Globally, esophageal cancer (including tumors of the gastroesophageal junction) is one of the most common cancers and is responsible for significant morbidity and mortality. While it is relatively uncommon in the United States and Western Europe, it is endemic in East Asia and parts of the developing world. The most common histology worldwide is squamous cell carcinoma, which predominates in countries where this cancer is common, while adenocarcinomas are the more common histology in the West. Irrespective of the histology or where it occurs, esophageal cancer is a virulent disease.
Despite poor outcomes, the diagnosis and multimodality treatment of this virulent disease has improved in the past two decades. This issue of Chinese Clinical Oncology seeks to provide a concise update on the management of esophageal cancer, from the perspective of a gastroenterologist and surgical, radiation and medical oncology. We are grateful to our collaborators and colleagues for their contribution and for offering their considered, authoritative opinions.
Dr. Pari Shah will review screening strategies for Barrett’s esophagus and the endoscopic therapy of early-stage esophageal cancer. Dr. Daniela Molena then discusses the challenges and various approaches to operating within the thoracic cavity, while Dr. Abraham Wu focuses on contemporary radiation techniques.
Taking a high level perspective, Drs. Neeha Zaidi and Ronan Kelly will review the management of locally advanced esophageal squamous cell cancer in the West, while Dr. Ilson highlights areas of controversy and consensus in the treatment of locally advanced esophageal adenocarcinoma.
From the perspective of systemic therapy, Dr. Ku focuses on cytotoxic chemotherapy, while Dr. Tomas Lyons describes the evaluation of targeted therapies and immunotherapy, an area of active investigation that has the potential to transform the treat of this cancer in the next decade. Dr. Elizabeth Won discusses the unique challenges of administering therapy in an older population, an increasingly relevant topic as the proportion of older people in many societies increases.
The wide range of expertise featured in this issue is a clear signal and reminder that this disease requires a multidisciplinary integrated approach. Continued improvements in each field and careful evaluation by a team of experts will enable us to provide compassionate, individualized and excellent care to each and every patient.