejunal loop on esophago-jejunostomy also revealed similar lesions, and FNA for the proximal-side hypoechoic mass was successful. The cytological diagnosis with immunohistochemistry was acinar cell carcinoma of the pancreas. Distal pancreatectomy with splenectomy was successfully performed. Histology of the resected specimen also showed the acinar cell carcinoma, similar with preoperative cytology, which involved the splenic vein and had extra-pancreatic extension but no lymph node metastasis. The tumor stage was IIA by the 2009 UICC classification. He had no tumor relapse on imaging follow-up until 12 months after the operation. Discussion There have been marked technical advancements in endoscopic ultrasonography-guided diagnosis, including FNA, even in patients with prior digestive tract surgery. However, the risk of complication is still a concern. Accurate histological diagnosis is useful in the field of pancreatic surgery, especially in cases of rare or small malignant lesions. Conclusion Curative pancreatectomy was possible in a case of acinar cell carcinoma, a rare pancreatic malignancy, which was diagnosed by preoperative endoscopic FNA diagnosis via esophago-jejunostomy after previous total gastrectomy.
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A cohort study on the risk of hepatectomy and pancreatectomy after history of abdominal surgery on other organs.
Nanashima A, Hiyoshi M, Imamura N, Yano K, Hamada T, Wada T, Nishida T, Tsuchiya K, Kawano F, Ikeda T, Takeno S
Annals of hepato-biliary-pancreatic surgery 22 ( 4 ) 344 - 349 2018.11
Language：English Publishing type：Research paper (scientific journal)
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Atsushi Nanashima, Naoya Imamura, Masahide Hiyoshi, Koichi Yano,Takeomi Hamada, Teru Chiyotanda, Hiroshi Ito.
International Journal of Surgery Case Reports 53 90 - 95 2018.10
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Surgery Case Reports
© 2018 The Author(s) Introduction: The present case report demonstrated the successfully radical operation (R0) for the highly advanced cholangiocarcinoma involving hilar hepatic arteries and portal vein, The careful preoperative diagnosis to define the adequate resection area and the expert operation was achieved without postoperative severe complications. Presentation of case: A 55-year-old male was admitted to our hospital with obstructive jaundice, and the perihilar cholangiocarcinoma (PC) was found. At the time of finding PC, enhanced computed tomography showed the widely extension and involved the surrounding right hepatic artery (RHA) and bilateral portal veins (PV). According to extension of PC, left trisectionectomy combined resection of RHA and PV trunk was scheduled. By supporting plastic surgeon's procedure, the scheduled R0 operation could be achieved and the patient was discharged without any severe complication but delayed intrahepatic abscess formation. After abscess drainage, he could immediately recovered and tumor relapse was not observed for a couple of months. By carefully preoperative examination, a complicated operation was successfully completed. Discussion: The major hepatectomy with arterio-portal resections and anastomosis for advanced has been challenged at the high-volume center and the improvement of survival seemed to be obtained and, however, operative risk is still remained. This operation could be achieved by the expert surgeons under precise planning or management. Conclusion: The role of HBP surgeons is to challenge aggressive surgery even for patients with highly advanced local extension of PC.
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Primary Hepatic MALT Lymphoma Difficult to Diagnose Preoperatively Reviewed
Wada Takashi, Hiyoshi Masahide, Tsuchimochi Yuki, Hamada Takeomi, Yano Koichi, Imamura Naoya, Fujii Yoshiro, Tanaka Hiroyuki, Nanashima Atsushi
The Japanese Journal of Gastroenterological Surgery 51 ( 10 ) 613 - 621 2018.10
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society of Gastroenterological Surgery
<p>A 79-year-old man was admitted to our institution for examination of a hepatic tumor detected by US during a medical checkup. Plain CT revealed a 2.5-cm low-density area in segment 2 of the liver in which a liver tumor was detected. Contrast-enhanced CT revealed that the tumor was enhanced in the early phase and wash out in the delayed phase. Vascular penetration was observed in the tumor, and swollen lymph nodes were found surrounding the common hepatic artery (CHA). PET-CT showed abnormal accumulation of fluorodeoxyglucose in the liver tumor and lymph nodes surrounding the CHA. Cholangiolocellular carcinoma was suspected, and surgery was performed. However, the pathological findings revealed that the resected tumor was a mucosa-associated lymphoid tissue (MALT) lymphoma. Few cases of primary hepatic MALT lymphoma have been reported, and its diagnosis is too difficult to have no specific imaging features. Hepatic MALT lymphoma is considered to have a good prognosis because there are few reports of metastasis or invasion. Surgical resection is often selected, although there are some cases with recurrence after surgery, so careful postoperative follow-up is needed.</p>
