Preface| Volume 32, ISSUE 4, Pxiii-xiv, November 2022

Overview of the Management of Esophageal Cancer

      Esophageal cancer surgery is an exciting, but challenging, part of thoracic surgery practice. The management of esophageal cancer requires thoughtful preoperative planning, technical oncologic resection, creativity in reconstruction, and meticulous postoperative care. It is also multidisciplinary, involving expertise from therapeutic endoscopists, medical and radiation oncologists, radiologists, and pathologists. Despite this, the thoracic surgeon maintains a central role for every patient from diagnosis to palliation. We envision this issue of Thoracic Surgery Clinics as an update on esophageal cancer for thoracic surgeons.
      Zyla and Kalimuthu start the issue by reviewing the pathologic condition of Barrett esophagus and esophageal adenocarcinoma and allow the reader to understand the pathologist’s perspective on the disease. With advances in sequencing technology, we have gained a deeper understanding of the genomic landscape of esophageal cancer. The future of esophageal cancer care will be in personalizing treatment based on tumor-specific markers. Jajosky and Fels Elliott review these advances and how this may ultimately impact clinical care.
      With increased survival data, esophageal cancer staging is evolving, and Marom reviews the latest staging system for esophageal cancer. The majority of resectable esophageal cancers require multimodality therapy, and the next three articles by Lewis and Lukovic, Abdelhakeem and Blum-Murphy, and Yang and Janjigian update us on adjuvant and neoadjuvant treatments, including immunotherapy.
      There have been significant advances in endoscopy and endoscopic therapy for gastrointestinal malignancies, and Dobashi and colleagues review endoscopic treatment and palliation options. Though the majority of cancers seen in the Western world are adenocarcinoma, squamous cell carcinoma does still exist, and Hsu and colleagues review lymphadenectomy as performed in the East.
      When the gastric conduit is not usable, colon and supercharged jejunal conduits need to be in the surgeon’s toolbox, and Sanchez and colleagues and Mohan and colleagues provide comprehensive reviews on the use of these conduits, respectively. Finally, Bonner and colleagues and Carroll and Devaud review the literature on common controversies, including the need for feeding tubes, clipping the thoracic duct, and how to treat Siewert II junctional tumors.
      We would like to thank all of the contributors and hope you enjoy this issue!