Clinical pathway of esophageal squamous cell cancers

Introduction Esophageal Squamous Cell Carcinoma (ESCC) is a prevalent form of esophageal cancer that typically develops in the upper and middle parts of the esophagus. This cancer is more common in certain areas, like Asia, Africa, and some parts of Europe, and is closely linked to smoking, drinking alcohol, and unhealthy diets with little fruit and vegetables. Identifying esophageal squamous cell cancer in its early stages is usually challenging since common symptoms like dysphagia and weight loss are often mild and can be ignored. Treatment becomes more complex, and the prognosis is less optimistic when the disease is typically identified in its advanced stages. This highlights the significance of having a well-defined and effective clinical pathway to assist in timely diagnosis and efficient disease management. The aim of creating this clinical pathway is to establish a structured system for assessing, diagnosing, and treating patients with ESCC. This medical protocol assists physicians in detecting esophageal squamous cell carcinoma early using suitable diagnostic techniques like endoscopy, biopsy, and imaging (CT, PET-CT) and initiating timely treatments like surgery, chemotherapy, and radiotherapy. This holistic method not only improves patient treatment results but also boosts their overall quality of life. methods Esophagal Squamous Cell Carcinoma (ESCC) necessitates a comprehensive and orderly method that spans from the early stages of detection to after-treatment monitoring. The key methods in this clinical pathway include the following steps: ۱: Initial clinical assessment Assessing early signs like dysphagia, unexplained weight loss, chest pain, and chronic cough. Risk factor assessment includes smoking, alcohol consumption, and a family history of esophageal cancer. ۲-Diagnostic methods Endoscopy Biopsy CT scan PET-CT MRI Esophageal manometry ۳-Determining the stage of the disease (Staging) TNM Staging T (Tumor): The size and scope of the esophageal wall primary tumor. N (Node): Examining the involvement of surrounding lymph nodes. M (Metastasis): Evaluation of the presence of distant metastases Staging based on imaging and biopsy findings for accurate treatment planning ۴-Therapeutic management Surgery (Esophagectomy) Chemotherapy((Neoadjuvant)- (Adjuvant) Radiotherapy Results The use of advanced diagnostic methods such as endoscopy and imaging (CT, PET-CT) along with biopsy play an important role in the early detection of esophageal squamous cell cancer. Early diagnosis of the disease can lead to the selection of more effective treatment methods and increase the chance of survival. Accurate staging of the disease using the TNM system allows doctors to choose the best treatment options, including surgery, chemotherapy, and radiotherapy. This systematic approach helps to improve treatment results and reduces the possibility of complications. Conclusion The clinical pathway of esophageal squamous cell cancers, by providing a comprehensive framework for diagnosis, treatment, and follow-up of the disease, helps to improve treatment outcomes and increase the chances of survival for patients. The accurate implementation of this path can lead to a reduction in mortality and an improvement in the quality of life of patients with ESCC. Also, the importance of a multispecialty approach and team cooperation in the successful management of this disease is emphasized.

کلیدواژه ها:

esophageal ، pathway ، squamous cell ، cancers