Trimodality Versus Surgery as Needed: Is Delayed or Salvage Esophagectomy Justified?

Abstract

For advanced carcinomas of the esophagus multimodal therapies consisting of neoadjuvant treatment with chemo- and/or radiation followed by surgical resection are the standard of care in western countries. Still unknown remains the question if clinical full responders to neoadjuvant treatment should receive an esophagectomy with all its perioperative risks as they could be pathological full responders potentially without further oncologic benefit. In this article we discuss the possible benefits and disadvantages of an organ sparing approach in comparison of the standard of care for patients with esophageal cancer.