Surgery for "advanced" lung and esophageal cancer: New horizons or false dawn?

In non operable patients with esophageal cancer a recent meta-analysis from 17 randomized trials including neoadjuvant RT, chemotherapy and surgery, have addressed a clear benefit from combined treatments over surgery alone, and also a positive trend over chemotherapy alone as neoadjuvant to surgery (19). [...]Patients presenting with clinical isolated locoregional recurrence or clinical solitary solid organ metastasis should be discussed in a dedicated multidisciplinary team meeting as to evaluate and define the place of salvage treatment which in well selected cases could offer a perspective of prolonged survival (20). Conclusion and perspective Although even after this symposium the indications for surgery and optimal management for advanced chest cancer remain uncertain, there are enough data to affirm that the presence of advanced lung and esophageal cancer does not always mean the end. [...]we think that in the near future guidelines will become obsolete because treatment will necessarily be individualized seeing that individual risk factors such as depression