从“单打独斗”到“合作共赢”:论多学科团队在食管胃结合部腺癌诊治中的现状和展望

From'fight alone'to'win-win cooperation':current status and prospect of role of the multidisciplinary team in the diagnosis and treatment for adenocarcinoma of esophagogastric junction

由于食管胃结合部腺癌特殊的肿瘤部位和生物学行为,其治疗模式也由传统的完全外科医师主导、手术治疗为先向包括胸外科、肿瘤内科、放疗科、麻醉科等在内的多学科团队合作的综合治疗发生转变。腔镜技术的发展使腹腔镜和胸腔镜共同治疗食管胃结合部腺癌将逐渐成为可能,加速康复外科理念则有望进一步推动食管胃结合部腺癌手术的微创化。同时,新辅助化疗方案的不断更新、新辅助放疗的逐步推广以及靶向和免疫治疗在新辅助治疗中大胆尝试对于食管胃结合部腺癌的手术切除率、病理学缓解率和远期生存率都获得令人鼓舞的效果。

Due to the unique position and biological behaviors of adenocarcinoma of esophagogastric junction[AEG),the pattern of treatment has gradually changed from surgery alone leading by surgeons to comprehensive treatment by multidisciplinary teams including thoracic surgeons,oncologists,radiotherapy physicians,anesthetists and so on.The development of laparoscopic surgery makes the jointed operation possible by laparoscopy and thoracoscopy.The concept of enhanced recovery after surgery could further promote minimally invasive surgery in AEG.Meanwhile,with the continuous innovation of neoadjuvant chemotherapy,popularization of neoadjuvant radiotherapy and bold attempt of targeted therapy and immunotherapy,the resection rate,pathologic release rate and long-term survival of AEG have already achieved inspiring effects.