Selecting the surgical approach to cancer of the esophagus.

Surgical treatment of cancer of the esophagus is influenced by two issues: use of surgical resection within a multimodality treatment approach and selection of the correct surgical approach. Selecting the correct surgical approach should be individualized and determined by the intent of surgery (curative or palliative), the anatomic location of the tumor (cervical or thoracic), the preferred method of reconstruction (colonic interposition or gastric pull-up), and whether surgery is the only therapeutic modality to be used or will be combined with neoadjuvant chemotherapy and/or radiotherapy. A discussion of the efficacy of treatment within a multimodality setting and a description of the surgical approach follow.