Kiesslich R, Möhler M, Hansen T, Galle P R, Lang H, Gockel I
Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Deutschland.
Internist (Berl). 2012 Nov;53(11):1315-27; quiz 1328-9. doi: 10.1007/s00108-012-3128-0.
The prognosis for patients with advanced esophageal cancer is poor. Proper risk assessment and knowledge of tumor biology may facilitate early diagnosis of adenocarcinomas and squamous cell cancer of the esophagus. New endoscopic techniques are available (e.g., (virtual) chromoendoscopy, autofluorescence, and endomicroscopy) for the early detection of cancer. Endoscopic therapy with complete resection of mucosal cancers offers long-term survival.En bloc resection combined with the removal of locoregional lymph nodes is the surgical option of choice for locally advanced cancer. In this respect, minimally invasive surgery offers the patient numerous advantages. Multimodal therapy results in better outcome for defined cancer stages and includes surgery, chemotherapy and chemoradiation. Multimodal treatment should always be individualized and requires cooperation of all subspecialties (tumor board conference). New chemotherapeutic strategies may offer improved survival but may also include new side effects. Patients with inoperable esophageal cancer also benefit from multimodal treatment.
晚期食管癌患者的预后较差。进行恰当的风险评估并了解肿瘤生物学特性，可能有助于早期诊断食管腺癌和鳞状细胞癌。目前已有新的内镜技术（如（虚拟）染色内镜检查、自体荧光检查和内镜显微镜检查）用于癌症的早期检测。对黏膜癌进行完整切除的内镜治疗可实现长期生存。整块切除联合局部区域淋巴结清扫是局部晚期癌症的首选手术方式。在这方面，微创手术为患者带来诸多益处。多模式治疗可使特定癌症分期的治疗效果更佳，包括手术、化疗和放化疗。多模式治疗应始终个体化，且需要所有亚专业（肿瘤委员会会议）的协作。新的化疗策略可能提高生存率，但也可能带来新的副作用。无法手术的食管癌患者也能从多模式治疗中获益。
