Department of Surgery, Boston University School of Medicine, 88 East Newton Street, Collamore C-500, Boston, MA 02118, USA.
Department of Surgery, Boston University School of Medicine, Boston Medical Center, 88 East Newton Street, Collamore C-500, Boston, MA 02118, USA.
Surg Clin North Am. 2019 Jun;99(3):419-437. doi: 10.1016/j.suc.2019.02.002. Epub 2019 Mar 30.
Multimodality therapy is the standard of care for locoregional esophageal cancers (greater than clinical T3 or Nþ), including Siewert type 1 and 2 gastroesophageal junction tumors. Induction regimen, chemotherapy only or chemoradiation, is an area of controversy and often institution-specific, as neither has shown to be superior. Response to induction therapy is an important prognostic marker. For esophageal squamous cell carcinoma, it may be acceptable to observe clinical complete responders after chemoradiotherapy and perform salvage esophagectomy for recurrent disease. Clinical T2N0 esophageal cancer presents a unique challenge given its inaccuracy in clinical staging; management of this particular subset is controversial.
多模态治疗是局部区域性食管癌（临床 T3 或 N+以上）的标准治疗方法，包括 Siewert 1 型和 2 型胃食管结合部肿瘤。诱导治疗方案，仅化疗或放化疗，是一个存在争议的领域，通常因机构而异，因为两者都没有显示出优越性。对诱导治疗的反应是一个重要的预后标志物。对于食管鳞癌，在放化疗后观察到临床完全缓解者，可以接受观察，对复发性疾病进行挽救性食管切除术。临床 T2N0 食管癌具有其临床分期不准确的独特挑战；对这一特殊亚组的处理存在争议。
