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Esophageal Cancer: Diagnosis and Treatment
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Esophageal Cancer: Diagnosis and Treatment

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

Deadline for manuscript submissions: closed (28 March 2024) | Viewed by 5748

Special Issue Editor

Dr. Kenneth L. Meredith

E-Mail Website
Guest Editor
Department of Surgical Oncology, Sarasota Memorial Hospital, Sarasota, FL, USA
Interests: surgical oncology; esophageal cancer; pancreatic cancer

Special Issue Information

Dear Colleagues,

Esophageal cancer is the sixth most common cause of cancer-related death worldwide, making it one of the most lethal gastrointestinal malignancies. There will be 21,560 patients diagnosed with esophageal cancer in the United States in the year 2023, and 16,120 patients will succumb to this disease. Esophageal cancer can be divided into two main histologic subtypes: adenocarcinoma and squamous cell carcinoma. While the squamous subtype remains the most prevalent, despite decreasing worldwide, the incidence of adenocarcinoma has continued to steadily and rapidly increase in developed, Western countries, even surpassing the prevalence of squamous cell carcinoma.

Despite improvements in surgical techniques, including minimally invasive and robotic approaches, as well as the development of adjuvant and neoadjuvant therapies, esophageal cancer has a dismal prognosis, with an overall 5-year survival rate of only 20 percent. Although advancements in the techniques of esophagectomy have shown a decrease in complications compared to the historical open approach, this operation is extremely complex and still carries significant risks of mortality and morbidity. The complication rate for esophagectomy has previously been reported as being between 17% and 74%.

Multimodal treatment plans consisting of combinations of chemotherapy, radiation, immunotherapy, and surgery are typically employed. Patients with locally advanced esophageal cancer will often undergo neoadjuvant therapy followed by surgery, which remains the gold standard of treatment. In this series we will focus on the critical aspects in the management of esophageal cancer, including systemic therapies, surgical techniques, and a review of post-operative outcomes.

Dr. Kenneth L. Meredith
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • esophageal cancer
  • esophagectomy
  • perioperative management
  • systemic therapies
  • neoadjuvant therapy

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Published Papers (3 papers)

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Research

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11 pages, 1535 KiB  
Article
Skeletal Muscle Quality and Quantity Affect Prognosis after Neoadjuvant Chemotherapy with a Triple Regimen of Docetaxel/Cisplatin/5-FU in Patients with Esophageal Cancer
by Nobuhito Ito, Masahiro Tajika, Tsutomu Tanaka, Keisaku Yamada, Akihiro Takagi, Sachiyo Onishi, Tetsuya Abe, Eiji Higaki, Hironori Fujieda, Yoshitaka Inaba, Kei Muro, Hiroki Kawashima and Yasumasa Niwa
J. Clin. Med. 2023, 12(21), 6738; https://doi.org/10.3390/jcm12216738 - 25 Oct 2023
Cited by 1 | Viewed by 1529
Abstract
The purpose of this study was to identify factors associated with the prognosis after docetaxel, cisplatin, and 5-fluorouracil (DCF) neoadjuvant chemotherapy (NAC) in patients with advanced esophageal squamous cell carcinoma (ESCC) undergoing surgical resection. We retrospectively examined a total of 100 patients who [...] Read more.
The purpose of this study was to identify factors associated with the prognosis after docetaxel, cisplatin, and 5-fluorouracil (DCF) neoadjuvant chemotherapy (NAC) in patients with advanced esophageal squamous cell carcinoma (ESCC) undergoing surgical resection. We retrospectively examined a total of 100 patients who received neoadjuvant DCF therapy for ESCC at our institution between 2011 and 2020. The psoas muscle index (PMI) was calculated from the psoas muscle area at the L3 vertebral level, and the intramuscular adipose tissue content (IMAC) was calculated from the mean CT value of the multifidus muscle and from four points of subcutaneous fat. The median PMI value was 6.11 cm2/m2 (range, 3.12–11.07 cm2/m2) in men and 3.65 cm2/m2 (range, 2.70–6.82 cm2/m2) in women. The median IMAC was −0.426 (range, −0.079–−0.968) in men and −0.359 (range, −0.079–−0.671) in women. Based on the PMI, IMAC, and other patient factors, factors associated with NAC-DCF postoperative survival were identified using multivariate Cox regression analysis. A high IMAC was significantly related to overall survival after surgery (p = 0.005, hazard ratio 2.699). A comparison of Kaplan–Meier curves showed that the 5-year survival rate was 76.5% in the low IMAC group and 42.7% in the high IMAC group (log-rank test; p = 0.001). A low IMAC was associated with good survival outcomes and was an independent prognostic factor in patients with cStage II/III ESCC who were treated with the NAC-DCF regimen and underwent surgical resection. Full article
(This article belongs to the Special Issue Esophageal Cancer: Diagnosis and Treatment)
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Review

