Clinical Updates on the Diagnosis and Treatment of Esophageal Cancer

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 767

Special Issue Editors


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Guest Editor
1. Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
2. Clinic of Esophageal and General Surgery, “Sf. Maria” Clinical Hospital, 011192 Bucharest, Romania
Interests: esophageal cancer; endoscopic diagnosis; endoscopic therapy; neoadjuvant therapies; surgical trends; palliative care

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Guest Editor
1. University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
2. Department of Gastroenterology, Clinic Fundeni Institute, 022328 Bucharest, Romania
Interests: esophageal cancer; endoscopic diagnosis; endoscopic therapy; neoadjuvant therapies; surgical trends; palliative care

Special Issue Information

Dear Colleagues,

The last decades have confirmed the emergence of esophageal cancer as a significant issue, justifying the statement that we are facing a true pandemic. The medical, diagnostic and therapeutic complexity of esophageal neoplastic pathology results from several unique characteristics, among which are the presence of two completely different histopathological forms (etiological, tumor behavior, therapeutic resources, research studies that are non-homogeneous in the selection of the statistical base, etc.), a complex, multidisciplinary diagnosis (gastroenterologist, radiologist-imager, pathologist) and the challenging management of therapeutic options. Therapeutic challenges arise from the difficulty of selecting a suitable solution for the patient and, on the other hand, from the complexity of this treatment (multimodal treatment, interventional gastroenterological, oncological and surgical).

Post-therapeutic results are modest and literature data on disease-free survival (DFS), progression-free survival (PFS) and overall survival (OS) confirm a not particularly spectacular improvement despite new diagnostic and therapeutic acquisitions. The natural question arises: what should be done and which direction should we take? The emergence of new diagnostic techniques, the possibility of screening for an early identification of neoplasia, the introduction of new oncologic attack schemes and non-surgical endoscopic maneuvers, as well as the introduction of minimally invasive surgical techniques, have opened up new resources for improving outcomes in the curative oncologic treatment and palliation of esophageal cancer.

Prof. Dr. Dragos Valentin Predescu
Dr. Mircea Manuc
Guest Editors

Manuscript Submission Information

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Keywords

  • esophageal cancer
  • endoscopic diagnosis
  • endoscopic therapy
  • neoadjuvant therapies
  • surgical trends
  • palliative care

Published Papers (1 paper)

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14 pages, 1862 KiB  
Systematic Review
Does Thoracic Duct Ligation at the Time of Esophagectomy Impact Long-Term Survival? An Individual Patient Data Meta-Analysis
by Alberto Aiolfi, Davide Bona, Matteo Calì, Michele Manara, Emanuele Rausa, Gianluca Bonitta, Moustafa Elshafei, Sheraz R. Markar and Luigi Bonavina
J. Clin. Med. 2024, 13(10), 2849; https://doi.org/10.3390/jcm13102849 - 12 May 2024
Viewed by 628
Abstract
Background: Thoracic duct ligation (TDL) during esophagectomy has been proposed to reduce the risk of postoperative chylothorax. Because of its role in immunoregulation, some authors argued that it had an unfavorable TDL effect on survival. The aim of this study was to [...] Read more.
Background: Thoracic duct ligation (TDL) during esophagectomy has been proposed to reduce the risk of postoperative chylothorax. Because of its role in immunoregulation, some authors argued that it had an unfavorable TDL effect on survival. The aim of this study was to analyze the effect of TDL on overall survival (OS). Methods: PubMed, MEDLINE, Scopus, and Web of Science were searched through December 2023. The primary outcome was 5-year OS. The restricted mean survival time difference (RMSTD), hazard ratios (HRs), and 95% confidence intervals (CI) were used as pooled effect size measures. The GRADE methodology was used to summarize the certainty of the evidence. Results: Five studies (3291 patients) were included. TDL was reported in 54% patients. The patients’ age ranged from 49 to 69, 76% were males, and BMI ranged from 18 to 26. At the 5-year follow-up, the combined effect from the multivariate meta-analysis is -3.5 months (95% CI −6.1, −0.8) indicating that patients undergoing TDL lived 3.5 months less compared to those without TDL. TDL was associated with a significantly higher hazard for mortality at 12 months (HR 1.54, 95% CI 1.38–1.73), 24 months (HR 1.21, 95% CI 1.12–1.35), and 28 months (HR 1.14, 95% CI 1.02–1.28). TDL and noTDL seem comparable in terms of the postoperative risk for chylothorax (RR = 0.66; p = 0.35). Conclusions: In this study, concurrent TDL was associated with reduced 5-year OS after esophagectomy. This may suggest the need of a rigorous follow-up within the first two years of follow-up. Full article
(This article belongs to the Special Issue Clinical Updates on the Diagnosis and Treatment of Esophageal Cancer)
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