2nd May 2024

A 65-year-old man presents with a 6-month history of progressive dysphagia, initially to solids and now to liquids, along with significant weight loss.

A 65-year-old man presents with a 6-month history of progressive dysphagia, initially to solids and now to liquids, along with significant weight loss. Endoscopic examination reveals a 4 cm mass in the mid-oesophagus, and biopsy confirms a moderately differentiated squamous cell carcinoma. CT and PET scans show no evidence of distant metastasis but suggest local invasion into surrounding tissues. The patient is otherwise fit, with a good performance status and no significant comorbidities.

Which is the most appropriate initial management for this patient?