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Cáncer de esófago

Jesper Lagergren¹, Elizabeth Smyth², David Cunningham²

¹Division of Cancer Studies, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, UK; Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.

Lancet (London, England)

|June 27, 2017

Resumen

El tratamiento del cáncer de esófago es complejo, ya que implica atención multidisciplinaria y tratamientos en evolución como la endoscopia y la terapia neoadyuvante. Los avances mejoran el pronóstico, pero persisten los desafíos en la calidad de vida y los cuidados paliativos.

Área de la Ciencia:

En el campo de la oncología
Gastroenterología
Oncología quirúrgica

Sus antecedentes:

El cáncer de esófago presenta importantes desafíos clínicos, que a menudo requieren un enfoque multidisciplinario.
Si bien los tratamientos extensos pueden afectar la calidad de vida, las últimas décadas muestran un mejor pronóstico para el cáncer de esófago.
Los tumores esofágicos en etapa temprana y premalignados se benefician cada vez más de las intervenciones endoscópicas.

Objetivo del estudio:

Ofrecer información sobre el tratamiento clínico actual del cáncer de esófago.
Para discutir las controversias en curso en el tratamiento y la investigación del cáncer de esófago.
Para resaltar las necesidades futuras y las direcciones en el cuidado del cáncer de esófago.

Principales métodos:

Revisión de las prácticas clínicas actuales en el tratamiento del cáncer de esófago.
Análisis de las terapias neoadyuvantes (quimioterapia, quimioradioterapia) en la enfermedad localmente avanzada.
Examen de las tendencias de estandarización y centralización quirúrgica.
Evaluación de las opciones terapéuticas para los cuidados paliativos en el cáncer de esófago.

Principales resultados:

Los procedimientos endoscópicos están ganando prominencia para los tumores esofágicos tempranos.
La terapia neoadyuvante es ahora un complemento estándar de la cirugía para el cáncer de esófago avanzado.
Los enfoques quirúrgicos se están estandarizando y centralizando, mejorando los resultados.
Hay varias estrategias de tratamiento paliativo disponibles para las etapas avanzadas.

Conclusiones:

El tratamiento del cáncer de esófago requiere una estrategia integral y multidisciplinaria.
La investigación en curso y los ensayos clínicos son cruciales para abordar las controversias sobre el tratamiento y mejorar los resultados de los pacientes.
Los esfuerzos futuros deben centrarse en mejorar la calidad de vida junto con las tasas de supervivencia en pacientes con cáncer de esófago.

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