We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

Trends in Management and Prognosis for Esophageal Cancer—Invited Critique

David W. McFadden, MD
Arch Surg. 2009;144(3):254. doi:10.1001/archsurg.2008.560.
Text Size: A A A
Published online


The review by Ruol et al of data from nearly 3500 patients with esophageal cancer treated at the University of Padova during a 25-year period confirms much of our current understanding of esophageal cancer. There have been changes in tumor location (proximal to distal) and histological type (squamous cell carcinoma to adenocarcinoma), enhanced multidisciplinary treatment algorithms, and improved surgical mortality and overall survival rates. According to Ruol et al, most of their patients, even in the most recent time period from 1996-2004, had squamous cell carcinoma. In addition, most patients were treated with thoracotomy-based resections, and, enviably, more than 70% of patients had 15 or more lymph nodes resected. Increasing use of preoperative chemoradiotherapy was temporally associated with increased R0 resection and long-term survival rates. The authors comment that a history of Barrett esophagus was disclosed in less than 30% of patients with adenocarcinoma, data that may lead to improved use of screening endoscopy in their population. They do not comment on the presence of Barrett epithelium in the resected specimens.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles