Recent Topics and Perspectives on Esophageal Cancer in Japan

Abstract

Despite recent advances in multidisciplinary treatment strategy, outcomes of esophageal cancer treatment still remain unsatisfactory. There are two histologic subtypes of esophageal cancer, namely, squamous cell carcinoma and adenocarcinoma, and these subtypes turned out to be genetically separate diseases. I focused on nine topics among the cancer's epidemiology, diagnosis, and treatment, and reviewed the literature. Although the number of patients with esophageal cancer has been continuously increasing, the cause of esophageal cancer is evident in a substantial proportion of patients, and public education may be able to decrease its incidence. Early detection and less invasive treatment will improve the outcome of patients. Minimally invasive esophagectomy decreased surgical invasiveness and improved short-term outcomes in the clinical trials. Centralization of patients to high-volume centers and introduction of multidisciplinary perioperative care bundle may further improve the outcome of patients undergoing esophagectomy. Although no targeting agent has shown efficacy in patients with esophageal cancer, immune checkpoint blockades are promising, and the results of phase III trials are awaited.

Keywords: Esophageal cancer; genetic background; immune checkpoint; minimally invasive esophagectomy; risk factor.

Figure 1.

Changes in the age group of patients with esophageal cancer treated in Japan.

Figure 2.

A. Temporal trends of histologic subtypes of esophageal cancer in Japanese patients undergoing esophagectomy, B. Increase in the relative proportion of esophageal ADC.