NCCN Guidelines for Patients® | Esophageal Cancer - page 63

NCCN Guidelines for Patients
: Esophageal Cancer
Version 1.2013
Part 6: Adenocarcinomas
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
Chemotherapy and
radiation therapy given at
the same time
Lymph node:
A small
group of disease-fighting
Supportive care:
Treatment for symptoms
that are caused by cancer
or by cancer treatment
surgical margins:
normal-looking tissue
around the edge of a tumor
Read pages 28–38
for information on
cancer treatments.
How the tumor responds to treatment will be assessed by a CT scan with
contrast, PET/CT, or upper GI endoscopy. These tests are described in Parts
2.1 and 3.1. If there are no signs of cancer, you may have an esophagectomy,
or instead of treatment, you could start follow-up testing. If cancer is found in or
near the esophagus, an esophagectomy is strongly recommended. Otherwise,
supportive care can be started. Supportive care is also recommended if tests
show a T4b tumor or M1 disease.
After an esophagectomy, you may need adjuvant treatment. If your doctors
were able to remove all the cancer that they could see and no cancer was found
in the surgical margins and lymph nodes, no more treatment is needed. The
next step of care is to start follow-up testing. If the surgical margins are cancer-
free but there’s cancer in the lymph nodes, observation is recommended.
Observation is testing on a regular basis for cancer growth. Observation is also
recommended when cancer is found in the surgical margins. If your doctors
weren’t able to remove all the cancer they could see or cancer was found in
distant sites, supportive care is the best option.
Next steps:
When you are finished with cancer treatment, read Part 6.3 for
follow-up testing. If you will receive supportive care, read Part 6.5 next.
computed tomography
= positron emission
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