Significance Of Dietary Factors In Occurrence, Prevention And Treatment Of Esophageal Carcinoma

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Abeer Asif
Shaifa Saleem
Ayesha Abdul Qadir Memon
Muhammad Mustafa
Arif Mahmood
Ghulam Rasool Bhurgri
Fahad Jibran Siyal
Muhammad Osama
Calvin R. Wei


esophageal cancer, nutritional supplement, dietary factors


Esophageal cancer (EC) is a relatively rare cancer but highly fatal cancer due to delayed diagnosis and its malignant aggressive nature. Chemotherapy, radiotherapy, and esophagectomy are the main treatments for EC. However, recently, another complementary treatment has emerged in EC care: nutrition therapy.

Nutrition therapy utilizes diet and supplements to ensure that patients have enough nutrition to undergo treatment with minimal side-effects and long-term consequences by increasing treatment efficacy, vulnerability of EC cells, and reducing recurrence. The purpose of this study is to identify various EC-causing factors, pre- and post-operative circumstances & dietary habits that influence their development, along with the clinical steps that can be taken to improve EC care through nutrition therapy. We also emphasize the role of various nutritional components and supplements in EC prevention, cancer treatment efficacy, and rates of overall survival (OS) and recurrence.We found that several substances, including 5-fluorouracil, beta-carotene, and moringa, have anti-tumor properties, whereas vitamin C, and zinc also have the ability to boost the efficacy of treatment. Supplemental nutrition, such as glutamine, zinc, and omega-3 fatty acids, also decreased toxicity and stopped muscle deterioration after initial therapy.

On the other hand, we found that alcohol, smoking, red meat, excessive hot beverages, and self-diagnosing supplements like B12 can all lead to increased risk of developing EC. Hence, individualized nutrition can minimize side effects, preserve muscle mass, and avert malnutrition

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1. Then EO, Lopez M, Saleem S, Gayam V, Sunkara T, Culliford A, et al. Esophageal Cancer: An Updated Surveillance Epidemiology and End Results Database Analysis. World journal of oncology. 2020;11(2):55-64.
2. Pennathur A, Gibson MK, Jobe BA, Luketich JD. Oesophageal carcinoma. The Lancet. 2013;381(9864):400-12.
3. Huang J, Koulaouzidis A, Marlicz W, Lok V, Chu C, Ngai CH, et al. Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries. 2021;13(1):141.
4. Society AC. Key Statistics for Esophageal Cancer 2023 [Available from:
5. Xie S-H, Lagergren J. Risk factors for oesophageal cancer. Best Practice & Research Clinical Gastroenterology. 2018;36-37:3-8.
6. Abnet CC, Arnold M, Wei W-Q. Epidemiology of Esophageal Squamous Cell Carcinoma. Gastroenterology. 2018;154(2):360-73.
7. Pournaghi S-J, Hojjat SK, Barazandeh Noveyri F, Tavakkoli Ghouchani H, Ahmadi A, Hamedi A, et al. Tobacco consumption, opium use, alcohol drinking and the risk of esophageal cancer in North Khorasan, Iran. Journal of Substance Use. 2019;24(1):105-9.
8. Shimizu M, Fukutomi Y, Ninomiya M, Nagura K, Kato T, Araki H, et al. Green Tea Extracts for the Prevention of Metachronous Colorectal Adenomas: A Pilot Study. Cancer Epidemiology, Biomarkers & Prevention. 2008;17(11):3020-5.
9. Satia JA, Littman A, Slatore CG, Galanko JA, White E. Long-term Use of β-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study. American Journal of Epidemiology. 2009;169(7):815-28.
10. Ahmadi AJCjoim. Potential prevention: Aloe vera mouthwash may reduce radiation-induced oral mucositis in head and neck cancer patients. 2012;18(8):635.
11. Wang X, Ha D, Mori H, Chen S. White button mushroom (Agaricus bisporus) disrupts androgen receptor signaling in human prostate cancer cells and patient-derived xenograft. The Journal of Nutritional Biochemistry. 2021;89:108580.
12. May PE, Barber A, D’Olimpio JT, Hourihane A, Abumrad NN. Reversal of cancer-related wasting using oral supplementation with a combination of β-hydroxy-β-methylbutyrate, arginine, and glutamine. The American Journal of Surgery. 2002;183(4):471-9.
13. Hiller JG, Cole SW, Crone EM, Byrne DJ, Shackleford DM, Pang J-MB, et al. Preoperative β-Blockade with Propranolol Reduces Biomarkers of Metastasis in Breast Cancer: A Phase II Randomized Trial. Clinical Cancer Research. 2020;26(8):1803-11.
14. Vuoso DC, D’Angelo S, Ferraro R, Caserta S, Guido S, Cammarota M, et al. Annurca apple polyphenol extract promotes mesenchymal-to-epithelial transition and inhibits migration in triple-negative breast cancer cells through ROS/JNK signaling. 2020;10(1):1-17.
15. Gong X, Smith JR, Swanson HM, Rubin LPJM. Carotenoid lutein selectively inhibits breast cancer cell growth and potentiates the effect of chemotherapeutic agents through ROS-mediated mechanisms. 2018;23(4):905.
16. İyikesici MSJNJoCP. Survival outcomes of metabolically supported chemotherapy combined with ketogenic diet, hyperthermia, and hyperbaric oxygen therapy in advanced gastric cancer. 2020;23(5):734-40.
17. Sahin K, Tuzcu M, Basak N, Caglayan B, Kilic U, Sahin F, et al. Sensitization of cervical cancer cells to cisplatin by genistein: the role of NF B and Akt/mTOR signaling pathways. 2012;2012.
18. Ambrosone CB, Zirpoli GR, Hutson AD, McCann WE, McCann SE, Barlow WE, et al. Dietary supplement use during chemotherapy and survival outcomes of patients with breast cancer enrolled in a cooperative group clinical trial (SWOG S0221). Journal of Clinical Oncology. 2020;38(8):804.
19. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.
20. Arnold M, Soerjomataram I, Ferlay J, Forman D. Global incidence of oesophageal cancer by histological subtype in 2012. Gut. 2015;64(3):381-7.
21. Montgomery E, Basman F, Brennan P, Malekzadeh R. Oesophageal cancer. World cancer report. 2014;15:528-43.
22. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global cancer observatory: cancer today. Lyon, France: international agency for research on cancer. 2018;3(20):2019.
23. Arnold M, Laversanne M, Brown LM, Devesa SS, Bray F. Predicting the future burden of esophageal cancer by histological subtype: international trends in incidence up to 2030. Official journal of the American College of Gastroenterology| ACG. 2017;112(8):1247-55.
24. Asombang AW, Chishinga N, Nkhoma A, Chipaila J, Nsokolo B, Manda-Mapalo M, et al. Systematic review and meta-analysis of esophageal cancer in Africa: epidemiology, risk factors, management and outcomes. World journal of gastroenterology. 2019;25(31):4512.
25. Meves V, Behrens A, Pohl JJV. Diagnostics and early diagnosis of esophageal cancer. 2015;31(5):315-8.
26. Behrens A, Pech O, Wuthnow E, Manner H, Pohl J, May A, et al. [Detection of early neoplasia in Barrett's oesophagus: focus attention on index endoscopy in short-segment-Barrett's oesophagus with random biopsies]. Zeitschrift fur Gastroenterologie. 2015;53(6):568-72.
27. Abnet CC, Arnold M, Wei WQ. Epidemiology of Esophageal Squamous Cell Carcinoma. Gastroenterology. 2018;154(2):360-73.
28. Pandeya N, Williams G, Green AC, Webb PM, Whiteman DC. Alcohol consumption and the risks of adenocarcinoma and squamous cell carcinoma of the esophagus. Gastroenterology. 2009;136(4):1215-24, e1-2.
29. Islami F, Fedirko V, Tramacere I, Bagnardi V, Jenab M, Scotti L, et al. Alcohol drinking and esophageal squamous cell carcinoma with focus on light-drinkers and never-smokers: a systematic review and meta-analysis. International journal of cancer. 2011;129(10):2473-84.
30. Freedman ND, Abnet CC, Caporaso NE, Fraumeni JF, Jr., Murphy G, Hartge P, et al. Impact of changing US cigarette smoking patterns on incident cancer: risks of 20 smoking-related cancers among the women and men of the NIH-AARP cohort. International journal of epidemiology. 2016;45(3):846-56.
31. IARC. List of classifications by cancer sites with sufficient or limited evidence in humans, IARC Monographs 2022 [Available from: 2019/07/Classifications_by_cancer_site.pdf.
32. Prabhu A, Obi KO, Rubenstein JH. The synergistic effects of alcohol and tobacco consumption on the risk of esophageal squamous cell carcinoma: a meta-analysis. The American journal of gastroenterology. 2014;109(6):822-7.
33. Wang QL, Xie SH, Li WT, Lagergren J. Smoking Cessation and Risk of Esophageal Cancer by Histological Type: Systematic Review and Meta-analysis. Journal of the National Cancer Institute. 2017;109(12).
34. Kamangar F, Chow WH, Abnet CC, Dawsey SM. Environmental causes of esophageal cancer. Gastroenterology clinics of North America. 2009;38(1):27-57, vii.
35. Gammon MD, Schoenberg JB, Ahsan H, Risch HA, Vaughan TL, Chow WH, et al. Tobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia. Journal of the National Cancer Institute. 1997;89(17):1277-84.
36. Engel LS, Chow WH, Vaughan TL, Gammon MD, Risch HA, Stanford JL, et al. Population attributable risks of esophageal and gastric cancers. Journal of the National Cancer Institute. 2003;95(18):1404-13.
37. Bagnardi V, Rota M, Botteri E, Tramacere I, Islami F, Fedirko V, et al. Light alcohol drinking and cancer: a meta-analysis. Annals of oncology : official journal of the European Society for Medical Oncology. 2013;24(2):301-8.
38. Hashibe M, McKay JD, Curado MP, Oliveira JC, Koifman S, Koifman R, et al. Multiple ADH genes are associated with upper aerodigestive cancers. Nature genetics. 2008;40(6):707-9.
