Surgery　has　been　taking　the　lead　of　treatment　for　esophageal　cancer　in　Japan.　Since　the　later　of　1990　chemoradiotherapy　for　esophageal　cancer　patients　has　become　popular　as　a　non-surgical　modality.　First　of　all,　chemoradiotherapy　was　applied　to　patients　with　highly　advanced　stage　(T4,　M1lym),　who　cannot　be　cured　by　surgery,　and　became　the　standard　treatment　modality　for　this　stage.　Then　chemoradiotherapy　has　been　applied　to　patients　with　early　stage　as　a　trial　based　on[he　remarkable　results　in　highly　advanced　stage.　The　result　of　the　JCOG　clinical　trial　showed　the　excellent　survival　equal　to　the　result　by　surgery　for　the　same　stage.　Therefore　a　randomized　controlled　trial　comparing　chemoradiotherapy　and　surgery　for　this　stage　is　ready　to　start.　Recently　the　group　of　active　medical　oncologists　has　been　applying chemoradiotherapy　to　the　middle　stage　patients(Stage　IIIII),　for　which　surgery　is　recognized　internationally　as　the　standard　modality　tor　esophageal　cancer　patients.　The　paradigm　shift　from　surgery　Io　nonsurgery　in　treatment　for　esophageal　cancer　induce　a　new　surgical　item,　salvage　surgery　following　the　failure　of　chemoradiotherapy　or　the　cancer　recurrence.

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