Christodoulidis Grigorios, Agko Sara Eirini, Koumarelas Konstantinos Eleftherios, Kouliou Marina Nektaria, Zacharoulis Dimitris
Department of General Surgery, University Hospital of Larissa, Larisa 41110, Thessalía, Greece.
Intensive Care Unit, Asklepios Paulinen Clinic Wiesbaden, Wiesbaden 65197, Hesse, Germany.
World J Clin Oncol. 2024 Dec 24;15(12):1463-1467. doi: 10.5306/wjco.v15.i12.1463.
Esophageal cancer (EC) is an aggressive malignancy with a poor prognosis, ranking seventh in incidence and sixth cancer-related deaths globally. EC is classified in two main types, the esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), with ESCC being more common in Eastern Europe, South Asia, and Africa, while EAC is prevalent in Western Europe and North America. Molecular analysis identifies three subgroups of ESCC, each with distinct genetic mutations and treatment responses. Early-stage EC is often difficult to detect, leading to late-stage diagnoses that necessitate systemic drug therapies, including molecular-targeted therapies and immunotherapies. Immunotherapy, particularly immune checkpoint inhibitor, has shown promising results in improving survival rates for metastatic or persistent EC. It is particularly important to target to multidisciplinary combination therapies, integrating surgery, chemoradiotherapy, targeted therapy and immunotherapy. Additionally, radioimmunotherapy is being explored for its potential to enhance treatment efficacy, especially in advanced and metastatic tumors. However, the pathological complete response rate to neoadjuvant chemoradiotherapy remains suboptimal, highlighting the need for novel treatment strategies. Future research should focus on optimizing treatment combinations and identifying predictive biomarkers to improve clinical outcomes for EC patients.
食管癌（EC）是一种侵袭性恶性肿瘤，预后较差，在全球发病率中排名第七，癌症相关死亡率排名第六。EC主要分为两种类型，即食管鳞状细胞癌（ESCC）和食管腺癌（EAC），ESCC在东欧、南亚和非洲更为常见，而EAC在西欧和北美较为普遍。分子分析确定了ESCC的三个亚组，每个亚组都有不同的基因突变和治疗反应。早期EC往往难以检测，导致晚期诊断，需要进行全身药物治疗，包括分子靶向治疗和免疫治疗。免疫治疗，特别是免疫检查点抑制剂，在提高转移性或持续性EC的生存率方面已显示出有前景的结果。针对多学科联合治疗尤为重要，将手术、放化疗、靶向治疗和免疫治疗相结合。此外，放射免疫治疗因其增强治疗效果的潜力而正在被探索，特别是在晚期和转移性肿瘤中。然而，新辅助放化疗的病理完全缓解率仍然不理想，这突出了对新治疗策略的需求。未来的研究应专注于优化治疗组合和确定预测性生物标志物，以改善EC患者的临床结局。
