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Multimodal treatment of esophageal cancer

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Abstract

Background

The treatment of localized esophageal cancer has been debated controversially over the past decades. Neoadjuvant treatment was used empirically, but evidence was limited due to the lack of high-quality confirmatory studies. Meanwhile, data have become much clearer due to recently published well-conducted randomized controlled trials and meta-analyses.

Methods

Neoadjuvant and perioperative platinum fluoropyrimidine-based combination chemotherapy has now an established role in the treatment of stage II and stage III esophageal adenocarcinoma and cancer of the esophago-gastric junction. Neoadjuvant chemoradiation is now the standard of care for treating stage II and stage III esophageal squamous cell cancer and can also be considered for treating esophageal adenocarcinoma.

Results

Patients with esophageal squamous cell cancer treated with definitive chemoradiation achieve comparable long-term survival compared with surgery. Short-term mortality is less with chemoradiation alone, but local tumor control is significantly better with surgery.

Conclusion

This expert review article outlines current data and literature and delineates recommendable treatment guidelines for localized esophageal cancer.

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Authors and Affiliations

  1. University Cancer Center Leipzig (UCCL), University Clinic Leipzig, Liebigstraße 20, 04103, Leipzig, Germany

    Florian Lordick

  2. Department of General Visceral and Cancer Surgery, University of Cologne, Cologne, Germany

    Arnulf H. Hölscher

  3. Department of Radiation Oncology, Catholic University of Leuven, Louvain, Belgium

    Karen Haustermans

  4. Institute of Pathology, University Clinic Leipzig, Leipzig, Germany

    Christian Wittekind

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  1. Florian Lordick
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  2. Arnulf H. Hölscher
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  3. Karen Haustermans
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  4. Christian Wittekind
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Correspondence to Florian Lordick.

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Lordick, F., Hölscher, A.H., Haustermans, K. et al. Multimodal treatment of esophageal cancer. Langenbecks Arch Surg 398, 177–187 (2013). https://doi.org/10.1007/s00423-012-1001-1

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