No lymphatic metastasis after surgery for esophageal cancer may not need chemotherapy or may need chemotherapy. Those with hypofractionation, patients with T3 or T4 stage, those with positive surgical margins, advanced metastasis or recurrent patients need chemotherapy after surgery even if there is no lymph node metastasis.
1. Indications of postoperative chemotherapy for esophageal cancer.
(1) T1 and T2 stage, and there is no lymph node metastasis, but the length of esophageal resection is insufficient, accompanied by low differentiation or undifferentiation, lymphatic or nerve infiltration.T1 stage means the tumor invades the mucosa lamina propria, mucosa muscularis or submucosa.T2 stage means the tumor invades the esophageal muscularis.
(2) Patients with T3 and T4 stages: T3 stage refers to tumor invasion of the esophageal epithelium, and T4 stage refers to tumor invasion of the esophageal peripheral structures.
(3) Those with positive surgical margins.
(4) Patients with advanced metastasis or recurrence should choose palliative chemotherapy.
2. Contraindications to postoperative chemotherapy for esophageal cancer, the following patients cannot undergo chemotherapy.
(1) Elderly and weak or malignant patients.
(2) Patients with serious dysfunction of heart, lung and kidney, fever with infection, bleeding or perforation of esophagus.
(3) White blood cells ≤3×10⁹/L or platelets ≤50×10⁹/L.
Patients with postoperative esophageal cancer should undergo regular treatment under the guidance of doctors.