Esophageal cancer: a case for aggressive staging and a tailored treatment plan.
A 57-year-old man with dysphagia was found to have a distal esophageal cancer. The tumor was staged radiographically (with endoesophageal ultrasonography) and operatively. The latter consisted of a thoracoscopic examination of the thoracic esophagus and surrounding lymph nodes, as well as a limited laparotomy to evaluate the stomach and the perigastric and celiac lymph nodes. It was determined that the patient had a high-risk lesion (locally advanced, T3-4 or N1). Induction chemotherapy with concurrent radiation therapy was administered. Following neoadjuvant treatment, the patient underwent an uneventful esophagectomy. No residual tumor was identified in the specimen. The patient was doing well 6 months following his surgery. This case demonstrates the use of staging to guide therapy in esophageal cancer.
Swanson
S J
SJ
Division of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
D000230:Adenocarcinoma / Q000145:classification / Q000628:therapy*; D001706:Biopsy; D017024:Chemotherapy, Adjuvant; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology; D004938:Esophageal Neoplasms / Q000145:classification / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D014057:Tomography, X-Ray Computed / Q000379:methods