Multicenter clinical trials for esophageal cancer.

Esophageal cancer is the 6th leading cause of death globally, and the incidence of esophageal cancer is dominant in Eastern Asia. To date, an international clinical trial had not been conducted so much in esophageal cancer. JCOG esophageal cancer group is established in 1978 and has conducted many clinical trials. Unlike the pharma-initiated trial, many clinical trials with multimodality treatment have been done in JCOG. Especially in esophageal cancer, standard treatment consists of multimodality treatment, including surgery, radiotherapy, chemotherapy, and endoscopic treatments. JCOG esophageal study group has a vision of the international trial with Asian countries in multimodality treatment. We started the WEB conference with Taiwanese investigators about multimodality treatment of esophageal cancer. We believe that this regular WEB conference will clarify the clinical question of each other and leads to future international co-operative trials. There were some proposals of cooperative trials with German or Korean study groups, but these didn’t realize. The differences of the standard treatment or financial issue exist to realize the international cooperative trial. The difference in the procedure of surgery is one of the big issues in esophageal cancer. We should discuss the details of clinical trials with international investigators. Further communication would be warranted.