Combined Modality Therapy for Management of Esophageal Cancer: Current Approach Based on Experiences from East and West

Abstract

Human evolutionary genetic divergence and distinctive environmental exposures have contributed to the development of clinicopathologic variations of esophageal cancer in Eastern and Western countries. Different treatment strategies have derived from the disparate regional experiences. Treatment strategy is more standardized in the West. Trimodality treatment with neoadjuvant chemoradiation followed by surgery is widely accepted as the standard treatment of locally advanced esophageal adenocarcinoma and esophageal squamous cell carcinoma. Trimodality treatment has not been adopted in many Eastern countries, and standard treatment is neoadjuvant chemotherapy. Several randomized trials are ongoing that may alter the standard management of esophageal cancer worldwide.

Keywords: Definitive chemoradiation; Esophageal adenocarcinoma; Esophageal squamous cell carcinoma; Lymphadenectomy; Multimodality therapy.