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J.Jpn. Surg. Soc.. 121(4): 442-447, 2020

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MULTIDISCIPLINARY TREATMENT FOR ESOPHAGEAL CANCER

1) Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
2) Department of Perioperative Functioning Care and Support, Hamamatsu University School of Medicine, Hamamatsu, Japan

Hirotoshi Kikuchi1), Yoshihiro Hiramatsu2), Kinji Kamiya1), Hiroya Takeuchi1)

Esophageal cancer has a poor prognosis and high mortality rate. Multidisciplinary treatment comprising surgery, chemotherapy, and radiotherapy plays important roles, especially in treating advanced esophageal squamous cell carcinomas that are potentially sensitive to chemotherapy and radiotherapy. Although surgery is a principal treatment strategy for patients with clinical stage I esophageal cancer, definitive chemoradiotherapy has become a standard treatment option based on the results of the Japan Clinical Oncology Group (JCOG)0502 study. For clinical stage II–III cancer, neoadjuvant chemotherapy followed by surgery is a standard treatment based on the results of the JCOG9907 study, while combined definitive chemoradiation at a dose of 50.4 Gy and salvage surgery is a treatment option for patients who wish to preserve their esophagus based on the results of the JCOG0909 study. For clinical stage IV esophageal cancer, chemoradiotherapy or chemotherapy plus salvage surgery is a treatment option for patients with good performance status. Immune checkpoint inhibitors will become powerful therapeutic tools that have the potential to create a new era of multidisciplinary treatment, leading to the improved prognosis of esophageal cancer patients.

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