Not being an oncologist or a thoracic surgeon to be capable of weighing your comorbidities against your recent EC dx... I can't really say.

But... in general... even if only stage 1 or 2... whether going thru chemotherapy and radiation first (as I did)... having the esophagectomy is the odds on favorite of never seeing your cancer again (I had this too, plus a year of immunotherapy). If left alone... no doubt it will kill you. I can't say whether that means in 6 months or two years... but it will grow... spread... and it will win. That's why, in general, our tumor boards do what gives us our best chance of survival. Now which is the more pressing issue for you... and which are even possible... the kidney transplant or the esophagectomy or some lesser ablation technique... I'm not sure.

Should ESD or EMR be possible for your stage of cancer... that would surely buy you time. And if it recurs, will most likely stay within the esophagus... with treatments to then begin... or an esophagectomy be done a year or two from now. Could it spread by then... when a recurrence is seen... and you be deemed stage 4 now? Yes, a possibility... but maybe not a probability. And I have no clue, in your current state, what chemoradiation treatments would do to your insides. Seek other opinions if possible. I'm guessing you are not in America.

On Sunday, Jan 19th, at 9am Eastern (2pm in the UK)... we're having a renowned Mayo thoracic surgeon on our free Zoom calls... to talk about esophagectomy surgery. She's no longer with Mayo Rochester and has moved back to Texas (Baylor)... but she's something special! Maybe you come talk to her on our call. She takes on very difficult EC cases... from a surgical standpoint. Let me know and I'll send you the one-touch Zoom link. And 27 years on dialysis... holy cow... is that a world record? How old are you?

Gary