A UK Medical Research Council trial result was presented at the 25th Congress of European Society of Medical Oncology (2000). 802 patients with oesophageal cancer were randomised to neoadjuvant (i.e. initial or "up-front") chemotherapy followed by surgery or surgery alone. There was a modest survival gain for the group receiving the chemotherapy. This may well alter management but the use of chemotherapy neoadjuvantly or synchronously with radiation therapy also remains a highly topical and contreversial subject in this disease.