Making sense of multimodality therapy for esophageal cancer.
The results of single modality treatment for esophageal cancer have been poor because of a high rate of local recurrence and distant metastasis. This is probably caused by the prevalence of advanced esophageal cancer at the time of diagnosis; only 3% of patients have Stage I disease, and most of them (80%) are Stage III or IV when they become symptomatic. The most frequently involved metastasis sites are lymph nodes (73%), lung (52%), and liver (47%). Neoadjuvant preoperative chemotherapy, radiotherapy, and combined chemoradiation have been added to the treatment of this disease to enhance local control, increase resectability rate, and improve disease-free survival. The results of recent trials are discussed.
Krasna
M J
MJ
Division of Thoracic Surgery, University of Maryland Medical System, Baltimore, Maryland 21201, USA. MKRASNA@SURGEY1.AB.UMD.EDU
Mao
Y S
YS
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008207:Lymphatic Metastasis; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome