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Oesophageal SCC Organ Preservation — SCE Medical Oncology MCQ

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ModerateGI CancersOesophageal SCC Organ PreservationSCE Medical Oncology

A 60-year-old man with locally advanced oesophageal SCC achieves a clinical complete response after definitive chemoradiotherapy (without surgery). What is the standard management after definitive CRT for oesophageal SCC?

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Correct answer: C — Active surveillance with endoscopy and CT — surgery reserved for residual/recurrent disease (organ preservation approach)

For oesophageal SCC treated with definitive chemoradiotherapy (as opposed to the neoadjuvant CRT→surgery approach used for adenocarcinoma), a clinical complete response can be managed with active surveillance (organ preservation). The French FFCD 9102 trial showed no OS benefit from salvage surgery after CRT response. Active surveillance includes regular endoscopy with biopsies, CT and clinical assessment. Salvage oesophagectomy is reserved for local recurrence/residual disease.

Reference: ESMO 2024 Oesophageal Cancer Guidelines; NICE NG83