Esophageal Cancer Management: Baby Steps Distally

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Virginia R. Litle, MD, Consulting Editor

Globally, esophageal cancer is a dismal disease accounting for more than 544,000 deaths each yearSung H. Ferlay J. Siegel R.L. et al.Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. and with a continued increase in incidence in the United States to ∼20,000 cases per year in 2021. The best chance of cure for locally advanced disease includes an esophagectomy with a concerning morbidity rate of ∼50%. On the other hand, positive progress is happening on all multimodal fronts. Not only has there been the paradigm shift for curative management of superficial cancers with endoscopic resections but also we are seeing the advances with use of immunotherapy and targeted therapies beyond trastuzumab. With evolving disease management and a continued global malignancy problem, we invited Toronto esophageal experts Drs Jonathan Yeung and Elena Elimova to guest edit this issue of Thoracic Surgery Clinics. Dr Yeung is the Director of Thoracic Foregut Surgery at Toronto General and is the successor to Dr Gail Darling’s robust esophageal program with multiple on-going prospective translational and technical studies. He is the perfect lead for that program and works closely with medical oncologist Dr Elena Elimova to move this field forward. Together they invited a panoply of experts to give us state-of-the art reviews of the ever-evolving topic of esophageal cancer care.

For food-for-thought, you will read about the continued controversies of routine biomarker testing of all tumors when diagnosed, technical considerations about routine drainage procedures and duct ligation as well as extent of recurrent nerve node dissection and duct resection for squamous cell carcinomas. Esophageal cancer is often approached by nonesophagologists and oncologists with a nihilistic approach; however, this issue of Thoracic Surgery Clinics reminds us that lung cancer is not the only thoracic malignancy casting a light of optimism on our field.

Thank you to all the contributors and to guest editors Drs Elimova and Yeung. Please enjoy the content as a current reference for managing a classically dismal disease with a sense of hope for our patients.

Sincerely,

REFERENCESung H. Ferlay J. Siegel R.L. et al.

Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.

CA Cancer J Clin. 71: 209-249Article InfoIdentification

DOI: https://doi.org/10.1016/j.thorsurg.2022.08.005

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© 2022 Published by Elsevier Inc.

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