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Cancers
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New Trends in Esophageal Cancer Management (Volume II)
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New Trends in Esophageal Cancer Management (Volume II)

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 15 August 2024 | Viewed by 4868

Special Issue Editor

Prof. Dr. Caroline Gronnier

E-Mail Website
Guest Editor
Department of Digestive Surgery, Magellan Center, Bordeaux University Hospital, 33600 Pessac, France
Interests: esophageal cancer; esophageal adenocarcinoma; esophageal squamous cell carcinoma; surgery; chemoradiotherapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of the Special Issue “New Trends in Esophageal Cancer Management”, available at https://www.mdpi.com/journal/cancers/special_issues/Esophageal_Cancer_Management.

Esophageal cancer retains the reputation of having a poor prognosis, due to having a generally evolved stage at the time of diagnosis, a terrain often altered by multiple co-morbidities, a rapid impact on the general state, particularly nutritional, and a need for cumbersome combinations of treatments, in particular, complex surgery. However, significant progress has been made over the last few decades. This has involved achieving better precision in pre-therapeutic assessments, making it possible to adjust the treatment modalities effectively; developing effective chemotherapies with acceptable side-effects; improving radiotherapy techniques that make it possible to concentrate high doses within a limited volume while sparing neighborhood structures; and improving surgical management, both at the level of perioperative care and during the surgical act itself, where the site of minimally-invasive surgery is clearer. Although the morbidity and mortality of esophagectomies remain some of the highest in gastrointestinal surgery, they have drastically decreased over the last few decades, allowing surgery to remain the primary treatment for resectable esophageal cancer. Additionally, due to therapeutic advances, it has become possible to manage much older patients too. At the same time, the epidemiological profile of this cancer has changed radically, due to a reduction in alcohol and tobacco consumption and an increase in the incidence of gastroesophageal reflux disease (GERD). Thus, adenocarcinoma of the esophagus has become more frequent than squamous cell carcinoma in Western countries; therefore, its tendency will be considered here too in order to group together this pathology in regard to center-specialized high-volume activity.

The objective of this Special Issue is to provide an overview of the current management of esophageal cancer concerning pre-treatment assessment, perioperative treatment, nutritional management, surgical treatment, and special situations. It aims to serve as an aid in the daily practice of physicians confronted with esophageal cancer.

Prof. Dr. Caroline Gronnier
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. Cancers 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 2900 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
  • esophageal adenocarcinoma
  • esophageal squamous cell carcinoma
  • surgery
  • chemoradiotherapy
  • perioperative chemotherapy
  • immunotherapy

Published Papers (5 papers)

