A Hoeben1, J Polak1, L Van De Voorde2, F Hoebers2, H I Grabsch3, J de Vos-Geelen4. 1. Department of Internal Medicine, Division of Medical Oncology. 2. Department of Radiation Oncology (MAASTRO Clinic). 3. Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands Department of Pathology & Tumour Biology, Leeds Institute of Cancer Studies and Pathology, University of Leeds, Leeds, UK. 4. Department of Internal Medicine, Division of Medical Oncology judith.de.vos@mumc.nl.
Abstract
BACKGROUND: The aim of this systematic review is to provide an overview of the diagnosis, treatment options and treatment-related complications of cervical esophageal carcinoma (CEC) and to subsequently provide recommendations to improve quality of care. DESIGN: Studies were identified in PubMed, EMBASE and Web of Science. A total of 107 publications fulfilled the inclusion criteria and were included. RESULTS: CEC is uncommon, accounting for 2%-10% of all esophageal carcinomas. These tumors are often locally advanced at presentation and have a poor prognosis, with a 5-year overall survival of 30%. Tobacco and alcohol consumption seem to be the major risk factors for developing CEC. Surgery is usually not possible due to the very close relationship to other organs such as the larynx, trachea and thyroid gland. Therefore, the current standard of care is definitive chemoradiation (dCRT) with curative intent. Treatment regimens used to treat CEC are adapted by established regimens in lower esophageal squamous cell carcinoma and head and neck squamous cell carcinoma. However, dCRT may be accompanied by severe side-effects and complications. Several diagnostic and predictive markers have been studied, but currently, there is no other biomarker than clinical stage to determine patient management. Suggestions to improve patient outcomes are to determine the exact radiation dose needed for adequate locoregional control and to combine radiotherapy with optimal systemic therapy backbone. CONCLUSION: CEC remains unchartered territory for many practising physicians and patients with CEC have a poor prognosis. To improve the outcome for CEC patients, future studies should focus on the identification of new diagnostic biomarkers or targets for radiosensitizers, amelioration of radiation schedules, optimal combination of chemotherapeutic agents and/or new therapeutic targets.
BACKGROUND: The aim of this systematic review is to provide an overview of the diagnosis, treatment options and treatment-related complications of cervical esophageal carcinoma (CEC) and to subsequently provide recommendations to improve quality of care. DESIGN: Studies were identified in PubMed, EMBASE and Web of Science. A total of 107 publications fulfilled the inclusion criteria and were included. RESULTS: CEC is uncommon, accounting for 2%-10% of all esophageal carcinomas. These tumors are often locally advanced at presentation and have a poor prognosis, with a 5-year overall survival of 30%. Tobacco and alcohol consumption seem to be the major risk factors for developing CEC. Surgery is usually not possible due to the very close relationship to other organs such as the larynx, trachea and thyroid gland. Therefore, the current standard of care is definitive chemoradiation (dCRT) with curative intent. Treatment regimens used to treat CEC are adapted by established regimens in lower esophageal squamous cell carcinoma and head and neck squamous cell carcinoma. However, dCRT may be accompanied by severe side-effects and complications. Several diagnostic and predictive markers have been studied, but currently, there is no other biomarker than clinical stage to determine patient management. Suggestions to improve patient outcomes are to determine the exact radiation dose needed for adequate locoregional control and to combine radiotherapy with optimal systemic therapy backbone. CONCLUSION: CEC remains unchartered territory for many practising physicians and patients with CEC have a poor prognosis. To improve the outcome for CEC patients, future studies should focus on the identification of new diagnostic biomarkers or targets for radiosensitizers, amelioration of radiation schedules, optimal combination of chemotherapeutic agents and/or new therapeutic targets.
Authors: Armando De Virgilio; Andrea Costantino; Carlo Castoro; Giuseppe Spriano; Bianca Maria Festa; Giuseppe Mercante; Davide Franceschini; Ciro Franzese; Marta Scorsetti; Andrea Marrari; Raffaele Cavina; Salvatore Marano Journal: J Cancer Res Clin Oncol Date: 2022-03-02 Impact factor: 4.553
Authors: Armando De Virgilio; Andrea Costantino; Carlo Castoro; Giuseppe Spriano; Bianca Maria Festa; Giuseppe Mercante; Davide Franceschini; Ciro Franzese; Marta Scorsetti; Andrea Marrari; Raffaele Cavina; Salvatore Marano Journal: Eur Arch Otorhinolaryngol Date: 2022-08-15 Impact factor: 3.236
Authors: Berend Jan van der Wilk; Ben M Eyck; Manon C W Spaander; Roelf Valkema; Sjoerd M Lagarde; Bas P L Wijnhoven; J Jan B van Lanschot Journal: Dig Surg Date: 2018-09-18 Impact factor: 2.588