title: Update on staging and surgical treatment options for esophageal cancer.
abstract: BACKGROUND
  Esophageal cancer remains a challenging clinical problem, with overall long-term survivorship consistently at a level of approximately 30%. The incidence of esophageal cancer is increasing worldwide, with the most dramatic increase being seen with respect to esophageal adenocarcinoma.
  
  
  CONCLUSIONS
  Pretreatment staging accuracy has improved with the utilization of CT and PET scans, as well as endoscopic ultrasound and endoscopic mucosal resection. In an increasing percentage of patients, endoscopic techniques are being utilized in selected patients for the treatment of high-grade dysplasia in Barrett's and intramucosal cancer. Surgery remains the treatment of choice in all appropriate patients with invasive and locoregional esophageal cancer, although multimodality therapy is now used in most patients with stage II or stage III disease.
  
  
  CONCLUSIONS
  Outcomes for esophagectomy have been dominated by concerns regarding high mortality and morbidity; however, mortality rates associated with esophageal resection have dramatically decreased, especially in high-volume specialty centers. This manuscript highlights some of the evolutionary issues associated with staging and endoscopic and surgical treatments of Barrett's and esophageal cancer.
authors.affiliation: Thoracic Surgery and Thoracic Oncology, C6-GS, Virginia Mason Medical Center, 1100 Ninth Ave, Seattle, WA 98101, USA. donald.low@vmmc.org
authors.forename: Donald E
authors.initials: DE
authors.lastname: Low
mesh_terms: D019160:Endosonography / Q000706:statistics & numerical data; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D016629:Esophagectomy; D006801:Humans; D009017:Morbidity / Q000639:trends; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D011379:Prognosis; D011788:Quality of Life; D015203:Reproducibility of Results; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology