Langenbeck's Archives of Surgery

, Volume 398, Issue 2, pp 177–187 | Cite as

Multimodal treatment of esophageal cancer

  • Florian Lordick
  • Arnulf H. Hölscher
  • Karen Haustermans
  • Christian Wittekind
Review Article

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.

Keywords

Esophageal cancer Neoadjuvant Chemotherapy Chemoradiation Response 

Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Florian Lordick
    • 1
  • Arnulf H. Hölscher
    • 2
  • Karen Haustermans
    • 3
  • Christian Wittekind
    • 4
  1. 1.University Cancer Center Leipzig (UCCL), University Clinic LeipzigLeipzigGermany
  2. 2.Department of General Visceral and Cancer SurgeryUniversity of CologneCologneGermany
  3. 3.Department of Radiation OncologyCatholic University of LeuvenLouvainBelgium
  4. 4.Institute of PathologyUniversity Clinic LeipzigLeipzigGermany

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