In a patient with esophageal cancer with lymph node involvement, would you consider treating with definitive chemo-radiation if they have a single area of retroperitoneal metastasis?

If a patient has non-regional retroperitoneal adenopathy without other distant metastasis (i.e., below the level of the celiac axis), that patient has M1 disease, and upfront definitive chemoRT would no longer be the standard of care (systemic therapy alone would be). However, I would then consider ...

The staging of esophageal cancer is rooted in surgical assessment and management. As the management of esophageal cancer has evolved, and the omission of surgery has become a relatively hot topic, I think we as physicians need to consider this subject thoughtfully.

A surgeon is not likely to do an e...

Perhaps things will begin to improve now that IO is finding a home in the management of esophageal cancer, but the likelihood of "cure" in a patient with oligometastatic esophageal cancer is rare, and the choice of treatment should be based on the initial stage of the disease. In cancers of the panc...

Yes, I would, assuming the patient does well with induction systemic therapy and does not develop widespread metastatic disease.

Agree with Dr. @Dr. First Last on the staging aspect.

My 2 cents: if RP LN is considered regional, I would start perioperative FLOT (ESOPEC trial), then take to surgery if the patient is a surgical candidate. I would exhaust all staging options if not done yet (PET, EUS, Biopsy if possible) to ensur...