Neoadjuvant Versus Adjuvant Therapy in Treating Resectable Thoracic Esophageal Cancer

Inclusion Criteria: * Histologically documented squamous cell carcinoma or adenocarcinoma of the thoracic esophagus (\> 20cm from the incisors) or gastroesophageal junction are included. * No distant metastases (M0). * Patients will be stratified by stage (clinical N0 versus clinical N1). * Patients with tumours within 3 cm distal spread into gastric cardia as detected by esophagogastroscopy. * Resectable mediastinal nodes are eligible. * No prior chemotherapy for this malignancy. * No prior radiotherapy that would overlap the field(s) treated in this study. * Patients with other malignancies are eligible only if \> 5 years without evidence of disease or completely resected or treated non-melanoma skin cancer. * Age \> 18 years and able to tolerate tri-modality therapy at the discretion of the treating thoracic surgeon, medical and radiation oncologists. Tumours must be resectable after assessment by the thoracic surgeon. Exclusion Criteria: * Cancers of the cervical esophagus (\< 20 cm are excluded). * Tumours that have \> 3 cm of spread into cardia of the stomach are considered gastric cancers and are ineligible. * Patients with biopsy (by endoscopic ultrasound, laparoscopy, or laparotomy ) proven metastatic supraclavicular nodes are ineligible. * Patients with biopsy proven metastatic celiac nodes are ineligible.