Benefits and risks of neoadjuvant therapy of esophageal and gastroesophageal junction tumors from the perspective of surgeon

03/2020

MUDr. Hana Faltová, Ph.D.; MUDr. Tomáš Haruštiak, Ph.D.; MUDr. Alexandr Pazdro; MUDr. Martin Šnajdauf; MUDr. Jiří Tvrdoň; prof. MUDr. Robert Lischke, Ph.D.

III. chirurgická klinika 1. LF UK a FN v Motole, Praha

SUMMARY

Esophageal cancer is highly malignant disease and at the time of diagnosis it is operable in only 30-40% of patients. The operation is questioned as monotherapy mainly in locally advanced stages because of worse results of long-term survival.¹² Oncological therapy alone, but also does not lead to satisfactory results without surgery. Studies on induction therapy protocols have not yet achieved a clear consensus in either adenocarcinomas or squamous cell carcinomas. One of the promising ways to move forward is to work with surgeons to determine the degree of tumor regression or lymph node involvement from the definitive resection. For surgeons, the benefits of cancer therapy are clearly noted in the form of increased microscopically radical resections and regressive tumor changes, which increases the locally operable findings and hence patient survival. However, the question remains the complications that neoadjuvant treatment may cause perioperatively.

Key words

esophageal tumors, neoadjuvant chemotherapy, neoadjuvant chemoradiotherapy, multimodal therapy, transthoracal resection of the esophagus