Bridging the gap: how do we improve long-term survival of locally-advanced esophageal cancer patients?
Gastrointestinal and thoracic oncologists have long struggled with an ugly truth about esophageal cancers: as a whole, these cancers have an unfortunate tendency to progress and recur in the short- and medium-term. The most important predictor of this propensity is the presence of nodal metastases (1,2). It would follow that systemic intervention should be targeted to those patients who have residual nodal metastases identified on pathology after neoadjuvant treatment and resection. However, this has not been instituted on a wide scale due to a paucity of high-level evidence supporting such directed interventions (3).