Among the myriad of malignant lesions affecting the gastrointestinal tract, esophageal cancer stands out as one of the most challenging to manage. Despite its relatively characteristic clinical presentation, which often involves elderly patients experiencing dysphagia, the subsequent diagnostic process must be meticulously refined to determine which patients are suitable for esophageal resection—a daunting procedure with a high mortality rate and a propensity for severe complications. This decision-making process also involves deciding whether a patient should receive neoadjuvant therapy or should be palliated with stents or chemoradiotherapy. In recent years, advancements in diagnosis and the integration of multimodal treatments have significantly enhanced this precision, sparing many patients from unnecessary exploratory surgeries that could lead to widespread disease. Conversely, this has also allowed patients with large, locally invasive tumors that were once considered unresectable to receive neoadjuvant chemotherapy, subsequently enabling them to undergo curative esophagectomies.
These improvements in diagnostic accuracy and treatment strategies have notably improved the five-year survival rate of patients with resected esophageal cancer, which has risen from a disheartening 5% fifteen years ago to a more hopeful 25% today. This book, authored by experts, two-thirds of whom are affiliated with the Memorial Sloan-Kettering Cancer Center (MSKCC) in New York, delves into the published evidence on various facets of managing esophageal cancer patients. It also offers recommendations based on the authors’ own experiences with the disease. The book encompasses chapters on diagnostic and therapeutic endoscopy, staging, perioperative therapy, surgical treatments (including transhiatal, radical, Ivor Lewis, and minimally invasive approaches), and postoperative complications.
The volume concludes with a chapter that addresses the epidemiology and challenges in managing esophageal cancer patients in India, a country where the disease is prevalent and disproportionately affects the economically disadvantaged. The author primarily discusses the experiences of the Tata Memorial Hospital in Mumbai, where an annual caseload of 1,200 patients is seen, with 180 undergoing surgery—making it one of the largest treatment experiences for esophageal cancer patients globally.
The Editor of this comprehensive volume is Manjit Singh Bains, a Professor of Clinical Cardiothoracic Surgery at the Cornell Weill Medical College in New York and an Attending Thoracic Surgeon at the MSKCC. It is through his efforts that the diverse range of subjects and authors have been brought together to contribute to this authoritative and informative book.
