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Thoracic surgeons release new guidelines for treatment of esophageal cancer
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New evidence-based clinical practice recommendations released by The Society of Thoracic Surgeons outline the importance of multimodality treatment for patients with cancer of the esophagus and gastroesophageal junction.
These peer-reviewed guidelines are part of a series released and to-be-released by The Society of Thoracic Surgeons (STS) addressing esophageal cancer treatment. They include nine recommendations, the most important of which is “that the care for these patients be done in a multidisciplinary setting,” Alex G. Little, MD, of the University of Arizona, Tucson, and chair of the guideline task force, told Healio Gastroenterology. “There is enough evidence to recommend multimodality treatment by the multispecialty group.”
Alex G. Little
Little said these are “guidelines, and not commandments. In other words, patients will vary, and individual circumstances may suggest to a thoughtful clinician that other pathways should be taken.”
The task force performed a systematic review of literature on multimodality therapy for esophageal cancer published from 1990 to present, using the PubMed/MEDLINE, EMBASE and Cochrane databases in June 2012 and April 2014. The resulting guidelines, which will appear in the November issue of The Annals of Thoracic Surgery, address issues related to multimodality therapy that range from adjuvant and neoadjuvant chemotherapy and chemoradiotherapy to restaging and surgical resection.
“There are some recommendations that suggest it is important to restage patients after their neoadjuvant chemotherapy or chemoradiation therapy,” Little said. Another suggests “that a multimodality program is more efficacious than surgery alone, but on the other hand, after the neoadjuvant therapy and after restaging, those who are eligible should receive surgery.” Little said most patients should be seen in a multidisciplinary setting, “so they receive treatment thoughtfully developed by multiple inputs as opposed to the first specialist they see.”
Disclosure: Little reports no relevant financial disclosures.