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 the appropriate extent of lymphadenectomy and the relative roles of multimodality treatment strategies, such as chemoradiotherapy 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 high-incidence areas such as China, where selected screenings are carried out.