Early Recurrence after Salvage Surgery Following Definitive Chemoradiotherapy for Esophageal Cancer

Hiroshi Sato, Yasuhiro Tsubosa and Ichiro Ito*

Department of Esophageal Surgery and Department of Pathology*, Shizuoka Cancer Center

The number of salvage surgeries for esophageal cancer after definitive chemoradiotherapy is currently increasing. From September 2002 to December 2003, 5 patients with squamous cell carcinoma of the esophagus, who derived no benefit from definitive chemoradiotherapy (CRT) underwent salvage surgery. Of these 3 were confirmed to have early recurrence after salvage surgery. Case 1: A 57-year-old man underwent lower esophagectomy combined with total gastrectomy for a primary lesion and lymph node metastasis in the lesser curvature of the stomach after CRT. Recurrence in the lymph node behind the pancreas was confirmed a month later. Case 2: A 74-year-old woman underwent right lymph node dissection for metastasis of 106 recR lymph node after CRT. Recurrence of the primary lesion without lymph node metastasis was confirmed a month later. Case 3: A 65-year-old man underwent pharyngolaryngoesophagectomy for residual cervical esophageal carcinoma after CRT. Microscopically, no viable cancer cells were confirmed in the resected specimen, but multiple lung metastases were confirmed 2 months later. Although salvage surgery is ostensibly curative, these cases all suffered recurrence within 2 months. Suitable indications and procedures for salvage surgery remain to be established and its outcome to be thoroughly evaluated. Under these conditions, informed consent is very important.

Key words
esophageal carcinoma, chemoradiotherapy, salvage surgery

Reprint requests
Hiroshi Sato Department of Esophageal Surgery, Shizuoka Cancer Center
Naga-izumi, Suntogun, Shizuoka, 411-8777 JAPAN

Accepted
July 28, 2004

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