What treatment options are available for positive margins?

Several guidelines have reviewed treatment options for positive margins and are summarized in Supplementary Table 1.

Recommendations on the Treatment Options Available for Positive Margins

By consensus, the workgroup has agreed to adopt the NCCN guidelines.

Recommendations are as follows:

1.Stage IA with R1 or R2: (1) re-resection (Category 2A) or (2) RT (Category 2B).

2.T2abN0: (1) re-resection +/- chemotherapy, (2) RT +/- chemotherapy (Category 2A).

3.Stage II positive margins with R1: (1) re-resection and chemotherapy, (2) chemo-radiation (either sequential or concurrent), with R2: (1) re-resection and chemotherapy or (2) concurrent chemo-radiation (Category 2A).

4.T1-3, N2 or T3N1 with R1: Chemo-radiation (either sequential or concurrent), with R2: concurrent chemo-radiation (Category 2A).