European Experiences

Esophageal cancer is a major global health burden in terms of incidence and mortality. The main histopathological subtypes are esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC). The majority of EC patients in North-West Europe are diagnosed with EAC subtype, in contrast to the worldwide predominant ESCC subtype. Adequate treatment selection by specialized multi-disciplinary teams is essential in mixed populations since these subtypes differ in etiology, genomic alterations, treatment susceptibility, and ultimately outcomes. Enhanced multi-omics in the last decade have increasingly allowed for individual profiling of tumors, including the determination of treatment susceptibility profiles. The outcomes of ESCC have improved in Europe over the last few decades, with increased centralization of EC management, enhanced perioperative optimization, multimodal treatment, new drugs such as targeted immune checkpoint inhibitors, and minimally invasive surgery. Even with these new developments, prognosis remains relatively poor, and more research is urgently needed. This chapter aims to summarize the current evidence regarding the diagnosis and treatment of esophageal squamous cell carcinoma in Europe.