How do you contour distal esophageal cancer in the postop setting after Ivor-Lewis pT3N3 (perigastric and periesophageal LN)?
What regional lymph nodes do you include perigastric, portahepatic, periesophageal, celiac, splenic, pancreaticoduodenal, sup. mesenteric, paraesophageal?
Do you treat the anastomosis in a different volume or combine the regional lymph nodes, preop GTV and anastomosis into one big volume?
Answer from: Radiation Oncologist at Academic Institution
This case is a tough one--bulky disease at the junction of the esophagus and stomach so both sets of regional lymph nodes are involved. The Ivor-Lewis or transthoracic approach means that the anastomosis between remaining esophagus and stomach is located in the chest.The anastomoses need to be...
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