Prognostication for patients with esophageal cancer

The ability to predict both short-term and long-term outcome after esophagectomy for cancer is invaluable. It helps us to select the appropriate patients for esophagectomy, to modify surgical procedures or perioperative care to lessen the chance of adverse events, and to decide if neoadjuvant or adjuvant therapies are of value. Predictors of morbidity and mortality after esophagectomy can include many individual factors or their combinations in the form of mathematical scores. Long-term prognosis depends to a large extent on disease stage, but the surgeon can play a major role as well, by minimizing postoperative complications and by performing a R0 resection with extended lymphadenectomy. The accuracy of prediction is improving as technology advances and understanding of the disease becomes more thorough. Information gained should be used for better individualized patient care.