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Early cancer

Guide 15. 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

Superficial T1b, N0, M0

• EMR followed by ablation or ESD

followed by ablation, or

• Esophagectomy

• EMR or ESD, or

• EMR followed by ablation or

ESD followed by ablation

All other T1b, N0, M0

• Esophagectomy

• EMR or ESD, or

• EMR followed by ablation or

ESD followed by ablation

Guide 16. Next treatment after esophagectomy

Surgery results

What are the options?

No cancer is found in the surgical margin or lymph nodes • Start follow-up care

Cancer is found in the surgical margin or lymph nodes • Chemoradiation

Some cancer remains in or near your esophagus

• Chemoradiation

Cancer is found in distant sites

• Chemoradiation, or

• Supportive care

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NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

6

Treatment guide: Adenocarcinoma

Early cancer