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NCCN Guidelines for Patients


Esophageal Cancer, Version 1.2016

Invasive cancer


Treatment guide: Squamous cell carcinoma Invasive cancer

Guide 7. 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?

T2, N0, M0

T3, N0, M0

T4a, N0, M0

T1b, N+, M0

T2, N+, M0

T3, N+, M0

T4a, N+, M0

Tumor isn’t in the neck area

• Esophagectomy in some cases, or

• Chemoradiation to shrink cancer

Tumor is in the neck area

• Chemoradiation to cure cancer

But able to have chemoradiation

• Chemoradiation to cure cancer

And unable to have chemoradiation

• Supportive care with or without

radiation therapy

T4b, N+, M0

• Chemoradiation to cure cancer, or

• Chemotherapy in some cases

• Same as above