The roles of multimodality treatment and lymphadenectomy in the management of esophageal cancer.
OBJECTIVE
To review the current status of multimodality treatment and lymphadenectomy in the management of esophageal cancer.


METHODS
Literature review.


METHODS
Multimodality treatment and lymphadenectomy in esophageal cancer.


METHODS
Results in research papers published selected by literature search.


RESULTS
Numerous studies have been carried out attempting to define the roles of various neoadjuvant or adjuvant regimens in the treatment of esophageal cancer. These included the use of radiotherapy or chemotherapy alone or in different combinations, with or without surgical resection. Randomized trials have failed to show significant improvement compared with surgical resection alone, although downstaging of disease and benefits on subgroups of patients could be demonstrated. Whether the extent of resection can influence outcome was tested by varying the surgical approach, and by increasing the extent of lymphadenectomy. Although indirect evidence exists suggesting more extensive resection may improve long term prognosis, definitive proof is lacking.


CONCLUSIONS
More well organized randomized controlled trials are needed to further elucidate the roles of these approaches in the treatment of esophageal cancer.
Department of Surgery, University of Hong Kong, Queen Mary Hospital, China.
S
S
Law
J
J
Wong
D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008197:Lymph Node Excision