How would you treat esophageal adenocarcinoma that is locally recurrent after neoadjuvant chemoradiotherapy and Ivor-Lewis esophagectomy?  

This is an extremely complicated question, where care has to be individualized in a multidisciplinary setting. Firstly, it's important to ascertain as much as possible that there is no evidence of metastatic disease with a PET/CT scan and contrast CT scan. An endoscopic ultrasound may also help to d...