Choices in treating carcinoma of the esophagus

A number of treatment regimens are now available for patients with esophageal carcinoma. They include several surgical procedures, chemotherapy and radiotherapy programs, either separate or combined, laser treatments, intubation and other palliative methods. Some of these programs are rigorous and are intended to be curative, others are purely palliative. Thus, each patient needs to be assessed by careful staging to select the most appropriate treatment. Analysis demonstrates that the factors principally and independently influencing prognosis are the depth of malignant penetration through the esophageal wall and the number of involved lymph nodes in addition to distal metastases. Modern staging techniques should be used to identify these prognostic factors preoperatively and at surgery before final decisions about treatment are made.