How do you initially treat patients with cN3 cM0 esophageal cancer?

This is an extremely heterogenous group and requires expert multidisciplinary review to generate an individualized plan. In fact, we discussed several patients with N3 disease -- very extensive but technically locoregional lymphadenopathy -- at our Disease Management Team meeting yesterday morning.

Our approach is based on the following general principles:

1. Have a clear understanding of what is locoregional vs. metastatic disease, e.g. retroperitoneal lymphadenopathy is stage IV disease for esopha...