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46

NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

Early cancer

5

Treatment guide: Squamous cell carcinoma Early cancer

Guide 3. Initial treatment

TNM scores

What are the options if approved

and agree to have surgery?

What are the options if not

approved or decline surgery?

Tis, N0, M0

• EMR or ESD,

• Ablation,

• EMR followed by ablation or ESD

followed by ablation, or

• Esophagectomy

• EMR or ESD,

• Ablation, or

• EMR followed by ablation or ESD

followed by ablation

T1a, N0, M0

• EMR or ESD,

• EMR followed by ablation or ESD

followed by ablation, or

• Esophagectomy

• EMR or ESD, or

• EMR followed by ablation or ESD

followed by ablation

T1b, N0, M0

• Esophagectomy

• EMR or ESD, or

• EMR followed by ablation or ESD

followed by ablation

Guide 4. Next treatment after esophagectomy

Surgery results

What are the options?

No cancer is in the surgical margin

• Start follow-up care

Cancer is in the surgical margin

• Chemoradiation

Some cancer remains in or near your esophagus • Chemoradiation

• Supportive care

Cancer is found in distant sites

• Chemoradiation

• Supportive care