Definitive chemoradiotherapy and salvage esophagectomy for squamous cell carcinoma of the esophagus]

Surgical resection has widely accepted as the first-choice treatment for esophageal carcinoma in Japan, and it has improved the survival of patients with esophageal carcinoma during the past decades. However, the survival rate remains relatively poor compared with that of other gastrointestinal carcinomas. Physical handicaps after esophagectomy also cannot be ignored. Definitive chemoradiation has become an accepted treatment for esophageal carcinoma. Persistent or recurrent local disease is often the problem to be solved. In this case, selected patients with local failures can be salvaged by esophagectomy. In this paper we discuss recent improvements in definitive chemoradiotherapy and the definition of salvage esophagectomy. We also present our short-term results of a prospective phase II study of definitive chemoradiotherapy and salvage esophagectomy in patients with resectable squamous cell carcinoma of the esophagus.