Epidemiology and pathogenesis of esophageal cancer: management and its controversial results (review).

Esophageal cancer including squamous cell and adenocarcinoma is considered to be a serious malignancy with respect to prognosis and a fatal outcome in the great majority of cases. Epidemiological data define a certain geographical distribution and relate pathogenesis and aetiology to several chemical substances as well as to Barrett's esophagus and reflux. Surgery remains the standard treatment for localized disease and offers approximately a 10% 5-year survival. Radiation therapy and chemotherapy have been exploited during the last decades not only in advanced cases but also in addition to surgery in a combined modality, in order to increase the cure rate. The controversial results of trials dealing with the management of esophageal cancer are critically reviewed.