Actualización del cáncer de esófago

Abstract

Esophageal cancer is the sixth leading cause of mortality due to cancer in the world. The epidermoid histologic type is the most frequent and is mainly related to toxic habits. It usually occurs in the proximal and middle third and produces extensive local and lymph node infiltration. Adenocarcinoma is more frequent in the distal esophageal third and gastroesophageal junction (GEJ). Its incidence is increasing in Western society, especially in younger patients, and it is associated with obesity and gastroesophageal reflux. The management of this neoplasm requires adequate staging and a multidisciplinary assessment that includes surgical, radiotherapeutic, and systemic treatment. Surgery is the mainstay in localized tumors of the middle and inferior third. Locally advanced cases may benefit from chemoradiotherapy. In disseminated stages, different determinations are important, such as HER2 status, microsatellite instability, mutational load, and immune activation. This allows for individualizing treatment, the pillar of which continues to be chemotherapy, and improving the prognosis of patients with this disease.