Neoadjuvant or adjuvant therapy for resectable esophageal cancer: is there a standard of care?

@article{Almhanna2013NeoadjuvantOA,
  title={Neoadjuvant or adjuvant therapy for resectable esophageal cancer: is there a standard of care?},
  author={Khaldoun Almhanna and Ravi Shridhar and Kenneth L. Meredith},
  journal={Cancer control : journal of the Moffitt Cancer Center},
  year={2013},
  volume={20 2},
  pages={
          89-96
        }
}
BACKGROUND Carcinoma of the esophagus is an aggressive and lethal disease with an increasing incidence worldwide. Despite changes in the treatment approach over the past two decades and even following complete resection, most patients will eventually relapse and die as a result of their disease. Several clinical trials evaluated different modalities in treating locally advanced esophageal cancer; however, because of stage migration and the changes in disease epidemiology, applying these trials… 
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What is the role of neoadjuvant chemotherapy, radiation, and adjuvant treatment in resectable esophageal cancer?
TLDR
In the authors' opinion, there is no longer any question as to whether induction therapy is appropriate for locally advanced esophageal cancer and the available evidence provided by large, prospective studies supports preoperative chemotherapy as opposed to surgery alone.
Locally Advanced Esophageal Carcinoma: Is There Still a Role of Surgery Alone Without Neoadjuvant Treatment?
TLDR
The results in the treatment of patients with locally advanced esophageal carcinoma undergoing primary TTE are comparable to the results reported for patients undergoing neoadjuvant chemo-radio-therapy followed by surgery in the pre-CROSS-study era.
Postoperative radiation in esophageal squamous cell carcinoma and target volume delineation
TLDR
The purpose of this review is to figure out the value of postoperative adjuvant therapy and address the disputes about target volume delineation according to published data, and provide suggestions on the optimization of the radiation field based on the major sites of relapse and the surgical non-clearance area.
Adjuvant chemotherapy and outcomes in esophageal carcinoma.
TLDR
The role of adjuvant chemotherapy following neoadjuvant chemoradiation and surgery in esophageal cancer is unclear and there were no significant differences in overall or recurrence-free survival between groups in either analysis.
Esophageal Cancer: Neoadjuvant and Adjuvant Therapy
TLDR
There is little evidence to support different treatment regimens for these two carcinomas in developed countries, and distinction on how the different histology should dictate treatment approach is not clear.
Esophageal cancer: A Review of epidemiology, pathogenesis, staging workup and treatment modalities.
TLDR
Tumor markers of esophageal cancer are an advancing area of research that could potentially lead to earlier diagnosis as well as playing a part in assessing tumor response to therapy.
Low- vs. High-Dose Neoadjuvant Radiation in Trimodality Treatment of Locally Advanced Esophageal Cancer
TLDR
Retrospective analysis of adults with non-metastatic esophageal cancer in the National Cancer Database (2004–2015) treated with neoadjuvant chemoradiotherapy supports the use of 41.4 Gy in patients with chemoradiation followed by esophagectomy, and indicates reduced perioperative mortality and superior overall survival with similar downstaging in locally advanced esophAGEal cancer.
Phase II study of neoadjuvant therapy with nab-paclitaxel and cisplatin followed by surgery in patients with locally advanced esophageal squamous cell carcinoma
TLDR
Weekly nab-paclitaxel with three-weekly cisplatin seems effective and safe as a neoadjuvant chemotherapy strategy for locally advanced ESCC and down-staged patients have favorable outcome.
Long term follow-up of a large patient population with stage 2 and 3 esophageal cancer
TLDR
Though five-year overall survival rates for esophageal cancer patients remain close to 20%, neoadjuvant chemoradiation may improve outcomes, and this large study with long follow-up demonstrates that patients can be selected for appropriate therapy.
Neoadjuvant chemotherapy with or without neoadjuvant radiotherapy compared with neoadjuvant chemoradiotherapy for esophageal cancer.
TLDR
Compared with NACR, the NAC ± NAR provided the same survival benefits but low post operation complication rate and in the future, it might be a choice for locally advanced ESCC.
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