Salvage esophagectomy after definitive chemoradiotherapy for synchronous double cancers of the esophagus and head-and-neck.
Head-and-neck cancer is frequently associated with esophageal cancer. Because the operative procedures for these synchronous double cancers are too invasive, definitive chemoradiotherapy tends to be applied as an initial treatment. A salvage esophagectomy for either recurrent or residual disease after definitive chemoradiotherapy in patients with such double cancer has never been reported. We reviewed 21 patients with esophageal cancer who underwent a salvage esophagectomy after definitive chemoradiotherapy. Among them, the treatment course of five patients who underwent a salvage esophagectomy for patients with synchronous double cancers of the esophagus and head-and-neck region was analyzed. Because head-and-neck cancer was well controlled after chemoradiotherapy in all five patients, a salvage esophagectomy was indicated for either recurrent or residual esophageal cancer after definitive chemoradiotherapy. Anastomotic leakage developed in four patients; however, no other complications including pulmonary complications were recognized. All of them were discharged to home and three of them are still alive without any recurrence for 20-43 months. A salvage esophagectomy should be considered as a treatment option for either recurrent or residual esophageal cancer with well-controlled head-and-neck cancer after definitive chemoradiotherapy when complete resection of the esophagus is expected.
Yoshida
R
R
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Morita
M
M
Ando
K
K
Masuda
T
T
Saeki
H
H
Oki
E
E
Sadanaga
N
N
Nakashima
T
T
Kakeji
Y
Y
Maehara
Y
Y
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D004938:Esophageal Neoplasms / Q000628:therapy*; D016629:Esophagectomy; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018365:Neoplasm, Residual / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000628:therapy; D018714:Radiotherapy, Adjuvant; D016879:Salvage Therapy