Rapid densification of ceramics has been realized and its merits were demonstrated through multiple approaches out of which UHS and flash sintering attract recent attention. So far, however, scalability remains difficult. A rise in throughput and scalability is enabled by the introduction of blacklight sintering powered by novel light source technology. Intense illumination with photon energy above the bandgap (blacklight) allows high absorption efficiency and, hence, very rapid, contactless heating for all ceramics. While heating the ceramic directly with light without any furnace promises scalability, it simultaneously offers highly accurate process control. For the technology transfer to industry, attainable material quality needs to be assured. Here, we demonstrate the excellent microstructure quality of blacklight-sintered ceramics observed with ultrahigh voltage electron microscopy revealing an option to tune nanoporosity. Moreover, we confirm that electronic, electron, oxygen, and lithium-ion conductivities are equal to conventionally sintered ceramics. This gives the prospect of transmitting the merits of rapid densification to the scale of industrial kilns.
Background Primary malignant melanoma of the esophagus is a rare tumor with a poor prognosis; the optimal treatment strategy has yet to be established. This study aimed to clarify clinical features, courses, and outcomes of patients undergoing surgical resection of primary malignant melanoma of the esophagus. Methods Six patients with primary malignant melanoma of the esophagus, in whom the absence of other primary melanomas had been confirmed, were selected from the medical database maintained in Toranomon Hospital. Their clinicopathological characteristics and long-term outcomes were retrospectively reviewed and analyzed. Results All 6 patients (five males and one female) underwent radical esophagectomy with three-field regional lymphadenectomy, and none received neoadjuvant therapy. Tumor invasion was classified into T1 in 5 (83%) cases and T3 in one (17%). Four (67%) patients had nodal metastases (one N1, one N2 and two N3). No distant metastatic lesions were detected preoperatively in any of our cases. Postoperative surveillance revealed recurrence in all 6 patients, and 5 (83%) died of the disease. The median overall survival was 24 months. One patient with a T3N3M0 tumor was treated after surgery with a dacarbazine-nimustine-vincristine regimen followed by irradiation for bone recurrence and survived for 87 months postoperatively. Another patient with a T1N3M0 tumor who survived for 27 months after liver and bone recurrence was treated with nivolumab, ipilimumab, and dacarbazine. Conclusion Although the courses of patients with primary malignant melanoma of the esophagus were consistently unfavorable, surgical resection with multidisciplinary therapeutic modalities may prolong survival in some cases.
Background
Treatment for patients who have achieved clinical complete response (cCR) after neoadjuvant therapy has not been established, with no consensus regarding the indications for either esophagectomy or non-surgical treatment.
Methods
Among 1545 patients with esophageal cancer at Toranomon Hospital between January 2006 and August 2017, 39 who achieved cCR after neoadjuvant treatment were divided into two groups according to treatment: esophagectomy group (n = 18) andtreatment group (n = 21) for comparison.
Results
No significant intergroup difference was observed in baseline characteristics. Pathological complete response was confirmed in 13 (72.2%) of the 18 patients who underwent esophagectomy, while residual tumor was detected at the location of primary tumor in 2 (11.1%) patients and lymph node metastasis was found in 3 (16.7%) patients. Recurrence-free survival (RFS) was significantly longer in the esophagectomy group than in the non-surgical group (P = 0.002). Disease-specific survival (DSS) was significantly longer in the esophagectomy group (P = 0.007). However, no significant intergroup difference was observed in overall survival estimated based on all deaths, including (P = 0.451).
Conclusion
With improved diagnostic accuracy, non-surgical treatment can be an option for patients estimated as cCR after treatment administered in a neoadjuvant setting. However, surgical resection is considered more appropriate because of residual tumor in some patients with cCR and because of superior DSS and RFS following esophagectomy compared with non-surgical treatment. Future studies must focus on ameliorating late postoperative complications such as respiratory failure and aspiration pneumonia.
Disclosure
All authors have declared no conflicts of interest.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.