Esophageal cancer is a malignant tumor with a high incidence in China. At pesent, advanced esophageal cancer patients are still frequently encountered. The primary treatment for resectable advanced esophageal cancer is surgery-based multimodality therapy, including preoperative neoadjuvant therapy, such as chemotherapy, chemoradiotherapy or chemotherapy plus immunotherapy, followed by radical esophagectomy with thoraco-abdominal two-field or cervico-thoraco-abdominal three-field lymphadenectomy via minimally invasive approach or thoracotomy. In addition, adjuvant chemotherapy, radiotherapy, or chemoradiotherapy, or immunotherapy may also be administered if suggested by postoperative pathological results. Although the treatment outcome of esophageal cancer has improved significantly in China, many clinical issues remain controversial. In this article, we summarize the current hotspots and important issues of esophageal cancer in China, including prevention and early diagnosis, treatment selection for early esophageal cancer, surgical approach selection, lymphadenectomy method, preoperative neoadjuvant therapy, postoperative adjuvant therapy, and nutritional support treatment.
食管癌是我国高发特色恶性肿瘤，目前我国临床上常见的食管癌仍以中晚期食管癌为主，其治疗模式是以外科为主的综合治疗，包括术前新辅助治疗（如化疗、放化疗和化疗加免疫治疗），微创或开胸根治性手术切除加胸腹二野或颈胸腹三野淋巴结清扫，后续依据术后病理结果给予辅助化疗、放疗、放化疗或免疫治疗。与过去相比，虽然我国食管癌的治疗效果有了明显提高，但仍有许多热点和难点问题并没有解决。本文对目前我国食管癌热点和难点问题进行了小结，包括食管癌的病因预防与早诊早治、早期食管癌的治疗选择、食管癌手术入路和方式及淋巴结清扫选择、新辅助治疗、术后辅助治疗和营养支持治疗选择中存在的争议，并对未来研究方向进行展望。.