Skip to main content

Advertisement

SpringerLink
Log in

Should Multidisciplinary Treatment Differ for Esophageal Adenocarcinoma Versus Esophageal Squamous Cell Cancer?

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Current treatment of locally advanced esophageal cancers (ECs) centres on a multimodal approach regardless of histology. While surgery remains the mainstay of curative intent therapy, its implementation alone results in suboptimal outcomes, which have improved significantly with the increased utilization of induction regimens comprising of concurrent chemoradiation (CRT) or chemotherapy alone followed by surgery. Due in large part to the positive results of the CROSS trial, neoadjuvant CRT has become the predominant standard applied in the West. However, the bulk of the data published to date suggests that a more nuanced approach to the management of locally advanced EC is required with respect to the application of radiation, which related to the differential sensitivity of esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (SCC) to radiation. While the latter demonstrates excellent radiosensitivity, which has translated into improved survival outcomes, the same cannot be said for patients with EAC who may be subject to greater toxicity without any benefit. Herein, the differential effectiveness of CRT in patients with EAC versus SCC is highlighted, with a focus on the randomized evidence to date.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013; 49(6):1374–403.

    Article  CAS  Google Scholar 

  2. Schonnemann KR, Mortensen MB, Bjerregaard JK, Fristrup C, Pfeiffer P. Characteristics, therapy and outcome in an unselected and prospectively registered cohort of patients with gastro-oesophageal cancer. Acta Oncol. 2014; 53(3):385–91.

    Article  CAS  Google Scholar 

  3. Parry K, Haverkamp L, Bruijnen RC, Siersema PD, Offerhaus GJ, Ruurda JP, et al. Staging of adenocarcinoma of the gastroesophageal junction. Eur J Surg Oncol. 2016; 42(3):400–06.

    Article  CAS  Google Scholar 

  4. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006; 355(1):11–20.

    Article  CAS  Google Scholar 

  5. Shapiro J, van Hagen P, Lingsma HF, Wijnhoven BP, Biermann K, ten Kate FJ, et al. Prolonged time to surgery after neoadjuvant chemoradiotherapy increases histopathological response without affecting survival in patients with esophageal or junctional cancer. Ann Surg. 2014; 260(5):807–13 (discussion 813-804).

  6. Smit JK, Güler S, Beukema JC, Mul VE, Burgerhof JG, Hospers GA, et al. Different recurrence pattern after neoadjuvant chemoradiotherapy compared to surgery alone in esophageal cancer patients. Ann Surg Oncol. 2013; 20(12):4008–15.

    Article  Google Scholar 

  7. Walsh TN, Noonan N, Hollywood D, Kelly A, Keeling N, Hennessy TP. A comparison of multimodal therapy and surgery for esophageal adenocarcinoma. N Engl J Med. 1996; 335(7):462–7.

    Article  CAS  Google Scholar 

  8. Kelsen DP, Ginsberg R, Pajak TF, Sheahan DG, Gunderson L, Mortimer J, et al. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med. 1998; 339(27):1979–84.

    Article  CAS  Google Scholar 

  9. Medical Research Council Oesophageal Cancer Working Group. Surgical resection with or without preoperative chemotherapy in oesophageal cancer: a randomised controlled trial. Lancet. 2002; 359(9319):1727–33.

    Article  Google Scholar 

  10. Klevebro F, von Döbeln GA, Wang N, Johnsen G, Jacobsen AB, Friesland S, et al. A randomized clinical trial of neoadjuvant chemotherapy versus neoadjuvant chemoradiotherapy for cancer of the oesophagus or gastro-oesophageal junction. Ann Oncol. 2016; 27(4):660–7.

    Article  CAS  Google Scholar 

  11. Bedenne L, Michel P, Bouché O, Milan C, Mariette C, Conroy T, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol. 2007; 25(10):1160–8.

    Article  CAS  Google Scholar 

  12. Law S, Wong KH, Kwok KF, Chu KM, Wong J. Predictive factors for postoperative pulmonary complications and mortality after esophagectomy for cancer. Ann Surg. 2004; 240(5):791–800.

    Article  Google Scholar 

  13. Bosset JF, Gignoux M, Triboulet JP, Tiret E, Mantion G, Elias D, et al. Chemoradiotherapy followed by surgery compared with surgery alone in squamous-cell cancer of the esophagus. N Engl J Med. 1997; 337(3):161–7.

    Article  CAS  Google Scholar 

  14. Cancer Genome Atlas Research Network, et al. Integrated genomic characterization of oesophageal carcinoma. Nature. 2017; 541(7636):169–75.

  15. Mariette C, Taillier G, Van Seuningen I, Triboulet JP. Factors affecting postoperative course and survival after en bloc resection for esophageal carcinoma. Ann Thorac Surg. 2004; 78(4):1177–83.

    Article  Google Scholar 

  16. Ferri LE, Ades S, Alcindor T, Chasen M, Marcus V, Hickeson M, et al. Perioperative docetaxel, cisplatin, and 5-fluorouracil (DCF) for locally advanced esophageal and gastric adenocarcinoma: a multicenter phase II trial. Ann Oncol. 2012; 23(6):1512–7.

    Article  CAS  Google Scholar 

  17. Schulz C, Kullmann F, Kunzmann V, Fuchs M, Geissler M, Vehling‐Kaiser U, et al. NeoFLOT: Multicenter phase II study of perioperative chemotherapy in resectable adenocarcinoma of the gastroesophageal junction or gastric adenocarcinoma: very good response predominantly in patients with intestinal type tumors. Int J Cancer. 2015; 137(3):678–85.

    Article  CAS  Google Scholar 

  18. Shapiro J, Van Lanschot JJ, Hulshof MC, van Hagen P, van Berge Henegouwen MI, Wijnhoven BP, et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol. 2015; 16(9):1090–8.

    Article  Google Scholar 

  19. Ohnuma H, Sato Y, Hayasaka N, Matsuno T, Fujita C, Sato M, et al. Neoadjuvant chemotherapy with docetaxel, nedaplatin, and fluorouracil for resectable esophageal cancer: A phase II study. Cancer Sci. 2018; 109(11):3554–63.

    Article  CAS  Google Scholar 

  20. Minsky BD, Pajak TF, Ginsberg RJ, Pisansky TM, Martenson J, Komaki R, et al. INT 0123 (Radiation Therapy Oncology Group 94-05) phase III trial of combined-modality therapy for esophageal cancer: high-dose versus standard-dose radiation therapy. J Clin Oncol. 2002; 20(5):1167–74.

    Article  CAS  Google Scholar 

  21. Kelsen DP, Winter KA, Gunderson LL, Mortimer J, Estes NC, Haller DG, et al. Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol. 2007;25(24):3719–25.

    Article  Google Scholar 

  22. Mariette C, Dahan L, Mornex F, Maillard E, Thomas PA, Meunier B, et al. Surgery alone versus chemoradiotherapy followed by surgery for stage I and II esophageal cancer: final analysis of randomized controlled phase III trial FFCD 9901. J Clin Oncol. 2014; 32(23):2416–22.

    Article  CAS  Google Scholar 

  23. Keegan N, Keane F, Cuffe S, Cunningham M, Ravi N, Lee G, et al. ICORG 10-14: Neo-AEGIS: A randomized clinical trial of neoadjuvant and adjuvant chemotherapy (modified MAGIC regimen) versus neoadjuvant chemoradiation (CROSS protocol) in adenocarcinoma of the esophagus and esophagogastric junction. J Clin Oncol. 2014; 32(5 Suppl).

  24. Leong T, Smithers BM, Michael M, Gebski V, Boussioutas A, Miller D, et al. TOPGEAR: a randomised phase III trial of perioperative ECF chemotherapy versus preoperative chemoradiation plus perioperative ECF chemotherapy for resectable gastric cancer (an international, intergroup trial of the AGITG/TROG/EORTC/NCIC CTG). BMC Cancer. 2015;15:532.

    Article  Google Scholar 

  25. Ku GY, Kriplani A, Janjigian YY, Kelsen DP, Rusch VW, Bains M, et al. Change in chemotherapy during concurrent radiation followed by surgery after a suboptimal positron emission tomography response to induction chemotherapy improves outcomes for locally advanced esophageal adenocarcinoma. Cancer. 2016;122(13):2083–90.

    Article  Google Scholar 

  26. Matsuda S, Takeuchi H, Kawakubo H, Ando N, Kitagawa Y. Current Advancement in Multidisciplinary Treatment for Resectable cStage II/III Esophageal Squamous Cell Carcinoma in Japan. Ann Thorac Cardiovasc Surg. 2016;22(5):275–83.

    Article  Google Scholar 

  27. Ma GW, Situ DR, Ma QL, Long H, Zhang LJ, Lin P, et al. Three-field vs two-field lymph node dissection for esophageal cancer: a meta-analysis. World J Gastroenterol. 2014;20(47):18022–30.

    Article  Google Scholar 

  28. Udagawa H, Ueno M, Shinohara H, Haruta S, Kaida S, Nakagawa M, et al. The importance of grouping of lymph node stations and rationale of three-field lymphoadenectomy for thoracic esophageal cancer. J Surg Oncol. 2012;106(6):742–7.

    Article  Google Scholar 

  29. Lerut T, Nafteux P, Moons J, Coosemans W, Decker G, De Leyn P, et al. Three-field lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resections: impact on staging, disease-free survival, and outcome: a plea for adaptation of TNM classification in upper-half esophageal carcinoma. Ann Surg. 2004; 240(6):962–72 (discussion 972–964).

  30. Pedrazzani C, de Manzoni G, Marrelli D, Giacopuzzi S, Corso G, Minicozzi AM, et al. Lymph node involvement in advanced gastroesophageal junction adenocarcinoma. J Thorac Cardiovasc Surg. 2007; 134(2):378–85.

    Article  Google Scholar 

  31. Leers JM, DeMeester SR, Chan N, Ayazi S, Oezcelik A, Abate E, et al. Clinical characteristics, biologic behavior, and survival after esophagectomy are similar for adenocarcinoma of the gastroesophageal junction and the distal esophagus. J Thorac Cardiovasc Surg. 2009;138(3):594–602 (discussion 601–592).

  32. Yabusaki H, Nashimoto A, Matsuki A, Aizawa M. Comparison of the surgical treatment strategies for Siewert type II squamous cell carcinoma in the same area as esophagogastric junction carcinoma: data from a single Japanese high-volume cancer center. Surg Today. 2014;44(8):1522–8.

    Article  Google Scholar 

  33. Kurokawa Y, Hiki N, Yoshikawa T, Kishi K, Ito Y, Ohi M, et al. Mediastinal lymph node metastasis and recurrence in adenocarcinoma of the esophagogastric junction. Surgery. 2015;157(3):551–5.

    Article  Google Scholar 

  34. Yamashita H, Seto Y, Sano T, Makuuchi H, Ando N, Sasako M. Results of a nation-wide retrospective study of lymphadenectomy for esophagogastric junction carcinoma. Gastric Cancer. 2017;20(Suppl 1):69–83.

    Article  CAS  Google Scholar 

  35. Hashimoto T, Kurokawa Y, Mori M, Doki Y. Surgical Treatment of Gastroesophageal Junction Cancer. J Gastric Cancer. 2018;18(3):209–17.

    Article  Google Scholar 

  36. Smyth EC, Lagergren J, Fitzgerald RC, Lordick F, Shah MA, Lagergren P, et al. Oesophageal cancer. Nat Rev Dis Primers. 2017;3:17048.

    Article  Google Scholar 

  37. Robb WB, Messager M, Dahan L, Mornex F, Maillard E, D’journo XB, et al. Patterns of recurrence in early-stage oesophageal cancer after chemoradiotherapy and surgery compared with surgery alone. Br J Surg. 2016;103(1):117–25.

    Article  CAS  Google Scholar 

  38. Xi M, Xu C, Liao Z, Hofstetter WL, Murphy MB, Maru DM, et al. The impact of histology on recurrence patterns in esophageal cancer treated with definitive chemoradiotherapy. Radiother Oncol. 2017; 124(2):318-324.

    Article  Google Scholar 

  39. Sudarshan M, Alcindor T, Ades S, Aloraini A, van Huyse M, Asselah J, et al. Survival and recurrence patterns after neoadjuvant docetaxel, cisplatin, and 5-fluorouracil (DCF) for locally advanced esophagogastric adenocarcinoma. Ann Surg Oncol. 2015; 22(1):324–30.

    Article  Google Scholar 

  40. Miyazaki T, Ojima H, Fukuchi M, Sakai M, Sohda M, Tanaka N, et al. Phase II study of docetaxel, nedaplatin, and 5-fluorouracil combined chemotherapy for advanced esophageal cancer. Ann Surg Oncol. 2015; 22(11):3653–8.

    Article  Google Scholar 

  41. Al-Batran SE, Hofheinz RD, Pauligk C, Kopp HG, Haag GM, Luley KB, et al. Histopathological regression after neoadjuvant docetaxel, oxaliplatin, fluorouracil, and leucovorin versus epirubicin, cisplatin, and fluorouracil or capecitabine in patients with resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4-AIO): results from the phase 2 part of a multicentre, open-label, randomised phase 2/3 trial. Lancet Oncol. 2016;17(12):1697–708.

    Article  CAS  Google Scholar 

  42. Ando N, Iizuka T, Kakegawa T, Isono K, Watanabe H, Ide H, et al. A randomized trial of surgery with and without chemotherapy for localized squamous carcinoma of the thoracic esophagus: the Japan Clinical Oncology Group Study. J Thorac Cardiovasc Surg. 1997;114(2):205–9.

    Article  CAS  Google Scholar 

  43. Ando N, Iizuka T, Ide H, Ishida K, Shinoda M, Nishimaki T,, et al. Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus: a Japan Clinical Oncology Group Study–JCOG9204. J Clin Oncol. 2003;21(24):4592–6.

    Article  Google Scholar 

  44. Ando N, Kato H, Igaki H, Shinoda M, Ozawa S, Shimizu H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19(1):68–74.

    Article  Google Scholar 

  45. Lin D, Leichman L. The current status of neoadjuvant therapy for esophageal cancer. Semin Thorac Cardiovasc Surg. 2014;26(2):102–9.

    Article  Google Scholar 

  46. Mariette C, Piessen G, Lamblin A, Mirabel X, Adenis A, Triboulet JP, et al. Impact of preoperative radiochemotherapy on postoperative course and survival in patients with locally advanced squamous cell oesophageal carcinoma. Br J Surg. 2006;93(9):1077–83.

    Article  CAS  Google Scholar 

  47. Schlag PM. Randomized trial of preoperative chemotherapy for squamous cell cancer of the esophagus. The Chirurgische Arbeitsgemeinschaft Fuer Onkologie der Deutschen Gesellschaft Fuer Chirurgie Study Group. Arch Surg. 1992;127(12):1446–50.

  48. Law S, Fok M, Chow S, Chu KM, Wong J. Preoperative chemotherapy versus surgical therapy alone for squamous cell carcinoma of the esophagus: a prospective randomized trial. J Thorac Cardiovasc Surg. 1997;114(2):210–7.

    Article  CAS  Google Scholar 

  49. Ancona E, Ruol A, Santi S, Merigliano S, Chiarion Sileni V, Koussis H, et al. Only pathologic complete response to neoadjuvant chemotherapy improves significantly the long term survival of patients with resectable esophageal squamous cell carcinoma: final report of a randomized, controlled trial of preoperative chemotherapy versus surgery alone. Cancer. 2001;91(11):2165–74.

    Article  CAS  Google Scholar 

  50. Boonstra JJ, Kok TC, Wijnhoven BP, van Heijl M, van Berge Henegouwen MI, ten Kate FJ, et al. Chemotherapy followed by surgery versus surgery alone in patients with resectable oesophageal squamous cell carcinoma: long-term results of a randomized controlled trial. BMC Cancer. 2011;11:181.

    Article  CAS  Google Scholar 

  51. Ychou M, Boige V, Pignon JP, Conroy T, Bouché O, Lebreton G, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol Off J Am Soc Clin Oncol. 2011;29(13):1715–21.

    Article  CAS  Google Scholar 

  52. Kelsen DP, Winter KA, Gunderson LL, Mortimer J, Estes NC, Haller DG, et al. Long-term results of RTOG trial 8911 (USA Intergroup 113): a random assignment trial comparison of chemotherapy followed by surgery compared with surgery alone for esophageal cancer. J Clin Oncol. 2007;25(24):3719–25.

    Article  Google Scholar 

  53. Alderson D, Cunningham D, Nankivell M, Blazeby JM, Griffin SM, Crellin A, et al. Neoadjuvant cisplatin and fluorouracil versus epirubicin, cisplatin, and capecitabine followed by resection in patients with oesophageal adenocarcinoma (UK MRC OE05): an open-label, randomised phase 3 trial. Lancet Oncol. 2017;18(9):1249–60.

    Article  CAS  Google Scholar 

  54. Al-Batran SE, Homann N, Schmalenberg H, Kopp HG, Haag GM, Luley KB, et al. Perioperative chemotherapy with docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) versus epirubicin, cisplatin, and fluorouracil or capecitabine (ECF/ECX) for resectable gastric or gastroesophageal junction (GEJ) adenocarcinoma (FLOT4-AIO): A multicenter, randomized phase 3 trial. J Clin Oncol. 2017;35(15 Suppl):4004.

    Article  Google Scholar 

  55. Nygaard K, Hagen S, Hansen HS, Hatlevoll R, Hultborn R, Jakobsen A, et al. Pre-operative radiotherapy prolongs survival in operable esophageal carcinoma: a randomized, multicenter study of pre-operative radiotherapy and chemotherapy. The second Scandinavian trial in esophageal cancer. World J Surg. 1992;16(6):1104–9 (discussion 1110).

  56. Le Prise E, Etienne PL, Meunier B, Maddern G, Hassel MB, Gedouin D, et al. A randomized study of chemotherapy, radiation therapy, and surgery versus surgery for localized squamous cell carcinoma of the esophagus. Cancer. 1994;73(7):1779–84.

    Article  Google Scholar 

  57. Cao XF, He XT, Ji L, Xiao J, Lv J. Effects of neoadjuvant radiochemotherapy on pathological staging and prognosis for locally advanced esophageal squamous cell carcinoma. Dis Esophagus. 2009;22(6):477–81.

    Article  Google Scholar 

  58. Lv J, Cao XF, Zhu B, Ji L, Tao L, Wang DD. Long-term efficacy of perioperative chemoradiotherapy on esophageal squamous cell carcinoma. World J Gastroenterol. 2010;16(13):1649–54.

    Article  CAS  Google Scholar 

  59. Urba SG, Orringer MB, Turrisi A, Iannettoni M, Forastiere A, Strawderman M. Randomized trial of preoperative chemoradiation versus surgery alone in patients with locoregional esophageal carcinoma. J Clin Oncol. 2001;19(2):305–13.

    Article  CAS  Google Scholar 

  60. Burmeister BH, Smithers BM, Gebski V, Fitzgerald L, Simes RJ, Devitt P, et al. Surgery alone versus chemoradiotherapy followed by surgery for resectable cancer of the oesophagus: a randomised controlled phase III trial. Lancet Oncol. 2005;6(9):659–68.

