Key Points

• Patients with squamous cell cancers pose different problems than patients with adenocarcinomas of the esophagus.
• Staging methods have become more sophisticated, accurate, and refined. This is likely to impact on future treatment strategies.
• Versatility is required in the choice of surgical procedures.
• Low mortality rates after esophagectomy can be achieved in specialized centers, and a volume-outcome relationship is evident, although the complication rate remains substantial.
• Main controversies remain on the appropriate extent of lymphadenectomy and the relative roles of multimodality treatment strategies, such as combinations of chemotherapy, radiotherapy, immune checkpoint inhibitors, and surgery, in the management of esophageal cancer.
• Excellent long-term results are obtained in patients with early cancer, although diagnosis at this stage is unlikely except in countries where screening endoscopies are carried out.