Multimodality therapy of esophageal cancer: an update

The incidence of adenocarcinoma of the esophagus is rapidly increasing in Western countries, particularly in Caucasian men. Both squamous cell carcinoma and adenocarcinoma are equally virulent tumors. In the absence of effective prevention and screening programs, most Western patients are found to have locally advanced or metastatic disease at the time of diagnosis. The outcome with regional therapy alone (either surgery or radiation) is poor. Multimodality therapy--treatment plans which include both systemic and regional treatments-is the focus of intense study. This review will summarize the current status of several different approaches that have the goal of increasing the cure rate in patients with newly diagnosed esophageal cancers.