Abstract: Esophageal squamous cell carcinoma (ESCC) withsupraclavicular lymph node metastasis exhibits features of both locoregional progression and potential systemic dissemination,representing a distinct and clinically controversial disease setting with respect to staging and treatment decision-making.The classification of supraclavicular nodal involvement varies across staging systems,which may influence the selection between curative-intent treatment and systemic therapy.Current evidence,largely derived from retrospective cohort studies,suggests that selected patients with ESCC and supraclavicular lymph node metastasis may achieve long-term survival through multidisciplinary management and aggressive local treatment following systemic therapy.With advances in immunotherapy and contemporary radiotherapy techniques,the feasibility of aggressive curative-intent surgical treatment for ESCC with supraclavicular lymph node metastasis is gradually increasing.This article provides an expert commentary on the anatomical basis of supraclavicular lymph node metastasis,controversies in staging,evidence supporting surgery and radiotherapy,multimodal treatment strategies,and future research directions.It emphasizes that treatment decisions should be individualized through multidisciplinary assessment based on disease burden,response to therapy,patient condition,and institutional expertise.

Key words: esophageal squamous cell carcinoma, supraclavicular lymph node metastasis, staging, surgery, multidisciplinary assessment