Current Advancement in Multidisciplinary Treatment for Resectable cStage II/III Esophageal Squamous Cell Carcinoma in Japan

• Published in: Annals of Thoracic and Cardiovascular Surgery Vol. 22; no. 5; pp. 275 - 283
• Main Authors: Matsuda, Satoru, Takeuchi, Hiroya, Kawakubo, Hirofumi, Ando, Nobutoshi, Kitagawa, Yuko
• Format: Journal Article
• Language: English
• Published: Japan The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery 01-01-2016
• Subjects: Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - therapy; Chemoradiotherapy, Adjuvant - adverse effects; Chemoradiotherapy, Adjuvant - mortality; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; esophageal cancer; Esophageal Neoplasms - mortality; Esophageal Neoplasms - pathology; Esophageal Neoplasms - therapy; Esophageal Squamous Cell Carcinoma; esophagectomy; Esophagectomy - adverse effects; Esophagectomy - mortality; Fluorouracil - administration & dosage; Humans; Japan; Lymph Node Excision - adverse effects; Lymph Node Excision - mortality; multidisciplinary treatment; Neoadjuvant Therapy - adverse effects; Neoadjuvant Therapy - mortality; Neoplasm Staging; Review; Treatment Outcome; Japan
• ISSN: 1341-1098; 2186-1005
• DOI: 10.5761/atcs.ra.16-00111

Multidisciplinary treatment comprising surgery, chemotherapy, and radiotherapy for resectable esophageal squamous cell carcinoma (ESCC) is widely used with improved prognosis. Transthoracic esophagectomy (TTE) with extended lymph node (LN) dissection, known as three field LN dissection, has been recommended for ESCC using open thoracotomy or the thoracoscopic approach. The Japan Clinical Oncology Group (JCOG) trial (JCOG1409) is investigating the patients’ long term survival using the thoracoscopic approach that has been shown to reduce the incidence of postoperative respiratory complication. For perioperative treatment, neoadjuvant chemotherapy using cisplatin plus 5-fluorouracil (5-FU), has been accepted as the standard of care in Japan based on the JCOG9907 trial. In Western countries, neoadjuvant chemoradiotherapy was shown to prolong overall survival for esophageal cancer, including ESCC. Although surgery has been recognized as an initial curative treatment for esophageal cancer, definitive chemoradiotherapy is an alternative treatment for patients who are unable to undergo thoracotomy or who decline to undergo surgery. This article reviews multidisciplinary treatment advances for ESCC. However, current standard treatments are country dependent and the ongoing trial may help standardize ESCC treatment across various societies.