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Background <p>While the incidence of squamous cell carcinoma of the esophagus is decreasing in Western countries, there is an increase in adenocarcinomas of the esophagus and gastroesophageal junction (AEG) [<CitationRef CitationID="CR42">42</CitationRef>]. Esophageal cancer is the seventh most common cancer worldwide and is associated with one of the highest mortality rates. In Germany, more than 7000&#xa0;esophageal cancers are newly diagnosed each year [<CitationRef CitationID="CR32">32</CitationRef>]. At first presentation, about 60% are in a&#xa0;resectable stage [<CitationRef CitationID="CR25">25</CitationRef>].</p> Objective <p>This article aims to present current guideline-based treatment and new developments in the perioperative treatment of adenocarcinomas of the esophagus and gastroesophageal junction.</p> Materials and methods <p>This work is based on a&#xa0;topic-related selective literature search in the PubMed database, ClinicalTrials.gov, and current guidelines.</p> Results <p>According to current guidelines, preoperative radiochemotherapy according to the CROSS regimen and perioperative chemotherapy with FLOT (5-fluorouracil, folinic acid, oxaliplatin, docetaxel) are possible treatment options for perioperative treatment of advanced resectable AEG and esophageal carcinomas (≥ T2 and/or N + tumors). Current results (ESOPEC) show a&#xa0;clear advantage of perioperative chemotherapy. In order to further improve perioperative chemotherapy, studies are investigating the addition of checkpoint inhibitors (MATTERHORN, KEYNOTE-585) or other targeted therapies such as HER2-targeting antibodies (HERFLOT, INNOVATION). However, it is still questionable whether the hereby achieved improvement in the rate of pathologically complete remissions also translates into longer survival.</p>

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Perioperative Therapiekonzepte bei Adenokarzinomen des Ösophagus und des gastroösophagealen Übergangs

  • 期刊论文

  • 发表日期：

    2025年1月6日

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  • Magdalena K. Scheck,
  • Sylvie Lorenzen

摘要

Background

While the incidence of squamous cell carcinoma of the esophagus is decreasing in Western countries, there is an increase in adenocarcinomas of the esophagus and gastroesophageal junction (AEG) [42]. Esophageal cancer is the seventh most common cancer worldwide and is associated with one of the highest mortality rates. In Germany, more than 7000 esophageal cancers are newly diagnosed each year [32]. At first presentation, about 60% are in a resectable stage [25].

Objective

This article aims to present current guideline-based treatment and new developments in the perioperative treatment of adenocarcinomas of the esophagus and gastroesophageal junction.

Materials and methods

This work is based on a topic-related selective literature search in the PubMed database, ClinicalTrials.gov, and current guidelines.

Results

According to current guidelines, preoperative radiochemotherapy according to the CROSS regimen and perioperative chemotherapy with FLOT (5-fluorouracil, folinic acid, oxaliplatin, docetaxel) are possible treatment options for perioperative treatment of advanced resectable AEG and esophageal carcinomas (≥ T2 and/or N + tumors). Current results (ESOPEC) show a clear advantage of perioperative chemotherapy. In order to further improve perioperative chemotherapy, studies are investigating the addition of checkpoint inhibitors (MATTERHORN, KEYNOTE-585) or other targeted therapies such as HER2-targeting antibodies (HERFLOT, INNOVATION). However, it is still questionable whether the hereby achieved improvement in the rate of pathologically complete remissions also translates into longer survival.