Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case report
Abstract Background Recurrences after radical esophagectomy are common. The prognosis for recurrent esophageal cancer is generally poor. Recurrences usually occur between 1 and 3 years of surgery, with the duration of median survival after recurrence ranging from 5 to 10 months. The number of sites...
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| Language: | English |
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Japan Surgical Society
2019-05-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-019-0634-5 |
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| author | Kosuke Hirose Hiroshi Saeki Yuichiro Nakashima Tomohiro Kamori Yoshiaki Fujimoto Tetsuro Kawazoe Hiroya Matsuoka Yasuhiro Haruta Shun Sasaki Tomoko Jogo Qingjiang Hu Yasuo Tsuda Koji Ando Eiji Oki Ryuzo Hiratsuka Yoshinao Oda Masaki Mori |
| author_facet | Kosuke Hirose Hiroshi Saeki Yuichiro Nakashima Tomohiro Kamori Yoshiaki Fujimoto Tetsuro Kawazoe Hiroya Matsuoka Yasuhiro Haruta Shun Sasaki Tomoko Jogo Qingjiang Hu Yasuo Tsuda Koji Ando Eiji Oki Ryuzo Hiratsuka Yoshinao Oda Masaki Mori |
| author_sort | Kosuke Hirose |
| collection | DOAJ |
| description | Abstract Background Recurrences after radical esophagectomy are common. The prognosis for recurrent esophageal cancer is generally poor. Recurrences usually occur between 1 and 3 years of surgery, with the duration of median survival after recurrence ranging from 5 to 10 months. The number of sites and involved organs vary among patients. Consequently, a standard therapeutic strategy has not been established, and the role of surgery in the management of recurrence is unclear. Case presentation A 67-year-old man presented with dysphagia 6 months previously and was diagnosed with esophageal squamous cell carcinoma (ESCC) in the upper thoracic region (T2M0M0, stage IB), for which he underwent thoracoscopy-assisted esophagectomy and lymphadenectomy. Adjuvant chemotherapy was not prescribed. Three years after the operation, he developed a solitary metastasis in the left lung, requiring segmentectomy followed by chemotherapy with combined cisplatin (CDDP) and 5-fluorouracil (5-FU). The following year, a metastatic lesion was recognized in the right lung, invading the chest wall, for which he underwent partial lobectomy with local chest wall resection. Multiple mediastinal and abdominal lymph node (LN) metastases were detected in the right lung a year later, which necessitated chemoradiation to a dose of 50.4 Gy with concomitant CDDP and 5-FU. Post-treatment computed tomography (CT) showed a good response. Positron emission tomography (PET)-CT revealed a reduction in the metastatic LNs with no fluoro-deoxy-glucose (FDG) uptake. The following year, metastases were detected in the left cervical LNs. Owing to the limited extent of metastases, resection was followed by chemoradiation to a dose of 50 Gy with CDDP and 5-FU. The following year, metastases were detected in the mediastinal LNs; chemotherapy was administered with nedaplatin and docetaxel. The follow-up CT and PET-CT demonstrated complete disappearance of the tumor, and the patient is currently surviving without recurrence for 11 years from the first curative operation. Conclusions This case demonstrates that aggressive multidisciplinary treatment including surgery and radiation to achieve local control could be a meaningful treatment strategy in cases with limited and slowly occurring recurrences. |
| format | Article |
| id | doaj-art-8aba679456144fcb97e0e06637c1adcf |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-8aba679456144fcb97e0e06637c1adcf2025-08-20T03:35:23ZengJapan Surgical SocietySurgical Case Reports2198-77932019-05-01511810.1186/s40792-019-0634-5Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case reportKosuke Hirose0Hiroshi Saeki1Yuichiro Nakashima2Tomohiro Kamori3Yoshiaki Fujimoto4Tetsuro Kawazoe5Hiroya Matsuoka6Yasuhiro Haruta7Shun Sasaki8Tomoko Jogo9Qingjiang Hu10Yasuo Tsuda11Koji Ando12Eiji Oki13Ryuzo Hiratsuka14Yoshinao Oda15Masaki Mori16Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityHiratsuka Gastrointestinal Surgical ClinicDepartment of Anatomic Pathology and Pathological Sciences, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Surgery and Science, Graduate School of Medical Sciences, Kyushu UniversityAbstract Background Recurrences after radical esophagectomy are common. The prognosis for recurrent esophageal cancer is generally poor. Recurrences usually occur between 1 and 3 years of surgery, with the duration of median survival after recurrence ranging from 5 to 10 months. The number of sites and involved organs vary among patients. Consequently, a standard therapeutic strategy has not been established, and the role of surgery in the management of recurrence is unclear. Case presentation A 67-year-old man presented with dysphagia 6 months previously and was diagnosed with esophageal squamous cell carcinoma (ESCC) in the upper thoracic region (T2M0M0, stage IB), for which he underwent thoracoscopy-assisted esophagectomy and lymphadenectomy. Adjuvant chemotherapy was not prescribed. Three years after the operation, he developed a solitary metastasis in the left lung, requiring segmentectomy followed by chemotherapy with combined cisplatin (CDDP) and 5-fluorouracil (5-FU). The following year, a metastatic lesion was recognized in the right lung, invading the chest wall, for which he underwent partial lobectomy with local chest wall resection. Multiple mediastinal and abdominal lymph node (LN) metastases were detected in the right lung a year later, which necessitated chemoradiation to a dose of 50.4 Gy with concomitant CDDP and 5-FU. Post-treatment computed tomography (CT) showed a good response. Positron emission tomography (PET)-CT revealed a reduction in the metastatic LNs with no fluoro-deoxy-glucose (FDG) uptake. The following year, metastases were detected in the left cervical LNs. Owing to the limited extent of metastases, resection was followed by chemoradiation to a dose of 50 Gy with CDDP and 5-FU. The following year, metastases were detected in the mediastinal LNs; chemotherapy was administered with nedaplatin and docetaxel. The follow-up CT and PET-CT demonstrated complete disappearance of the tumor, and the patient is currently surviving without recurrence for 11 years from the first curative operation. Conclusions This case demonstrates that aggressive multidisciplinary treatment including surgery and radiation to achieve local control could be a meaningful treatment strategy in cases with limited and slowly occurring recurrences.http://link.springer.com/article/10.1186/s40792-019-0634-5Esophageal cancerRecurrenceLong survivalMultidisciplinary treatment |
| spellingShingle | Kosuke Hirose Hiroshi Saeki Yuichiro Nakashima Tomohiro Kamori Yoshiaki Fujimoto Tetsuro Kawazoe Hiroya Matsuoka Yasuhiro Haruta Shun Sasaki Tomoko Jogo Qingjiang Hu Yasuo Tsuda Koji Ando Eiji Oki Ryuzo Hiratsuka Yoshinao Oda Masaki Mori Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case report Surgical Case Reports Esophageal cancer Recurrence Long survival Multidisciplinary treatment |
| title | Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case report |
| title_full | Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case report |
| title_fullStr | Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case report |
| title_full_unstemmed | Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case report |
| title_short | Successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma: a case report |
| title_sort | successful multidisciplinary treatment including repeated metastasectomy for recurrent squamous cell esophageal carcinoma a case report |
| topic | Esophageal cancer Recurrence Long survival Multidisciplinary treatment |
| url | http://link.springer.com/article/10.1186/s40792-019-0634-5 |
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