Organ Sparing Therapy for Locally Advanced Esophageal Cancer

Whether resection as part of planned multimodality therapy is necessary for patients who experience a complete clinical response after induction therapy is unknown. There are few studies on outcomes after organ sparing strategies for locally advanced esophageal cancer, i.e. definitive chemoradiotherapy followed by salvage esophagectomy and neoadjuvant chemoradiotherapy followed by active surveillance. A review of the data reveals potential benefit to sparing patients esophagectomy who have a complete clinical response after induction therapy, albeit with increased surgical risk if higher doses of radiation therapy are administered as part of a curative bimodality strategy.