Testing the waters of adjuvant chemotherapy after esophagectomy

Esophageal cancer continues to be associated with a high mortality rate despite significant advances in the therapeutic treatment over the past 15 years; in patients with resectable tumors, a 15–25% rate of 5-year overall survival (OS) has been reported (1). Multimodality therapy has been demonstrated to be beneficial in improving survival for patients with locally advanced disease. Options include chemotherapy and radiation, either alone or in combination, administered before or after esophagectomy. When considering the utility of adjuvant chemotherapy (aCT) in esophageal cancer, it is important to understand current areas of debate pertaining to multimodality therapy.