Management of Clinical T2N0 Esophageal and Gastroesophageal Junction Adenocarcinoma: What Is the Optimal Treatment?

Holguin, Rolfy A. Perez; Olecki, Elizabeth J.; Stahl, Kelly A.; Wong, William G.; Vining, Charles C.; Dixon, Matthew; Peng, June S.

doi:10.1007/s11605-022-05441-7

Cited by 3 publications

(1 citation statement)

References 24 publications

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“… 7 , 11 , 28 Interestingly, a new trend has begun regarding the treatment of patients with comparatively early-stage cancer; for example, patients with early-stage-cancer, such as T2N0-stage gastric cancer patients have also been treated with neoadjuvant therapy, and pCR rates as high as 50–60% were achieved, although it has not been proven to improve survival. 34 , 35 The question is how long the trend of preoperatively treating patients with increasingly earlier stages of cancer can be continued, in light of the low complication rates associated with oncological treatments. Obviously, further studies will be needed to support the use of preoperative oncological treatment in an increasingly larger spectrum of cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Changes in Oncological Surgical Principles Driven by Advances in Preoperative Treatments

Horváth,

Bellyei,

Pozsgai

et al. 2023

TCRM

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From a surgical point of view, the development of preoperative oncological treatment has had a profound effect on the surgical treatment trends of cancer as well as on the outcomes of cancer patients. Consequently, these changes have challenged formerly entrenched oncological surgical principles. In our short report, we aimed to summarize the main shifts regarding the surgical principles of cancer treatment due to the development of preoperative oncological therapy in recent years. As a result of successful preoperative treatment, surgeons may perform less radical surgeries, the required free resection margin has been narrowed down to a few millimeters in dimension and preoperative treatment is justified in both definitely resectable tumors and in oligometastatic tumors as well. For prognosis assessment, the post-preoperative oncological treatment stage is now considered decisive, rather than the pretreatment stage as previously thought. Other changes include the introduction of the watch and wait strategy and the reverse order of treatment of the primary tumor and metastasis. Observing the continuously improving outcomes of cancer patients and the developments in oncological treatment modalities, a further expansion of the indication of preoperative treatments is to be expected.

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