JLE

Hépato-Gastro & Oncologie Digestive

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Multidisciplinary management of superficial esophageal cancer Volume 22, issue 10, Décembre 2015

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Authors
1 CHU de Nantes,
Institut des Maladies de l’Appareil Digestif,
unité d’oncologie digestive,
1 place Alexis Ricordeau,
44093 Nantes Cedex 1,
France
2 CHU de Nantes,
Institut des Maladies de l’Appareil Digestif,
unité d’endoscopie digestive,
Nantes,
France
3 Institut de Cancérologie de l’Ouest,
Département de radiothérapie,
Saint-Herblain,
France
* Tirés à part

More than 80% of esophageal cancers are locally advanced or metastatic at the time of diagnosis. For superficial tumors, different therapeutic strategies might be discussed. Endoscopic resection techniques (endoscopic mucosal resection and submucosal dissection) are the treatment of choice in selected patients with very superficial lesions at low risk of lymph node metastasis. Surgical resection is the first-line treatment in patients with high risk of lymph node metastasis, or as a rescue in case of endoscopic treatment failure. No prospective randomized study comparing endoscopic and surgical techniques have been published so far. In case of contraindication to these techniques, radio-chemotherapy or radiotherapy alone should be discussed, but data from randomized trials are lacking. Therapeutic strategies should be individualized, based on clinical and histological criteria, and discussed in multi-disciplinary meeting in expert centers.