Optimal Therapy for Resectable Esophageal Squamous Cell Carcinoma

来源 :第五届浙江省胸部肿瘤论坛暨长三角专家峰会 | 被引量 : 0次 | 上传用户:wcf333
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Esophageal cancer is the eighth most common cancer worldwide, and especially in some areas of China, esophageal cancer is the fourth most common cause of death, occurs most often in the thorax, and is of squamous cell carcinoma histology in 95% of cases. Despite improvements in surgical and radiotherapy techniques and refinements of chemotherapeutic regimens, long-term survival, even from localized esophageal cancer, remains poor. Surgery alone was the mainstay of therapeutic intervention in the past, but high rates of local and systemic failure have prompted investigation into the multidisciplinary management. Treatment paradigms differ between Western and Asian countries, but the unifying theme that has emerged in the past decade implies that surgery alone can no longer be considered the standard of care. The multi-disciplinary management of patients with locally advanced esophageal cancer using neoadjuvant and adjuvant therapy with radiotherapy, chemotherapy, and chemoradiotherapy offers great opportunity for margin negative resection, improved loco-regional control and increased survival, and should be an optional treatment paradigm. The results were different slightly between histological subtypes. Neoadjuvant chemoradiotherapy is currently the standard of care for esophageal adenocarcinoma in many Western countries. However, the optimal treatment strategy for resectable esophageal SSC is still a controversial topic. In this review, we discuss the key issues raised by the recent availability on the esophageal squamous cell carcinoma treatment with the addition of chemotherapy, radiotherapy, and chemoradiotherapy to the surgical management of resectable disease and how clinical trials and meta-analysis inform current clinical practice.
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