食管癌患者的护理或具有食管癌高风险的个体的护理发生了巨大变化。食管鳞状细胞癌和腺癌的流行病学在过去几十年间分化，只有食管腺癌的发病率显著增加。然而，仅在过去十年中，已确定了区分这两种疾病形式的分子特征。这一进展有望通过基于癌症特异性基因组或表观遗传改变的新型微创诊断技术的发展，提高食管癌筛查水平。手术技术也演变为与较小术后并发症相关的更少侵入性方法，而不危及肿瘤治疗结果。随着多学科护理的改进、放射治疗的进步以及检测微小残留疾病的新工具的出现，某些患者甚至不再需要手术切除肿瘤。然而，治疗食管癌患者中最令人期待的进展或许是免疫检查点抑制剂的出现，这种药物可以利用并增强机体免疫反应抵抗癌症。本文评述了这些治疗食管癌的进展，代表着我们改善患者预后追求的新起点。© 2023. Springer Nature Limited.

The care of patients with oesophageal cancer or of individuals who have an elevated risk of oesophageal cancer has changed dramatically. The epidemiology of squamous cell and adenocarcinoma of the oesophagus has diverged over the past several decades, with a marked increase in incidence only for oesophageal adenocarcinoma. Only in the past decade, however, have molecular features that distinguish these two forms of the disease been identified. This advance has the potential to improve screening for oesophageal cancers through the development of novel minimally invasive diagnostic technologies predicated on cancer-specific genomic or epigenetic alterations. Surgical techniques have also evolved towards less invasive approaches associated with less morbidity, without compromising oncological outcomes. With improvements in multidisciplinary care, advances in radiotherapy and new tools to detect minimal residual disease, certain patients may no longer even require surgical tumour resection. However, perhaps the most anticipated advance in the treatment of patients with oesophageal cancer is the advent of immune-checkpoint inhibitors, which harness and enhance the host immune response against cancer. In this Review, we discuss all these advances in the management of oesophageal cancer, representing only the beginning of a transformation in our quest to improve patient outcomes.© 2023. Springer Nature Limited.