39. Druesne-Pecollo N, Tehard B, Mallet Y, Gerber M, Norat T, Hercberg S, et al. Alcohol and genetic polymorphisms: effect on risk of alcohol-related cancer. The Lancet Oncology. 2009;10(2):173-80.
40. Islami F, Sheikhattari P, Ren JS, Kamangar F. Gastric atrophy and risk of oesophageal cancer and gastric cardia adenocarcinoma--a systematic review and meta-analysis. Annals of oncology : official journal of the European Society for Medical Oncology. 2011;22(4):754-60.
41. Chow WH, Finkle WD, McLaughlin JK, Frankl H, Ziel HK, Fraumeni JF, Jr. The relation of gastroesophageal reflux disease and its treatment to adenocarcinomas of the esophagus and gastric cardia. Jama. 1995;274(6):474-7.
42. Rubenstein JH, Taylor JB. Meta-analysis: the association of oesophageal adenocarcinoma with symptoms of gastro-oesophageal reflux. Alimentary pharmacology & therapeutics. 2010;32(10):1222-7.
43. O'Doherty MG, Freedman ND, Hollenbeck AR, Schatzkin A, Abnet CC. A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH-AARP Diet and Health Study. Gut. 2012;61(9):1261-8.
44. Huang FL, Yu SJ. Esophageal cancer: Risk factors, genetic association, and treatment. Asian journal of surgery. 2018;41(3):210-5.
45. Steffen A, Schulze MB, Pischon T, Dietrich T, Molina E, Chirlaque MD, et al. Anthropometry and esophageal cancer risk in the European prospective investigation into cancer and nutrition. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2009;18(7):2079-89.
46. Hoyo C, Cook MB, Kamangar F, Freedman ND, Whiteman DC, Bernstein L, et al. Body mass index in relation to oesophageal and oesophagogastric junction adenocarcinomas: a pooled analysis from the International BEACON Consortium. International journal of epidemiology. 2012;41(6):1706-18.
47. Buas MF, He Q, Johnson LG, Onstad L, Levine DM, Thrift AP, et al. Germline variation in inflammation-related pathways and risk of Barrett's oesophagus and oesophageal adenocarcinoma. Gut. 2017;66(10):1739-47.
48. Rosenberg PS, Greene MH, Alter BP. Cancer incidence in persons with Fanconi anemia. Blood. 2003;101(3):822-6.
49. Dhillon PK, Farrow DC, Vaughan TL, Chow WH, Risch HA, Gammon MD, et al. Family history of cancer and risk of esophageal and gastric cancers in the United States. International journal of cancer. 2001;93(1):148-52.
50. Jiang X, Tseng CC, Bernstein L, Wu AH. Family history of cancer and gastroesophageal disorders and risk of esophageal and gastric adenocarcinomas: a case-control study. BMC cancer. 2014;14:60.
51. Turati F, Negri E, La Vecchia C. Family history and the risk of cancer: genetic factors influencing multiple cancer sites. Expert review of anticancer therapy. 2014;14(1):1-4.
52. Pan D, Su M, Zhang T, Miao C, Fu L, Yang L, et al. A Distinct Epidemiologic Pattern of Precancerous Lesions of Esophageal Squamous Cell Carcinoma in a High-risk Area of Huai'an, Jiangsu Province, China. Cancer prevention research (Philadelphia, Pa). 2019;12(7):449-62.
53. Islami F, Ren JS, Taylor PR, Kamangar F. Pickled vegetables and the risk of oesophageal cancer: a meta-analysis. British journal of cancer. 2009;101(9):1641-7.
54. Islami F, Boffetta P, Ren JS, Pedoeim L, Khatib D, Kamangar F. High-temperature beverages and foods and esophageal cancer risk--a systematic review. International journal of cancer. 2009;125(3):491-524.
55. Zhu H-C, Yang X, Xu L-P, Zhao L-J, Tao G-Z, Zhang C, et al. Meat Consumption Is Associated with Esophageal Cancer Risk in a Meat- and Cancer-Histological-Type Dependent Manner. Digestive Diseases and Sciences. 2014;59(3):664-73.
56. Castellsagué X, Muñoz N, De Stefani E, Victora CG, Castelletto R, Rolón PA. Influence of mate drinking, hot beverages and diet on esophageal cancer risk in south america. International Journal of Cancer. 2000;88(4):658-64.
57. Luo H, Ge H. Hot Tea Consumption and Esophageal Cancer Risk: A Meta-Analysis of Observational Studies. Front Nutr. 2022;9:831567.
58. Zheng P, Zheng HM, Deng XM, Zhang YD. Green tea consumption and risk of esophageal cancer: a meta-analysis of epidemiologic studies. BMC Gastroenterol. 2012;12:165.
59. Gao YT, McLaughlin JK, Blot WJ, Ji BT, Dai Q, Fraumeni JF, Jr. Reduced risk of esophageal cancer associated with green tea consumption. J Natl Cancer Inst. 1994;86(11):855-8.
60. Cronin-Fenton D. A burning question: does hot green tea drinking increase the risk of esophageal squamous cell carcinoma? Clinical Epidemiology. 2018;10:1321-3.
61. Bollschweiler E, Wolfgarten E, Nowroth T, Rosendahl U, Mönig SP, Hölscher AH. Vitamin intake and risk of subtypes of esophageal cancer in Germany. Journal of Cancer Research and Clinical Oncology. 2002;128(10):575-80.