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19 pages, 1144 KiB  
Review
VAC-Stent in the Treatment of Post-Esophagectomy Anastomotic Leaks: A New “Kid on the Block” Who Marries the Best of Old Techniques—A Review
by Giuseppe Dell’Anna, Lorella Fanti, Jacopo Fanizza, Rukaia Barà, Alberto Barchi, Ernesto Fasulo, Ugo Elmore, Riccardo Rosati, Vito Annese, Liboria Laterza, Lorenzo Fuccio, Francesco Azzolini, Silvio Danese and Francesco Vito Mandarino
J. Clin. Med. 2024, 13(13), 3805; https://doi.org/10.3390/jcm13133805 - 28 Jun 2024
Cited by 3 | Viewed by 2067
Abstract
Esophagectomy, while a pivotal treatment for esophageal cancer, is not without adverse events. Among these, anastomotic leak (AL) is the most feared complication, threatening patient lives and incurring significant healthcare costs. The management of AL is complex and lacks standardization. Given the high [...] Read more.
Esophagectomy, while a pivotal treatment for esophageal cancer, is not without adverse events. Among these, anastomotic leak (AL) is the most feared complication, threatening patient lives and incurring significant healthcare costs. The management of AL is complex and lacks standardization. Given the high morbidity and mortality rates associated with redo-surgery, which poses risks for already fragile patients, various endoscopic treatments have been developed over time. Self-expandable metallic stents (SEMSs) were the most widely used treatment until the early 2000s. The mechanism of action of SEMSs includes covering the wall defect, protecting it from secretions, and promoting healing. In 2010, endoscopic vacuum therapy (EVT) emerged as a viable alternative for treating ALs, quickly gaining acceptance in clinical practice. EVT involves placing a dedicated sponge under negative pressure inside or adjacent to the wall defect, aiming to clear the leak and promote granulation tissue formation. More recently, the VAC-Stent entered the scenario of endoscopic treatment of post-esophagectomy ALs. This device combines a fully covered SEMS with an integrated EVT sponge, blending the ability of SEMSs to exclude defects and maintain the patency of the esophageal lumen with the capacity of EVT to aspirate secretions and promote the formation of granulation tissue. Although the literature on this new device is not extensive, early results from the application of VAC-Stent have shown promising outcomes. This review aims to synthesize the preliminary efficacy and safety data on the device, thoroughly analyze its advantages over traditional techniques and disadvantages, explore areas for improvement, and propose future directions. Full article
(This article belongs to the Special Issue Esophageal Cancer: Diagnosis and Treatment)
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11 pages, 1348 KiB  
Review
Novel Advances in Qualitative Diagnostic Imaging for Decision Making in Multidisciplinary Treatment for Advanced Esophageal Cancer
by Shinichi Okazumi, Gaku Ohira, Koichi Hayano, Tomoyoshi Aoyagi, Shunsuke Imanishi and Hisahiro Matsubara
J. Clin. Med. 2024, 13(2), 632; https://doi.org/10.3390/jcm13020632 - 22 Jan 2024
Viewed by 1593
Abstract
Background: Recently, neoadjuvant therapy and the succeeding surgery for advanced esophageal cancer have been evaluated. In particular, the response to the therapy has been found to affect surgical outcomes, and thus a precise evaluation of treatment effect is important for this strategy. In [...] Read more.
Background: Recently, neoadjuvant therapy and the succeeding surgery for advanced esophageal cancer have been evaluated. In particular, the response to the therapy has been found to affect surgical outcomes, and thus a precise evaluation of treatment effect is important for this strategy. In this study, articles on qualitative diagnostic modalities to evaluate tumor activities were reviewed, and the diagnostic indices were examined. Methods: For prediction of the effect, perfusion CT and diffusion MRI were estimated. For the histological response evaluation, perfusion CT, diffusion-MRI, and FDG-PET were estimated. For downstaging evaluation of T4, tissue-selective image reconstruction using enhanced CT was estimated and diagnostic indices were reviewed. Results: The prediction of the effect using perfusion CT with ‘pre CRT blood flow’ and diffusion MRI with ‘pre CRT ADC value’; the estimation of the histological response using perfusion CT with ‘post CRT blood flow reduction, using diffusion MRI with ‘post CRT ADC increasing’, and using FDG-PET with ‘post CRT SUV reduction’; and the downstaging evaluation of T4 using CT image reconstruction with ‘fibrous changed layer’ were performed well, respectively. Conclusions: Qualitative imaging modalities for prediction or response evaluation of neoadjuvant therapy for progressive esophageal cancer were useful for the decision making of the treatment strategy of the multidisciplinary treatment. Full article
(This article belongs to the Special Issue Esophageal Cancer: Diagnosis and Treatment)
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