| Theme | Clinical Gastroenterology -- Past 30 Years and Future Vision | |
|---|---|---|
| Title | Esophageal Cancer -- Progress over the Past 30 Years and Future Aims | |
| Publish Date | 2015/01 | |
| Author | Hiroyasu Makuuchi | Department of Digestive Surgery, Tokai University School of Medicine |
| [ Summary ] | There has been considerable progress in the diagnosis and treatment of esophageal cancer over the past 30 years, and now, it is a curable disease. Developments in diagnostic techniques have led to the replacement of X‒ray esophagography with direct visualization using slender fiberscopes, video endoscopy, high vision endoscopy. Other new diagnostic techniques include NBI, magnifying endoscopy, EUS and transnasal endoscopy. Advancements in the treatment of esophageal cancer include post‒surgical rather than pre‒surgical irradiation, three field lymphadenectomy, and neoadjuvant chemotherapy. Chemo‒radiotherapy (CRT), endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used in Japan. Future targets for the management of esophageal cancer include improved diagnosis of lymphnode matastasis and revision of the guidelines for differentiation type and infiltrative growth pattern (INF). Efforts should also focus on progress in endoscopic surgery, improved neoadjuvant chemotherapy, expanded application of ESD, refinement of radiation fields and the dose of CRT, and the inclusion of S‒1 under health insurance cover. |
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