Esophageal cancer is characterized by early and frequent metastasis. Surgery is the primary treatment for early-stage disease, whereas patients with patients with locally advanced disease receive perioperative chemotherapy or chemoradiotherapy. Squamous cancers can be treated with primary chemoradiotherapy without surgery, depending on their response to therapy and patient tolerance for subsequent surgery. Chemotherapy with a fluorinated pyrimidine and a platinum agent, followed by later treatment with taxanes and irinotecan, provides some benefit. Agents that inhibit the erb-b2 receptor tyrosine kinase 2 (ERBB2 or HER2), or vascular endothelial growth factor, including trastuzumab, ramucirumab, and apatinib, increase response and survival times. Esophageal adenocarcinomas have mutations in tumor protein p53 and mutations that activate receptor-associated tyrosine kinase, vascular endothelial growth factor, and cell cycle pathways, whereas esophageal squamous tumors have a distinct set of mutations. Esophageal cancers develop systems to evade anti-tumor immune responses, but studies are needed to determine how immune checkpoint modification contributes to esophageal tumor development.

食道癌的特征是早期和频繁转移。手术是早期疾病的主要治疗方法，而患有局部晚期疾病的患者则接受围手术期化疗或放化疗。鳞癌可以通过不接受手术的原发放化疗进行治疗，这取决于它们对治疗的反应和患者对后续手术的耐受性。用氟化的嘧啶和铂试剂进行化学疗法，然后再用紫杉烷类和伊立替康治疗，会带来一些好处。抑制erb-b2受体酪氨酸激酶2（ERBB2或HER2）或血管内皮生长因子（包括曲妥珠单抗，拉莫西鲁单抗和阿帕替尼）的药物可增加应答和生存时间。食管腺癌的肿瘤蛋白p53发生突变，并激活受体相关酪氨酸激酶，血管内皮生长因子和细胞周期途径的突变，而食管鳞状细胞癌则发生了一系列明显的突变。食道癌开发了逃避抗肿瘤免疫反应的系统，但是需要进行研究以确定免疫检查点的修饰如何促进食道肿瘤的发展。