title: Multidisciplinary Approach to the Management of Esophageal Malignancies.
abstract: A multidisciplinary approach in the management of complex malignancies is becoming more common, and likewise, adopting such an approach to the care of patients with locally advanced esophageal is recommended in order to optimize clinical outcomes.
  
  
  
  In this review, we discuss both the surgical and medical oncology perspectives in the management of patients with locally advanced esophageal cancer. We review the data supporting the current standard-of-care approach, namely trimodality therapy with neoadjuvant chemo-radiotherapy followed by surgery. Other aspects of managing these patients including the control of dysphagia and pain as well as nutritional support are discussed. Finally, we review data that support the importance of incorporating a multidisciplinary streamlined approach in the management of these patients.
  
  
  
  Rather than having patients see each provider separately, a multidisciplinary approach to esophageal cancer allows for the seamless flow of communication and proactive management of the patient's symptoms. These benefits include increasing the likelihood of evidence-based decision making, shorter time to treatment, and increased patient quality of life, all of which can result in improved patient outcomes.
  
  
  
  The use of a multidisciplinary team can lead to a more accurate staging paradigm and thereby, better management decisions that translate to improved clinical outcomes. Therefore, optimizing the multidisciplinary approach for the care of patients with locally advanced esophageal cancer is essential for successful and individualized patient care.
authors.affiliation: Department of Hematology and Oncology, The University of North Carolina, 170 Manning Drive, CB #7305, Chapel Hill, NC, 27599, USA.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Joseph
authors.affiliation: Department of Surgery, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Shachar
authors.initials: S
authors.lastname: Laks
authors.affiliation: Department of Surgery, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Meyers
authors.affiliation: Department of Hematology and Oncology, The University of North Carolina, 170 Manning Drive, CB #7305, Chapel Hill, NC, 27599, USA. autumn_mcree@med.unc.edu.
authors.forename: Autumn J
authors.initials: AJ
authors.lastname: McRee
mesh_terms: D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy; D010819:Physician's Role; D066231:Surgeons