Collaborative multidisciplinary management and expertise of cT2–3 locally advanced operable esophageal squamous cell carcinoma: a report of two cases

Abstract

Background The accurate clinical staging of esophageal squamous cell carcinoma (ESCC) is pivotal for guiding treatment strategies. However, the current precision in staging for clinical T (cT)2 and cT3 stages remains unsatisfactory. This article discusses the role of multidisciplinary teams (MDTs) in the clinical staging and formulation of neoadjuvant treatment strategies for locally advanced operable ESCC. These challenges underscore the importance of precise staging in the decision-making process for appropriate therapeutic interventions. Case Description Through the lens of two patient case studies with locally advanced resectable ESCC, the article showcases the intricate process of treatment planning undertaken by MDTs. It captures a range of expert perspectives from Japan, China, Hong Kong (China), Korea, the USA, and Europe, focusing on the challenges of differentiating between cT2 and cT3 stages of the disease, which is a critical determinant in the management and therapeutic approach for patients. Conclusions The article concludes that the accurate staging of ESCC is a cornerstone in determining the most suitable treatment strategies. It underscores the vital role that MDTs play in both clinical staging and the decision-making process for treatment. Highlighting the limitations in current diagnostic methods, the article emphasizes the urgent need for advanced research and the refinement of diagnostic tools to improve the precision of staging, particularly between the cT2 and cT3 stages. It suggests that future research should consider whether a reclassification of these stages could be warranted to enhance treatment planning and outcomes for patients with ESCC.

Special requirements for TNM-staging in esophageal cancer

“…In the present paper ( 1 ), Leng et al have evaluated the multidisciplinary management of operable clinical T2–3 esophageal squamous cell carcinomas (ESCCs) by presenting two case reports to several experts, within different professions, on three continents: East-Asia (China, Japan, and Korea), America (the Unites States) and Europe (the Netherlands). The authors conclude that further research is needed to address the challenges in clinical staging, as it is found to be very difficult to differentiate between T2 and T3 tumors.…”