A neoadjuvant approach to esophageal cancer

Patients with symptomatic esophageal cancer represent a significant challenge to the thoracic clinician, whether medical oncologist, surgeon, or radiation therapist. Historically, cure has been rare and palliation has been a more realistic goal. Surgery was often viewed as radical or risky as limited long-term survival was weighed against expected operative morbidity and mortality. Epidermoid tumors were minimally responsive to available chemotherapy. Primary radiotherapy achieved similar overall survival; however, recurrent dysphagia limited its palliative benefit.