Pre-operative Epirubicin, Cisplatin, and Capecitabine in Patients With Newly Diagnosed Localised Oesophageal Adenocarcinoma

Inclusion Criteria: * Age \> 18 years. * Histologically verified adenocarcinoma of the thoracic oesophagus or type 1, 2 and 3 tumours of the oesophagogastric junction (type 1 refers to lower oesophageal, type 2 refers to cardial and type 3 refers to subcardinal cancers). * AJCC Stage II-III (T2-3 N0-1 M0) (28), as assessed by spiral or multi-slice CT and endoscopic ultrasound, where primary surgery would be considered with curative intent. * No previous chemotherapy, radiotherapy or other investigational drug treatment for this indication. * WHO performance status 0,1 or 2. * Adequate bone marrow function with platelets \> 100 x 109/l; WBC \> 3 x 109/l; neutrophils \> 1.5 x 109/l at the time of study entry. * Serum bilirubin \< 35 mol/l. * Serum creatinine \< 180 mol/l and measured creatinine clearance over 60ml/min. * No concurrent uncontrolled medical condition. * No previous malignant disease other than non-melanotic skin cancer or carcinoma in situ of the uterine cervix in the last 10 years. * Life expectancy \> 3 months. * Adequate contraceptive precautions if relevant. * Informed written consent. Exclusion Criteria: * The presence of locally advanced or metastatic disease precluding curative surgical resection (T4 or Stage IV or M1a-b) * Total dysphagia (O'Rourke's swallowing function scoring system 5) precluding swallowing of capecitabine even when crushed * Medical or psychiatric conditions that compromise the patient's ability to give informed consent. * Patients with disease in any of the following areas on the basis of CT scan and/or endoscopic ultrasound: * Evidence of liver, lung or other distant metastases * Para-aortic/coeliac lymphadenopathy \> 1cm diameter on CT, \> 6mm diameter on EUS * Invasion of airways, aorta, pericardium, or lung * New York Heart Association classification Grade III or IV. * Uncontrolled angina pectoris. * Pregnancy or breast feeding. * Impaired renal function with measured creatinine clearance less than 60 ml/min. * Known malabsorption syndromes. * Patients with a known hypersensitivity to 5-FU or with a dihydropyrimidine dehydrogenase (DPD) deficiency.