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Multimodality Therapy for Esophageal Cancer: How to Approach This Disease in the Absence of Level 1 Evidence

From the Cancer Institute, Saint Joseph Medical Center, Towson, MD

Authors’ disclosures of potential conflicts of interest are found at the end of this article.

Address reprint requests to Mark J. Krasna, MD, Medical Director, Saint Joseph Cancer Institute, 7501 Osler Drive, Building A, Towson, MD 21204; e-mail markkrasna{at}catholichealth.net

Overview: Esophageal cancer is rare but increasing in frequency in the Western world. A stage-specific approach to esophageal cancer is warranted. Surgery alone is appropriate for patients at good risk with stage I and II disease. In patients with locoregional advanced disease, surgery is appropriate in combination with either neoadjuvant or adjuvant chemotherapy and radiation. Palliative surgery is a thing of the past in the era of stenting and laser therapy. A stage-specific approach can result in reasonable survival for patients with this dreaded disease.