62. Li J, Zou X, Wang H, Tao D, Qiao Y, Gu Y, et al. Effect of riboflavin-fortified-salt intervention on esophageal preancerous lesions among population with high risk in Yanting County. Zhongguo Zhongliu Fangzhi Zazhi. 2009;16:325-8.
63. Zhao Y, Guo C, Hu H, Zheng L, Ma J, Jiang L, et al. Folate intake, serum folate levels and esophageal cancer risk: an overall and dose-response meta-analysis. Oncotarget. 2017;8(6):10458-69.
64. Bo Y, Lu Y, Zhao Y, Zhao E, Yuan L, Lu W, et al. Association between dietary vitamin C intake and risk of esophageal cancer: A dose-response meta-analysis. International journal of cancer. 2016;138(8):1843-50.
65. Yamaji T, Inoue M, Sasazuki S, Iwasaki M, Kurahashi N, Shimazu T, et al. & Japan Public Health, Center-based Prospective Study Group.(2008). Fruit and vegetable consumption and squamous cell carcinoma of the esophagus in Japan: the JPHC study. Int J Cancer.123(8):1935-40.
66. Liu J, Wang J, Leng Y, Lv C. Intake of fruit and vegetables and risk of esophageal squamous cell carcinoma: A meta-analysis of observational studies. International Journal of Cancer. 2013;133(2):473-85.
67. Freedman ND, Park Y, Subar AF, Hollenbeck AR, Leitzmann MF, Schatzkin A, et al. Fruit and vegetable intake and esophageal cancer in a large prospective cohort study. International Journal of Cancer. 2007;121(12):2753-60.
68. Wang A, Zhu C, Fu L, Wan X, Yang X, Zhang H, et al. Citrus Fruit Intake Substantially Reduces the Risk of Esophageal Cancer: A Meta-Analysis of Epidemiologic Studies. Medicine (Baltimore). 2015;94(39):e1390.
69. Vingeliene S, Chan DSM, Aune D, Vieira AR, Polemiti E, Stevens C, et al. An update of the WCRF/AICR systematic literature review on esophageal and gastric cancers and citrus fruits intake. Cancer Causes & Control. 2016;27(7):837-51.
70. Zhao W, Liu L, Xu S. Intakes of citrus fruit and risk of esophageal cancer: A meta-analysis. Medicine (Baltimore). 2018;97(13):e0018.
71. Cirmi S, Navarra M, Woodside JV, Cantwell MM. Citrus fruits intake and oral cancer risk: A systematic review and meta-analysis. Pharmacological Research. 2018;133:187-94.
72. Ge XX, Xing MY, Yu LF, Shen P. Carotenoid intake and esophageal cancer risk: a meta-analysis. Asian Pac J Cancer Prev. 2013;14(3):1911-8.
73. Sato S, Kajiyama Y, Sugano M, Iwanuma Y, Sonoue H, Matsumoto T, et al. Alvocidib (Flavopiridol) suppresses tumor growth in SCID mice with human esophageal cancer xenografts without inducing apoptosis. Surg Oncol. 2006;15(2):107-13.
74. Ma J, Li Q, Fang X, Chen L, Qiang Y, Wang J, et al. Increased total iron and zinc intake and lower heme iron intake reduce the risk of esophageal cancer: A dose-response meta-analysis. Nutrition Research. 2018;59:16-28.
75. Taylor PR, Li B, Dawsey SM, Li J-Y, Yang CS, Guo W, et al. Prevention of Esophageal Cancer: The Nutrition Intervention Trials in Linxian, China1. Cancer Research. 1994;54(7_Supplement):2029s-31s.
76. Li K, Zhang B. The association of dietary β-carotene and vitamin A intake on the risk of esophageal cancer: a meta-analysis. Rev Esp Enferm Dig. 2020;112(8):620-6.
77. Ma JL, Zhao Y, Guo CY, Hu HT, Zheng L, Zhao EJ, et al. Dietary vitamin B intake and the risk of esophageal cancer: a meta-analysis. Cancer Manag Res. 2018;10:5395-410.
78. Aghajanzadeh M, Safarpour F, Koohsari MR, Ghanaei FM, Bodaghi SM, Tozandehgani H. Functional outcome of gastrointestinal tract and quality of life after esophageal reconstruction of esophagus cancer. Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association. 2009;15(1):24-8.
79. Ginex P, Thom B, Jingeleski M, Vincent A, Plourde G, Rizk N, et al. Patterns of symptoms following surgery for esophageal cancer. Oncology nursing forum. 2013;40(3):E101-7.
80. Greene CL, DeMeester SR, Worrell SG, Oh DS, Hagen JA, DeMeester TR. Alimentary satisfaction, gastrointestinal symptoms, and quality of life 10 or more years after esophagectomy with gastric pull-up. The Journal of thoracic and cardiovascular surgery. 2014;147(3):909-14.
81. Mak RH, Mamon HJ, Ryan DP, Miyamoto DT, Ancukiewicz M, Kobayashi WK, et al. Toxicity and outcomes after chemoradiation for esophageal cancer in patients age 75 or older. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 2010;23(4):316-23.
