Adjuvant treatment for esophageal cancer

Esophagectomy is the standard treatment for resectable esophageal cancer (EC). Recently, the prognosis of EC has gradually improved owing to the introduction of minimally invasive surgery, enhanced postoperative recovery, and perioperative nutritional treatment. However, more than half of the patients who undergo esophagectomy experience recurrence, even after curative esophagectomy. Once EC recurs, the prognosis for patients with recurrent EC is limited. Tumor cell metastasis is the most common cause of recurrence. Micrometastatic cells grow in unresectable regions after curative esophagectomy. Therefore, control of micrometastasis is necessary to prevent the recurrence of EC in the perioperative period. Perioperative adjuvant treatment has been introduced for various malignancies, including EC, to prevent recurrence due to micrometastasis. Since 1990, evidence has emerged regarding postoperative adjuvant treatment, preoperative adjuvant treatment, and perioperative adjuvant treatment for resectable EC. To optimize adjuvant treatment for resectable esophageal cancer, it is necessary to understand the characteristics of each approach before the introduction of adjuvant treatment for resectable esophageal cancer. This review summarizes the background, current status, and future perspectives of adjuvant therapy for resectable esophageal cancer.