[Guidelines in therapy of esophageal carcinoma]

Tumor stage and tumor localization (suprabifurcal and infrabifurcal) are the two decisive criteria referred to in the surgical treatment of esophageal cancer. Complete tumor resection (R0 resection) is a prerequisite for curative efforts. The thoracic squamous cell tumors are adequately treated by an abdominothoracic resection with abdominal and mediastinal lymph node dissection. The transmediastinal approach does not meet the requirements of an oncological resection and is only indicated under special conditions. In contrast the distal adenocarcinomas (Barrett carcinoma) can be curatively resected by both surgical approaches, the transthoracic and the transmediastinal. Presently, an adjuvant therapy after R0 resection of esophageal cancer is not indicated outside of clinical studies. Neoadjuvant methods in case of a local advanced tumor are currently being clinically tested.