Treatment Algorithm

Question 1

Treatment options for cTis - T1bN0

Answer 1

esophagectomy, endoscopic resection or ablation

Question 2

Treatment options for cT1bN1 and higher, operable

Answer 2

pre-op chemoRT then surgery or definitive chemoRT or surgery upfront with post-op chomoRT if LN+ or if pN1+ or higher, + margins

Question 3

Treatment options for cT1bN1 and higher, cervical location SCC histology

Answer 3

Definitive chemoRT preferred. Surgery can be very morbid at this location. Consider boost of the primary tumor to 66-70 Gy

Question 4

Treatment options for cT1bN1 and higher, inoperable

Answer 4

Definitive chemoRT

Question 5

Treatment options for M1

Answer 5

Palliative RT, chemotherapy, or best supportive care

Question 6

What is the difference in terms of managing post-op chemoRT between adenocarcinoma vs. SCC for pN1+ or higher?

Answer 6

If adenocarcinoma proceed with post-op chemoRT but if it’s SCC then observation is recommended