Surgical treatment of esophageal cancer in the era of multimodality management

Alicia S Borggreve, B Feike Kingma, Serg A Domrachev, Mikhail A Koshkin, Jelle P Ruurda, Richard van Hillegersberg, Flavio R Takeda, Lucas Goense

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)192-209
Number of pages18
JournalAnnals of the New York Academy of Sciences
Volume1434
Issue number1
Early online date2018
DOIs
Publication statusPublished - Dec 2018

Keywords

  • Journal Article
  • Review
  • Perioperative treatment
  • Esophageal surgery
  • Enhanced recovery
  • Patient selection
  • Esophageal cancer
  • Esophageal Neoplasms/diagnosis
  • Humans
  • Neoadjuvant Therapy/methods
  • Lymph Node Excision/methods
  • Patient Selection

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