Oesophageal cancer treatment

Surgery for oesophageal cancer is the treatment of choice because it offers superior quality of swallowing and a chance of cure. In experienced hands, resection can now be carried out with low morbidity and mortality. The choice of operation depends on the tumour stage and the risk of major surgery in individual patients. The efficacy of new procedures, such as video-assisted endoscopic resection or ultra-radical three-field lymphadenectomy, is under evaluation. Multimodal therapy has a promising role in selected patients with oesophageal cancer, but definitive results can only come from prospective randomized studies. More precise identification of risk factors for anastomotic failure should further reduce technique-related morbidity and mortality, and thereby improve the quality of survival.