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76

NCCN Guidelines for Patients

®

Esophageal Cancer, Version 1.2016

6

Treatment guide: Adenocarcinoma

Invasive cancer

Invasive cancer

Guide 21. 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,

• Chemoradiation in some cases and if you haven’t received it before, or

• Chemotherapy if receiving perioperative treatment

No cancer is found in

the surgical margin

but is found in lymph

nodes

• Observation if you received preoperative chemotherapy or chemoradiation,

• Chemoradiation if you haven’t received it before, or

• Chemotherapy if receiving perioperative treatment

Cancer is in the

surgical margin

• Observation if you received preoperative chemotherapy or chemoradiation, or

• Chemoradiation if you haven’t received it before

Some cancer

remains in or near

your esophagus

• Chemoradiation if you haven’t received it before, or

• Supportive care

Cancer is found in

distant sites

• Chemoradiation if you haven’t received it before, or

• Supportive care

Guide 20. Next treatment after chemoradiation

Intent of chemoradiation

Treatment results

What are the options?

To shrink cancer (preoperative)

There are no signs of cancer

• Esophagectomy, or

• Start follow-up care

Some cancer remains in or near

your esophagus

• Esophagectomy, or

• Supportive care

Cancer is found in distant sites • Supportive care

To cure cancer (definitive)

There are no signs of cancer

• Start follow-up care

Some cancer remains in or near

your esophagus

• Esophagectomy, or

• Supportive care

Cancer is found in distant sites • Supportive care