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Originally published as Ann Surg Oncol Early Release 10.1245/ASO.2004.10.026 on June 14, 2004

Annals of Surgical Oncology 11:665-673 (2004)
© 2004 Society of Surgical Oncology
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ORIGINAL ARTICLES

Controversies in the Multimodality Management of Locally Advanced Esophageal Cancer: Evidence-Based Review of Surgery Alone and Combined-Modality Therapy

R. Iyer, MD, N. Wilkinson, MD, T. Demmy, MD and M. Javle, MD

From the Departments of Medical (RI, MJ) and Surgical (NW, TD) Oncology, Roswell Park Cancer Institute, Buffalo, New York.

Correspondence: Address correspondence and reprint requests to: Milind M. Javle, MD, Assistant Professor of Medicine, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263; Fax: 716-845-8008; E-mail: milind.javle{at}roswellpark.org

Most patients with esophageal cancer present with locoregional disease, and the optimal initial management is controversial. The current National Comprehensive Cancer Network (NCCN) practice guidelines support diverse treatment options for locoregional disease, including surgical resection alone, definitive chemoradiation therapy, and preoperative combined-modality (neoadjuvant/trimodality) therapy. Many cancer centers worldwide favor a neoadjuvant approach, although the evidence supporting this practice is inconsistent. A concise review of the literature is presented. The topics discussed do not necessarily reflect each author’s opinions or clinical practices.

Key Words: Chemoradiation • Chemotherapy • Esophageal cancer • Neoadjuvant therapy • Surgery




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