title: Pre- and postoperative treatment modalities for esophageal squamous cell carcinoma.
abstract: BACKGROUND
  The objective of this article was to review randomized clinical trials (RCTs) utilizing pre- and postoperative treatment modalities for esophageal squamous cell carcinoma (ESCC).
  
  
  METHODS
  A computerized (MEDLINE) and manual search was performed to identify articles published on this topic between 1984 and 2012.
  
  
  RESULTS
  We identified a total of 49 published RCTs, which included a total of 8,785 patients with ESCC. Treatment modalities consisted of pre- (n=38) and postoperative (n=11) chemo-, radio- and chemoradiotherapy. While both preoperative chemotherapy and chemoradiotherapy apparently improve R0 resection, they often result in substantial postoperative morbidity and mortality. Only for preoperative chemoradiotherapy does there seem to be a significant benefit in overall survival.
  
  
  CONCLUSIONS
  R0 resection remains the only curative therapy for patients with ESCC. While preoperative chemoradiotherapy may improve overall survival, there is still the need for well-designed RCTs, which should include a homogeneous patient collective, to clarify the question of definitive benefit.
authors.affiliation: Department of Internal Medicine I, Division of Oncology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
authors.forename: Christiane M R
authors.initials: CM
authors.lastname: Thallinger
authors.forename: Barbara
authors.initials: B
authors.lastname: Kiesewetter
authors.forename: Markus
authors.initials: M
authors.lastname: Raderer
authors.forename: Michael
authors.initials: M
authors.lastname: Hejna
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic