Perioperative management of esophageal cancer

Abstract

At present, the incidence of esophageal carcinoma continues to rise and will form an increasingly large health burden in the years ahead. Action is needed to curb this "quiet epidemic". Despite remarkable progress in available treatment strategies during the last decade, some patients that opt for curative therapy remain unresponsive to treatment. One of the primary reasons why not all patients respond to – or some suffer from – the currently available treatment regimens can be attributed to high inter-patient variability in response to such treatment. Therefore, the key to successful improvement of healthcare outcomes is to take this inter-patient variability into consideration to design a successful treatment plan for individual patients. As such, the aim of this thesis was to contribute to this improvement by optimizing patient selection and improve the use of existing therapies for patients with esophageal cancer. To achieve this aim this thesis points towards the use of specific diagnostic tools, novel predictors and models for individual treatment efficacy and risk estimation, and remaining gaps in esophageal cancer research. Some findings have already changed – or provide a basis for changes in – the perioperative management of these patients.