    Article  Google Scholar 

  61. van Hagen P, Hulshof MC, Van Lanschot JJ, Steyerberg EW, Henegouwen MV, Wijnhoven BP, et al. Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med. 2012;366(22):2074–84.

    Article  Google Scholar 

  62. Bass GA, Furlong H, O’Sullivan KE, Hennessy TP, Walsh TN. Chemoradiotherapy, with adjuvant surgery for local control, confers a durable survival advantage in adenocarcinoma and squamous cell carcinoma of the oesophagus. Eur J Cancer. 2014;50(6):1065–75.

    Article  CAS  Google Scholar 

  63. Bosset JF, Mercier M, Triboulet JP, Conroy T, Seitz JF. Surgical resection with and without chemotherapy in oesophageal cancer. Lancet. 2002;360(9340):1173–4 (author reply 1175).

  64. Nakamura K, Kato K, Igaki H, Ito Y, Mizusawa J, Ando N, et al. Three-arm phase III trial comparing cisplatin plus 5-FU (CF) versus docetaxel, cisplatin plus 5-FU (DCF) versus radiotherapy with CF (CF-RT) as preoperative therapy for locally advanced esophageal cancer (JCOG1109, NExT study). Jpn J Clin Oncol. 2013;43(7):752–5.

    Article  Google Scholar 

  65. Reynolds JV, Preston SR, O’neill B, Baeksgaard L, Griffin SM, Mariette C, et al. ICORG 10-14: NEOadjuvant trial in Adenocarcinoma of the oEsophagus and oesophagoGastric junction International Study (Neo-AEGIS). BMC Cancer. 2017;17(1):401.

    Article  CAS  Google Scholar 

  66. Stahl M, Walz MK, Stuschke M, Lehmann N, Meyer HJ, Riera-Knorrenschild J, et al. Phase III comparison of preoperative chemotherapy compared with chemoradiotherapy in patients with locally advanced adenocarcinoma of the esophagogastric junction. J Clin Oncol. 2009;27(6):851–6.

    Article  CAS  Google Scholar 

  67. Burmeister BH, Thomas JM, Burmeister EA, Walpole ET, Harvey JA, Thomson DB, et al. Is concurrent radiation therapy required in patients receiving preoperative chemotherapy for adenocarcinoma of the oesophagus? A randomised phase II trial. Eur J Cancer. 2011;47(3):354–360.

    Article  Google Scholar 

  68. Deng HY, Wang WP, Wang YC, Hu WP, Ni PZ, Lin YD, et al. Neoadjuvant chemoradiotherapy or chemotherapy? A comprehensive systematic review and meta-analysis of the options for neoadjuvant therapy for treating oesophageal cancer. Eur J Cardiothorac Surg. 2017;51(3):421–31.

    PubMed  Google Scholar 

  69. Wijnhoven BP, van Lanschot JJ, Tilanus HW, Steyerberg EW, van der Gaast A. Neoadjuvant chemoradiotherapy for esophageal cancer: a review of meta-analyses. World J Surg. 2009;33(12):2606–14.

    Article  Google Scholar 

  70. Klevebro F, Friesland S, Hedman M, Tsai JA, Lindblad M, Rouvelas I, et al. Neoadjuvant chemoradiotherapy may increase the risk of severe anastomotic complications after esophagectomy with cervical anastomosis. Langenbecks Arch Surg. 2016;401(3):323–31.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Thoracic Surgery, McGill University, Montreal, QC, Canada

    Jonathan Cools-Lartigue MD, PhD & Lorenzo Ferri MD, PhD

Authors
  1. Jonathan Cools-Lartigue MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lorenzo Ferri MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lorenzo Ferri MD, PhD.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cools-Lartigue, J., Ferri, L. Should Multidisciplinary Treatment Differ for Esophageal Adenocarcinoma Versus Esophageal Squamous Cell Cancer?. Ann Surg Oncol 26, 1014–1027 (2019). https://doi.org/10.1245/s10434-019-07162-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-019-07162-9

Search

Navigation