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Research

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12 pages, 632 KiB  
Article
Outcomes after Surgical Treatment of Oesophagogastric Cancer with Synchronous Liver Metastases: A Multicentre Retrospective Cohort Study
by Sander J. M. van Hootegem, Carlo A. de Pasqual, Simone Giacopuzzi, Elke Van Daele, Hanne Vanommeslaeghe, Johnny Moons, Philippe Nafteux, Pieter C. van der Sluis, Sjoerd M. Lagarde and Bas P. L. Wijnhoven
Cancers 2024, 16(4), 797; https://doi.org/10.3390/cancers16040797 - 16 Feb 2024
Viewed by 656
Abstract
Approximately 10–12% of patients with oesophageal or gastric cancer (OGC) present with oligometastatic disease at diagnosis. It remains unclear if there is a role for radical surgery in these patients. We aimed to assess the outcomes of OGC patients who underwent simultaneous treatment [...] Read more.
Approximately 10–12% of patients with oesophageal or gastric cancer (OGC) present with oligometastatic disease at diagnosis. It remains unclear if there is a role for radical surgery in these patients. We aimed to assess the outcomes of OGC patients who underwent simultaneous treatment for the primary tumour and synchronous liver metastases. Patients with OGC who underwent surgical treatment between 2008 and 2020 for the primary tumour and up to five synchronous liver metastases aiming for complete tumour removal or ablation (i.e., no residual tumour) were identified from four institutional databases. The primary outcome was overall survival (OS), calculated with the Kaplan–Meier method. Secondary outcomes were disease-free survival and postoperative outcomes. Thirty-one patients were included, with complete follow-up data for 30 patients. Twenty-six patients (84%) received neoadjuvant therapy followed by response evaluation. Median OS was 21 months [IQR 9–36] with 2- and 5-year survival rates of 43% and 30%, respectively. While disease recurred in 80% of patients (20 of 25 patients) after radical resection, patients with a solitary liver metastasis had a median OS of 34 months. The number of liver metastases was a prognostic factor for OS (solitary metastasis aHR 0.330; p-value = 0.025). Thirty-day mortality was zero and complications occurred in 55% of patients. Long-term survival can be achieved in well-selected patients who undergo surgical resection of the primary tumour and local treatment of synchronous liver metastases. In particular, patients with a solitary liver metastasis seem to have a favourable prognosis. Full article
(This article belongs to the Special Issue New Trends in Esophageal Cancer Management (Volume II))
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13 pages, 2983 KiB  
Article
Diagnostic Performance of a Novel Ultra-Thin Endoscopy under Narrow-Band Imaging for Superficial Squamous Cell Carcinoma of the Pharynx and Esophagus
by Akira Dobashi, Yuko Hara, Hiroto Furuhashi, Hiroaki Matsui, Naoya Tada, Mamoru Ito, Toshiki Futakuchi, Masakuni Kobayashi, Shingo Ono, Daisuke Aizawa, Takashi Yamauchi, Machi Suka and Kazuki Sumiyama
Cancers 2024, 16(3), 529; https://doi.org/10.3390/cancers16030529 - 26 Jan 2024
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Abstract
This study aimed to evaluate the diagnostic utility of the ultra-thin endoscope (UTE) for superficial squamous cell carcinoma (SSCC) compared to magnifying endoscopy (ME) under narrow-band imaging. Participants underwent endoscopic examination, and images of pharyngeal and esophageal SCCs, as along with suspicious SSCC [...] Read more.
This study aimed to evaluate the diagnostic utility of the ultra-thin endoscope (UTE) for superficial squamous cell carcinoma (SSCC) compared to magnifying endoscopy (ME) under narrow-band imaging. Participants underwent endoscopic examination, and images of pharyngeal and esophageal SCCs, as along with suspicious SSCC lesions, were collected using UTE and ME on the same day. Three image catalogs (UTE, ME-1, and ME-2) were created and reviewed by three expert endoscopists. ME-1 and ME-2 contained the same endoscopic images. The primary endpoint was the intra-observer agreement for diagnosing SCC. Eighty-six lesions (SCC = thirty-nine, non-SCC = forty-seven) in 43 participants were identified. The kappa values for the intra-observer agreement between UTE and ME-1 vs. the control (ME-1 vs. ME-2) were 0.74 vs. 0.84, 0.63 vs. 0.76, and 0.79 vs. 0.88, respectively. The accuracies for diagnosing SCC by UTE and ME-1 were 87.2% vs. 86.0%, 78.0% vs. 73,2%, and 75.6 vs. 82.6%, respectively, with no significant differences (p > 0.05). The rates of lesions that were diagnosed with confidence by UTE and ME-1 were 30.2% vs. 27.9%, 55.8% vs. 62.8%, and 58.1% vs. 55.8%, respectively. UTE demonstrates substantial diagnostic performance for SSCC in the pharynx and esophagus. Full article
(This article belongs to the Special Issue New Trends in Esophageal Cancer Management (Volume II))
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15 pages, 809 KiB  
Article
Treatment Outcomes and Risk Factors for Incomplete Treatment after Definitive Chemoradiotherapy for Non-Resectable or Metastatic Esophageal Cancer
by Chu-Pin Pai, Ling-I Chien, Chien-Sheng Huang, Han-Shui Hsu and Po-Kuei Hsu
Cancers 2023, 15(22), 5421; https://doi.org/10.3390/cancers15225421 - 15 Nov 2023
Viewed by 662
Abstract
Among patients with unresectable or metastatic esophageal cancer who receive definitive chemotherapy or chemoradiotherapy, the rates of treatment-related adverse events and incomplete treatment remain high. We conducted this study to investigate survival after definitive treatments and identify predicting factors for incomplete treatment. The [...] Read more.
Among patients with unresectable or metastatic esophageal cancer who receive definitive chemotherapy or chemoradiotherapy, the rates of treatment-related adverse events and incomplete treatment remain high. We conducted this study to investigate survival after definitive treatments and identify predicting factors for incomplete treatment. The data of patients who received definitive chemotherapy or chemoradiotherapy for esophageal cancer were retrospectively examined. The patients were assigned to Group 1: incomplete definitive treatment; Group 2: complete definitive treatment; or Group 3: complete definitive treatment with additional salvage surgery. The data of 273 patients (90, 166, and 17 in Groups 1, 2, and 3, respectively) were analyzed. In the survival analysis, the median overall survival of Groups 1, 2, and 3 were 2.6, 10.3, and 29.5 months, respectively. A significant difference in 3-year overall survival was observed among the groups (2.2%, 12.4%, and 48.5%, p < 0.001). In multivariable analysis, the independent risk factors for incomplete definitive treatment included poor performance score (hazard ratio (HR): 5.23, p = 0.001), bone metastasis (HR: 2.18, p = 0.024), airway invasion (HR: 2.90, p = 0.001), and liver cirrhosis (HR: 3.20, p = 0.026). Incomplete definitive treatment is associated with a far worse prognosis. Poor performance, bone metastasis, airway invasion, and liver cirrhosis are risk factors for incomplete treatment. Full article
(This article belongs to the Special Issue New Trends in Esophageal Cancer Management (Volume II))
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Review