82. Zhou X, Wang JL, Lu J, Song Y, Kwak KS, Jiao Q, et al. Reversal of cancer cachexia and muscle wasting by ActRIIB antagonism leads to prolonged survival. Cell. 2010;142(4):531-43.
83. Johns N, Stephens NA, Fearon KC. Muscle wasting in cancer. The international journal of biochemistry & cell biology. 2013;45(10):2215-29.
84. Cox S, Powell C, Carter B, Hurt C, Mukherjee S, Crosby TD. Role of nutritional status and intervention in oesophageal cancer treated with definitive chemoradiotherapy: outcomes from SCOPE1. British journal of cancer. 2016;115(2):172-7.
85. Pan P, Tao G, Sun X. Subjective global assessment and prealbumin levels of esophageal cancer patients undergoing concurrent chemoradiotherapy. Nutricion hospitalaria. 2015;31(5):2167-73.
86. Deans DA, Tan BH, Wigmore SJ, Ross JA, de Beaux AC, Paterson-Brown S, et al. The influence of systemic inflammation, dietary intake and stage of disease on rate of weight loss in patients with gastro-oesophageal cancer. British journal of cancer. 2009;100(1):63-9.
87. Nitenberg G, Raynard B. Nutritional support of the cancer patient: issues and dilemmas. Critical reviews in oncology/hematology. 2000;34(3):137-68.
88. Care NCCfA. Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition. 2006.
89. Di Fiore F, Lecleire S, Pop D, Rigal O, Hamidou H, Paillot B, et al. Baseline nutritional status is predictive of response to treatment and survival in patients treated by definitive chemoradiotherapy for a locally advanced esophageal cancer. The American journal of gastroenterology. 2007;102(11):2557-63.
90. Abdel-Latif MMM, Babar M, Kelleher D, Reynolds JV. A pilot study of the impact of Vitamin C supplementation with neoadjuvant chemoradiation on regulators of inflammation and carcinogenesis in esophageal cancer patients. Journal of Cancer Research and Therapeutics. 2019;15(1):185-91.
91. Abdel-latif MMM, Raouf AA, Sabra K, Kelleher D, Reynolds JV. Vitamin C Enhances Chemosensitization of Esophageal Cancer Cells in Vitro. Journal of Chemotherapy. 2005;17(5):539-49.
92. Lin L-C, Que J, Lin K-L, Leung HW-C, Lu C-L, Chang C-H. Effects of Zinc Supplementation on Clinical Outcomes in Patients Receiving Radiotherapy for Head and Neck Cancers: A Double-Blinded Randomized Study. International Journal of Radiation Oncology*Biology*Physics. 2008;70(2):368-73.
93. Lin Y-S, Lin L-C, Lin S-W. Effects of zinc supplementation on the survival of patients who received concomitant chemotherapy and radiotherapy for advanced nasopharyngeal carcinoma: Follow-up of a double-blind randomized study with subgroup analysis. The Laryngoscope. 2009;119(7):1348-52.
94. Sato S, Kajiyama Y, Sugano M, Iwanuma Y, Tsurumaru M. Flavopiridol as a radio-sensitizer for esophageal cancer cell lines. Diseases of the Esophagus. 2004;17(4):338-44.
95. Schrump DS, Matthews W, Chen GA, Mixon A, Altorki NK. Flavopiridol mediates cell cycle arrest and apoptosis in esophageal cancer cells. Clinical Cancer Research. 1998;4(11):2885-90.
96. Wang SK YL, Wang TT, Huang GL, Yang LG, Sun GJ. Inhibition of Proliferation and Induction of Apoptosis by the Combination of β-carotene and 1,25-dihydroxyvitamin D3 in Human Esophageal Cancer EC9706 Cells. Asian Pacific Journal of Cancer Prevention. 2012;13(12):6327-32.
97. Agostinis P, Berg K, Cengel KA, Foster TH, Girotti AW, Gollnick SO, et al. Photodynamic therapy of cancer: an update. CA: a cancer journal for clinicians. 2011;61(4):250-81.
98. Smith MS, Cash B, Konda V, Trindade AJ, Gordon S, DeMeester S, et al. Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 2019;32(9).
99. Wu H, Minamide T, Yano T. Role of photodynamic therapy in the treatment of esophageal cancer. Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society. 2019;31(5):508-16.
100. Pohl H, Sonnenberg A, Strobel S, Eckardt A, Rösch T. Endoscopic versus surgical therapy for early cancer in Barrett's esophagus: a decision analysis. Gastrointestinal endoscopy. 2009;70(4):623-31.
101. Pech O. Hybrid Argon Plasma Coagulation in Patients With Barrett Esophagus. Gastroenterology & hepatology. 2017;13(10):610-2.
102. Thota PN, Arora Z, Dumot JA, Falk G, Benjamin T, Goldblum J, et al. Cryotherapy and Radiofrequency Ablation for Eradication of Barrett's Esophagus with Dysplasia or Intramucosal Cancer. Digestive diseases and sciences. 2018;63(5):1311-9.
103. Ajani JA, D'Amico TA, Bentrem DJ, Chao J, Corvera C, Das P, et al. Esophageal and Esophagogastric Junction Cancers, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network : JNCCN. 2019;17(7):855-83.