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Rare case of ectopic pancreas presenting with persistent umbilical discharge. Reviewed
Nakame K, Hamada R, Suzuhigashi M, Nanashima A, Ieiri S
Pediatrics international : official journal of the Japan Pediatric Society 60 ( 9 ) 891 - 892 2018.8
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Hidaka M, Eguchi S, Okuda K, Beppu T, Shirabe K, Kondo K, Takami Y, Ohta M, Shiraishi M, Ueno S, Nanashima A, Noritomi T, Kitahara K, Fujioka H
Annals of surgery 271 ( 2 ) 339 - 346 2018.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Annals of Surgery
Objective:The aim of the present study was to evaluate the value of anatomical resection for hepatocellular carcinoma (HCC) with microportal vascular invasion (vp1) between 2000 and 2010.Background:Vascular invasion has been reported as a prognostic factor of liver resection for HCC. Anatomical resection for HCC has resulted in optimum outcomes of eradicating intrahepatic micrometastases through the portal vein, but opposite results have also been reported.Methods:A clinical chart review was performed for 546 patients with HCC with vp1. We retrospectively evaluated the recurrence-free survival (RFS) between anatomical (AR) and nonanatomical resection (NAR). The site of recurrence was also compared between these groups. The influence of AR on the overall survival (OS) and RFS rates was analyzed in patients selected by propensity score matching, and the prognostic factors were identified.Results:A total of 546 patients were enrolled, including 422 in the AR group and 124 in the NAR group. There was no difference in the 5-year OS and RFS rates between the 2 groups. Local recurrence was significantly more frequent in the NAR group than in the AR group. In a multivariate analysis, hepatitis C virus, serum protein induced by vitamin K absence II of 380 mAU/mL or more, tumor diameter of 5 cm or more, and age of 70 years or older were significant predictors of a poor RFS after liver resection. There were no significant differences in the OS or RFS between the AR and NAR groups by a propensity score-matched analysis.Conclusions:Although local recurrence around the resection site was suppressed by AR, AR for HCC with vp1 did not influence the RFS or OS rates after hepatectomy in the modern era.
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Significance of bile duct resection for advanced gallbladder cancer without biliary infiltration.
Fujii Y, Nanashima A, Hiyoshi M, Imamura N, Yano K, Hamada T
American journal of surgery 2018.7
Language：English Publishing type：Research paper (scientific journal)
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Management of pancreatolithiasis: A nationwide survey in Japan Reviewed
Inui K., Masamune A., Igarashi Y., Ohara H., Tazuma S., Sugiyama M., Suzuki Y., Miyoshi H., Yamamoto S., Takeyama Y., Nakano E., Takuma K., Sakagami J., Hayashi K., Kogure A., Ito T., Mukai T., Maetani I., Nagahama M., Serikawa M., Ueki T., Furuya K., Isayama H., Moriyama I., Shigeno M., Mizukami K., Nanashima A., Oana S., Ikehata A., Watanabe N., Hirooka Y., Ogoshi K., Sasaki Y., Iwata Y., Kudo Y., Nakayama A., Nakamura M.
Pancreas 47 ( 6 ) 708 - 714 2018.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Pancreas
© 2018 Wolters Kluwer Health, Inc. Objectives The aim of this study was to assess prevailing treatment of pancreatolithiasis in Japan. Methods We surveyed clinical data from 1834 patients (1479 men and 355 women) at 125 hospitals. Results Extracorporeal shock-wave lithotripsy (ESWL) was performed alone in 103 patients (5.6%), ESWL plus an endoscopic procedure in 446 (24.3%), endoscopic treatment alone in 261 (14.2%), and surgery in 167 (9.1%). Other treatments were given to 358 (19.5%), whereas 499 (27.2%) received no treatment. Symptoms were relieved in 85.7% after ESWL, 80.8% after endoscopic treatment alone, and 92.8% after surgery. Early complication rates within 3 months after ESWL, endoscopic treatment alone, and surgery were 8%, 4.5%, and 27.1%, respectively. Late complications after ESWL, endoscopic procedures alone, and surgery were 1.7%, 2.5%, and 8.2%, respectively. Symptom relief but also early and late complications were greater after surgery than after ESWL and endoscopic treatment. Among 417 patients undergoing ESWL, 61 (14.6%) required surgery, as did 32 (16%) of 200 patients treated endoscopically. Surgery was required less frequently following initial operative treatment (11/164 patients [6.7%]). Nonsurgical initial treatments were chosen more frequently. Conclusions First-line treatment of pancreatolithiasis should be ESWL with or without endoscopy because of minimal invasiveness and fewer complications.