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13 pages, 758 KiB  
Review
A Meta-Analysis and Review of Radiation Dose Escalation in Definitive Radiation Therapy between Squamous Cell Carcinoma and Adenocarcinoma of Esophageal Cancer
by Yu Liou, Tien-Li Lan and Chin-Chun Lan
Cancers 2024, 16(3), 658; https://doi.org/10.3390/cancers16030658 - 03 Feb 2024
Viewed by 881
Abstract
Esophageal cancer, ranked as the eighth most prevalent cancer globally, is characterized by a low survival rate and poor prognosis. Concurrent chemoradiation therapy (CCRT) is the standard therapy in the non-surgical treatment of localized carcinoma of the esophagus. Nevertheless, the radiation doses employed [...] Read more.
Esophageal cancer, ranked as the eighth most prevalent cancer globally, is characterized by a low survival rate and poor prognosis. Concurrent chemoradiation therapy (CCRT) is the standard therapy in the non-surgical treatment of localized carcinoma of the esophagus. Nevertheless, the radiation doses employed in CCRT remain notably lower compared to the curative definite chemoradiation therapy utilized in the management of other carcinomas. In order to increase the local control rates and enhance the treatment outcomes, several clinical trials have used high-dose radiation to analyze the effect of dose escalation. Despite the integration of technically advanced RT schemes such as intensity-modulated radiation therapy (IMRT), the results of these trials have failed to demonstrate a significant improvement in overall survival or local progression-free survival. In this review, we investigated previous clinical trials to determine the ineffectiveness of radiation dose escalation in the context of CCRT for esophageal cancer. We aim to clarify the factors contributing to the limited efficacy of escalated radiation doses in improving patient outcomes. Furthermore, we delve into recent research endeavors, exploring prospective radiation dose modifications being altered based on the histological characteristics of the carcinoma. The exploration of these recent studies not only sheds light on potential refinements to the existing treatment protocols but also seeks to identify novel approaches that may pave the way for more efficacious and personalized therapeutic strategies for esophageal cancer management. Full article
(This article belongs to the Special Issue New Trends in Esophageal Cancer Management (Volume II))
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25 pages, 759 KiB  
Review
Molecular Biology and Clinical Management of Esophageal Adenocarcinoma
by Shulin Li, Sanne Johanna Maria Hoefnagel and Kausilia Krishnawatie Krishnadath
Cancers 2023, 15(22), 5410; https://doi.org/10.3390/cancers15225410 - 14 Nov 2023
Cited by 1 | Viewed by 1709
Abstract
Esophageal adenocarcinoma (EAC) is a highly lethal malignancy. Due to its rising incidence, EAC has become a severe health challenge in Western countries. Current treatment strategies are mainly chosen based on disease stage and clinical features, whereas the biological background is hardly considered. [...] Read more.
Esophageal adenocarcinoma (EAC) is a highly lethal malignancy. Due to its rising incidence, EAC has become a severe health challenge in Western countries. Current treatment strategies are mainly chosen based on disease stage and clinical features, whereas the biological background is hardly considered. In this study, we performed a comprehensive review of existing studies and discussed how etiology, genetics and epigenetic characteristics, together with the tumor microenvironment, contribute to the malignant behavior and dismal prognosis of EAC. During the development of EAC, several intestinal-type proteins and signaling cascades are induced. The anti-inflammatory and immunosuppressive microenvironment is associated with poor survival. The accumulation of somatic mutations at the early phase and chromosomal structural rearrangements at relatively later time points contribute to the dynamic and heterogeneous genetic landscape of EAC. EAC is also characterized by frequent DNA methylation and dysregulation of microRNAs. We summarize the findings of dysregulations of specific cytokines, chemokines and immune cells in the tumor microenvironment and conclude that DNA methylation and microRNAs vary with each different phase of BE, LGD, HGD, early EAC and invasive EAC. Furthermore, we discuss the suitability of the currently employed therapies in the clinic and possible new therapies in the future. The development of targeted and immune therapies has been hampered by the heterogeneous genetic characteristics of EAC. In view of this, the up-to-date knowledge revealed by this work is absolutely important for future EAC studies and the discovery of new therapeutics. Full article
(This article belongs to the Special Issue New Trends in Esophageal Cancer Management (Volume II))
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