NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Esophageal and Esophagogastric Junction Cancers Version 1.2014 NCCN.org NCCN Guidelines for Patients® available at www.nccn.org/patients Continue Version 1.2014, 05/30/14 © National Comprehensive Cancer Network, Inc. 2014, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. Printed by Alexandre Ferreira on 11/11/2014 10:31:35 AM. For personal use only. Not approved for distribution. Copyright © 2014 National Comprehensive Cancer Network, Inc., All Rights Reserved. NCCN Guidelines Version 1.2014 Panel Members NCCN Guidelines Index Esophageal/EGJ Table of Contents Esophageal and Esophagogastric Junction Cancers Discussion * Jaffer A. Ajani, MD/Chair † ¤ Charles S. Fuchs, MD, MPH † Lawrence R. Kleinberg, MD § Walter J. Scott, MD ¶ The University of Texas Dana-Farber/Brigham and The Sidney Kimmel Fox Chase Cancer Center MD Anderson Cancer Center Women’s Cancer Center Comprehensive Cancer Center at Johns Hopkins Vivian E. Strong, MD ¶ * Thomas A. D’Amico, MD/Vice Chair ¶ Hans Gerdes, MD ¤ Þ Memorial Sloan Kettering Cancer Center Duke Cancer Institute Memorial Sloan Kettering W. Michael Korn, MD Cancer Center UCSF Helen Diller Family Thomas K. Varghese, Jr, MD ¶ Khaldoun Almhanna, MD, MPH † Comprehensive Cancer Center Fred Hutchinson Cancer Research Moffitt Cancer Center Robert E. Glasgow, MD ¶ Center/Seattle Cancer Care Alliance Huntsman Cancer Institute Stephen Leong, MD David George Beer, PhD ¶ at the University of Utah University of Colorado Cancer Mary Kay Washington, MD, PhD ≠ University of Michigan Center Vanderbilt-Ingram Cancer Center Comprehensive Cancer Center James A. Hayman, MD, MBA § University of Michigan A. Craig Lockhart, MD, MHS † Christopher Willett, MD § David J. Bentrem, MD ¶ Comprehensive Cancer Center Siteman Cancer Center at Duke Cancer Institute Robert H. Lurie Comprehensive Barnes-Jewish Hospital and Cancer Center of Northwestern Steven Hochwald, MD Washington University School of Cameron D. Wright, MD ¶ University Roswell Park Cancer Institute Medicine Massachusetts General Hospital Stephen Besh, MD † Wayne L. Hofstetter, MD ¶ Mary F. Mulcahy, MD ‡ Debra Zelman ¥ St. Jude Children’s Research The University of Texas Robert H. Lurie Comprehensive Debbie’s Dream Foundation: Hospital/University of Tennessee MD Anderson Cancer Center Cancer Center of Northwestern Curing Stomach Cancer Cancer Institute University David H. Ilson, MD, PhD † Þ Prajnan Das, MD, MS, MPH § Memorial Sloan Kettering Mark B. Orringer, MD ¶ The University of Texas Cancer Center University of Michigan MD Anderson Cancer Center Comprehensive Cancer Center Edmund Kassis, MD Crystal Denlinger, MD † The Ohio State University James A. Posey, MD † Fox Chase Cancer Center Comprehensive Cancer Center - University of Alabama at James Cancer Hospital and Birmingham Comprehensive Marwan G. Fakih, MD Solove Research Institute Cancer Center City of Hope Comprehensive Cancer Center Rajesh N. Keswani, MD ¤ Aaron R. Sasson, MD ¶ Robert H. Lurie Comprehensive UNMC Eppley Cancer Center at Paul Fanta, MD Cancer Center of Northwestern The Nebraska Medical Center UC San Diego Moores Cancer Center University † Medical oncology § Radiotherapy/Radiation oncology Continue ¤ Gastroenterology ‡ Hematology/Hematology oncology NCCN ¶ Surgery/Surgical oncology ≠ Pathology Lauren Gallagher, RPh, PhD Þ Internal medicine ¥ Patient Advocacy Nicole McMillian, MS *Writing committee member Hema Sundar, PhD NCCN Guidelines Panel Disclosures Version 1.2014, 05/30/14 © National Comprehensive Cancer Network, Inc. 2014, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. Printed by Alexandre Ferreira on 11/11/2014 10:31:35 AM. For personal use only. Not approved for distribution. Copyright © 2014 National Comprehensive Cancer Network, Inc., All Rights Reserved. NCCN Guidelines Version 1.2014 Sub-Committees NCCN Guidelines Index Esophageal/EGJ Table of Contents Esophageal and Esophagogastric Junction Cancers Discussion Principles of Systemic Therapy Principles of Surgery Principles of Radiation Therapy Mary F. Mulcahy, MD ‡/Lead Thomas A. D’Amico, MD ¶/Lead Lawrence R. Kleinberg, MD §/Lead Robert H. Lurie Comprehensive Duke Cancer Institute The Sidney Kimmel Comprehensive Cancer Center of Northwestern Cancer Center at Johns Hopkins University Robert E. Glasgow, MD ¶ Huntsman Cancer Institute Prajnan Das, MD, MS, MPH § Jaffer A. Ajani, MD/Chair † ¤ at the University of Utah The University of Texas The University of Texas MD Anderson Cancer Center MD Anderson Cancer Center Wayne L. Hofstetter, MD ¶ The University of Texas