Collaborative Multidisciplinary Management and Expertise of cT2-3 Locally Advanced Operable Esophageal Squamous Cell Carcinoma: A Report of Two Cases

Authors

Xuefeng Leng
Daisuke Kurita
Yi Zhu
Seiichiro Abe
Ruixiang Zhang
Xufeng Guo
Liang Dai
Ian Yu-Hong Wong
Seong Yong Park
Berend J van der Wilk
Xing Gao
Yung-Chang Chen
Rui Zhao
Jiahua Lv
Haomiao Qing
Yang Liu
Kyle G Mitchell
Bas P L Wijnhoven
Yongtao Han
Hiroyuki Daiko

Publication Date

11-30-2023

Journal

Journal of Thoracic Disease

Abstract

BACKGROUND: The accurate clinical staging of esophageal squamous cell carcinoma (ESCC) is pivotal for guiding treatment strategies. However, the current precision in staging for clinical T (cT)2 and cT3 stages remains unsatisfactory. This article discusses the role of multidisciplinary teams (MDTs) in the clinical staging and formulation of neoadjuvant treatment strategies for locally advanced operable ESCC. These challenges underscore the importance of precise staging in the decision-making process for appropriate therapeutic interventions.

CASE DESCRIPTION: Through the lens of two patient case studies with locally advanced resectable ESCC, the article showcases the intricate process of treatment planning undertaken by MDTs. It captures a range of expert perspectives from Japan, China, Hong Kong (China), Korea, the USA, and Europe, focusing on the challenges of differentiating between cT2 and cT3 stages of the disease, which is a critical determinant in the management and therapeutic approach for patients.

CONCLUSIONS: The article concludes that the accurate staging of ESCC is a cornerstone in determining the most suitable treatment strategies. It underscores the vital role that MDTs play in both clinical staging and the decision-making process for treatment. Highlighting the limitations in current diagnostic methods, the article emphasizes the urgent need for advanced research and the refinement of diagnostic tools to improve the precision of staging, particularly between the cT2 and cT3 stages. It suggests that future research should consider whether a reclassification of these stages could be warranted to enhance treatment planning and outcomes for patients with ESCC.

Keywords

Clinical staging, esophageal cancer, multidisciplinary treatment, case report

DOI

10.21037/jtd-23-1277

PMID

38090303

PMCID

PMC10713291

PubMedCentral® Posted Date

11-30-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes