Current trends in surgical treatment of esophageal cancer

Esophagectomy with cervical, mediastinal and abdominal lymph-node dissection has contributed to the improved survival of patients with esophageal cancer. However, surgery alone cannot provide more satisfactory survival, and new strategies are needed to progress survival. For patients in the advanced stage, combined therapy, such as chemoradiation followed by surgery, is attempted to improve their survival. Three-field lymph node dissection causes a huge surgical stress and it is not necessary for all patients. The optimal fields for lymph-node dissection should be selected according to the depth of the tumor invasion and the location of the primary lesion. Thoracoscopic and/or laparoscopic methods have been adopted over recent years adopted to reduce surgical stress.