[Resection of esophageal cancer infiltrating the left main bronchus following complete response to preoperative radiochemotherapy--a case report].
We report a case of esophageal cancer infiltrating the left main bronchus in which radical esophagectomy with clear surgical margins could be performed after preoperative radiochemotherapy. The patient was a 57-year-old man, who was found to have esophageal squamous cell carcinoma of the middle thoracic esophagus during a work-up of dysphagia. Bronchoscopy revealed an elevated region protruding into the lumen of the left main bronchus. After radiochemotherapy (liniac irradiation + low-dose FP therapy), the esophageal and bronchial lesion became smaller. The case was evaluated as a clinically complete response. Bronchoscopic ultrasonography showed a clear boundary between the membranous portion of the trachea and the esophageal wall. Based on these findings, the lesion was considered resectable and radical surgery, including 3-field lymph node dissection, was performed. The resected esophageal specimen had residual cancer cells in the muscularis propria covered with normal mucosa. However, the patient is currently healthy with no evidence of disease. The indication for surgical resection in cases of esophageal cancer with contiguous spread, and a good response to preoperative radiochemotherapy, is controversial. It is necessary to verify the effectiveness of surgical resection, as a secondary treatment, by accumulating data on cases such as the present one.
Takemura
Masashi
M
Dept. of Gastroenterological Surgery, Osaka City University Graduate School of Medicine.
Osugi
Harushi
H
Lee
Shigeru
S
Taguchi
Shinichi
S
Kaneko
Masahiro
M
Tanaka
Yoshinori
Y
Fukuhara
Kenichirou
K
Fujiwara
Yushi
Y
Nishizawa
Satoshi
S
Kinoshita
Hiroaki
H
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001984:Bronchial Neoplasms / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002945:Cisplatin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016629:Esophagectomy; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D011879:Radiotherapy Dosage
D002945:Cisplatin; D005472:Fluorouracil