Fang Wentao
Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University Center For Clinical Diagnosis and Treatment of Esophageal Diseases, Shanghai 200030, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Oct 25;20(10):1122-1126.
The eighth edition of Union for International Cancer Control (UICC) and the American Joint Committee on Cancer(AJCC) announced in 2017 the new staging of esophageal cancer, focusing on the prognostic significance of accurate staging and lymph node metastasis before treatment of esophageal carcinoma, the rationality of early tumor therapy, and the importance of induction therapy. The modified 2017 edition of the National Comprehensive Cancer Network (NCCN) guidelines, based on above contents matching UICC/AJCC eighth edition of the new staging of esophageal cancer, added preoperative clinical staging to guide the selection of treatment, and re-defined the indications of endoscopic resection and operation for early esophageal squamous cell carcinoma, meanwhile emphasized once again the importance of preoperative induction therapy for locally advanced esophageal squamous cell carcinoma. While there are still many pendent problems that need to be explored further, the knowledge of the law of progression in esophageal cancer and the factors related to prognosis, launching targeted researches for solving practical problems, and the emphasis of standardized diagnosis and treatment are the basic strategies to improve the efficacy of esophageal carcinoma.
国际癌症控制联盟(UICC)和美国癌症联合委员会(AJCC)第八版于2017年公布了食管癌新分期,重点关注食管癌治疗前准确分期及淋巴结转移的预后意义、早期肿瘤治疗的合理性以及诱导治疗的重要性。基于上述内容并匹配UICC/AJCC第八版食管癌新分期的2017版美国国立综合癌症网络(NCCN)指南,增加了术前临床分期以指导治疗选择,重新定义了早期食管鳞状细胞癌内镜切除和手术的适应证,同时再次强调了术前诱导治疗对局部晚期食管鳞状细胞癌的重要性。虽然仍有许多悬而未决的问题需要进一步探索,但了解食管癌的进展规律和预后相关因素、开展针对性研究以解决实际问题以及强调规范化诊疗是提高食管癌疗效的基本策略。