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Safe Resection of Renal Cell Carcinoma with Liver Invasion Using Liver Hanging Technique Supported by Preoperative Portal Vein Embolization. Reviewed
Fujii M, Kamimura T, Tsukino H, Furukoji E, Sakae T, Yano K, Imamura N, Mukai S, Nanashima A, Kamoto T
Case reports in urology 2018 5139034 2018.6
Language：English Publishing type：Research paper (scientific journal)
DOI： 10.1155/2018/5139034
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Nanashima A., Imamura N., Sumida Y., Hiyoshi M., Hamada T., Nagayasu T.
Anticancer Research 38 ( 4 ) 2343 - 2352 2018.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Anticancer Research
© 2018 International Institute of Anticancer Research. All Rights Reserved. Background/Aim: Intraductal papillary neoplasm of the bile duct (IPNB) is defined as a non-invasive malignancy and disparity of its histological diagnosis with related diseases remains. Patients and Methods: Twenty-six cases of IPNB and 12 of papillary adenocarcinomas (PAC) at two Institutes were investigated. Results: The prevalence of biliary dilatation and mucin secretion in the group with IPNB was significantly higher compared to the group with PAC (p<0.01). IPNB was predominantly located in the proximal bile duct compared to the location of PAC (p<0.01). Mis-matching of a second histological diagnosis was observed in 27% of IPNB and 25% of PAC, respectively. The prevalence of tumor relapse was significantly higher in PAC than in IPNB (p<0.05), and the overall survival was significantly better in IPNB than in PAC (p<0.01). Conclusion: Although IPNB is currently defined under histological criteria, morphologies were various and disparity in histological diagnosis for IPNB remains problematic when the clinical strategy is contemplated.
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Kunizaki M., Hamasaki K., Wakata K., Tobinaga S., Sumida Y., Hidaka S., Yasutake T., Miyazaki T., Matsumoto K., Yamasaki T., Sawai T., Hamamoto R., Nanashima A., Nagayasu T.
Anticancer Research 38 ( 3 ) 1807 - 1813 2018.3
Language：English Publishing type：Research paper (scientific journal) Publisher：Anticancer Research
© 2018 International Institute of Anticancer Research. All rights reserved. Background/Aim: Identifying useful biomarkers is central to selecting optimal therapeutic strategies for esophageal squamous cell carcinoma (ESCC). Serum p53 antibody (S-p53Ab), squamous cell carcinoma antigen (SCC-Ag), and carcinoembryonic antigen (CEA) were investigated to evaluate the significance of single and combined tumor markers in determining the diagnosis and prognosis of ESCC. Materials and Methods: Serum samples were obtained preoperatively from 133 patients with histologically-confirmed ESCC, including 32 patients with stage I (24.1%). Levels of S-p53Ab were assessed by enzyme-linked immunosorbent assay, using a new version of a highly specific, quantitative kit. The cut-off value for S-p53Ab was 1.3 U/ml. Results: S-p53Ab was detected in 39.1% (52 out of 133) of patients with ESCC, including 40.0% (20 out of 50) of patients with early-stage ESCC. Positive rates for S-p53Ab, CEA, and SCC-Ag among patients with stage I ESCC (n=32) were 40.6%, 12.5%, and 31.3%, respectively. Positivity for S-p53Ab was not associated with positivity for CEA or SCC-Ag (p=0.249 and 0.747, respectively). The positive rate for diagnosis of ESCC increased from 39.1% to 65.4% when S-p53Ab was combined with SCC-Ag in this study. We found no significant correlation between the presence of S-p53Ab in ESCC and overall survival. Conversely, Cox regression analysis revealed that the International Union Against Cancer/TNM classification and systemic inflammation scorewere independent prognostic factors for ESCC in this series (hazard ratio(HR)=3.811, 95% confidence interval(CI)=1.548- 9.378, p=0.004; and HR=2.218; 95% CI=1.087-4.523, p=0.029, respectively). Kaplan–Meier analysis revealed significant differences between patients with elevated S-p53Ab and SCC-Ag and patients with elevated levels of only one or neither of these factors (p=0.009). Conclusion: The diagnostic rate with S-p53Ab was better than that with SCC-Ag and CEA in patients with early-stage ESCC. Combined detection of S-p53Ab and SCC-Ag can markedly improve diagnostic sensitivity and may permit more accurate stratification of patients with ESCC.