Surgery in Esophageal Cancer: How Radical Should It Be

The extent of resection for esophageal cancer is a subject of much debate. What clinical evidence there is would indicate that relatively early-stage disease would benefit more from orthodox cancer surgery than more advanced disease. However, no resolution of these arguments is likely unless randomized controlled trials are performed in single centers with a sufficient number of patients and with surgeons who are willing and able to perform different operations with equal skill. Surgery alone, when applied optimally, is the single most effective modality of treatment for cure or palliation. Only when the best results of surgery are achieved can the added value of adjuvant treatment be beneficial and evaluable.