The multidisciplinary management of gastrointestinal cancer. Multimodal treatment of oesophageal cancer.
Treatment of oesophageal cancer requires a multidisciplinary approach. Single modality treatment, especially surgical excision, is only indicated in small tumours or in patients unable to support multimodal treatment. In Stage I-II adenocarcinoma, multimodal treatment using neoadjuvant therapy is indicated in the absence of contra-indications. However, this statement is not universally accepted. The choice between radio-chemotherapy and chemotherapy depends on patients' characteristics and the preferences of the treatment centre. In selected Stage III adenocarcinomas, especially from the lower oesophagus, neoadjuvant chemotherapy (with post-operative chemotherapy when feasible) may induce tumour regression, which may facilitate surgical resection and improve survival rates, as has been demonstrated for cancers of the oesophagogastric junction.
Veuillez
Véronique
V
Service Hépato-Gastroentérologie et Oncologie Digestive, Hopital Ambroise Paré, AP-HP, 92100 Boulogne, France. philippe.rougier@apr.ap-hop-paris.fr
Rougier
Philippe
P
Seitz
Jean-François
JF
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016629:Esophagectomy; D006801:Humans; D020360:Neoadjuvant Therapy; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D018579:Patient Selection; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome