However it remains true that the choice of diagnostic and staging modalities varies among different centers depending on the local availability of the high-end imaging techniques and operators expertise. As far as the evolution of EUS-guided therapeutic procedures is concerned, to our view, there will be in the near future great opportunities for the development

of diagnostic and therapeutic EUS and pancreatic pathology will be the best testing bench for the new era of EUS. Acknowledgements Disclosure: The authors declare no conflict of interest.
According to the American Cancer Inhibitors,research,lifescience,medical society, the estimated number of new esophageal cancer diagnoses in 2012 will approach 17,500, approximately 500 more cases than in 2011, with a male preponderance Inhibitors,research,lifescience,medical (1). Over the past decade, the rate of esophageal adenocarcinoma has risen Akt inhibitor significantly, specifically among the Caucasian population (2). Risk factors include higher rates of gastroesophageal reflux and obesity. The standard treatment modality for local and locoregional disease had primarily been surgery. Treatment has evolved to combine additional therapeutic modalities in Inhibitors,research,lifescience,medical conjunction with surgery, specifically with varying combinations of radiation and chemotherapy (3-6). Improvement in outcomes

seen with multimodality therapy has prompted further investigation into alternative chemotherapies and radiation protocols Inhibitors,research,lifescience,medical (7,8). The rate of complete pathological response (pCR) is increasingly used as a measure of efficacy of neoadjuvant therapies and predictor of outcome (9). Tepper

et al. reported in 2008 a pCR of 33% after undergoing neoadjuvant therapy consisting Inhibitors,research,lifescience,medical of cisplatin, fluorouracil, and conformal radiation to 50.4 Gy (4). More recently in the CROSS study, a pCR rate of 29% was observed utilizing neoadjuvant paclitaxel/carboplatin and concurrent radiotherapy to a total dose of 41.4Gy (6,10). Following initial presentation of this data, our institution implemented a similar neoadjuvant concurrent chemoradiotherapy regimen using paclitaxel Bay 11-7085 and carboplatin beginning in July 2010. In contrast to the CROSS study, the radiation total dose prescribed was 50.4 Gy. Patients then proceeded to surgical resection. In this study, we evaluated patient, tumor, imaging, and treatment characteristics and response in consecutive patients treated using this trimodality regimen. Materials and methods Eligibility Patients with histologically documented adenocarcinoma of the distal esophagus (thoracic esophagus below 25 cm) or gastroesophageal junction (GEJ) were eligible for review on this IRB approved retrospective study. Those patients who received all aspects of their trimodality therapy at our institution were included for evaluation.