Clinical practice guidelines address multimodality treatment for esophageal cancer

The Society of Thoracic Surgeons (STS) has released new clinical practice guidelines for treating cancer of the esophagus and gastroesophageal junction (area where the esophagus meets the stomach).

The guidelines, published in the November 2014 issue of The Annals of Thoracic Surgery, include nine evidence-based recommendations that address issues related to multimodality care, including neoadjuvant therapy (chemotherapy and radiation therapy given prior to surgery). The goal of this therapy is to reduce the extent of cancer before an operation to maximize the chance of obtaining a cure.

"Despite the widespread enthusiasm for multimodality therapy and the myriad of its aspects, currently available data for each component of care are not truly definitive," said Guideline Task Force Chair, Alex G. Little, MD, from the University of Arizona in Tucson. "The recommendations included in our document are guidelines, not mandates, but we feel they identify best current practices."

STS' Clinical Practice Guidelines are intended to assist physicians and other health care providers in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions. Prior to publication, each guideline undergoes an intense peer-review process, which provides critical, unbiased scientific assessment of the document and helps to identify future areas of investigation.

The Society has 18 current clinical practice guideline documents, including one released in July 2013 on factors affecting the diagnosis and treatment of localized esophageal cancer. Future guidelines on esophageal cancer will address esophageal resection and early stage disease.

"Understanding that technology continues to advance and even biological behavior can be modified, patient care decisions should be made by a multispecialty group with input from all relevant specialists," said Dr. Little.