Abstract
Adjuvant therapy following surgery has been the mainstream in surgical adjuvant therapy in Japan. A randomized controlled trial (RCT) by the JEOG showed no significant differences in survivals between the surgery plus radiation group and the surgery plus chemotherapy (CDDP/VDS) group. The JEOG subsequent RCT also showed no significant differences in survivals between the surgery alone group which consisted of thoracotomy and laparotomy with three-field dissection and the surgery plus chemotherapy (CDDP/VDS) group. The JEOG subsequent RCT comparing surgery with and without chemotherapy (CDDP/5-FU) is now in the middle of the follow up period. Otherwise in western countries, neoadjuvant therapy, especially neoadjuvant chemotherapy or chemoradiotherapy has become popular from 1980's. However it is still uncertain whether neoadjuvant therapy offers the advantage on survival or not. Salvage surgery for the suspected T4 tumors has become to be available following downstaging by means of chemoradiotherapy and to be possible new strategy for far advanced esophageal cancer.
