Preoperative Chemotherapy for Localized Squamous Cell Carcinoma of the Esophagus? We Should Go Back to the Drawing Board!

Excerpt

Squamous cell carcinoma is rampant in certain parts of the world and it is the most common histologic subtype of esophageal cancer globally. Compared to adenocarcinoma, where obesity, gastroesophageal reflux, and Barrett esophagus seem to play a role, tumorigenesis of squamous cell carcinoma of the esophagus is associated with smoking, alcohol consumption, and poor nutrition (or nutritional deficiencies).1 Recent molecular studies have identified a subgroup of tumor initiating cells for squamous cell carcinoma with TGF-β and integrin/focal adhesion kinase (FAK) signaling and a cancer stem cell signature has been correlated with a number of self-renewal genes orchestrated by Bmi1, Hmaga2, and Sox2. 2 Genome-wide association studies have also identified three susceptibility loci related to tobacco and alcohol.3 Further molecular studies are needed to develop better risk stratification and therapeutics for squamous cell carcinoma patients. …