104. Wright CD. Esophageal cancer surgery in 2005. Minerva chirurgica. 2005;60(6):431-44.
105. Rentz J, Bull D, Harpole D, Bailey S, Neumayer L, Pappas T, et al. Transthoracic versus transhiatal esophagectomy: a prospective study of 945 patients. The Journal of thoracic and cardiovascular surgery. 2003;125(5):1114-20.
106. Hagen JA, Peters JH, DeMeester TR. Superiority of extended en bloc esophagogastrectomy for carcinoma of the lower esophagus and cardia. The Journal of thoracic and cardiovascular surgery. 1993;106(5):850-8; discussion 8-9.
107. Peracchia A, Bonavina L, Botturi M, Pagani M, Via A, Saino G. Current status of surgery for carcinoma of the hypopharynx and cervical esophagus. Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus. 2001;14(2):95-7.
108. Miyata H, Yamasaki M, Takahashi T, Kurokawa Y, Nakajima K, Takiguchi S, et al. Larynx-preserving limited resection and free jejunal graft for carcinoma of the cervical esophagus. World journal of surgery. 2013;37(3):551-7.
109. Mariette C, Markar SR, Dabakuyo-Yonli TS, Meunier B, Pezet D, Collet D, et al. Hybrid Minimally Invasive Esophagectomy for Esophageal Cancer. The New England journal of medicine. 2019;380(2):152-62.
110. Straatman J, van der Wielen N, Cuesta MA, Daams F, Roig Garcia J, Bonavina L, et al. Minimally Invasive Versus Open Esophageal Resection: Three-year Follow-up of the Previously Reported Randomized Controlled Trial: the TIME Trial. Annals of surgery. 2017;266(2):232-6.
111. Steenhagen E. Preoperative nutritional optimization of esophageal cancer patients. Journal of thoracic disease. 2019;11(Suppl 5):S645.
112. Zhang B, Najarali Z, Ruo L, Alhusaini A, Solis N, Valencia M, et al. Effect of perioperative nutritional supplementation on postoperative complications—systematic review and meta-analysis. Journal of Gastrointestinal Surgery. 2019;23(8):1682-93.
113. Mantziari S, Hübner M, Demartines N, Schäfer M. Impact of preoperative risk factors on morbidity after esophagectomy: is there room for improvement? World journal of surgery. 2014;38(11):2882-90.
114. Anandavadivelan P, Lagergren P. Cachexia in patients with oesophageal cancer. Nature reviews Clinical oncology. 2016;13(3):185-98.
115. Evans DC, Martindale RG, Kiraly LN, Jones CM. Nutrition optimization prior to surgery. Nutrition in Clinical Practice. 2014;29(1):10-21.
116. Gillis C, Carli F. Promoting perioperative metabolic and nutritional care. Anesthesiology. 2015;123(6):1455-72.
117. Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KC. Cancer-associated cachexia. Nature reviews Disease primers. 2018;4(1):1-18.
118. Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN guideline: clinical nutrition in surgery. Clinical nutrition. 2017;36(3):623-50.
119. Vigano A, Kasvis P, Di Tomasso J, Gillis C, Kilgour R, Carli F. Pearls of optimizing nutrition and physical performance of older adults undergoing cancer therapy. Journal of geriatric oncology. 2017;8(6):428-36.
120. Wischmeyer PE, Carli F, Evans DC, Guilbert S, Kozar R, Pryor A, et al. American society for enhanced recovery and perioperative quality initiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesthesia & Analgesia. 2018;126(6):1883-95.
121. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clinical nutrition. 2017;36(1):11-48.
122. Sandrucci S, Beets G, Braga M, Dejong K, Demartines N. Perioperative nutrition and enhanced recovery after surgery in gastrointestinal cancer patients. A position paper by the ESSO task force in collaboration with the ERAS society (ERAS coalition). European Journal of Surgical Oncology. 2018;44(4):509-14.
123. Yu Z, Li S, Liu D, Liu L, He J, Huang Y, et al. Society for Translational Medicine Expert Consensus on the prevention and treatment of postoperative pulmonary infection in esophageal cancer patients. Journal of thoracic disease. 2018;10(2):1050.
124. Eliasen M, Grønkjær M, Skov-Ettrup LS, Mikkelsen SS, Becker U, Tolstrup JS, et al. Preoperative alcohol consumption and postoperative complications: a systematic review and meta-analysis. Annals of surgery. 2013;258(6):930-42.
125. Oppedal K, Møller AM, Pedersen B, Tønnesen H. Preoperative alcohol cessation prior to elective surgery. Cochrane Database of Systematic Reviews. 2012(7).
126. Rubinsky AD, Bishop MJ, Maynard C, Henderson WG, Hawn MT, Harris AH, et al. Postoperative risks associated with alcohol screening depend on documented drinking at the time of surgery. Drug and Alcohol Dependence. 2013;132(3):521-7.
127. Tønnesen H, Nielsen P, Lauritzen J, Møller A. Smoking and alcohol intervention before surgery: evidence for best practice. British journal of anaesthesia. 2009;102(3):297-306.
