Delayed Surgical Intervention After Induction Chemoradiotherapy for Esophageal Cancer

Like other solid cancers, the timing of surgery after neoadjuvant chemoradiotherapy is a controversial topic that is not yet well-established in patients with locally advanced esophageal cancer. Majority of the centers use 6 weeks as the cut-off, although there is no clear evidence base for this. Existing evidence has produced mixed results in identifying the ideal time to surgery (TTS) due to heterogeneity in patient characteristics, treatment regimens, limited follow-up, and a drastic change in the way patients have been managed in the recent decade. In this chapter, we summarize the evidence supporting 6–8 weeks as a potential guide to confer better pathological and survival outcomes, while acknowledging the need for further work to confirm this.