Esophageal cancer: patient evaluation and pre-treatment staging

摘要: Improvements in the overall survival of patients with esophageal cancer can future only be achieved by tailored therapeutic strategies which are based on individual histologic tumor type, location, stage at time presentation, consideration established prognostic factors and physiologic status patient. The major aim every diagnostic strategy is to assess whether a complete macroscopic microscopic resection (i.e. an R0 resection) primary surgical approach high degree likelihood. This requires classification type (squamous cell or adenocarcinoma), exclusion distant solid organ metastases, localization relation tracheobronchial tree, determination T-category surrounding structures tumor. currently combination contrast radiography, endoscopy biopsy, endoscopic ultrasonography CT scan. PET scanning will more widely used staging because it appears superior current imaging modalities lymph node metastases allows early assessment response neoadjuvant treatment. Systematic risk analysis dedicated composite scoring system essential patient reduce postoperative mortality. Only hospitals sufficient case load ('hospital volume') interest management this disease ('centers excellence') provide required expertise standards for evaluation therapy.