Recognition of diagnosis and treatment of borderline resectable esophageal cancer
10.3760/cma.j.cn112139-20250408-00183
- VernacularTitle:边界可切除食管癌诊治的再思考
- Author:
Xufeng GUO
1
Author Information
1. 上海市胸科医院 上海交通大学医学院附属胸科医院胸外科，上海 200030
- Publication Type:Journal Article
- Keywords:
Esophageal neoplasms;
Diagnosis;
Borderline resectable;
Clinical diagnosis;
Neoadjuvant therapy
- From:
Chinese Journal of Surgery
2025;63(11):988-991
- CountryChina
- Language:Chinese
-
Abstract:
In the precision diagnosis and treatment of esophageal cancer, individualized stratification based on accurate preoperative clinical staging is crucial for formulating treatment strategies. The internationally widely used TNM staging system for esophageal cancer further divides T4-stage tumors into two subtypes according to the resectability of the primary tumor: cT4a (resectable) and cT4b (unresectable). However, in actual clinical practice, patients with borderline resectable esophageal cancer still face issues of unclear conceptual definitions and inaccurate staging, which may lead to biased treatment decisions. The Japan Esophageal Society has released the 12th Edition of Japanese Classification of Esophageal Cancer, which for the first time proposes the staging concepts of resectable cT3r and borderline resectable cT3br, along with corresponding imaging evaluation criteria, to guide the diagnosis of borderline resectable esophageal cancer. Improving the level of awareness regarding borderline resectable esophageal cancer, including clinical diagnosis and treatment planning, is crucial for further improving the prognosis of such patients. In the era of precision medicine, it is necessary to re-examine the diagnosis and treatment strategies for borderline resectable esophageal cancer. It is recommended to conduct multidisciplinary team discussions and adopt multidimensional preoperative examination methods to determine the accurate clinical stage of the tumor. While immunotherapy is developing rapidly, the value of radiotherapy in neoadjuvant therapy for borderline resectable esophageal cancer needs to be emphasized, which will provide an important tool for optimizing the comprehensive treatment model of borderline resectable esophageal cancer.
