The Japan Esophageal Society consensus meeting 2010

The consensus meeting was held at the 64th Annual Meeting of the Japan Esophageal Society (JES) in 2010. The majority of the 150 participants were surgeons with a license as a specialist in esophageal surgery or as a certified esophagologist authorized by the JES working in a university hospital or cancer center. Using the answer pad system, each participant chose one answer among three to five answers to a total of 32 questions. Concerning the Japanese Classification of Esophageal Cancer, the majority supported dividing T4 into T4a and T4b, to classify the N category based on a combination of the spread and the number of lymph nodes with metastasis, and to maintain the anatomical staging and the same staging systems for squamous cell carcinoma and adenocarcinoma. Concerning perioperative management, the majority supported no intubation or overnight intubation for respiratory support, the early start of tube feeding within POD 1-3, and the start of peroral intake on around POD 7 after esophagography. Concerning treatment strategy, the majority supported endoscopic treatment for T1a-EP/LPM cancer and esophagectomy for T1b-SM2/SM3 cancer. There was no consensus on the treatment for T1a-MM/T1b-SM1 cancer. They supported neoadjuvant CT followed by esophagectomy for stage II-III cancer, and they supported dCRT as necessary with salvage surgery for cT4 cancer. The JES Consensus Meeting 2010 clarified the motion for the next revision of the Japanese Classification and also determined the policy for the treatment strategy in practice for esophageal cancers.