Christodoulidis G, Agko SE, Koumarelas KE, Kouliou MN, Zacharoulis D. Advancements and challenges in the treatment of esophageal cancer: A comprehensive review. World J Clin Oncol 2024; 15(12): 1463-1467 [PMID: 39720647 DOI: 10.5306/wjco.v15.i12.1463]
Corresponding Author of This Article
Grigorios Christodoulidis, PhD, Department of General Surgery, University Hospital of Larissa, Mezourlo, Larisa 41110, Thessalía, Greece. gregsurg@yahoo.gr
Research Domain of This Article
Oncology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Grigorios Christodoulidis, Marina Nektaria Kouliou, Department of General Surgery, University Hospital of Larissa, Larisa 41110, Thessalía, Greece
Sara Eirini Agko, Intensive Care Unit, Asklepios Paulinen Clinic Wiesbaden, Wiesbaden 65197, Hesse, Germany
Konstantinos Eleftherios Koumarelas, Department of Emergency Medicine, General Hospital of Larissa, Larisa 41221, Thessalía, Greece
Dimitris Zacharoulis, Department of Surgery, University Hospital of Larissa, Larisa GR41334, Thessalía, Greece
Author contributions: Christodoulidis G, Agko SE, Koumarelas KE, Kouliou MN and Zacharoulis D contributed to this paper; Christodoulidis G designed the overall concept and outline of the manuscript; Christodoulidis G, Agko SE, Koumarelas KE, Kouliou MN and Zacharoulis D contributed to the discussion and design of the manuscript; Christodoulidis G, Agko SE, Koumarelas KE, Kouliou MN and Zacharoulis D contributed to the writing, editing the manuscript, and review of literature.
Conflict-of-interest statement: We declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Grigorios Christodoulidis, PhD, Department of General Surgery, University Hospital of Larissa, Mezourlo, Larisa 41110, Thessalía, Greece. gregsurg@yahoo.gr
Received: June 25, 2024 Revised: July 23, 2024 Accepted: October 15, 2024 Published online: December 24, 2024 Processing time: 118 Days and 12.8 Hours
Abstract
Esophageal cancer (EC) is an aggressive malignancy with a poor prognosis, ranking seventh in incidence and sixth cancer-related deaths globally. EC is classified in two main types, the esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), with ESCC being more common in Eastern Europe, South Asia, and Africa, while EAC is prevalent in Western Europe and North America. Molecular analysis identifies three subgroups of ESCC, each with distinct genetic mutations and treatment responses. Early-stage EC is often difficult to detect, leading to late-stage diagnoses that necessitate systemic drug therapies, including molecular-targeted therapies and immunotherapies. Immunotherapy, particularly immune checkpoint inhibitor, has shown promising results in improving survival rates for metastatic or persistent EC. It is particularly important to target to multidisciplinary combination therapies, integrating surgery, chemoradiotherapy, targeted therapy and immunotherapy. Additionally, radioimmunotherapy is being explored for its potential to enhance treatment efficacy, especially in advanced and metastatic tumors. However, the pathological complete response rate to neoadjuvant chemoradiotherapy remains suboptimal, highlighting the need for novel treatment strategies. Future research should focus on optimizing treatment combinations and identifying predictive biomarkers to improve clinical outcomes for EC patients.
Core Tip: Esophageal cancer remains an aggressive and deadly malignancy, with significant global incidence and mortality rates. The primary histological types, esophageal squamous cell carcinoma and esophageal adenocarcinom, exhibit distinct geographic prevalence and molecular characteristics. Early detection challenges necessitate advanced systemic treatments. Recent advancements in immunotherapy, especially immune checkpoint inhibitors, combined with traditional therapies, have shown promising improvements in survival rates.
