The evolution of views on the complex treatment of esophageal cancer

INTRODUCTION. Currently, the choice of tactics in the treatment of esophageal cancer remains an urgent problem. Important factors are: the stage of the disease, the functional state of the patient, as well as the morphological type of tumor. An integrated approach is today the standard for this pathology. However, after radical treatment, a significant number of complications are observed, in particular, the development of leakage of esophagogastroanastomosis. Today, according to world literature, it is generally accepted that the development of anastomotic leakage is associated with the detection of the disease in late stages, the consequences of radiation during combined chemoradiotherapy, and extensive surgical intervention for esophageal cancer.

The OBJECTIVE was to improve the results of treatment of patients with malignant neoplasms of the esophagus and esophagogastric junction, through the use of an integrated approach.

METHODS AND MATERIALS. During the period of 1988–2022, treated 2784 patients with cancer of the esophagus and esophagogastric junction were treated at the Republican Clinical Oncology Dispensary named after Prof. M. Z. Sigal. The study group included 1,799 patients who received surgical treatment, combined chemoradiotherapy in combination with surgery, and external beam radiation therapy in combination with surgery.

RESULTS. Due to changes in treatment tactics for patients with cancer of the esophagus and esophagogastric junction, postoperative mortality after surgical complications decreased from 24.3 % to 6.2 %, and anastomotic leakage in the postoperative period decreased from 27.0 % to 8.1 %.

CONCLUSION. Changes in the treatment of patients with cancer of the esophagus and esophagogastric junction made it possible to reduce the development of postoperative complications and increase life expectancy. The molecular genetic approach allows for effective analysis of screening, early diagnosis, treatment and rehabilitation.

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