An integrated care pathway for the treatment of esophageal cancer

A minimally invasive esophagectomy (i.e., removal of the esophagus) combined with oncology care to treat esophageal cancer. Thanks to its newly-opened UPMC Hillman Cancer Center, IRCCS ISMETT is offering integrated care for the treatment of thoracic neoplasms, including those of the esophagus and gastroesophageal junction.

The first patient benefiting from integrated care at ISMETT-UPMC Hillman Cancer Center is a 56-year-old man from Sicily. The patient performed four cycles of chemotherapy at ISMETT and, just over two months after the diagnosis of esophageal cancer, underwent a minimally invasive laparoscopic and thoracoscopic esophagectomy.

A minimally invasive esophagectomy is a very complex procedure performed through small incisions of only a few millimeters in the chest and abdomen, instead of the large traditional incisions. This procedure involves the complete removal of the esophagus and its replacement with a portion of the stomach or intestine, and can last up to 6-7 hours. Today this operation is performed in very few centers throughout Italy, including ISMETT. “Our patient,” says Dr. Alessandro Bertani, director of ISMETT’s Thoracic Surgery program, “was discharged seven days after surgery, and was able to resume his normal life. The final histology tests confirmed the excellent results in terms of treatment of the neoplasm.”

These minimally invasive and technically highly complex procedures were developed at UPMC (University of Pittsburgh Medical Center), partner of ISMETT. The benefits for patients are extremely important, allowing them to resume their normal life and be discharged in a few days. Postoperative pain is reduced compared with traditional surgery, and rehabilitation times are shorter. In addition, patients are able to resume their cancer treatment sooner than those who undergo traditional surgery. “Esophageal cancers are epidemiologically rarer than lung cancers,” explains Dr. Sergio Rizzo, Chief of the Medical Oncology Service at ISMETT-UPMC Hillman, “and can benefit from a multi-modal combination of treatment that offers best patient survival rates and also the possibility of being followed in a single center, with optimal patient care management before and after surgery.”