Trattamento dell’adenocarcinoma dell’esofago: stato dell’arte e prospettive future

Adenocarcinoma is the predominant histological subtype of oesophageal and junctional cancer in Western countries, which is associated with poor survival. The establishment of diagnostic advances and the multidisciplinary approach has provided high accuracy in clinical staging, allowing the implementation of innovative combination therapies characterised by a disease-tailored optimization of the levels of invasiveness and efficacy. The staging of tumour invasion is constantly evolving, incorporating new intermediates and their respective susceptibility to specific multimodal treatments. Therapeutic determinants for improved medium-and long-term survival for oesophageal adenocarcinoma include advanced techniques for endoscopic surveillance of precancerous diseases; the combination of traditional surgical practices with new technologies and standardised perioperative protocols; and the development of tumour molecular profiles as targets for enhanced systemic therapies (i.e., immunotherapy). However, only high-volume centres have demonstrated to provide the most comprehensive care for oesophageal adenocarcinoma by ensuring the progression of scientific innovation and the availability of all necessary resources.