Prevention and treatment of esophageal cancer


Esophageal cancer is the fourth leading cause of cancer-related mortality in China, with a very dismal outcome. This project systematically investigated the epidemiology, diagnostic and therapeutic technologies for esophageal cancer during the past 13 years, established and applied a set of standardized treatment guidelines and key technologies for Chinese esophageal cancer.


1. Establishment of technology system of early diagnosis and treatment. This project firstly in the world provide substantial evidence that ESCC is resulted from gradual progression of severe squamous cell dysplasia, and defined the starting point for early treatment, as well as established optimal practice for endoscopic examination and treatment techniques for early diagnosis and therapy of esophageal cancer.


2. Establishment of multidiscipline treatment for locally advanced stage esophageal cancer, improving the rates for complete resection and patient 5-year survival. Be the first in the world to demonstrate that radiotherapy could improve 5-year survival and clearified the therapeutic indications. And redefined the principles of multimodality treatment for esophageal small cell carcinoma.


3. Discoveries on new risk factors and genetic susceptibility indicators for high risk population, demonstrating a synergy effect between genetic and environmental factors in the carcinogenesis of esophageal cancer. This project systematically investigated and reported the risk factors of precancerous lesions for the first time, and confirmed that serum Vitamin D is positively correlated with the risk of ESCC, which altered the prevention strategy.


4. Discoveries on a total of 63 molecular biomarkers associated with clinic-pathological factors, and reported for the first time that microRNAs could be potiential biomarkers for diagnosis and prognosis of ESCC.


5. Creation of the system for implementation and physician education for standardized esophageal cancer treatment. This project drafted the first official guideline for Standardized Diagnosis and Treatment for Esophageal Cancer in China, which have been widely distributed and applied.  The project team have set up 33 sites for early diagnosis and treatment of esophageal cancer, and endoscopically screend a total of 256,803 high risk people. Technique demonstrations, training courses, and speaking tours have trained approximately 6,800 doctors from 82 hospitals.  This project established the biggest network platform in the world and evalutated 31883 patients, showing an increased overall 5-year survival rate and hospital stay shortened by 1 to 8 days in locally advanced esophageal cancer patients.


Since the implementation of the project, the project group have published 175 papers, 94 of those were indexed by SCI, with a total impact factor of 458, and 1534 times of citations.  This project has been granted 3 provincial level first class scientific and technological prizes including the Chinese Medical Science and Technology Awards, along with 4 patents, and 1 computer software copyright.