Current status of esophageal cancer treatment in Asia

Abstract

Esophageal cancer is becoming a different disease in Asian and Western countries. The rapidly rising incidence of adenocarcinoma of the lower esophagus and cardia has replaced squamous cell cancers as the predominant cell type in the west. The different cell type and tumor location to some extent influence how the disease is treated; other factors are cultural and the way health care is financed. The goals of treatment, however, are the same; to provide long-term cure with minimal morbidity and mortality and to preserve patients’ quality of life. Surgical resection has remained the mainstay treatment in Asia. Improvement in surgical outcome has taken place in many centers throughout Asia in the past two decades. Emphasis has been centered on epidemiology of the disease, reducing morbidity and mortality of esophagectomy, and identifying effective surgical or nonsurgical methods of treatments. Randomized controlled trials are also increasingly employed to test many unresolved problems. The Asian contributions are elaborated with specific examples from Japan, Hong Kong, and China.