Hucl Tomas
Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic -
Minerva Chir. 2018 Aug;73(4):410-416. doi: 10.23736/S0026-4733.18.07809-4. Epub 2018 Jun 29.
Esophageal cancer is a common disease with poor survival rates. The treatment and prognosis of patients with esophageal cancer depend on the stage of the disease. Accurate clinical staging is critical for stratifying patients for treatment. While advanced cancers are generally treated by neoadjuvant chemoradiotherapy and surgery, early cancers may be amendable to endoluminal, minimally invasive treatments, thus saving patients from unnecessary surgery. Endoscopic ultrasonography has a major role in loco-regional staging of esophageal cancer and should be performed in all patients after excluding significant comorbidities and distant metastases. However, the role of endosonography seems to be limited in early cancer, since it does not determine the depth of invasion with sufficient accuracy. This can prove decisive for treatment planning. Despite substantial efforts, its main role in early cancer is still confined to ruling out the deeper involvement or lymph node metastasis. A preferable treatment is for patients to undergo a diagnostic endoscopic resection, which facilitates correct pathological staging and final treatment decision.
食管癌是一种常见疾病，生存率较低。食管癌患者的治疗和预后取决于疾病的分期。准确的临床分期对于将患者分层进行治疗至关重要。晚期癌症通常采用新辅助放化疗和手术治疗，而早期癌症可能适合腔内微创治疗，从而使患者避免不必要的手术。内镜超声在食管癌的局部区域分期中起着重要作用，在排除严重合并症和远处转移后，所有患者均应进行此项检查。然而，内镜超声在早期癌症中的作用似乎有限，因为它不能足够准确地确定浸润深度。这对于治疗规划可能具有决定性意义。尽管付出了巨大努力，其在早期癌症中的主要作用仍局限于排除更深层次的浸润或淋巴结转移。一种更好的治疗方法是让患者接受诊断性内镜切除，这有助于进行正确的病理分期并做出最终治疗决策。