128. Lauridsen SV, Thomsen T, Kaldan G, Lydom LN, Tønnesen H. Smoking and alcohol cessation intervention in relation to radical cystectomy: a qualitative study of cancer patients’ experiences. BMC cancer. 2017;17(1):1-9.
129. Low DE, Allum W, De Manzoni G, Ferri L, Immanuel A, Kuppusamy M, et al. Guidelines for perioperative care in esophagectomy: enhanced recovery after surgery (ERAS®) society recommendations. World journal of surgery. 2019;43(2):299-330.
130. Brady MC, Kinn S, Stuart P, Ness V. Preoperative fasting for adults to prevent perioperative complications. Cochrane database of systematic reviews. 2003(4).
131. Sarin A, Chen Ll, Wick EC. Enhanced recovery after surgery—preoperative fasting and glucose loading—a review. Journal of surgical oncology. 2017;116(5):578-82.
132. Ljungqvist O. ERAS—enhanced recovery after surgery: moving evidence‐based perioperative care to practice. Journal of Parenteral and Enteral Nutrition. 2014;38(5):559-66.
133. Nygren J, Thorell A, Ljungqvist O. Preoperative oral carbohydrate therapy. Current opinion in anaesthesiology. 2015;28(3):364-9.
134. Amer M, Smith M, Herbison G, Plank L, McCall J. Network meta-analysis of the effect of preoperative carbohydrate loading on recovery after elective surgery. Journal of British Surgery. 2017;104(3):187-97.
135. Torgersen Z, Balters M. Perioperative nutrition. Surgical Clinics. 2015;95(2):255-67.
136. Findlay JM, Gillies RS, Millo J, Sgromo B, Marshall RE, Maynard ND. Enhanced recovery for esophagectomy: a systematic review and evidence-based guidelines. Annals of surgery. 2014;259(3):413-31.
137. Parekh D, Dancer RC, Lax S, Cooper MS, Martineau AR, Fraser WD, et al. Vitamin D to prevent acute lung injury following oesophagectomy (VINDALOO): study protocol for a randomised placebo controlled trial. Trials. 2013;14(1):1-7.
138. Dancer RC, Parekh D, Lax S, D'Souza V, Zheng S, Bassford CR, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015;70(7):617-24.
139. Muñoz M, Gómez-Ramírez S, Kozek-Langeneker S, Shander A, Richards T, Pavía J, et al. ‘Fit to fly’: overcoming barriers to preoperative haemoglobin optimization in surgical patients. British Journal of Anaesthesia. 2015;115(1):15-24.
140. Ayantunde AA, Ng MY, Pal S, Welch NT, Parsons SL. Analysis of blood transfusion predictors in patients undergoing elective oesophagectomy for cancer. BMC surgery. 2008;8(1):1-7.
141. Melis M, McLoughlin JM, Dean EM, Siegel EM, Weber JM, Shah N, et al. Correlations between neoadjuvant treatment, anemia, and perioperative complications in patients undergoing esophagectomy for cancer. Journal of Surgical Research. 2009;153(1):114-20.
142. Abbrederis K, Bassermann F, Schuhmacher C, Voelter V, Busch R, Roethling N, et al. Erythropoietin-alfa during neoadjuvant chemotherapy for locally advanced esophagogastric adenocarcinoma. The Annals of thoracic surgery. 2006;82(1):293-7.
143. Rades D, Tribius S, Yekebas EF, Bahrehmand R, Wildfang I, Kilic E, et al. Epoetin alfa improves survival after chemoradiation for stage III esophageal cancer: final results of a prospective observational study. International Journal of Radiation Oncology* Biology* Physics. 2006;65(2):459-65.
144. Steenhagen E, van Vulpen JK, van Hillegersberg R, May AM, Siersema PD. Nutrition in peri-operative esophageal cancer management. Expert review of gastroenterology & hepatology. 2017;11(7):663-72.
145. Okada G, Momoki C, Habu D, Kambara C, Fujii T, Matsuda Y, et al. Effect of postoperative oral intake on prognosis for esophageal cancer. Nutrients. 2019;11(6):1338.
146. Barlow R, Price P, Reid TD, Hunt S, Clark GW, Havard TJ, et al. Prospective multicentre randomised controlled trial of early enteral nutrition for patients undergoing major upper gastrointestinal surgical resection. Clinical Nutrition. 2011;30(5):560-6.
147. Fujita T, Daiko H, Nishimura M. Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomy in patients with esophageal cancer. European surgical research. 2012;48(2):79-84.
148. Xiao-Bo Y, Qiang L, Xiong Q, Zheng R, Jian Z, Jian-Hua Z, et al. Efficacy of early postoperative enteral nutrition in supporting patients after esophagectomy. Minerva chirurgica. 2014;69(1):37-46.
149. Sun H-b, Liu X-b, Zhang R-x, Wang Z-f, Qin J-j, Yan M, et al. Early oral feeding following thoracolaparoscopic oesophagectomy for oesophageal cancer. European Journal of Cardio-Thoracic Surgery. 2015;47(2):227-33.
150. Weijs TJ, Berkelmans GH, Nieuwenhuijzen GA, Dolmans AC, Kouwenhoven EA, Rosman C, et al. Immediate postoperative oral nutrition following esophagectomy: a multicenter clinical trial. The Annals of thoracic surgery. 2016;102(4):1141-8.
