title: Esophageal cancer treated by endoscopic submucosal dissection after neoadjuvant chemoradiotherapy: a case report.
abstract: BACKGROUND
  The treatment of esophageal cancer remains clinically challenging because of the overall poor prognosis associated with the disease. The mortality rate associated with surgical treatment is high, and the majority of diagnosed patients are old. As such, surgery is not possible in many cases, even when the cancer has progressed to a resectable state.
  
  
  METHODS
  We present the case of an 82-year-old Korean man who presented to our institution with intermittent odynophagia. Esophageal cancer with submucosal invasion and metastasis to three regional lymph nodes was diagnosed. After neoadjuvant chemoradiotherapy, his regional lymph nodes disappeared. Because of his poor pulmonary function, surgical treatment could not be performed. Endoscopic submucosal dissection was carried out instead, and endoscopic triamcinolone injections were performed serially. Neither recurrence nor abnormal symptoms such as dysphagia or regurgitation have developed for 36 months.
  
  
  CONCLUSIONS
  The literature suggests that endoscopic submucosal dissection after chemoradiotherapy is a viable treatment modality in patients with esophageal cancer with a high surgical treatment risk.
authors.forename: Jang Hwan
authors.initials: JH
authors.lastname: Lim
authors.forename: Sang Ah
authors.initials: SA
authors.lastname: Lee
authors.forename: Gyoun Eun
authors.initials: GE
authors.lastname: Kang
authors.forename: Jong Min
authors.initials: JM
authors.lastname: Kim
authors.forename: Jin Kyung
authors.initials: JK
authors.lastname: Park
authors.forename: Yun Jin
authors.initials: YJ
authors.lastname: Chung
authors.forename: Jae Kwon
authors.initials: JK
authors.lastname: Jung
authors.forename: Chang Keun
authors.initials: CK
authors.lastname: Park
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Daegu Fatima Hospital, 183 Ayangro, Dong-gu, Daegu 701-600, South Korea. storm5333@naver.com.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Lee
mesh_terms: D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery / Q000628:therapy*; D059248:Chemoradiotherapy; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D016896:Treatment Outcome