Management of Locally Advanced Esophageal Cancer

Nicolas Zhou; Ravi Rajaram; Wayne L Hofstetter

doi:10.1016/j.soc.2020.06.003

Management of Locally Advanced Esophageal Cancer

Surg Oncol Clin N Am. 2020 Oct;29(4):631-646. doi: 10.1016/j.soc.2020.06.003. Epub 2020 Jul 21.

Authors

Nicolas Zhou¹, Ravi Rajaram¹, Wayne L Hofstetter²

Affiliations

¹ Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77005, USA.
² Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77005, USA. Electronic address: WHofstetter@MDAnderson.org.

PMID: 32883463
DOI: 10.1016/j.soc.2020.06.003

Abstract

Management of locally advanced esophageal cancer is evolving. Trimodality therapy with chemoradiation followed by surgical resection has become the standard of care. However, the value of planned surgery after response to therapy is in question. In this article, we discuss the current practice principles and evidence for the treatment of locally advanced esophageal cancer. Topics will include various neoadjuvant therapies, trimodality versus bimodality therapy, and outcomes for salvage esophagectomies. In addition, emerging novel therapies, such as HER2 inhibitors and immunotherapy, are available for unresectable or metastatic disease, enabling a greater armamentarium of tumor biology-specific treatments.

Keywords: Adenocarcinoma; Chemoradiation; Esophageal cancer; HER2; MSI; PD-L1; Salvage; Squamous cell carcinoma.

Publication types

Review

MeSH terms

Combined Modality Therapy
Disease Management
Esophageal Neoplasms / pathology*
Esophageal Neoplasms / therapy*
Humans