HEALTH PROFESSIONAL · SOURCE READING

Treatment Option Overview for Esophageal Cancer

Source: Esophageal Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: March 21, 2025 · Captured 2026-09-09.

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For patients with minimally invasive resectable esophageal cancer, surgical resection alone offers the potential for cure. In contrast, therapeutic management for patients with locally advanced resectable esophageal cancer has evolved significantly over the last few decades. Because of the risk of distant metastases and local relapse, multimodality therapy with chemotherapy, radiation therapy, and surgical resection has become the standard of care.

The following combinations may provide effective palliation in individual cases:

Surgery.

Chemotherapy.

Radiation therapy.

Stents, photodynamic therapy, and endoscopic therapy with Nd:YAG laser. Self-expandable metal stent positioning is the recommended method for palliation of dysphagia from esophageal cancer.[1-6]

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Table 12. Treatment Options for Esophageal Cancer
Stage (TNM Staging Criteria)	Treatment Options
Stage 0 Esophageal Cancer	Surgery
Stage 0 Esophageal Cancer	Endoscopic resection
Stage I Esophageal Cancer	Chemoradiation therapy followed by surgery
Stage I Esophageal Cancer	Surgery alone
Stage II Esophageal Cancer	Chemoradiation therapy followed by surgery
	Surgery alone
	Chemotherapy followed by surgery
	Definitive chemoradiation therapy
Stage III Esophageal Cancer	Chemoradiation therapy followed by surgery
	Preoperative chemotherapy followed by surgery
	Definitive chemoradiation therapy
Stage IV Esophageal Cancer	Chemoradiation therapy followed by surgery (for patients with stage IVA disease)
	Chemotherapy, which has provided partial responses for patients with metastatic distal esophageal adenocarcinomas
	Adjuvant therapy for patients with completely resected (negative margins) esophageal adenocarcinoma, esophageal squamous cell carcinoma, or gastroesophageal junction cancer who had residual pathological disease after concurrent chemoradiation therapy
	Immunotherapy and chemoimmunotherapy for patients with previously untreated, unresectable, advanced or metastatic esophageal squamous cell carcinoma
	Immunotherapy and chemoimmunotherapy for patients with previously untreated advanced or metastatic esophageal adenocarcinoma or gastroesophageal junction cancer
	Immunotherapy for patients who relapse after one prior line of standard therapy
	Nivolumab and chemotherapy for patients with adenocarcinoma
	Nd:YAG endoluminal tumor destruction or electrocoagulation
	Endoscopic-placed stents to provide palliation of dysphagia
	Radiation therapy with or without intraluminal intubation and dilation
	Intraluminal brachytherapy to provide palliation of dysphagia
	Clinical trials evaluating single-agent or combination chemotherapy
Recurrent Esophageal Cancer	Palliative use of any of the other therapies, including supportive care
Recurrent Esophageal Cancer	Immunotherapy and chemoimmunotherapy for patients with recurrent esophageal squamous cell carcinoma

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Continue within this section

Surgery →Preoperative Chemotherapy Plus Anti-Human Epidermal Growth Factor Receptor 2 Therapy and/or Immunotherapy →Preoperative Chemoradiation Therapy →Preoperative Chemotherapy →Perioperative Chemotherapy →Definitive Chemoradiation Therapy →Adjuvant Therapy →Immunotherapy and Chemoimmunotherapy →Postoperative Radiation Therapy →Capecitabine and Fluorouracil Dosing →

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