Multimodale Therapiekonzepte beim Oesophaguskarzinom

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Item Type:	Article
Title:	Multimodale Therapiekonzepte beim Oesophaguskarzinom
Creators Name:	Schlag, P.M. and Benhidjeb, T.
Abstract:	Once the diagnosis of esophageal cancer is established, the decision on treatment will depend on the stage of the disease. Since improvement of prognosis can only be expected in patients with complete removal of their tumor, preoperative staging plays a pivotal role in the decision-making process. En bloc esophagectomy together with the regional lymph nodes remains the treatment of choice in medically fit patients with localized esophageal carcinoma (Stage I-IIB, T 1-T 2/N 0-N 1/M 0). Due to early involvement of mediastinal structures, curative resection is unlikely to be achieved in patients with locally advanced esophageal carcinoma (Stage III, T 3-T 4/N 0-N 1/M 0). Most available data indicate that neoadjuvant radiochemotherapy leads in a significant number of patients to downstaging of the tumor, increases the rate of R0 resection, improves local tumor control, and prolongs the recurrence free interval. However, neoadjuvant radiochemotherapy resulted in a marked increase of morbidity and postoperative mortality and survival without improvement of survival. At present, neoadjuvant therapy is still experimental and there is no consensus for an optimal treatment regimen. Its use outside of an investigational setting can not be recommended. Future research must focus on more effective and less toxic neoadjuvant modalities (e.g. new chemotherapy agents, hyperthermia).
Keywords:	Esophageal Carcinoma, Multimodality Therapy
Source:	Viszeralchirurgie
ISSN:	1435-3067
Volume:	36
Number:	1
Page Range:	6-11
Date:	2001
Official Publication:	https://doi.org/10.1055/s-2001-11139

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