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Vol. 99. Issue 7.
Pages 490-499 (August - September 2021)
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Vol. 99. Issue 7.
Pages 490-499 (August - September 2021)
Review article
DOI: 10.1016/j.cireng.2021.07.006
Surgery for metachronous oligometastatic esophageal cancer: Is there enough evidence?
Cirugía para el cáncer de esófago oligometastásico metacrónico: ¿hay suficiente evidencia?
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Dimitrios Schizasa, Michail Vailasa,
Corresponding author
mike_vailas@yahoo.com

Corresponding author.
, Maria Sotiropouloua, Ioannis A. Ziogasb, Konstantinos S. Mylonasa, Ioannis Katsarosa, Alkistis Kapelouzoua, Theodore Liakakosa
a First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 17 Agiou Thoma, 11527 Athens, Greece
b Department of Surgery, Vanderbilt University Medical Center, 1313 21st Avenue South, Nashville, TN, USA
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Table 1. Oncological outcomes of patients with recurrent disease in the liver treated with resection.
Table 2. Oncological outcomes of patients with recurrent disease in the lung treated with resection.
Table 3. Oncological outcomes of patients with recurrent disease in miscellaneous sites treated with resection.
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Abstract

Esophageal cancer is the sixth most common cause of cancer-related mortality worldwide. Despite advances in diagnostic modalities and treatment options, five-year survival rates are below 20%. Esophagectomy with extended lymph node dissection is the mainstay of treatment. More than 50% of patients experience recurrence within 1-3 years postoperatively. Recurrent disease may present locoregionally at the site of anastomosis or as recurrence through lymphatic spread in lymph node basins, as hematogenic metastasis, or as a combination of these. The standard treatment of recurrence is currently predicated on systemic chemotherapy and/or radiotherapy. Recent evidence suggests that surgical treatment of metachronous oligometastatic disease may be prognostically advantageous over medical management alone. Given the considerably low response rates to chemoradiotherapy, many institutions have adopted surgical treatment strategies for oligo-recurrent disease on a case-by-case basis. The aim of this article is to review the current evidence on the role of surgical treatment for metachronous oligometastases from esophageal cancer.

Keywords:
Cancer
Esophageal cancer
Metachronous
Metastasis
Oligometastatic
Surgery
Resumen

El cáncer de esófago es la sexta causa más frequente de mortalidad relacionada con el cáncer en todo el mundo. A pesar de los avances en los medios de diagnóstico y las opciones de tratamiento, la tasa de supervivencia a los cinco años es menor del 20%. La esofagectomía con la disección de ganglios linfáticos extendida es la base del tratamiento. Más del 50% de los pacientes experimentan recurrencia dentro de 1-3 años después de la operación. La enfermedad recurrente puede presentarse como recidiva locorregional en el sitio de la anastomosis o como recidiva a través de diseminación en los ganglios linfáticos, como metástasis hematológicas o como una combinación de todos ellos. El tratamiento estándar de la recidiva se basa actualmente en la quimioterapia sistémica y/o radioterapia. La evidencia reciente sugiere que el tratamiento quirúrgico de la enfermedad oligometastásica metacrónica puede tener ventajas pronósticas superiores al tratamiento exclusivamente médico. Dada la tasa de respuesta considerablemente baja a la quimiorradioterapia, muchas instituciones han adoptado estrategias de tratamiento quirúrgico para la enfermedad oligorrecurrente caso por caso. El objetivo de este artículo es revisar la evidencia actual sobre el papel del tratamiento quirúrgico de las oligometástasis metacrónicas del cáncer de esófago.

Palabras clave:
Cáncer
Cáncer de esófago
Metacrónico
Metástasis
Oligometastásico
Cirugía

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