NCCN Guidelines for Patients® | Esophageal Cancer - page 67

67
NCCN Guidelines for Patients
®
: Esophageal Cancer
Version 1.2013
Part 6: Adenocarcinomas
Par t 1
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Par t 4
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Par t 9
Definitions:
Concurrent
chemoradiation:
Chemotherapy and
radiation therapy given at
the same time
Lymph node:
A small
group of disease-fighting
cells
Supportive care:
Treatment for symptoms
that are caused by cancer
or by cancer treatment
surgical margins:
The
normal-looking tissue
around the edge of a tumor
!
Read pages 16–17
for definitions of
TNM scores.
TNM scores
Primary treatment
No cancer in
the margins and
lymph nodes
Follow-up testing, or
Results
Adjuvant treatment
Cancer is in
the margins or
lymph nodes
Chemoradiation
Supportive care
Chemoradiation, or
M1 disease
was found
Some tumor
was left behind
Option 4
Esophagectomy
Chemoradiation
This chart maps a possible fourth treatment course for people healthy enough
for surgery. An esophagectomy without neoadjuvant treatment is recommended
when surgery alone is likely to remove all the cancer. Adjuvant treatment is based
on the results of surgery.
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, you may have
chemoradiation, or instead of treatment, you could start follow-up testing. Your
doctor is more likely to recommend chemoradiation if you have a T3 or T4a tumor.
If cancer is found in the surgical margins or lymph nodes, chemoradiation is
needed. Likewise, if your doctors weren’t able to remove all the cancer they could
T2, N0, M0
T3, N0, M0
T4a, N0, M0
T1b, N+, M0
T2, N+, M0
T3, N+, M0
T4a, N+, M0
Acronyms:
5-FU
=
fluorouracil
CT
=
computed tomography
GI
=
gastrointestinal
PET
=
positron emission
tomography
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