Esophageal cancer practice guidelines 2022 edited by the Japan esophageal society: part 1

Japan Esophageal Society · 2023 · Japan

Source and licence

Authors: Yuko Kitagawa, Ryu Ishihara, Hitoshi Ishikawa et al.
Title: Esophageal cancer practice guidelines 2022 edited by the Japan esophageal society: part 1
Journal: Esophagus, 2023
DOI: 10.1007/s10388-023-00993-2
Licence: CC BY 4.0
Changes: Verbatim excerpts; formatting adapted

Full text retrieved 2026-10-27 from Europe PMC · PMC10024303

Licence statement of the original publication

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This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.

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Recommendations

Verbatim, with grade of recommendation or strength of consensus where given.

Explanatory note

In regard to the toxicity, the late toxicities reported in the patients who received definitive chemoradiotherapy in the JCOG9906 Study were esophagitis (Grade 3–4; 13%), pericardial effusion (Grade 3–4; 16%), pleural effusion (Grade 3–4; 9%), and radiation pneumonitis (Grade 3–4; 4%); death of four cases was also reported [80]. Out of the 22 observational studies, 6 from Japan reported operation-related deaths at an incidence rate of 0–4% among patients treated by surgery. In the JCOG9907 Study, there were two cases of operation-related death among 330 cases. It should be noted that there is a potential risk of serious complications among patients receiving definitive chemoradiotherapy as well as among those treated by surgery [81].

Recommendation statement

In patients with cStage II or III esophageal cancer who failed to show a pathologic complete response after preoperative chemoradiotherapy plus surgery with radical resection, there is strong evidence to recommend postoperative nivolumab therapy, regardless of the histologic type or tumor expression level of programmed death ligand 1 (PD-L1). (Rate of consensus: 81% [21/26], strength of evidence: A)
In patients with cStage II or III esophageal cancer who have undergone preoperative chemotherapy plus surgery with radical resection, but failed to achieve a pathologic complete response, there is currently no evidence to recommend postoperative nivolumab therapy. (Rate of consensus: 92% [24/26], strength of evidence: D)
In patients without a history of anti-PD-1 antibody therapy, there is strong evidence to recommend nivolumab therapy (squamous cell carcinoma). (Rate of consensus: 100% [25/25]; strength of evidence: A)
In patients without a history of anti-PD-1 antibody therapy, there is only weak evidence to recommend pembrolizumab therapy (squamous cell carcinoma with a CPS of ≥ 10 or MSI-H or TMB-H). (Rate of consensus: 96.2% [25/26]; strength of evidence: B)
In patients without a history of anti-PD-1 antibody therapy or taxane therapy, there is only weak evidence to recommend paclitaxel therapy. (Rate of consensus: 96.4% [27/28]; strength of evidence: C)
In patients with a history of anti-PD-1 antibody therapy, but no history of taxane therapy, there is only weak evidence to recommend paclitaxel therapy. (Rate of consensus: 100% [28/28]; strength of evidence: C)

Contents of the original publication

The section headings of the original.

Introduction
Purpose of the guidelines
Target users
Target patients
Precautions for use
Method of development of the esophageal cancer practice guideline
Public hearing and external review
Revision
Efforts related to public relations/dissemination (including plans)
Epidemiology, present status, and risk factors
Summary
General remarks
Risk factors
Treatment algorithms for esophageal cancer and treatment policies based on the algorithm
Japanese classification of esophageal cancer and tumor, node, metastasis (TNM) (Union for International Cancer Control [UICC]) classification
Treatment algorithm for cStage 0 to I esophageal cancer (Fig. 1)
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Treatment algorithm for cStage II to Stage III esophageal cancer (Fig. 2)
Summary
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Treatment algorithm for cStage IVA esophageal cancer (Fig. 3)
Summary
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Treatment algorithm for cStage IVB esophageal cancer (Figs. 4 and 5)
Summary
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note
Recommendation statement
Explanatory note

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