If a patient has distal esophageal adenocarcinoma and a PET+ left supraclavicular lymph node, and nothing in between, would you cover the entire esophagus? Both supraclavicular fields?  

My experience is anecdotal. I have often seen nodal spread from the paraaortic or GEJ nodes skip to the supraclavicular nodes with nothing in between. Since treatment of the entire esophagus would not be tolerated by most patients, I have elected to treat standard volumes and the involved SC nodal s...