Most patients with esophageal cancer are diagnosed with locoregionally advanced disease at presentation, with an overall 5-year survival rate of 19%. 1 Clinical trials have failed to specify the optimal treatment regimen; however, a multimodal approach to therapy is considered the standard of care for patients with locoregionally advanced disease. 2 Most often, patients are treated with chemoradiotherapy with or without subsequent esophagectomy. Curative-intent interventions for advanced esophageal cancer are necessarily aggressive and may be associated with significant morbidity and even treatment-related mortality. Appropriate selection of patients for intervention is necessary so that those who are most likely to benefit can initiate curative-intent therapy, whereas those who are unlikely to benefit from intervention may be appropriately initiated on less toxic palliative-intent treatment. The use of positron emission tomography (PET) in esophageal cancer staging has improved the ability to detect distant disease at diagnosis, 3-7 an important factor in determining the appropriate treatment regimen and prognosis…
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