Methods of combined treatment of esophageal cancer: surgical aspects and multidisciplinary approach
Kondratskyi Y.M., Pepenin M.O., Horodetskyi A.V., Dobrzhanskyi O.Y., Shudrak Y.A., Koval N.O., Kolesnyk A.V., Turchak V.O., Khudyntsev A.M., Nikolaienko V.O.
Summary. Esophageal cancer remains one of the most aggressive malignancies of the gastrointestinal tract, characterized by high mortality and unsatisfactory long-term survival rates despite advances in oncologic care. Contemporary management is based on a multimodal strategy that integrates systemic therapy, radiation therapy, and surgery. Surgical resection continues to represent the cornerstone of curative treatment; however, its role has evolved within the framework of perioperative chemotherapy and chemoradiotherapy protocols. Recent clinical trials have demonstrated improved survival outcomes with neoadjuvant and perioperative treatment approaches, particularly in locally advanced disease. At the same time, advances in minimally invasive and robotic esophagectomy, enhanced recovery protocols, and perioperative optimization have significantly influenced postoperative morbidity and mortality. The choice of surgical technique, extent of lymphadenectomy, and anastomotic configuration remains a matter of ongoing debate and requires individualized decision-making within a multidisciplinary team. This article provides a comprehensive overview of current strategies for combined treatment of esophageal cancer, with a particular focus on surgical aspects, perioperative management, and integration within multidisciplinary care pathways. Special attention is given to evidence-based decision-making, complication prevention, and future perspectives in personalized oncologic surgery.
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