James A. Hayman, MD, MBA § Khaldoun Almhanna, MD, MPH † MD Anderson Cancer Center University of Michigan Moffitt Cancer Center Comprehensive Cancer Center Mark B. Orringer, MD ¶ Crystal Denlinger, MD † University of Michigan Christopher Willett, MD § Fox Chase Cancer Center Comprehensive Cancer Center Duke Cancer Institute David H. Ilson, MD, PhD † Þ Walter J. Scott, MD ¶ Memorial Sloan-Kettering Cancer Fox Chase Cancer Center Center Thomas K. Varghese, Jr, MD ¶ Principles of Palliative/Best supportive care A. Craig Lockhart, MD, MHS † Fred Hutchinson Cancer Hans Gerdes, MD ¤ Þ Siteman Cancer Center at Barnes- Research Center/Seattle Cancer Memorial Sloan Kettering Cancer Center Jewish Hospital and Washington Care Alliance University School of Medicine James A. Hayman, MD, MBA § Cameron D. Wright, MD ¶ University of Michigan Massachusetts General Hospital Comprehensive Cancer Center Rajesh N. Keswani, MD ¤ Robert H. Lurie Comprehensive ¤ Gastroenterology Cancer Center of Northwestern University ¶ Surgery/Surgical oncology Þ Internal medicine Mary F. Mulcahy, MD ‡ § Radiotherapy/Radiation oncology Robert H. Lurie Comprehensive ‡ Hematology/Hematology oncology Continue Cancer Center of Northwestern University NCCN Guidelines Panel Disclosures Version 1.2014, 05/30/14 © National Comprehensive Cancer Network, Inc. 2014, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. Printed by Alexandre Ferreira on 11/11/2014 10:31:35 AM. For personal use only. Not approved for distribution. Copyright © 2014 National Comprehensive Cancer Network, Inc., All Rights Reserved. NCCN Guidelines Version 1.2014 Sub-Committees NCCN Guidelines Index Esophageal/EGJ Table of Contents Esophageal and Esophagogastric Junction Cancers Discussion Squamous Cell Carcinoma and Principles of Genetic Risk Assessment Principles of Endoscopic Staging and Therapy Adenocarcinoma Treatment David George Beer, PhD ¶/Co-Lead Hans Gerdes, MD ¤ Þ/Lead Christopher Willett, MD §/Lead University of Michigan Memorial Sloan-Kettering Cancer Center Duke Cancer Institute Comprehensive Cancer Center Wayne L. Hofstetter, MD ¶ Jaffer A. Ajani, MD † ¤ Mary Kay Washington, MD, PhD ≠/Co-Lead The University of Texas The University of Texas Vanderbilt-Ingram Cancer Center MD Anderson Cancer Center MD Anderson Cancer Center Crystal Denlinger, MD † Rajesh N. Keswani, MD ¤ David J. Bentrem, MD ¶ Fox Chase Cancer Center Robert H. Lurie Comprehensive Robert H. Lurie Comprehensive Cancer Cancer Center of Northwestern University Center of Northwestern University David H. Ilson, MD, PhD † Þ Memorial Sloan-Kettering Cancer Center David H. Ilson, MD, PhD † Þ Principles of Pathologic Review Memorial Sloan-Kettering Cancer Center Mark B. Orringer, MD ¶ and HER2-neu Testing University of Michigan Mary Kay Washington, MD, PhD ≠ Walter J. Scott, MD ¶ Comprehensive Cancer Center Vanderbilt-Ingram Cancer Center Fox Chase Cancer Center Vivian E. Strong, MD ¶ Memorial Sloan-Kettering Cancer Center ¤ Gastroenterology ¶ Surgery/Surgical oncology Þ Internal medicine § Radiotherapy/Radiation oncology Continue ‡ Hematology/Hematology oncology ≠ Pathology NCCN Guidelines Panel Disclosures Version 1.2014, 05/30/14 © National Comprehensive Cancer Network, Inc. 2014, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. Printed by Alexandre Ferreira on 11/11/2014 10:31:35 AM. For personal use only. Not approved for distribution. Copyright © 2014 National Comprehensive Cancer Network, Inc., All Rights Reserved. NCCN Guidelines Version 1.2014 Table of Contents NCCN Guidelines Index Esophageal/EGJ Table of Contents Esophageal and Esophagogastric Junction Cancers Discussion NCCN Esophageal and Esophagogastric Junction Cancers Panel Members NCCN Esophageal and Esophagogastric Junction Cancers Sub-Committee Members Clinical Trials: NCCN believes that Summary of the Guidelines Updates the best management for any cancer Workup and Evaluation (ESOPH-1) patient is in a clinical trial. Squamous Cell Carcinoma Participation in clinical trials is Locoregional Disease (ESOPH-2) especially encouraged. Primary Treatment for Medically Fit Patients (ESOPH-3) and (ESOPH-4) To find clinical trials online at NCCN Surgical Outcomes For Patients Who Have Not Received Preoperative Therapy (ESOPH-6) member institutions, click here: Surgical Outcomes For Patients Who Have Received Preoperative Therapy (ESOPH-7) nccn.org/clinical_trials/physician.html. Primary Treatment for Medically Unfit Patients (ESOPH-8) Follow-up and Recurrence (ESOPH-9) NCCN Categories of Evidence and Palliative Management (ESOPH-10) Consensus: All recommendations