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- Title
Aktuelle prä- und perioperative Konzepte in der Tumortherapie beim lokal fortgeschrittenen Ösophaguskarzinom aus chirurgischer Perspektive.
- Authors
Hoeppner, Jens
- Abstract
Locally advanced esophageal cancer is mostly treated in multimodal therapy protocols according to the current western treatment guidelines. In squamous cell cancer, neoadjuvant chemoradiotherapy is in the foreground. Unimodal surgical and chemoradiation treatment alternatives achieve poorer results for this entity. Surgical salvage resection for tumor recurrence after definitive chemoradiotherapy can be carried out with good oncological results but the frequency of postoperative complications is increased. For locally advanced adenocarcinoma of the esophagus, perioperative chemotherapy and neoadjuvant chemoradiotherapy are two competing level 1 evidence-based treatment concepts that are superior to treatment by surgery alone. The results of head-to-head comparative treatment studies are still pending. A significant number of patients show a complete locoregional remission of the tumor in the surgical specimen after treatment with the modern neoadjuvant protocols. Currently, European prospective randomized noninferiority studies with an oncological endpoint are testing the possibilities of organ-retaining concepts in clinical complete remission (surgery as needed; watch and wait). For the future, it is to be expected that the curative treatment results of locally advanced esophageal carcinoma will again significantly improve, in particular through the additional possibilities of immunotherapy and organ-preserving therapy concepts for postneoadjuvant complete remission.
- Subjects
COMBINED modality therapy; MEDICAL protocols; CHEMORADIOTHERAPY; CANCER chemotherapy
- Publication
Der Chirurg, 2021, Vol 92, Issue 12, p1094
- ISSN
0009-4722
- Publication type
Article
- DOI
10.1007/s00104-021-01475-w