Clinical Trials Update in Resectable Esophageal Cancer

Rákkutatás · Esophageal cancer

The treatment of resectable esophageal cancer has evolved into a multidisciplinary paradigm centered on multimodality therapy, with recent advances in perioperative chemotherapy, immunotherapy and minimally invasive surgical techniques leading to improved pathologic response rates, disease‑free survival and overall survival.

Management of resectable esophageal cancer has evolved into a multidisciplinary paradigm centered on multimodality therapy. Historically, induction chemoradiotherapy followed by surgery, as established by the CROSS trial, became the standard of care for locally advanced disease due to improvements in R0 resection rates and overall survival. More recently, the ESOPEC trial reexamined this paradigm in esophageal adenocarcinoma, demonstrating superior survival and improved systemic disease control with perioperative chemotherapy using the FLOT regimen compared with chemoradiotherapy. In parallel, the MATTERHORN trial further advanced perioperative treatment by showing improved event‑free survival with the addition of the immune checkpoint inhibitor durvalumab to FLOT chemotherapy. Alongside these systemic therapy advances, surgical management has transitioned toward minimally invasive and robotic‑assisted esophagectomy, offering equivalent oncologic outcomes with reduced perioperative morbidity.

These developments underline the shift from single‑modality surgery to combined systemic and local treatments, which now improve survival and reduce recurrence in patients with potentially curable esophageal cancer.

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