CLINICAL RECOMMENDATIONS FOR DIAGNOSIS, TREATMENT AND MONITORING OF PATIENTS WITH ESOPHAGEAL AND ESOPHAGOGASTRIC JUNCTION CANCERS
Broj: 9-10, 2016, Rubrika: Smjernice
Liječ Vjesn 2016;138:233–239



Autori: Vesna Bišof, Antonio Juretić, Dinko Stančić-Rokotov, Nadan Rustemović, Damir Miletić, Marijo Boban, Tomislav Omrčen, Jasminka Jakić Razumović, Ira Pavlović, Ana Fröbe, Mislav Čonkaš, Zoran Rakušić, Damir Gugić

SažetakSummaryPregled članka
Rak jednjaka i ezofagogastričnog prijelaza obuhvaća histološki i biološki različite zloćudne tumore kod kojih se napredak u razumijevanju ovih bolesti još nije pretočio u znatnije poboljšanje preživljenja oboljelih. Dijagnoza se postavlja biopsijom učinjenom tijekom ezofagogastroskopije. Liječenje lokoregionalne bolesti najčešće je multimodalno te uključuje kirurgiju, radioterapiju i kemoterapiju. Utvrđivanje njihova optimalnog redoslijeda predmet je brojnih kliničkih ispitivanja i metaanaliza. Metastatska bolest liječi se palijativnom kemoterapijom i suportivnom terapijom. Odluku o liječenju donosi multidisciplinarni tim individualiziranim pristupom svakom bolesniku. U tekstu koji slijedi sadržane su kliničke upute radi standardizacije dijagnostičkih postupaka, liječenja i praćenja bolesnika s rakom jednjaka i ezofagogastričnog prijelaza u Republici Hrvatskoj.

Esophageal and esophagogastric junction cancers comprise histologically and biologically different malignant tumors in which the progress in the understanding of the disease has not been followed by the improvement in the survival. Diagnosis is set by tumor biopsy during endoscopy. Multimodal approaches containing surgery, radiotherapy and chemotherapy are frequently applied in the treatment of locoregionally advanced disease. However, the optimal sequence of the treatment options is still the issue of numerous clinical trials and meta-analyzes. Metastatic disease is treated with palliative chemotherapy and best supportive care. Treatment decisions should be individualized according to patients’ characteristics and made after multidisciplinary team discussion. The following text presents the clinical guidelines in order to standardize the diagnostic procedures, treatment and monitoring of patients with esophageal and esophagogastric junction cancers in the Republic of Croatia.

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