2nd May 2024

A 57-year-old woman presents with progressive dysphagia to solids and recent weight loss.

A 57-year-old woman presents with progressive dysphagia to solids and recent weight loss. Endoscopy reveals a 3 cm tumour in the lower oesophagus, and biopsies confirm a moderately differentiated adenocarcinoma. Imaging shows no evidence of metastasis or lymph node involvement, and the tumour appears to be confined to the oesophagal wall. Her performance status is good, and she has no significant comorbidities.

What is the most appropriate initial management for this patient?