Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives

Transthoracic esophagectomy is currently the predominant curative treatment option for resectable esophageal adenocarcinoma. The majority of carcinomas present as locally advanced tumors requiring multimodal strategies with either neoadjuvant chemoradiotherapy or perioperative chemotherapy alone. Mi...

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Autores principales:	Wolfgang Schröder, Suzanne S. Gisbertz, Daan M. Voeten, Christian A. Gutschow, Hans F. Fuchs, Mark I. van Berge Henegouwen
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	esophageal adenocarcinoma transthoracic esophagectomy minimally invasive (robotic) techniques: perioperative management patient selection surgical outcome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/140f2764cfb746fd836495a2ed1fc7bf
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spelling	oai:doaj.org-article:140f2764cfb746fd836495a2ed1fc7bf2021-11-25T17:04:34ZSurgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives10.3390/cancers132258342072-6694https://doaj.org/article/140f2764cfb746fd836495a2ed1fc7bf2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5834https://doaj.org/toc/2072-6694Transthoracic esophagectomy is currently the predominant curative treatment option for resectable esophageal adenocarcinoma. The majority of carcinomas present as locally advanced tumors requiring multimodal strategies with either neoadjuvant chemoradiotherapy or perioperative chemotherapy alone. Minimally invasive, including robotic, techniques are increasingly applied with a broad spectrum of technical variations existing for the oncological resection as well as gastric reconstruction. At the present, intrathoracic esophagogastrostomy is the preferred technique of reconstruction (Ivor Lewis esophagectomy). With standardized surgical procedures, a complete resection of the primary tumor can be achieved in almost 95% of patients. Even in expert centers, postoperative morbidity remains high, with an overall complication rate of 50–60%, whereas 30- and 90-day mortality are reported to be <2% and <6%, respectively. Due to the complexity of transthoracic esophagetomy and its associated morbidity, esophageal surgery is recommended to be performed in specialized centers with an appropriate caseload yet to be defined. In order to reduce postoperative morbidity, the selection of patients, preoperative rehabilitation and postoperative fast-track concepts are feasible strategies of perioperative management. Future directives aim to further centralize esophageal services, to individualize surgical treatment for high-risk patients and to implement intraoperative imaging modalities modifying the oncological extent of resection and facilitating surgical reconstruction.Wolfgang SchröderSuzanne S. GisbertzDaan M. VoetenChristian A. GutschowHans F. FuchsMark I. van Berge HenegouwenMDPI AGarticleesophageal adenocarcinomatransthoracic esophagectomyminimally invasive (robotic) techniques: perioperative managementpatient selectionsurgical outcomeNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5834, p 5834 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	esophageal adenocarcinoma transthoracic esophagectomy minimally invasive (robotic) techniques: perioperative management patient selection surgical outcome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	esophageal adenocarcinoma transthoracic esophagectomy minimally invasive (robotic) techniques: perioperative management patient selection surgical outcome Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Wolfgang Schröder Suzanne S. Gisbertz Daan M. Voeten Christian A. Gutschow Hans F. Fuchs Mark I. van Berge Henegouwen Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives
description	Transthoracic esophagectomy is currently the predominant curative treatment option for resectable esophageal adenocarcinoma. The majority of carcinomas present as locally advanced tumors requiring multimodal strategies with either neoadjuvant chemoradiotherapy or perioperative chemotherapy alone. Minimally invasive, including robotic, techniques are increasingly applied with a broad spectrum of technical variations existing for the oncological resection as well as gastric reconstruction. At the present, intrathoracic esophagogastrostomy is the preferred technique of reconstruction (Ivor Lewis esophagectomy). With standardized surgical procedures, a complete resection of the primary tumor can be achieved in almost 95% of patients. Even in expert centers, postoperative morbidity remains high, with an overall complication rate of 50–60%, whereas 30- and 90-day mortality are reported to be <2% and <6%, respectively. Due to the complexity of transthoracic esophagetomy and its associated morbidity, esophageal surgery is recommended to be performed in specialized centers with an appropriate caseload yet to be defined. In order to reduce postoperative morbidity, the selection of patients, preoperative rehabilitation and postoperative fast-track concepts are feasible strategies of perioperative management. Future directives aim to further centralize esophageal services, to individualize surgical treatment for high-risk patients and to implement intraoperative imaging modalities modifying the oncological extent of resection and facilitating surgical reconstruction.
format	article
author	Wolfgang Schröder Suzanne S. Gisbertz Daan M. Voeten Christian A. Gutschow Hans F. Fuchs Mark I. van Berge Henegouwen
author_facet	Wolfgang Schröder Suzanne S. Gisbertz Daan M. Voeten Christian A. Gutschow Hans F. Fuchs Mark I. van Berge Henegouwen
author_sort	Wolfgang Schröder
title	Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives
title_short	Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives
title_full	Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives
title_fullStr	Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives
title_full_unstemmed	Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives
title_sort	surgical therapy of esophageal adenocarcinoma—current standards and future perspectives
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/140f2764cfb746fd836495a2ed1fc7bf
work_keys_str_mv	AT wolfgangschroder surgicaltherapyofesophagealadenocarcinomacurrentstandardsandfutureperspectives AT suzannesgisbertz surgicaltherapyofesophagealadenocarcinomacurrentstandardsandfutureperspectives AT daanmvoeten surgicaltherapyofesophagealadenocarcinomacurrentstandardsandfutureperspectives AT christianagutschow surgicaltherapyofesophagealadenocarcinomacurrentstandardsandfutureperspectives AT hansffuchs surgicaltherapyofesophagealadenocarcinomacurrentstandardsandfutureperspectives AT markivanbergehenegouwen surgicaltherapyofesophagealadenocarcinomacurrentstandardsandfutureperspectives
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Surgical Therapy of Esophageal Adenocarcinoma—Current Standards and Future Perspectives

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