Esophageal and Esophagogastric Junction Cancers, Version 1.2015

Abstract

Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Adenocarcinoma is more common in North America and Western European countries, originating mostly in the lower third of the esophagus, which often involves the esophagogastric junction (EGJ). Recent randomized trials have shown that the addition of preoperative chemoradiation or perioperative chemotherapy to surgery significantly improves survival in patients with resectable cancer. Targeted therapies with trastuzumab and ramucirumab have produced encouraging results in the treatment of advanced or metastatic EGJ adenocarcinomas. Multidisciplinary team management is essential for patients with esophageal and EGJ cancers. This portion of the NCCN Guidelines for Esophageal and EGJ Cancers discusses management of locally advanced adenocarcinoma of the esophagus and EGJ.

Assessment of HER2 status in patients with gastroesophageal adenocarcinoma treated with epirubicin-based chemotherapy: heterogeneity-related issues and prognostic implications

“…In 88 patients, two blocks obtained from the same resection specimen were retrieved, and for 76 of them, a third additional block was also available. Per patient, the median number of biopsy fragments retrieved was five (range [1][2][3][4][5][6][7][8].…”

“…Additionally, despite the lack of a global standard [3], use of anthracyclines is supported by a meta-analysis highlighting significant survival advantages with anthracycline-containing triplets in a palliative setting [4]. As a result, regimens such as ECF (or ECF modifications) are recommended by current European and North American guidelines for both resectable and first-line settings [5][6][7].…”

Changing trends and experience with esophageal cancer surgery in a single university hospital: are the results similar or not?

“…There are also comparisons of the results in Western and Eastern countries, finding that the latter had better results. The latest version of the NCCN Guideline recommends Neoadjuvant Therapy (chemotherapy or chemoradiotherapy) for patients whose esophageal cancer is staged at T1b N + (Stage 2B) or more advanced (11), although the level of evidence is low (generally level 2A) (12). There are conflicting results in meta-analyses of survival advantages and morbidity associated with neoadjuvant therapies (13)(14)(15).…”

Splenic hilar dissection in the treatment of proximal advanced gastric cancer: what is an adequate strategy?

“…Actually, in western countries, splenectomy has been recommended to be avoided if possible (12). Another concern after splenectomy is reduction of immunologic function, which may be related with immunocompromised or cancer growing.…”