Open AccessSuccessful treatment of cervical and upper thoracic esophageal adenocarcinoma using induction chemotherapy followed by surgery: a case report
Author(s) -
Takeharu Imai,
Yoshihiro Tanaka,
Hidenori Ojio,
Yuta Sato,
Tomonari Suetsugu,
Masahiro Fukada,
Itaru Yasufuku,
Yoshinori Iwata,
Hisashi Imai,
Naoki Okumura,
Nobuhisa Matsuhashi,
Tsuyoshi Takahashi,
Kei Noguchi,
Tatsuhiko Miyazaki,
Kazuhiro Yoshida
Publication year - 2021
Publication title -
international cancer conference journal
Language(s) - English
Resource type - Journals
ISSN - 2192-3183
DOI - 10.1007/s13691-021-00505-y
Subject(s) - medicine , adenocarcinoma , surgery , induction chemotherapy , chemotherapy , dissection (medical) , stage (stratigraphy) , mediastinum , cancer , paleontology , biology
Cervical esophageal adenocarcinoma has a low incidence rate and its treatment involves various strategies. We report a patient with locally advanced cervical to upper esophageal adenocarcinoma who was able to undergo induction chemotherapy and radical surgery. A 55-year-old man was diagnosed with a poorly differentiated adenocarcinoma between the cervical and upper thoracic esophagus. The primary lesion had infiltrated into the tracheal membrane and had metastasized into the cervical lymph nodes. The initial diagnosis was T4bN1M1 stage IVB. The lower edge of the tumor was close to the tracheal bifurcation, making it difficult to create a longitudinal tracheal foramen during surgery. Therefore, when biweekly-DCF therapy was performed as induction chemotherapy, the tumor shrank sufficiently and its infiltration into the tracheal membrane decreased subsequently. We performed total laryngopharyngoesophagectomy with three-field lymph node dissection and reconstruction using free jejunal grafts and subtotal stomach via a posterior mediastinum route and a permanent tracheal foramen as a radical surgery. The pathological diagnosis was T2/MP, N1, and the effect of chemotherapy was grade 2. Cervical esophageal adenocarcinoma was rare, but technically reliable and safe oncologic surgery was possible after induction chemotherapy.