Oesophageal cancer

Abstract Surgery has been the cornerstone of curative treatment for patients with locally advanced oesophageal cancer. Over the last decades, the addition of chemotherapy and radiotherapy to surgery has been extensively tested to improve survival outcomes. Several studies have shown that there is no clear benefit from adding neoadjuvant radiotherapy, adjuvant radiotherapy, or adjuvant chemotherapy without any preoperative chemotherapy to surgery. It has been shown that neoadjuvant or perioperative chemotherapy as well as neoadjuvant chemoradiotherapy improve survival outcomes when given in addition to surgery. For squamous cell carcinoma, neoadjuvant chemoradiotherapy followed by surgery has been widely adopted as the treatment standard. For adenocarcinoma, both perioperative chemotherapy and neoadjuvant chemoradiotherapy have shown to be effective and no clear advantage of one over the other has yet been reported. Patients for whom surgery is contraindicated can be treated curatively with definitive chemoradiotherapy. More recently, promising results have been reported for the use of targeted therapies to treat oesophageal cancer. In many countries, adjuvant nivolumab has been approved for treating patients with pathologically residual disease after neoadjuvant chemoradiotherapy and surgery. In future, organ preservation after a clinically complete response to neoadjuvant treatment could also become a new treatment option.