Guidelines for Standardized Diagnosis and Treatment of Esophageal Cancer As we all know, esophageal cancer is one of the most serious malignant tumors endangering people’s health in China, with the fifth highest incidence rate and the fourth highest mortality rate. The annual number of deaths from esophageal cancer in China is 211,000, which is more than half of the total number of deaths from esophageal cancer in the world. At the same time, due to the differences between the eastern and western races and the etiology of esophageal cancer, the characteristics of esophageal cancer in China are different from those in Europe and the United States and other low incidence regions (the lower thoracic segment of esophagus and adenocarcinoma are more frequent), with the middle thoracic segment and squamous carcinoma being the most common, among which the proportion of esophageal squamous carcinoma is as high as over 90%. However, for a long time, the diagnosis and treatment criteria of esophageal cancer in China are based on the Clinical Practice Guidelines for Esophageal Cancer of the National Comprehensive Cancer Network (NCCN). This blindly copying foreign standards is against the current situation of esophageal cancer diagnosis and treatment in China, and may bring blindness in treatment. Therefore, it is necessary to formulate a guideline for diagnosis and treatment of esophageal cancer with Chinese characteristics. For this reason, the Esophageal Cancer Committee of China Anti-Cancer Association, together with renowned experts and scholars in the field of esophageal cancer nationwide, published in April 2011 the first standardized diagnosis and treatment guideline for esophageal cancer in China (hereinafter referred to as “the guideline”), which is different from the NCCN guideline, after more than one year of careful preparation. With the rapid development of medical technology, there are more and more means of diagnosis and treatment for esophageal cancer, which has improved the level of diagnosis and treatment of esophageal cancer to a certain extent, and also brought about the diversification of diagnosis and treatment concepts. Therefore, it is imperative to standardize the diagnosis and treatment of esophageal cancer to improve the diagnosis and treatment of esophageal cancer. In the United States, the 5-year survival rate of all tumor patients is 68% on average, while in China, it is only 25%, which is mainly due to the irregularity of tumor diagnosis and treatment. The NCCN was established in 1995 and consists of an academic consortium of 21 top cancer centers in the U.S. The process of developing its guidelines is very complex and rigorous, and the content is comprehensive and authoritative. 2007, NCCN cooperated with China for the first time to launch the Chinese version of NCCN guidelines, covering lung cancer, breast cancer, colon cancer, gastric cancer and other cancers, but esophageal cancer has been missing. Considering that esophageal cancer, as one of the top ten characteristic tumors in China that has been designated by the Ministry of Health of China, it is not necessarily appropriate to copy the NCCN Clinical Practice Guidelines for Esophageal Cancer, the well-known experts in the field of esophageal cancer in China have combined consensus, controversies, recommendations and everyone’s years of clinical experience and research results in their respective fields from the aspects of epidemiology, diagnosis, differential diagnosis and treatment (including neoadjuvant therapy and adjuvant therapy, etc.) of esophageal cancer. In the Guidelines, we analyzed and summarized the epidemiology, diagnosis, differential diagnosis, treatment (including neoadjuvant treatment and adjuvant treatment), combined with consensus, controversies, recommendations and clinical experience and research results in our respective fields for many years, and finally made an in-depth description and argument. Of course, the occurrence and development of esophageal cancer are very complicated. Compared with the operation process of NCCN, the Guidelines are very different in terms of human, material and financial resources invested. Moreover, due to the relatively short time for completion, the collection of some major arguments, especially high-level evidence that meets the requirements of evidence-based medicine, is also relatively lacking, and the cooperation among various disciplines and research institutions is not close enough. However, the Esophageal Cancer Specialty Committee still made every effort to extract from the available evidence and strive for accuracy. Therefore, the Guidelines will certainly play an important role in promoting the standardization of esophageal cancer diagnosis and treatment and the development of large-scale multicenter prospective studies as well as improving the diagnosis and treatment of esophageal cancer. In order to enable clinicians to better understand and digest the Guidelines, we have organized several well-known experts in the field of esophageal cancer who participated in the development of the Guidelines to give a detailed interpretation and analysis of several hot issues in China Medical Tribune, in order to provide some guidance and help for your clinical work.