Esophageal carcinoma: matching patients with treatment methods

[...] a high incidence of lymph node involvement may be due to the extensive lymphatic drainage found in the lamina propria and muscularis mucosa deep to the basement membrane, which makes the esophagus unique among the gastrointestinal hollow viscus organs.3 Additionally, patients may develop cancer before they develop cancer-specific symptoms, often producing a long lead time between the onset of cancer and tissue diagnosis. There was no improvement in overall 5-year survival rates in subjects who underwent adjuvant chemotherapy with no nodal involvement.4 Definitive chemoradiotherapy in locally advanced esophageal cancer has curative potential, but the rates of local recurrence and metastatic disease can be high with this treatment, with a local recurrence rate of approximately 50%.7 Surgery Surgical resection is the treatment of choice for early-stage esophageal cancer (stages 0 and I) and is chosen based on the extent and location of the lesion.8 Stages I and II cancers are usually treated with surgery alone or followed by subsequent chemoradiation and/or radiation.