Second primary carcinoma in the residual cervical esophagus after thoracic esophagectomy: report of five cases.
OBJECTIVE
Development of second primary carcinomas after thoracic esophagectomy has become of much concern, because recently the prognosis of thoracic esophageal carcinoma after esophagectomy with extended lymph node dissection has been improving. We report our experience of diagnosing and treatment second primary carcinomas arising in the remaining esophagus after thoracic esophagectomy.


METHODS
Among 253 patients who underwent esophagectomy for thoracic esophageal carcinoma more than 2 years previously, second primary esophageal carcinomas developed in five (2.0%), and these five patients were examined.


RESULTS
All second primary carcinomas were found by endoscopy, and were diagnosed as superficial carcinoma (Tis or T1) of the residual cervical esophagus. One patient underwent laser irradiation, another endoscopic mucosal resection, two had surgical mucosectomy, and one segmental resection of the esophagus. After the second treatment, three patients were disease free for 37-38 months, one died of recurrent disease of the first carcinoma 36 months later, and one died of distant metastases of the second carcinoma 8 months later. There have been no local recurrences after treatments for the second primaries.


CONCLUSIONS
A variety of low-trauma treatments were employed for the second carcinomas because they were found at an early stage. Endoscopic follow-up is proposed to detect second lesions at an early stage.
Murata
S
S
Department of Surgery, National Cancer Center Hospital and Research Institute, Tokyo, Japan.
Kato
H
H
Tamura
H
H
Tachimori
Y
Y
Watanabe
H
H
Yamaguchi
H
H
Nakanishi
Y
Y
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D004945:Esophagoscopy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000601:surgery