title: Salvage esophagectomy after definitive chemoradiotherapy for synchronous double cancers of the esophagus and head-and-neck.
abstract: 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.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Yoshida
authors.forename: M
authors.initials: M
authors.lastname: Morita
authors.forename: K
authors.initials: K
authors.lastname: Ando
authors.forename: T
authors.initials: T
authors.lastname: Masuda
authors.forename: H
authors.initials: H
authors.lastname: Saeki
authors.forename: E
authors.initials: E
authors.lastname: Oki
authors.forename: N
authors.initials: N
authors.lastname: Sadanaga
authors.forename: T
authors.initials: T
authors.lastname: Nakashima
authors.forename: Y
authors.initials: Y
authors.lastname: Kakeji
authors.forename: Y
authors.initials: Y
authors.lastname: Maehara
mesh_terms: 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