[A case of advanced esophageal cancer with direct bronchial invasion successfully treated by multidisciplinary therapy].
A 66-year-old man with advanced esophageal cancer (staging Mt, 6.0 cm, cT3N0M0, cStage II) was administered neoadjuvant chemotherapy (NAC: 5-fluorouracil and cisplatin). As the tumor continued to grow after one course of NAC, video-assisted thoracoscopic surgery(VATS) was used to perform an esophagectomy along with 3-field lymph node dissection and retrosternal route reconstruction using a gastric tube. The second course of NAC was not administered. Intraoperative findings showed the direct invasion of the primary esophageal cancer into the membranous portion of the left bronchus. The maximum possible tumor tissue was resected and removed. The tumor tissue was exposed extensively to the surface of the esophageal adventitia and a residual tumor at the surface of the left bronchus was suspected. It was diagnosed as CT-pT4 (left bronchus), N0, M0, CT-pStage III. Subsequently, we administered chemoradiotherapy consisting of weekly low-dose docetaxel with radiation for the residual tumor (60 Gy/30 Fr). The patient is still alive 40 months after surgery without any signs of recurrence.
Dept. of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University.
Yusuke
Y
Haba
Koichi
K
Okamoto
Toshifumi
T
Watanabe
Tomoya
T
Tsukada
Jun
J
Kinoshita
Isamu
I
Makino
Keishi
K
Nakamura
Katsunobu
K
Oyama
Itasu
I
Ninomiya
Sachio
S
Fushida
Takashi
T
Fujimura
Tetsuo
T
Ohta
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001980:Bronchi / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D000077277:Esophageal Squamous Cell Carcinoma; D016629:Esophagectomy; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness