RESEARCH Proton pump inhibitors (P a

Full list of author information is available at the end of the articleBackground Esophageal cancer is one of the most fatal malignancies in the world, with a dramatic increase in incidence in the western world, especially of the adenocarcinoma subtype [1]. Despite improvements in the management of esophageal cancer patients, the general outcome re-mains very poor for both histological subtypes, with an overall 5-year survival of approximately 10 % and a 5-year post-esophagectomy survival rate of approximately 15-40 % [2,3]. The main reason lies in the lack of early clinical symptoms, which usually results in advanced tumour stages at the date of diagnosis. In an attempt to improve outcome of patients after surgery, and to poten-tially increase the number of patients who qualify for surgery by reducing the size of the primary tumour, neo-adjuvant therapy is used. Several recent meta-analyses have demonstrated the potential of neoadjuvant therapy in advancing overall survival for both histological sub-types, particularly for therapy responders. Additionally, tumour reduction and nodal “down-staging ” were de-scribed as independent prognostic factors for better out