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An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
[Is esophagectomy necessary for esophageal cancer patients with complete response after neoadjuvant
1Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Esophageal Cancer Institute, Guangzhou 510060, China
Abstract:
Esophageal cancer is one of the common cancers in China. More and more researches indicated that comprehensive treatment should be recommended for locally advanced esophageal cancer with resectable potential, especially the application of neoadjuvant chemoradiotherapy (CRT) was used to improve survival. However, the response to neoadjuvant chemoradiotherapy is various due to individual heterogeneity. Previous studies showed that pathological complete response (pCR) was considered as an important predictor of improved prognosis in esophageal cancer patients undergoing neoadjuvant CRT. Esophageal cancer patients with pCR had better prognosis than those without pCR. The watch and wait strategy may be a feasible option for surgically eligible rectal cancer patients with clinical complete response (cCR) after neoadjuvant chemoraidotherapy. Can the watch and wait strategy be used for reference to esophageal cancer? Whether patients with cCR following neoadjuvant CRT should undergo operation is analyzed in this article. According to present efficacy evaluation, cCR is inadequate to predict pCR. In addition, esophagectomy is favored for its curative effect and controllable complications. Therefore, we believe surgical resection, the chief component of multimodality treatment, should be recommended for all patients with locally advanced esophageal cancer.
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