scholarly journals Salvage esophagectomy for local recurrent esophageal cancer after definitive chemoradiotherapy followed by photodynamic therapy: A case report

2021 ◽  
Vol 80 ◽  
pp. 105617
Author(s):  
Wataru Hirose ◽  
Yusuke Taniyama ◽  
Fumiyoshi Fujishima ◽  
Chiaki Sato ◽  
Michiaki Unno ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Photodynamic Therapy ◽  
Case Report ◽  
Definitive Chemoradiotherapy ◽  
Salvage Esophagectomy

scholarly journals Definitive Chemoradiotherapy and Salvage Esophagectomy for Esophageal Cancer Associated With Multiple Lung Metastases: A Case Report

2014 ◽  
Vol 99 (5) ◽  
pp. 640-644
Author(s):  
Yoshihiko Fujinaka ◽  
Masaru Morita ◽  
Takefumi Ohga ◽  
Yoshihiro Kakeji ◽  
Tokujiro Yano ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Case Report ◽  
Distant Metastasis ◽  
Multimodal Therapy ◽  
Lung Metastases ◽  
Salvage Surgery ◽  
Complete Response ◽  
Definitive Chemoradiotherapy ◽  
Node Metastases ◽  
Salvage Esophagectomy

Abstract The prognosis of esophageal cancer with distant metastasis is dismal. We report a 70-year-old man with esophageal cancer and multiple lung and lymph node metastases. Complete response was achieved following definitive chemoradiotherapy. Twenty-four months after the initial chemoradiotherapy, local recurrence was detected but there was no evidence of distant metastasis. Therefore, the patient underwent salvage esophagectomy. The surgery was well tolerated without any postoperative complications. The patient is still alive 48 months after the salvage surgery. Our experience suggests that salvage esophagectomy is an important component of multimodal therapy for the recurrence of esophageal cancer.

PS01.236: MEDIASTINOSCOPIC SALVAGE ESOPHAGECTOMY FOR RECURRENT ESOPHAGEAL CANCER AFTER DEFINITIVE CHEMORADIOTHERAPY IN A PREVIOUSLY PNEUMONECTOMIZED PATIENT

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 116-117
Author(s):  
Tomoyuki Okumura ◽  
Yasuyuki Seto ◽  
Susumu Aikou ◽  
Makoto Moriyama ◽  
Shinich Sekine ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Tumor Recurrence ◽  
Conflicts Of Interest ◽  
Primary Lung Cancer ◽  
Esophageal Wall ◽  
Thoracic Esophagus ◽  
Definitive Chemoradiotherapy ◽  
Transhiatal Approach ◽  
Salvage Esophagectomy ◽  
Sealing Device

Abstract Background Mediastinoscopic esophagectomy is a minimally invasive surgery for thoracic esophageal cancer avoiding one-lung ventilation or transthoracic procedure. Methods We performed for the first time in the literature, salvage esophagectomy with combination of mediastinoscopic cervical approach and laparoscopic/mediastinoscopic transhiatal approach for recurrent thoracic esophageal squamous cell carcinoma (ESCC) after definitive chemoradiotherapy (dCRT) in a patient who had previously undergone a left pneumonectomy for primary lung cancer. Results A 66-year-old man was diagnosed as local recurrence of lower ESCC (cT3N0M0 cStage II) at 9 years after dCRT. His medical history included left-sided pneumonectomy for lung adenocarcinoma 9 years previously. Then the patient was diagnosed as lower thoracic ESCC (cT3N1M0 cStage III) at 2 months after pneumonectomy. He received dCRT consisting of CDDP/5-FU infusion and irradiation (60 Gy) and achieved complete response. No evidence of tumor recurrence was observed at endoscopic surveillance up until 6 years after dCRT. For this present surgery, a cervical wound was made and the intramediastinal procedure was performed under pneumomediastinum. After mobilization of upper/middle thoracic esophagus, the esophageal wall was safely separated from the remaining part and the stump of the left main bronchus. Dense adhesions between the esophagus and fibrotic tissue at the site of previous left mediastinal pleural resection was divided using a sealing device. In the abdomen, 5 ports were inserted to perform abdominal and transhiatal procedures under CO2 insufflation. After mobilization of the stomach, fibrotic scar tissue around the lower esophagus was divided using a sealing device and the peri-esophageal space dissected from cervical and transhiatal approach were connected to completely mobilize the thoracic esophagus. The esophagectomy was uneventfully carried out followed by reconstruction with gastric conduit via retrosternal rout. Pathological findings demonstrated a moderately differentiated ESCC (pT3-AD pN1 M0 pStage III), indicating that R0 resection was successfully performed. The patient has been closely observed as an outpatient and was alive and healthy at 3 months after the operation without tumor recurrence. Conclusion Mediastinoscopic esophagectomy is a safe and curative treatment strategy for esophageal cancer patients who had a previous pneumonectomy, even in salvage surgery for recurrent cancer after dCRT. Disclosure All authors have declared no conflicts of interest.

scholarly journals Different strategy of salvage esophagectomy between residual and recurrent esophageal cancer after definitive chemoradiotherapy

2018 ◽  
Vol 10 (3) ◽  
pp. 1554-1562 ◽  
Author(s):  
Yusuke Taniyama ◽  
Yusuke Taniyama ◽  
Tadashi Sakurai ◽  
Takahiro Heishi ◽  
Hiroshi Okamoto ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Definitive Chemoradiotherapy ◽  
Salvage Esophagectomy

