Surgical treatment of esophageal cancer in the era of multimodality management.

Autor: Borggreve AS; Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.; Moscow Clinical Scientific Center, Moscow, Russia., Kingma BF; Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands., Domrachev SA; Moscow State University of Medicine and Dentistry, Moscow, Russia., Koshkin MA; Moscow Clinical Scientific Center, Moscow, Russia., Ruurda JP; Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands., van Hillegersberg R; Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands., Takeda FR; Sao Paulo Institute of Cancer, University of Sao Paulo School of Medicine, Sao Paulo, Brazil., Goense L; Department of Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Jazyk: angličtina
Zdroj: Annals of the New York Academy of Sciences [Ann N Y Acad Sci] 2018 Dec; Vol. 1434 (1), pp. 192-209. Date of Electronic Publication: 2018 May 15.
DOI: 10.1111/nyas.13677
Abstrakt: Over the last decades, the treatment of resectable esophageal cancer has evolved into a multidisciplinary process in which all players are essential for treatment to be successful. Medical oncologists and radiation oncologists have been increasingly involved since the implementation of neoadjuvant therapy, which has been shown to improve survival. Although esophagectomy is still considered the cornerstone of curative treatment for locally advanced esophageal cancer, it remains associated with considerable postoperative morbidity, despite promising results of minimally invasive techniques. In this light, both physical status and response to neoadjuvant therapy may be important factors for selecting patients who will benefit from surgery. Furthermore, it is important to optimize the entire perioperative trajectory: from the initial outpatient clinic visit to postoperative discharge. Enhanced recovery after surgery is increasingly recognized for esophagectomy and emphasizes perioperative aspects, such as nutrition, physiotherapy, and pain management. To date, several facets of esophageal cancer treatment remain topics of debate, such as the preferred neoadjuvant treatment, anastomotic technique, extent of lymphadenectomy, organization of postoperative care, and the role of surgery beyond locally advanced disease. Here, we describe the current and future perspectives in the surgical treatment of patients with esophageal cancer in the context of the available literature.
(© 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.)
Databáze: MEDLINE
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