What's New | Decker

Donald E Low, FACS, FRCSC, FRCSI (Hon), FRCSE (Hon), Andrea Wirsching, MD, MSc

Clinical pathways for esophagectomy have been recently introduced in different esophageal centers worldwide.
The reported esophagectomy pathway has been refined over a 20-year period and covers pre-, peri-, and postoperative care.
Optimized pain control, enteral feedings, catheter removal, and postoperative mobilization represent central pathway components.
A decrease in hospital stay, costs, and morbidity has been associated with standardized clinical pathways.

Updated chemotherapy regimens and new areas of research throughout the paper.
New section on stereotactic body radiation therapy and proton therapy and the role these therapies play in treating cancer.
Updated information regarding how cancer cells mutate and develop resistance to treatment.
New section on directed chemotherapy including selected hepatic artery infusion and isolated limb perfusion and infusion.
Updated section on immunotherapy including references to recent scientific studies.

Updated information regarding histologic and cytologic evaluation and new areas of research throughout the paper.
New section added addressing metastatic disease and theories supporting the way in which these tumor cells spread. New scientific studies demonstrating how metastatic tumors may harbor resistive subtypes.
New information added regarding liquid biopsy and its potential role in diagnosing cancer.

Updated chemotherapy regimens and new areas of research throughout the paper.
New section on stereotactic body radiation therapy and proton therapy and the role these therapies play in treating cancer.
Updated information regarding how cancer cells mutate and develop resistance to treatment.
New section on directed chemotherapy including selected hepatic artery infusion and isolated limb perfusion and infusion.
Updated section on immunotherapy including references to recent scientific studies.

Updated chemotherapy regimens and new areas of research throughout the paper.
New section on stereotactic body radiation therapy and proton therapy and the role these therapies play in treating cancer.
Updated information regarding how cancer cells mutate and develop resistance to treatment.
New section on directed chemotherapy including selected hepatic artery infusion and isolated limb perfusion and infusion.
Updated section on immunotherapy including references to recent scientific studies.

Updated information regarding histologic and cytologic evaluation and new areas of research throughout the paper.
New section added addressing metastatic disease and theories supporting the way in which these tumor cells spread. New scientific studies demonstrating how metastatic tumors may harbor resistive subtypes.
New information added regarding liquid biopsy and its potential role in diagnosing cancer.

Updated information regarding histologic and cytologic evaluation and new areas of research throughout the paper.
New section added addressing metastatic disease and theories supporting the way in which these tumor cells spread. New scientific studies demonstrating how metastatic tumors may harbor resistive subtypes.
New information added regarding liquid biopsy and its potential role in diagnosing cancer.

Steven N Hochwald, MD, FACS, Rupen Shah, MD

Multimodal approach to therapy demonstrates survival benefits, employing neoadjuvant chemotherapy, radiation therapy, or both, followed by surgical resection.
EUSG vs. PET/MRI - PET/MRI demonstrates slightly superior accuracy for staging of lymph nodes, and may provide an important role in preoperative esophageal cancer in the future.
Evidence that ¹⁸F-FDG PET/CT is the best systemic staging modality in esophageal cancer. Although expensive, and thus not the initial approach for diagnosis, PET/CT allows for optimization of relationship of anatomic abnormalities and hypermetabolic areas. The degree of hypermetabolism has also shown utility in prognosis. Furthermore, some argue that repeat PET/CT after neoadjuvant therapy should be performed to detect metastatic disease previously not appreciated.

Esophageal Cancer