Neoadjuvant therapy for esophageal cancer: surgical considerations.
Esophageal carcinoma is often diagnosed at an advanced, non resectable stage. Only early stages show a better prognosis. Surgical treatment represents the gold standard. The various surgical techniques do not seem to affect survival. Based on the severity of esophageal cancer and on poor outcome achievable with surgery alone, multimodality treatments are the most suitable. The possible negative impact on the complication rate after neoadjuvant therapy is still debated. Most randomized trials have not demonstrated as yet an improvement in prognosis in patients undergoing a three-modality treatment. However, patients with complete pathologic response after surgical resection were shown to have a better prognosis. In conclusion, additional randomized trials are required, aimed at evaluating all technical and therapeutic variables which affect prognosis.
Piraino
Alessio
A
U.O. di Chirurgia Toracica, Università Cattolica del S. Cuore, Policlinico A. Gemelli, Roma, Italy. alessio.piraino@libero.it
Vita
Maria Letizia
ML
Tessitore
Adele
A
Cusumano
Giacomo
G
Congedo
Maria Teresa
MT
Margaritora
Stefano
S
Porziella
Venanzio
V
Meacci
Elisa
E
Cesario
Alfredo
A
Granone
Pierluigi
P
D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000601:surgery* / Q000628:therapy; D016629:Esophagectomy; D006801:Humans; D020360:Neoadjuvant Therapy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate