[Chinese expert consensus on early diagnosis and treatment of esophageal cancer].

Although the incidence rate of esophageal cancer in China is on the decline, China is still a high-incidence country of esophageal cancer with great regional variation. In recent years, the five-year survival of esophageal cancer in China has improved significantly. However, due to the absence of typical symptoms in early stage, there still exists a large esophageal cancer diagnostic yield gap between China and developed countries. At present, there are no international guidelines defining the target population for esophageal squamous cell carcinoma (ESCC) screening. Exploring and implementing effective esophageal cancer screening together with early diagnosis and early treatment are the keys to reducing the mortality and improving the survival rate and life quality. Endoscopic therapies, such as endoscopic submucosal dissection (ESD), endoscopic mucosal resection (EMR), and radiofrequency ablation (RFA), are used to treat early-stage esophageal cancer. If the tumor invasion is deep or lymph node metastasis is suspected, surgery is needed, meanwhile radiation therapy could also be an optional treatment. Regular follow-up and surveillance are required for any strategy above to deal with relapse and metachronous primary cancers. The Early Diagnosis and Treatment Group of the Chinese Medical Association Oncology Branch has reached an expert consensus on screening and diagnostic protocols for esophageal cancer, on endoscopic and surgical treatment of early esophageal cancer and precancerous lesions, as well as on postoperative monitoring and adjuvant therapy. This consensus follows the evidence-based medicine at both domestic and international levels, combines the current clinical practice and application experience in the treatment of esophageal cancer in China, is based on a multidisciplinary treatment model, and can be used as a reference for clinicians.中国食管癌发病率有下降趋势，但中国仍是食管癌高发国家，且食管癌发病有明显的地区差异。近年来，中国食管癌的5年生存率有明显提高，但因早期食管癌缺乏典型的临床症状，早期发现率偏低，与发达国家相比还有较大差距。目前国外尚无指南对食管鳞状细胞癌筛查目标人群进行界定，寻找和实施有效的筛查方案和早诊早治是降低食管癌死亡率、提高生存率和生存质量的关键手段。早期食管癌的治疗措施为内镜治疗，包括内镜黏膜下剥离术、内镜下黏膜切除术、内镜下射频消融术等，若肿瘤侵犯程度较深或怀疑有淋巴结转移，需采取手术治疗，同时放射治疗也可作为一种可选择的治疗方式。无论哪种方式的治疗，均需规律随访和监测，积极处理复发性病变和异时性新发肿瘤。中华医学会肿瘤学分会早诊早治学组根据国内外循证医学依据，结合目前中国食管癌治疗的临床实践与应用经验，以多学科诊疗模式为基础，就食管癌的筛查和诊断方案、早期食管癌及癌前病变的内镜和外科处理以及术后监测和辅助治疗等达成专家共识，供临床医师参考。.