Baba Yoshifumi, Watanabe Masayuki, Yoshida Naoya, Baba Hideo
Yoshifumi Baba, Naoya Yoshida, Hideo Baba, Department of Gastroenterological Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto 860-8556, Japan.
World J Gastrointest Oncol. 2014 May 15;6(5):121-8. doi: 10.4251/wjgo.v6.i5.121.
Squamous cell carcinoma and adenocarcinoma are types of esophageal cancer, one of the most aggressive malignant diseases. Since both histological types present entirely different diseases with different epidemiology, pathogenesis and tumor biology, separate therapeutic strategies should be developed against each type. While surgical resection remains the dominant therapeutic intervention for patients with operable esophageal squamous cell carcinoma (ESCC), alternative strategies are actively sought to reduce the frequency of post-operative local or distant disease recurrence. Such strategies are particularly sought in the preoperative setting. Currently, the optimal management of resectable ESCC differs widely between Western and Asian countries (such as Japan). While Western countries focus on neoadjuvant or definitive chemoradiotherapy, neoadjuvant chemotherapy followed by surgery is the standard treatment in Japan. Importantly, each country and region has established its own therapeutic strategy from the results of local randomized control trials. This review discusses the current knowledge, available data and information regarding neoadjuvant treatment for operable ESCC.
鳞状细胞癌和腺癌是食管癌的类型，食管癌是最具侵袭性的恶性疾病之一。由于这两种组织学类型呈现出截然不同的疾病，具有不同的流行病学、发病机制和肿瘤生物学特性，因此应针对每种类型制定单独的治疗策略。对于可手术切除的食管鳞状细胞癌（ESCC）患者，手术切除仍然是主要的治疗干预手段，同时人们也在积极寻求替代策略以降低术后局部或远处疾病复发的频率。这种策略尤其在术前阶段被探索。目前，可切除ESCC的最佳治疗方案在西方国家和亚洲国家（如日本）之间存在很大差异。西方国家侧重于新辅助或根治性放化疗，而在日本，新辅助化疗后手术是标准治疗方法。重要的是，每个国家和地区都根据当地随机对照试验的结果制定了自己的治疗策略。本综述讨论了关于可手术切除ESCC新辅助治疗的当前知识、现有数据和信息。
