“…33 However, randomized studies have not shown an advantage for preoperative chemotherapy over surgery alone in overall survival, DFS, or local control rates 34 -36 (2-year survival, 35% vs. 37% for surgery alone). By combining chemotherapy and radiotherapy prior to surgery, the outcome for patients with Stage I-III tumors seems to be improved, with a mean survival rate of 26.5% at 2 years 6,8,34,[37][38][39][40] and a low (Ͻ 5%) hospital mortality rate. 24,[41][42][43] Walsh et al 44 showed clearly that multimodal therapy is superior to surgery alone for patients with esophageal adenocarcinoma, with a 3-year survival rate of 32% versus 6%.…”