Esophageal Cancer: Recent advances

Abstract

Esophageal carcinoma has, over the past decade, undergone a sea of change, not only in its pathological distribution, but also in the diagnosis, staging and subsequent management. Although the advent of better imaging techniques has helped in diagnosing patients at an earlier period, the majority of them have unresectable disease at the time of presentation. Despite aggressive treatment protocols involving either one or a combination of the options of surgery, radiation, and chemotherapy, the fiveyear survival remains dismal in the order of 10 to 15%. The two most commonly used surgical techniques for resecting the esophagus, the Ivor Lewis and the transhiatal esophagectomy, have similar results in terms of morbidity, mortality and, more importantly, five-year survival following resection. There has been an increasing interest in the surgical treatment of carcinoma esophagus by a minimally invasive approach, as meta-analysis of clinical series have shown that a faster recovery time without any statistically significant difference in the in-hospital mortality or morbidity when compared to conventional surgery. Nonrandomized studies suggest that patients receiving neoadjuvant chemo-radiation have a five year survival advantage compared with those treated with surgery alone, especially if they had a complete histological response to the preoperative regimen. Lastly, palliative procedures, form the mainstay of management of patients with non-resectable disease.

Promoter methylation and expression of TIMP3 gene in gastric cancer

“…Previous studies have focused on changes in gene expression that are inherited through meiosis and do not involve a change in DNA sequence but affect the expression and gene regulating function of DNA, mainly by chemical modification. This mechanism is gaining increased attention from researchers of tumor formation processes [15,16]. …”

Adenoid cystic carcinoma of the esophagus: report of two cases and review of the Chinese literature

“…The first choice for treatment of ACC of the esophagus is radical excision. Chemotherapy is not usually chosen due to a poor response rate [8-10]. Postoperative radiotherapy may help improvement of progressive dysphagia [11-13].…”

Health‐related quality of life in patients with esophageal cancer or precancerous lesions assessed by EQ‐5D: A multicenter cross‐sectional study

“…The prognosis of EC is poor, with a five‐year relative survival of 20.9% in China . The postoperative prognosis of patients with early EC is much better, with a five‐year survival rate of ≥90% as reported in the study by Sadiq and Mansour . However, most early EC or precancerous lesions which show no typical clinical symptoms cannot be easily detected .…”