Huizer Tamara J, Lagarde Sjoerd M, Nuyttens Joost J M E, Oudijk Lindsey, Spaander Manon C W, Valkema Roelf, Mostert Bianca, Wijnhoven Bas P L
Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Innov Surg Sci. 2024 Nov 7;10(1):11-19. doi: 10.1515/iss-2023-0010. eCollection 2025 Mar.
Neoadjuvant chemoradiotherapy in patients with esophageal- and gastroesophageal junction cancer induces tumor regression. In approximately one fourth of patients, this leads to a pathological complete response in the resection specimen. Hence, active surveillance may be an alternative strategy in patients without residual disease after neoadjuvant chemoradiotherapy. Previous studies have shown that the combination of esophagogastroduodenoscopy with bite-on-bite biopsies, endoscopic ultrasound with fine needle aspiration of suspected lymph nodes, and a PET-CT-scan can be considered adequate for the detection of residual disease. So far, it has been unclear whether active surveillance with surgery as needed is a safe treatment option and leads to non-inferior overall survival compared to standard esophagectomy after neoadjuvant chemoradiotherapy. This review will discuss the current status of active surveillance for esophageal and junctional cancer.
食管及胃食管交界癌患者的新辅助放化疗可诱导肿瘤退缩。在大约四分之一的患者中，这会导致切除标本出现病理完全缓解。因此，对于新辅助放化疗后无残留病灶的患者，主动监测可能是一种替代策略。既往研究表明，食管胃十二指肠镜检查联合逐块活检、内镜超声检查联合对可疑淋巴结进行细针穿刺活检以及PET-CT扫描可被认为足以检测残留病灶。到目前为止，尚不清楚按需进行手术的主动监测是否是一种安全的治疗选择，以及与新辅助放化疗后的标准食管切除术相比，其总生存期是否不劣于标准食管切除术。本综述将讨论食管和交界癌主动监测的现状。
