TECAD Cirurgia Digestiva Practice Questions - TECAD - Título De Especialista Em Cirurgia Do Aparelho Digestivo (CBCD AMB) Exam

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A 58-year-old male smoker is diagnosed with a moderately differentiated squamous cell carcinoma (SCC) of the middle third of the thoracic esophagus, located 28 cm from the incisors. Endoscopic ultrasound (EUS) and PET-CT stage the tumor as cT3 N1 M0 (resectable locally advanced, with two positive periesophageal lymph nodes and no distant metastases). Bronchoscopy shows no tracheobronchial invasion. Based on the CROSS trial and CBCD oncological consensus, what is the best treatment strategy?

Neoadjuvant chemoradiation (weekly carboplatin and paclitaxel with 41.4 Gy radiation) followed by restaging and transthoracic esophagectomy with two-field lymphadenectomy Upfront three-stage transthoracic esophagectomy (McKeown procedure) followed by adjuvant chemotherapy Definitive high-dose chemoradiotherapy (60 Gy) without surgical resection Endoscopic submucosal dissection followed by brachytherapy

Correct Answer:

Neoadjuvant chemoradiation (weekly carboplatin and paclitaxel with 41.4 Gy radiation) followed by restaging and transthoracic esophagectomy with two-field lymphadenectomy

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