[Treatment of esophageal cancer]

Esophageal cancer is usually detected in the advanced stage due to its anatomical characteristics. Recently, early esophageal cancers are detected more frequently with the nationwide screening of digestive tract cancer and development of new endoscopic technology in Korea. From the treatment view point, esophageal cancer can be categorized into early, locally advanced resectable, locally advanced unresectable, and metastatic esophageal cancer. Traditionally, surgery has been the mainstay of treatment for resectable esophageal cancer. However, endoscopic resection can be another therapeutic option in selected early esophageal cancer cases. Although most studies with preoperative chemoradiotherapy and subsequent surgery in locally advanced resectable cancer could not demonstrate definite survival benefit, many authorities prefer this multimodality approach to surgery alone. Best supportive care is always necessary for those with unresectable esophageal cancer, and palliation for dysphagia can be considered according to the patients' status. For the best management of esophageal cancer, the development of diagnostic method for more accurate staging should be followed.