151. Berkelmans GH, Wilts BJ, Kouwenhoven EA, Kumagai K, Nilsson M, Weijs TJ, et al. Nutritional route in oesophageal resection trial II (NUTRIENT II): study protocol for a multicentre open-label randomised controlled trial. BMJ open. 2016;6(8):e011979.
152. Heneghan HM, Zaborowski A, Fanning M, McHugh A, Doyle S, Moore J, et al. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery. Annals of surgery. 2015;262(5):803-8.
153. Huddy J, Macharg F, Lawn A, Preston S. Exocrine pancreatic insufficiency following esophagectomy. Diseases of the Esophagus. 2013;26(6):594-7.
154. Nakatani M, Migita K, Matsumoto S, Wakatsuki K, Ito M, Nakade H, et al. Prognostic Significance of the Prognostic Nutritional Index in Patients with Recurrent Esophageal Squamous Cell Carcinoma. Nutrition and Cancer. 2018;70(3):467-73.
155. Hao J, Chen C, Wan F, Zhu Y, Jin H, Zhou J, et al. Prognostic Value of Pre-Treatment Prognostic Nutritional Index in Esophageal Cancer: A Systematic Review and Meta-Analysis. Front Oncol [Internet]. 2020 2020; 10:[797 p.]. Available from:
156. Sultan J, Griffin SM, Di Franco F, Kirby JA, Shenton BK, Seal CJ, et al. Randomized clinical trial of omega-3 fatty acid-supplemented enteral nutrition versus standard enteral nutrition in patients undergoing oesophagogastric cancer surgery. British Journal of Surgery. 2012;99(3):346-55.
157. Ryan AM, Reynolds JV, Healy L, Byrne M, Moore J, Brannelly N, et al. Enteral Nutrition Enriched With Eicosapentaenoic Acid (EPA) Preserves Lean Body Mass Following Esophageal Cancer Surgery: Results of a Double-Blinded Randomized Controlled Trial. Annals of Surgery. 2009;249(3):355-63.
158. Tiloke C, Phulukdaree A, Chuturgoon AA. The Antiproliferative Effect of Moringa oleifera Crude Aqueous Leaf Extract on Human Esophageal Cancer Cells. J Med Food. 2016;19(4):398-403.
159. Zhang Y, Zhu X, Huang T, Chen L, Liu Y, Li Q, et al. β-Carotene synergistically enhances the anti-tumor effect of 5-fluorouracil on esophageal squamous cell carcinoma in vivo and in vitro. Toxicology Letters. 2016;261:49-58.
160. Qiu Y, You J, Wang K, Cao Y, Hu Y, Zhang H, et al. Effect of whole-course nutrition management on patients with esophageal cancer undergoing concurrent chemoradiotherapy: A randomized control trial. Nutrition. 2020;69:110558.
161. Yoshida S, Kaibara A, Ishibashi N, Shirouzu K. Glutamine supplementation in cancer patients. Nutrition. 2001;17(9):766-8.
162. Matsuda Y, Habu D, Lee S, Kishida S, Osugi H. Enteral Diet Enriched with ω-3 Fatty Acid Improves Oxygenation After Thoracic Esophagectomy for Cancer: A Randomized Controlled Trial. World Journal of Surgery. 2017;41(6):1584-94.
163. Chaitanya NCSK, Shugufta K, Suvarna C, Bhopal T, Mekala S, Ponnuru H, et al. A Meta-Analysis on the Efficacy of Zinc in Oral Mucositis during Cancer Chemo and/or Radiotherapy—An Evidence-Based Approach. Journal of Nutritional Science and Vitaminology. 2019;65(2):184-91.
164. Wang SA, Li F, Zhu J, Chen X, Ren W, Gao B. Multidisciplinary nutritional management improves nutritional and hospitalized outcomes of patients with esophageal cancer undergoing chemoradiotherapy: A randomized control trial. Medicine (Baltimore). 2023;102(12):e33335.
165. Motoori M, Sugimura K, Tanaka K, Shiraishi O, Kimura Y, Miyata H, et al. Comparison of synbiotics combined with enteral nutrition and prophylactic antibiotics as supportive care in patients with esophageal cancer undergoing neoadjuvant chemotherapy: A multicenter randomized study. Clin Nutr. 2022;41(5):1112-21.
166. Long H, Yang H, Lin Y, Situ D, Liu W. Fish oil-supplemented parenteral nutrition in patients following esophageal cancer surgery: effect on inflammation and immune function. Nutr Cancer. 2013;65(1):71-5.
167. Yang L, Gao J, Zhou Y, Tao Z, He J, Yang J, et al. Effect of Oral Nutritional Supplements on Patients with Esophageal Cancer During Radiotherapy. Cancer Biother Radiopharm. 2023;38(2):89-94.
168. Yamashita K, Yamasaki M, Miyazaki Y, Matsuura N, Tanaka K, Makino T, et al. Protein-enhanced feeds after esophagectomy for esophageal cancer attenuate postoperative catabolism: a prospective observational study. Surg Today. 2022;52(4):624-32

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