Esophageal cancer.

Esophageal cancer is a disease of the developing nations worldwide, and it is associated with nutritional deficiencies and exposure to tobacco and alcohol. In the West, the epidemiology is changing with an unexplained increase in adenocarcinoma of the distal esophagus and gastroesophageal junction, whereas rates for squamous cell carcinoma remain stable. Advances in our understanding of the epidemiology and molecular biology of this disease are being translated into clinical applications in screening and prognosis. Combined-modality therapy with chemotherapy, radiation therapy, and surgery appears promising for improving long-term and disease-free survival. The optimum combinations of modalities and best surgical procedures await to be defined in controlled clinical trials. This article uses the recent literature to illustrate our evolving knowledge of the basic biology and clinical management of esophageal cancer.