| Abstract: |
Esophageal cancer is characterized by early and frequent metastasis. Surgery is the primary treatment for early-stage disease, whereas patients with patients with locally advanced disease receive perioperative chemotherapy or chemoradiotherapy. Squamous cancers can be treated with primary chemoradiotherapy without surgery, depending on their response to therapy and patient tolerance for subsequent surgery. Chemotherapy with a fluorinated pyrimidine and a platinum agent, followed by later treatment with taxanes and irinotecan, provides some benefit. Agents that inhibit the erb-b2 receptor tyrosine kinase 2 (ERBB2 or HER2), or vascular endothelial growth factor, including trastuzumab, ramucirumab, and apatinib, increase response and survival times. Esophageal adenocarcinomas have mutations in tumor protein p53 and mutations that activate receptor-associated tyrosine kinase, vascular endothelial growth factor, and cell cycle pathways, whereas esophageal squamous tumors have a distinct set of mutations. Esophageal cancers develop systems to evade anti-tumor immune responses, but studies are needed to determine how immune checkpoint modification contributes to esophageal tumor development. © 2018 AGA Institute |
| Keywords: |
vasculotropin; cancer chemotherapy; treatment outcome; treatment response; disease-free survival; vascular endothelial growth factor a; cancer surgery; unclassified drug; genetics; mutation; salvage therapy; squamous cell carcinoma; carcinoma, squamous cell; antineoplastic agents; disease free survival; postoperative care; chemotherapy, adjuvant; neoadjuvant therapy; cancer staging; lymph node metastasis; antineoplastic agent; lymph node dissection; lymphatic metastasis; lymph node excision; adenocarcinoma; metastasis; antineoplastic combined chemotherapy protocols; epidermal growth factor receptor 2; pathology; diagnostic imaging; protein p53; biopsy; postoperative complication; postoperative complications; survival time; blood; early cancer; adjuvant chemotherapy; vasculotropin a; tumor suppressor protein p53; genomics; surgery; esophagus resection; receptor, erbb-2; trastuzumab; esophagus cancer; esophageal adenocarcinoma; tp53 protein, human; esophagus; esophagus tumor; esophageal neoplasms; esophagectomy; protein inhibitor; chemoradiotherapy; endosonography; preoperative therapy; trends; erbb2 protein, human; complication; preoperative chemotherapy; procedures; endoscopic ultrasonography; esophagoscopy; postoperative chemotherapy; immune checkpoint inhibitor; adjuvant chemoradiotherapy; chemoradiotherapy, adjuvant; ramucirumab; humans; prognosis; human; priority journal; article; robotic surgical procedure; antagonists and inhibitors; robotic surgical procedures; robot assisted surgery; immune checkpoint inhibitors; positron emission tomography-computed tomography; positron emission tomography computed tomography; apatinib; vegf targeted therapy; her2 targeted therapy
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