Treatment of Locally Advanced Resectable Oesophageal Squamous Cell Carcinoma (cT2–T4a or cN1–3, M0)

This protocol addresses oesophageal squamous-cell carcinoma (SCC) that is locally advanced but remains resectable, staged cT2–T4a or cN1–3 with no distant metastasis (M0). Curative-intent management in this setting requires careful staging and a structured multi-modality approach.

Surgery is the backbone of curative-intent treatment for locally advanced resectable oesophageal SCC. Definitive chemoradiotherapy with surveillance and salvage oesophagectomy when needed for local tumour control is also a recognised option, even in upfront resectable cases.

For patients who undergo neoadjuvant treatment and have residual pathological disease in the resection specimen, the protocol includes an adjuvant immunotherapy agent. The full regimen, eligibility criteria, sequencing, and follow-up details are in the complete protocol.

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References

DOI: 10.1016/j.annonc.2022.07.003

Surgery is still the backbone of curative-intent treatment for both histological subtypes of locally advanced resectable oesophageal cancer (cT2-T4a or cN1-3), although deﬁnitive CRT with surveillance and salvage oesophagectomy when needed for local tumour control is also a recommended option, even in upfront resectable cases of oesophageal SCC.
Patients with SCC or AC of the oesophagus including OGJ cancer who have undergone neoadjuvant CRT and show evidence of residual pathological disease in the resection specimen (ypT1 and/or ypN1) should be treated with adjuvant nivolumab [I, A; ESMO-MCBS v1.1 score: A].

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