Esophageal cancer is the eighth most common cancer worldwide and the sixth most common cause of cancer death. Esophageal resection is a complex and invasive procedure associated with significant weight loss, and the implementation of neoadjuvant treatments, in addition to surgery, might worsen the patient’s body composition and functional status.
Despite important improvements in anesthesia and surgical fields, esophagectomy still remains a challenging surgery for all the professionals involved. Post-operative mortality reaches 8%, although it is typically less than 5% in high-volume centers, and significant complications occur in up to 70% of patients.
The current standard treatment for the majority of solid cancers includes surgery and concurrent medical therapies. Nonetheless, cancer treatments impose impactful physiological stress, and have detrimental effects on acute and long-term health outcomes. The importance for multidisciplinary, supportive preoperative interventions to counter the decline in physiological and functional reserves cannot be understated. The preoperative period constitutes a unique opportunity to address comorbidities and modifiable risk factors.
The identification of patients at higher risk of postoperative complications and prolonged recovery is pivotal in perioperative medicine. Traditional tools, focusing on age, pre-existing medical comorbidities, laboratory testing and few selected systems (e.g., heart failure, renal failure, respiratory mechanics impairment) are considered to provide low incremental value. Hence, over the last decades, interest is mounting on the role of specialized functional assessment to improve the risk stratification of surgical patients.
The main scope of this Research Topic is to address these main topics in patients undergoing esophageal resections for cancer:
- Preoperative tools used to determine the perioperative risk, focusing on functional capacity and nutritional evaluation strategies.
-Prehabilitation programs, describing patients' selection criteria, adopted programs and strategies used to monitor patients and evaluate their compliance to proposed treatments.
- Impact of neoadjuvant chemio/RT on preoperative functional capacity, including description of strategies used to minimize this event.
- Post-operative management, describing the relationship between pre-operative risk stratification and post-operative monitoring ( i.e., ICU admission or general ward monitoring, type of monitoring in general wards).
Original work, retrospective analyses, systematic meta-analyses, and narrative reviews will be accepted.
Keywords:
Risk Stratification, Preoperative evaluation tools, Esophagectomy, Preoperative functional capacity, Pre-habilitation
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
Esophageal cancer is the eighth most common cancer worldwide and the sixth most common cause of cancer death. Esophageal resection is a complex and invasive procedure associated with significant weight loss, and the implementation of neoadjuvant treatments, in addition to surgery, might worsen the patient’s body composition and functional status.
Despite important improvements in anesthesia and surgical fields, esophagectomy still remains a challenging surgery for all the professionals involved. Post-operative mortality reaches 8%, although it is typically less than 5% in high-volume centers, and significant complications occur in up to 70% of patients.
The current standard treatment for the majority of solid cancers includes surgery and concurrent medical therapies. Nonetheless, cancer treatments impose impactful physiological stress, and have detrimental effects on acute and long-term health outcomes. The importance for multidisciplinary, supportive preoperative interventions to counter the decline in physiological and functional reserves cannot be understated. The preoperative period constitutes a unique opportunity to address comorbidities and modifiable risk factors.
The identification of patients at higher risk of postoperative complications and prolonged recovery is pivotal in perioperative medicine. Traditional tools, focusing on age, pre-existing medical comorbidities, laboratory testing and few selected systems (e.g., heart failure, renal failure, respiratory mechanics impairment) are considered to provide low incremental value. Hence, over the last decades, interest is mounting on the role of specialized functional assessment to improve the risk stratification of surgical patients.
The main scope of this Research Topic is to address these main topics in patients undergoing esophageal resections for cancer:
- Preoperative tools used to determine the perioperative risk, focusing on functional capacity and nutritional evaluation strategies.
-Prehabilitation programs, describing patients' selection criteria, adopted programs and strategies used to monitor patients and evaluate their compliance to proposed treatments.
- Impact of neoadjuvant chemio/RT on preoperative functional capacity, including description of strategies used to minimize this event.
- Post-operative management, describing the relationship between pre-operative risk stratification and post-operative monitoring ( i.e., ICU admission or general ward monitoring, type of monitoring in general wards).
Original work, retrospective analyses, systematic meta-analyses, and narrative reviews will be accepted.
Keywords:
Risk Stratification, Preoperative evaluation tools, Esophagectomy, Preoperative functional capacity, Pre-habilitation
Important Note:
All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.