RT Book, Section A1 Altorki, Nasser K. A1 Stiles, Brendon M. A2 Sugarbaker, David J. A2 Bueno, Raphael A2 Burt, Bryan M. A2 Groth, Shawn S. A2 Loor, Gabriel A2 Wolf, Andrea S. A2 Williams, Marcia A2 Adams, Ann SR Print(0) ID 1170406448 T1 Radical En Bloc Esophagectomy T2 Sugarbaker’s Adult Chest Surgery, 3e YR 2020 FD 2020 PB McGraw-Hill Education PP New York, NY SN 9781260026931 LK accesssurgery.mhmedical.com/content.aspx?aid=1170406448 RD 2024/10/09 AB Despite improvements in perioperative care, surgical techniques, and neoadjuvant therapy over the past decade, the prognosis of esophageal cancer remains poor. More than 95% of new patients diagnosed annually in the United States succumb to disease. Among the subset of patients resected with curative intent (R0 resection), the 5-year survival after transthoracic esophagectomy or transhiatal esophagectomy rarely exceeds 30% based on reports from large surgical series.1–4 The principal justification for these poor results is the finding that most patients develop metastatic disease and already may have disseminated disease at the time of diagnosis. A careful analysis of the patterns of failure after surgical resection also implicates inadequate locoregional control. The locoregional failure rates are unacceptably high after conventional surgical resection, ranging from 30% to 60%.5–8 Although the addition of preoperative therapy may reduce rates of local failure and improve survival (Cross trial), a meaningful improvement in the survival of patients with esophageal cancer is unlikely without adequate surgical resection of the primary disease.