RA10.04: POSTOPERATIVE PNEUMONIA IS ASSOCIATED WITH SHORT-TERM AND LONG-TERM MORTALITY OF DEFINITIVE CHEMORADIOTHERAPY FOLLOWED BY SALVAGE ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 43-43
Author(s):  
Masashi Takeuchi ◽  
Hirofumi Kawakubo ◽  
Shuhei Mayanagi ◽  
Kazumasa Fukuda ◽  
Rieko Nakamura ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
Prediction Model ◽  
Salvage Surgery ◽  
Postoperative Pneumonia ◽  
Short Term ◽  
Definitive Chemoradiotherapy ◽  
Invasive Approach ◽  
Salvage Esophagectomy

Abstract Background Although definitive chemoradiotherapy (CRT) with salvage esophagectomy has improved overall survival (OS) for esophageal cancer, it is a more invasive approach than neoadjuvant CRT followed by surgery or surgery alone, and causes high mortality after surgery. The purpose of this study was to investigate the short and long-term outcomes of salvage esophagectomy, to determine their prognostic factors, and to create a prediction model for OS using a classification and regression tree (CART). Methods Ninety patients who had undergone CRT followed by esophagectomy for thoracic esophageal cancer at Keio University Hospital, Tokyo, Japan, between June 1994 and August 2014 were identified for this study. We divided the 90 patients into two groups—the salvage group and the neoadjuvant group—according to the dose of irradiation of CRT. Forty-four patients who underwent CRT with radiation dose less than 50 Gy, followed by planned esophagectomy, were allocated to the neoadjuvant group. Forty-six patients with salvage esophagectomy for locally recurrent or residual cancer after definitive CRT (greater than 50 Gy) were allocated to the salvage group. Results Patients from the salvage group tended to have a lower OS (median survival: Salvage, 25 months vs neoadjuvant, 50 months, P = 0.149). In the salvage group, pneumonia and age were identified as factors predictive of in-hospital mortality. OS was significantly lower in patients with postoperative pneumonia and female gender. We set the prediction model for OS in the salvage group using survival CART. The group of R1/2 resection aged ≥ 56.5 years and the group suffering from postoperative pneumonia were the groups at highest risk; the area under the curve was 0.72. Conclusion The present study demonstrates the short-term and long-term prognostic factors of salvage esophagectomy after definitive CRT for esophageal cancer. Achieving improvement in OS after salvage surgery requires increased R0 resection rates and decreased pulmonary complications. Both informed decision making in the adoption of salvage surgery and specific plans to reduce pneumonia through means such as pulmonary rehabilitation are required. Disclosure All authors have declared no conflicts of interest.

PS02.139: THE TREATMENT STRATEGY AND CLINICAL OUTCOMES FOR SALVAGE ESOPHAGECTOMY AFTER DEFINITIVE CHEMORADIOTHERAPY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 160-160
Author(s):  
Kyohei Ogawa ◽  
Kosuke Narumiya ◽  
Kenji Kudo ◽  
Yosuke Yagawa ◽  
Shinsuke Maeda ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Clinical Outcomes ◽  
Treatment Strategy ◽  
Conflicts Of Interest ◽  
High Rate ◽  
Hospital Death ◽  
Definitive Chemoradiotherapy ◽  
Unresectable Tumor ◽  
Back Ground ◽  
Salvage Esophagectomy

Abstract Background Definitive chemoradiotherapy for esophageal cancer which was unresectable tumor has become common therapy. In recently, we have perform chemoradiotherapy for resectable tumor because esophagectomy for esophageal cancer is an invasive surgical procedure. But some cases were recurrent. We examined the treatment strategy and clinical outcomes of salvage esophagectomy after definitive chemoradiotherapy for esophageal cancer. Methods We reviewed 46 cases of subjects with esophageal cancer who underwent salvage esophagectomy after definitive chemoradiotherapy with more than 50Gy of radiation from 2000 to 2017. We exam (1) Back ground (2) Term after Chemoradiotherapy (3)Surgical approach (4) Route of reconstruction (5)Rang of lymphanodectomy (6)Complication (7)Prognosis. Results Age 63.0(43–79), Male: Female = 44:2, Location: Upper/Middle/Lower = 15/25/8, T1/T2/T3/T4 = 11:2:25:8 R0: R1: R2 = 35:9:2 (2) Within1 year/More than 1 year = 31/15 (3) Neck digection/Right thoracotomy: Left thoracotomy: laparotomy = 8:31:5:2 (4) Mediastinal rute/Ante/Retro = 34:9:3 (5) 1 Field:2 Field:3 Field = 11:27:8 (6) Anastleakage/Pneumonia/Abcess/Meningitis/Fluid in the thoracic cavity = 11: 9: 4: 1: 8 (7) 5-years survival rate was 36%. Hospital death was4.3% Conclusion There were high rate complications for salvage esophagectomy after definitive chemoradiotherapy for esophageal cancer. Patients should be carefully selected for salvage esophagectomy.Surgeons should consider the indications and techniques for esophageal surgery to increase cure rates and decrease morbidity. Disclosure All authors have declared no conflicts of interest.

Postoperative Pneumonia is Associated with Long-Term Oncologic Outcomes of Definitive Chemoradiotherapy Followed by Salvage Esophagectomy for Esophageal Cancer

2018 ◽  
Vol 22 (11) ◽  
pp. 1881-1889 ◽  
Author(s):  
Masashi Takeuchi ◽  
Hirofumi Kawakubo ◽  
Shuhei Mayanagi ◽  
Kayo Yoshida ◽  
Kazumasa Fukuda ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Oncologic Outcomes ◽  
Postoperative Pneumonia ◽  
Definitive Chemoradiotherapy ◽  
Salvage Esophagectomy
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