title: Multimodal treatment of esophageal cancer.
abstract: BACKGROUND
  The treatment of localized esophageal cancer has been debated controversially over the past decades. Neoadjuvant treatment was used empirically, but evidence was limited due to the lack of high-quality confirmatory studies. Meanwhile, data have become much clearer due to recently published well-conducted randomized controlled trials and meta-analyses.
  
  
  METHODS
  Neoadjuvant and perioperative platinum fluoropyrimidine-based combination chemotherapy has now an established role in the treatment of stage II and stage III esophageal adenocarcinoma and cancer of the esophago-gastric junction. Neoadjuvant chemoradiation is now the standard of care for treating stage II and stage III esophageal squamous cell cancer and can also be considered for treating esophageal adenocarcinoma.
  
  
  RESULTS
  Patients with esophageal squamous cell cancer treated with definitive chemoradiation achieve comparable long-term survival compared with surgery. Short-term mortality is less with chemoradiation alone, but local tumor control is significantly better with surgery.
  
  
  CONCLUSIONS
  This expert review article outlines current data and literature and delineates recommendable treatment guidelines for localized esophageal cancer.
authors.affiliation: University Cancer Center Leipzig (UCCL), University Clinic Leipzig, Liebigstraße 20, Leipzig, Germany. florian.lordick@medizin.uni-leipzig.de
authors.forename: Florian
authors.initials: F
authors.lastname: Lordick
authors.forename: Arnulf H
authors.initials: AH
authors.lastname: Hölscher
authors.forename: Karen
authors.initials: K
authors.lastname: Haustermans
authors.forename: Christian
authors.initials: C
authors.lastname: Wittekind
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016629:Esophagectomy; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018570:Risk Assessment