Surgical management of esophageal cancer

Esophageal cancer (EC) is an aggressive malignancy associated with an overall poor prognosis. The specific risk factors for EC vary by histologic type as well as geographic distribution but there is no widely applicable screening strategy to date. Patients can present with vague symptoms which can prove to be a diagnostic challenge. Furthermore, cases tend to present at a late stage, making therapeutic approach difficult. Despite ongoing changes in management strategy, surgery remains the only viable option for cure in early stage malignancy. Advances in operative and peri-operative management have led to a relatively safe and efficacious procedure that provides durable therapy. Additionally, careful consideration of procedure specific factors can help maximize patient benefit. This review focuses on the surgical approaches to the management of EC and highlights select current trends and recent advances.