食管癌术后辅助治疗专家共识（2026版）

doi:10.3877/cma.j.issn.2095-8773.2026.03.01

食管癌是中国高发的消化道恶性肿瘤。手术是可切除食管癌的重要根治性治疗手段。然而，术后复发转移仍是影响患者长期生存的主要原因。术后辅助治疗作为综合治疗的重要组成部分，有助于清除潜在微小残留病灶（MRD），降低复发风险，改善患者生存预后。近年来，食管癌围手术期治疗如放化疗或免疫治疗等不断发展，但不同临床应用场景下术后辅助治疗的适用人群、治疗方案及管理策略仍存在一定争议，临床实践尚缺乏统一规范。为进一步规范中国食管癌术后辅助治疗的临床实践，中国抗癌协会食管癌专业委员会组织国内多学科专家，共同制订中国食管癌术后辅助治疗专家共识。本共识围绕食管癌术后辅助治疗的基本原则与管理、不同临床场景下的辅助治疗策略、生物标志物及特殊人群管理等关键问题，提出18条推荐意见，旨在为中国食管癌术后辅助治疗提供规范化、个体化的临床决策参考，并为未来相关临床研究指明方向。

关键词: 食管癌, 术后辅助治疗, 专家共识

Esophageal cancer is one of the most common gastrointestinal malignancies in China. Surgery remains the cornerstone of curative-intent treatment for patients with resectable disease. However, postoperative recurrence and metastasis remain major causes of poor long-term survival. As an essential component of multidisciplinary treatment, postoperative adjuvant therapy aims to eradicate potential minimal residual disease (MRD), reduce the risk of recurrence, and improve survival outcomes. In recent years, perioperative treatment strategies for esophageal cancer, including chemoradiotherapy and immunotherapy, have evolved rapidly. Nevertheless, considerable controversy remains regarding the indications, treatment regimens, and management strategies for postoperative adjuvant therapy across different clinical settings, and standardized clinical practice is still lacking. To further standardize the clinical practice of postoperative adjuvant therapy for esophageal cancer in China, the Esophageal Cancer Committee of the Chinese Anti-Cancer Association convened a multidisciplinary panel of experts to develop the Chinese Expert Consensus on Postoperative Adjuvant Therapy for Esophageal Cancer (2026 Edition). This consensus addresses key issues, including the fundamental principles and management of postoperative adjuvant therapy, treatment strategies across different clinical scenarios, the application of biomarkers, and the management of special populations. A total of 18 recommendations are proposed to provide standardized and individualized guidance for clinical decision-making and to identify priorities for future clinical research.

Key words: Esophageal cancer, Postoperative adjuvant therapy, Expert consensus

表1 共识证据等级的定义

证据质量分级	分级划分标准
Ⅰ类	可信区间较窄的荟萃分析，或多个随机对照试验且每组样本量大于30例
Ⅱ类	可信区间较宽的荟萃分析，或单个随机对照试验且每组样本量大于30例；至少1个随机对照试验且每组样本量介于10~29（含）例，或来自卫生系统的管理数据
Ⅲ类	无对照的试验，个案报告或病例系列报告，或专家意见

表1 共识证据等级的定义

证据质量分级	分级划分标准
Ⅰ类	可信区间较窄的荟萃分析，或多个随机对照试验且每组样本量大于30例
Ⅱ类	可信区间较宽的荟萃分析，或单个随机对照试验且每组样本量大于30例；至少1个随机对照试验且每组样本量介于10~29（含）例，或来自卫生系统的管理数据
Ⅲ类	无对照的试验，个案报告或病例系列报告，或专家意见

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[9]	中国研究型医院学会放射学专业委员会, 上海抗癌协会实体肿瘤聚焦诊疗专业委员会. 血管包裹肿瘤簇在肝细胞癌影像诊疗中的临床应用专家共识（2026年版）[J/OL]. 中华消化病与影像杂志(电子版), 2026, 16(03): 193-198.
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[15]	中国卒中学会遗传学分会. 肯尼迪病诊断和管理中国专家共识2025[J/OL]. 中华脑血管病杂志(电子版), 2026, 20(03): 240-249.

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Expert consensus on postoperative adjuvant therapy for esophageal cancer (2026 edition)

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Expert consensus on postoperative adjuvant therapy for esophageal cancer (2026 edition)