Endoscopic resection with adjuvant chemo-radiotherapy for superficial esophageal squamous cell carcinoma: A critical review. (April 2018)

• Record Type: Journal Article
• Authors: Kam, Tsz Yeung; Kountouri, Melpomeni; Roth, Arnaud; Jean-Loui, Frossard; Huber, Olivier; Mönig, Stefan; Zilli, Thomas
• Is Part Of: Critical reviews in oncology/hematology. Volume 124(2018)
• Page Start: 61
• Page End: 65
• Publication Date: 2018-04
• Subjects: Esophageal cancer -- Radiotherapy -- Chemotherapy -- Endoscopic dissection -- Submucosal; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2018.02.011
• Languages: English
• ISSNs: 1040-8428

Abstract

Abstract: Radical esophagectomy with extended lymph node dissection is considered the standard of care in treatment of squamous cell carcinoma of esophagus with deep mucosal invasion (pT1a m3) or submucosal involvement (pT1b). However, despite the increasing use of minimally invasive approaches, it remains a major surgery associated with significant morbidities and even mortality risk. Endoscopic resection (ER) results in excellent local control in early superficial mucosal (pT1a) disease yet there is substantial risk of lymph node metastases in T1b disease. Therefore, ER followed by combined with chemo-radiotherapy (CRT) would potentially improve the outcome in pT1a m3 or pT1b disease and would be an attractive conservative alternative to esophagectomy. Retrospective series published so far have shown promising results for this combined treatment. Herein the current literature of the indications, treatment outcome and toxicities of this treatment strategy are discussed and critically reviewed.