O esophageal cancer has one of the highest mortality rates amongst patients with gastrointestinal cancers. Five-year survival is less than 20% in most series. Only patients diagnosed in an early stage can be cured. The incidence of oesophageal and gastroesophageal junction adenocarcinoma has been rising during recent years and has now become the most frequent tumour type in the West. Across Europe, 45,000 new cases per year, 40,000 deaths per year and an overall 5-year survival of 15% have been estimated. In recent decades there has been a signifi cant improvement in the management of oesophageal cancer. This includes better patient selection, refi ned surgical technique, improvement in perioperative care and a more rational application of adjuvant therapies. Modern management of patients with oesophageal cancer requires a multidisciplinary approach involving surgeons, medical oncologists, gastroenterologists, radiologists, radiation oncologists and pathologists.Patients with oesophageal cancer can be divided into two main groups. The fi rst group of patients are diagnosed in an asymptomatic or an early stage (