Herziene richtlijn ‘Oesofaguscarcinoom’

Conflict of interest: P.D. Siersema received travel cost reimbursement from the Dutch Association of Comprehensive Cancer Centres (Vereniging Integrale Kankercentra), performed unpaid advice work for Janssen BV, the Netherlands and Boston Scientific Corp., USA and received research funding from Janssen BV, The Netherlands, Boston Scientific Corp., USA, Philips BV, The Netherlands, Astra Zeneca BV, The Netherlands, Cook Medical Ltd., Ireland, World Cancer Research Fund, (Dutch Cancer Society (KWF Kankerbestrijding) and The Netherlands organisation for health research and development (ZonMw). Financial support for this article: none declared.

• In the revised guideline ‘Oesophageal cancer’ it is advised to treat patients with resectable oesophageal cancer (with the exception of T1N0 tumours) simultaneously with chemoradiotherapy before operation.

• In the case of patients with resectable, but not operable, oesophageal cancer, the treatment of choice is simultaneous (concomitant) chemoradiotherapy.

• Guidelines have been formulated for the method of resection that strongly depends on the location of the tumour: in the oesophagus or at the gastro-oesophageal junction.

• As a palliative measure in dysphagia in patients with a life expectancy of at least 3 months, brachytherapy is preferred over stent placement.

• There is no scientific evidence supporting supplementation of vitamin B₁₂ in all patients after resection of oesophageal cancer with gastric tube reconstruction; however, a study on the value of this has commenced.

• The working party advises registering measurable outcomes with regard to the diagnosis, perioperative mortality, morbidity and long-term survival of patients. Criteria with regard to the volume, the infrastructure, degree of specialisation of medical and paramedical specialists and demonstrated outcomes of health care should be included therein.