Key Points

• Multimodality therapy is an important component of curative-intent treatment of cancer of the esophagus. The evidence on the optimal preoperative management is controversial, with some authors advocating for neoadjuvant chemotherapy or perioperative chemotherapy and others advocating for concurrent chemotherapy and radiation therapy (CRT).
• There are compelling data that neoadjuvant CRT followed by surgery has a survival benefit compared with surgery alone for patients with locally advanced and/or node positive disease.
• There is level one evidence that adjuvant immunotherapy use following treatment with CRT for patients with non pathologic complete response improved disease free survival (DFS), whether this will translate into an overall survival benefit has yet to be determined.