A Tradition of Innovation Takes on Esophageal Cancer

The article from the fall 2017 issue of University of Maryland Medicine Rounds highlights the multidisciplinary care for esophageal cancer at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center. Here are just some of the many reasons to refer your patient with esophageal cancer to the experienced team at UMGCCC:

• Endoscopic therapies for early stage cancer. When esophageal cancer is diagnosed in its early stages, usually when a patient with Barrett’s esophagus is being regularly screened, endoscopic mucosal resection can often mitigate the need for esophagectomy. Bruce Greenwald, MD, Professor of Medicine at the University of Maryland School of Medicine, has significant experience with endoscopic diagnostic and treatment procedures for esophageal cancer and was one of the first gastroenterologists to adopt the use of cryotherapy for early stage esophageal malignancies.

• Trimodality therapy for later stage cancers. With stage 2-3 esophageal cancers, lengths of survival are improved when patients have access to all treatment modalities. UMGCCC's thoracic tumor board coordinates care so that patients undergo chemoradiation before esophagectomy and then receive necessary follow-up care. This treatment approach may incorporate proton therapy, which can be particularly beneficial for esophageal cancer because the radiation dose can be programmed to stop at the treatment site and eliminates or significantly decreases the risks of damaging the heart and lungs.

• Excellent esophagectomy outcomes. Led by Whitney Burrows, MD, Associate Professor of Surgery, UMGCCC's esophageal cancer surgical team is skilled in both open (Ivor Lewis) and minimally invasive esophagectomy approaches. Patients who have their esophagectomies at the University of Maryland have significantly fewer complications and toxicities than national averages, allowing our patients to have easier recoveries and better qualities of life.

• Thoracic Intermediate Care Unit. The University of Maryland Medical Center is one of only a handful of hospitals in the nation to have a dedicated inpatient unit for patients recovering from thoracic surgery. The specialized post-op care provided on this unit translates into earlier discharges and improved patient outcomes.

Related Content

• UMGCCC Esophageal Cancer Service

• Current Esophageal Cancer Clinical Trials at UMGCCC

• Cyrotherapy Ablation at UMMC

Related Articles

Trimodality Therapy Prognostic Factors

• Boggs DH, Hanna A, Burrows W, Horiba N, Suntharalingam M. Primary gross tumor volume is an important prognostic factor in locally advanced esophageal cancer patients treated with trimodality therapy. J Gastrointest Cancer. 2015 Jun;46(2):131-7.

• Koshy M, Greenwald BD, Hausner P, Krasna MJ, Horiba N, Battafarano R, Burrows W, Suntharalingam M. Outcomes after trimodality therapy for esophageal cancer: the impact of histology on failure patterns. Am J Clin Oncol. 2011 Jun;34(3):259-64.

Early Stage Cancer Treatment

• Tsai FC, Ghorbani S, Greenwald BD, et al. Safety and efficacy of endoscopic spray cryotherapy for esophageal cancer. Dis Esophagus. 2017 Nov;30(11):1-7.

• Greenwald BD, Dumot JA. Cryotherapy for Barrett's esophagus and esophageal cancer. Curr Opin Gastroenterol. 2011 Jul;27(4):363-7.

Proton Therapy

• Verma V, Lin SH, Simone CB 2nd, Mehta MP. Clinical outcomes and toxicities of proton radiotherapy for gastrointestinal neoplasms: a systematic review. J Gastrointest Oncol. 2016 Aug;7(4):644-64.

• Chuong MD, Hallemeier CL, Jabbour SK, Yu J, Badiyan S, Merrell KW, Mishra M, Li H, Verma V, Lin SH. Improving outcomes for esophageal cancer using proton beam therapy. Int J Radiat Oncol Biol Phys. 2016 May;95(1):488-97.

Chemotherapy

• Jiang Y. Impact of genetic targets on cancer therapy in esophagogastric cancer. Adv Exp Med Biol. 2013;779:55-65.

Imaging

• Lin J, Kligerman S, Goel R, Sajedi P, Suntharalingam M, Chuong MD. State-of-the-art molecular imaging in esophageal cancer management: implications for diagnosis, prognosis, and treatment. J Gastrointest Oncol. 2015 Feb;6(1):3-19.

Ongoing Management

• Khangura SK, Greenwald BD. Endoscopic management of esophageal cancer after definitive chemoradiotherapy. Dig Dis Sci. 2013 Jun;58(6):1477-85.

• Kim GJ, Koshy M, Hanlon AL, Horiba MN, Edelman MJ, Burrows WM, Battafarano RJ, Suntharalingam M. The benefit of chemotherapy in esophageal cancer patients with residual disease after trimodality therapy. Am J Clin Oncol. 2016 Apr;39(2):136-41.

• Carr SR. When pigs fly: early endoscopy after esophagectomy is safe. J Thorac Cardiovasc Surg. 2017 Sep;154(3):1159-1160.