Comment je traite... les cancers localises de l'oesophage. Etat actuel des donnees et strategie therapeutique. 2eme partie : l'interet des approches multimodales avec ou sans chirurgie.
VAN DAELE, Daniel; Honoré, Pierre; COLLIGNON, Joëlleet al.
2017 • In Revue Médicale de Liège, 72 (4), p. 168-174
Neoadjuvant therapy; Rescue surgery; Esophageal cancer
Abstract :
[en] In recent years, the treatment of esophagus cancer has been completely changed, thus competing the dogma of surgery as the cornerstone treatment. Multimodality treatments as radio-chemotherapy directly followed by surgery, or delayed surgery, significantly improve patient survival compared to surgery alone. Neoadjuvant radiochemotherapy is associated with a higher complete pathologic response rate and improved survival compared to chemotherapy alone. Immediate surgery after radio-chemotherapy is challenged for patients who present a complete clinical response, especially in case of squamous cell carcinoma. Indeed, systematic resection is associated with a significant postoperative mortality rate and has not proven any survival advantage in complete clinical responders as opposed to delayed resection in case of locally persistent or recurrent disease. In squamous cell carcinoma, this could lead to organ preservation, thus avoiding the mortality and durable functional impairment of esophagectomy. This review will discuss the positioning of the multimodality treatment strategy with neoadjuvant radiochemotherapy and chemotherapy and also the strategy of organ preservation.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
VAN DAELE, Daniel ; Centre Hospitalier Universitaire de Liège - CHU > Service de gastroentérologie, hépatologie, onco. digestive
Honoré, Pierre ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
COLLIGNON, Joëlle ; Centre Hospitalier Universitaire de Liège - CHU > Service d'oncologie médicale
POLUS, Marc ; Centre Hospitalier Universitaire de Liège - CHU > Service de gastroentérologie, hépatologie, onco. digestive
LOLY, Catherine ; Centre Hospitalier Universitaire de Liège - CHU > Service de gastroentérologie, hépatologie, onco. digestive
MUTIJIMA NZARAMBA, Eugène ; Centre Hospitalier Universitaire de Liège - CHU > Service d'anatomie et cytologie pathologiques
De Roover, Arnaud ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Coucke, Philippe ; Université de Liège - ULiège > Département des sciences cliniques > Radiothérapie
Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Martinive, Philippe ; Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Département des sciences biomédicales et précliniques
Language :
French
Title :
Comment je traite... les cancers localises de l'oesophage. Etat actuel des donnees et strategie therapeutique. 2eme partie : l'interet des approches multimodales avec ou sans chirurgie.
Alternative titles :
[en] Comprehensive therapeutic strategy for localized esophageal cancer. Second part : interest of multimodal approaches with or without surgery
Publication date :
2017
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium
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