Surgical treatment of esophageal cancer in the era of multimodality management

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 t...

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Bibliographic Details
Published in:Annals of the New York Academy of Sciences 2018-12, Vol.1434 (1), p.192-209
Main Authors: Borggreve, Alicia S., Kingma, B. Feike, Domrachev, Serg A., Koshkin, Mikhail A., Ruurda, Jelle P., Hillegersberg, Richard, Takeda, Flavio R., Goense, Lucas
Format: Article
Language:English
Subjects:
Cancer
Cancer therapies
enhanced recovery
Esophageal cancer
esophageal surgery
Esophagus
Light effects
Morbidity
Nutrition
Pain
patient selection
Patients
perioperative treatment
Physical therapy
Radiation
Surgery
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Summary: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.
ISSN:0077-8923
1749-6632
DOI:10.1111/nyas.13677