[Therapeutic strategies for advanced respectable esophageal cancer].
There are obvious differences in the clinical characteristics of patients with advanced respectable esophageal cancer between Japan and Western countries. In Japan, more than 90% of patients with esophageal cancer are histologically diagnosed with squamous cell carcinoma. On the other hand, the incidence of esophageal adenocarcinoma is rapidly increasing in the West. As a standard surgical approach, relatively invasive transthoracic extended esophagectomy has been established in Japan since the 1980s and has contributed to improved long-term survival of patients with squamous cell carcinoma. The current standard care for resectable stage II/III esophageal squamous cell carcinoma is neoadjuvant chemotherapy with 5-fluorouracil/cisplatin and radical esophagectomy based on the results of Japan Clinical Oncology Group trial 9907. In the West, relatively less invasive transhiatal esophagectomy with limited lymph node dissection has played a role in the multidisciplinary treatment of esophageal adenocarcinoma. Recently, a multimodal approach to esophageal cancer treatment including definitive chemoradiotherapy has been a focus of attention in both Japan and the West. For the further improvement of long-term survival of patients with esophageal cancer, the optimization of multimodal treatments and establishment of a global standard are essential.
Kitagawa
Yuko
Y
Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy; D005060:Europe; D006801:Humans; D007564:Japan; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D016879:Salvage Therapy; D014481:United States