That is a bit unusual, to have the solid esophageal tumor not more than at a T2 depth thru the esophageal layers, yet have 3 to 6 positive lymph nodes. But the key, for now, is that it appears that only lymph nodes local to the solid esophageal tumor are lighting up some. If there were distant lymph nodes lighting up (shoulder, hip, etc), then he would have an M1 designation.... and surgery might become far less likely. Treatments... and his response to his first-line treatments, is what matters now. The lymph nodes mostly disappear on future scans, combined with a shrinking esophageal tumor... and surgery is most likely. So time to get going! His next scan will be compared to his diagnostic scans. But post-op treatments (known as adjuvant treatments) will also most likely be coming. But first things first. No need to look too far ahead. There are steps to go thru in trying to get to NED status. Don't put too much emphasis on his clinical staging. If he gets to surgery, his post-op pathology will be more definitive... and his staging will be revised.

Gary