Multimodality management of esophageal cancer

Abstract

Esophageal cancer is a morbid disease with a grim prognosis. The outcomes of treatment even in non-metastatic disease undergoing potentially curative surgery are poor with 5-year survival ranging from 20 to 35 %. Several multimodality treatment options have been investigated in well-conducted randomised trials and meta-analyses evaluating both neoadjuvant and adjuvant therapies. However, there is still lack of uniform practice in the management of operable esophageal cancer. We review the current evidence for multimodality treatment of esophageal cancer, critically analysing the evidence supporting the use of each strategy, the pros and cons of each approach and discuss our approach in management. Neoadjuvant chemotherapy or chemoradiotherapy are currently the standard of care in localised esophageal cancer.

Keywords: Adjuvant therapy; Esophageal cancer; Neoadjuvant.

Figures

Fig. 1

Survival after neoadjuvant chemotherapy for resectable esophageal carcinoma Reproduced with permission from Sjoquist KM et al. [19]: Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable esophageal carcinoma: an updated meta-analysis. Lancet Oncol 2011; 12: 681-692

Fig. 2

Survival after neoadjuvant chemoradiotherapy for resectable esophageal carcinoma Reproduced with permission from Sjoquist KM et al. [19]: Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable esophageal carcinoma: an updated meta-analysis. Lancet Oncol 2011; 12: 681-692