title: Esophageal carcinoma: current controversial topics.
abstract: Worldwide, esophageal carcinoma is a common gastrointestinal cancer with a high mortality. The incidence of adenocarcinoma of the esophagus is increasing in the western world, but squamous cell carcinoma remains dominant in the underdeveloped parts of the world. Both types of esophageal carcinoma remain equally virulent. Currently, there are no optimal preventative screening programs available and most patients present with advanced or metastatic disease. Although many options are available for improving diagnostic accuracy, a single method has not displayed significant advantages over the others. In addition, selecting a superior treatment regimen has not surfaced. Preferred resection techniques exist, but one method has not illustrated improvements in survival over the others. A lack of improved survival rates with single modality therapies has led to a multi modality approach. However, developments in neoadjuvant and adjuvant therapies have led to mixed conclusions. Collectively, past studies have not shown an optimal neoadjuvant or adjuvant regimen in terms of survival benefit. This review highlights existing staging modalities and treatment regimens for esophageal carcinoma, in an effort to illustrate the controversial nature surrounding its management.
authors.affiliation: Department of Hematology/Oncology, Sylvester Cancer Institute, University of Miami School of Medicine, Miami, Florida 33136, USA.
authors.forename: M
authors.initials: M
authors.lastname: Patel
authors.forename: K
authors.initials: K
authors.lastname: Ferry
authors.forename: D
authors.initials: D
authors.lastname: Franceschi
authors.forename: I
authors.initials: I
authors.lastname: Kaklamanos
authors.forename: A
authors.initials: A
authors.lastname: Livingstone
authors.forename: Bach
authors.initials: B
authors.lastname: Ardalan
mesh_terms: D000970:Antineoplastic Agents; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging
chemical_list: D000970:Antineoplastic Agents