CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(09): E1126-E1129
DOI: 10.1055/a-0599-6008
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Salvage endoscopic resection in patients with esophageal adenocarcinoma after chemoradiotherapy

Irma C. Noordzij
1   Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands
,
Wouter L. Curvers
1   Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands
,
Clément J. Huysentruyt
2   PAMM (laboratory of Pathology and Medical Microbiology), Eindhoven, the Netherlands
,
Grard A.P. Nieuwenhuijzen
3   Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands
,
Geert-Jan Creemers
4   Department of Oncology, Catharina Hospital, Eindhoven, the Netherlands
,
Maurice J.C. van der Sangen
5   Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands
,
Erik J. Schoon
1   Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, the Netherlands
› Author Affiliations
Further Information

Publication History

submitted 19 September 2017

accepted after revision 02 February 2018

Publication Date:
11 September 2018 (online)

Abstract

Background and study aims For early esophageal adenocarcinoma, endoscopic resection is an accepted curative treatment with an excellent long-term prognosis. Case series from Japan have reported endoscopic resection of residual esophageal squamous cell carcinoma after chemoradiotherapy. This is the first report describing endoscopic resection of residual esophageal adenocarcinoma after chemoradiotherapy. Two patients with advanced esophageal adenocarcinoma had been treated with chemoradiotherapy because comorbidity precluded esophageal resection. When residual tumor was observed endoscopically, complete remission was achieved by salvage endoscopic therapy alone or in combination with argon plasma coagulation (APC). Both patients achieved long-term sustained remission and died of non-tumor-related causes.

 
  • References

  • 1 Pohl H, Sirovich B, Welch HG. Esophageal adenocarcinoma incidence: are we reaching the peak?. Cancer Epidemiol Biomarkers Prev 2010; 19: 1468-1470
  • 2 Ell C, May A, Pech O. et al. Curative endoscopic resection of early esophageal adenocarcinomas (Barrett's cancer). Gastrointest Endosc 2007; 65: 3-10
  • 3 Yano T, Muto M, Hattori S. et al. Long-term results of salvage endoscopic mucosal resection in patients with local failure after definitive chemoradiotherapy for esophageal squamous cell carcinoma. Endoscopy 2008; 40: 717-721
  • 4 Takeuchi M, Kobayashi M, Hashimoto S. et al. Salvage endoscopic submucosal dissection in patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma. Scand J Gastroenterol 2013; 48: 1095-1101
  • 5 Hatogai K, Yano T, Kojima T. et al. Local efficacy and survival outcome of salvage endoscopic therapy for local recurrent lesions after definitive chemoradiotherapy for esophageal cancer. Radiat Oncol 2016; 11: 31
  • 6 Nakatani K, Tanabe S, Koizumi W. et al. Successful treatment of S-1 + CDDP followed by salvage EMR for a case with metastatic Barrett's esophageal cancer. Dis Esophagus 2007; 20: 173-177
  • 7 Shapiro J, van Lanschot JJ, Hulshof MC. et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol 2015; 16: 1090-1098
  • 8 Shapiro J, ten Kate FJ, van Hagen P. et al. Residual esophageal cancer after neoadjuvant chemoradiotherapy frequently involves the mucosa and submucosa. Ann Surg 2013; 258: 678-688
  • 9 Theisen J, Stein HJ, Dittler HJ. et al. Preoperative chemotherapy unmasks underlying Barrett's mucosa in patients with adenocarcinoma of the distal esophagus. Surg Endosc 2002; 16: 671-673
  • 10 Noordman BJ, Shapiro J, Spaander MC. et al. Accuracy of Detecting Residual Disease After Cross Neoadjuvant Chemoradiotherapy for Esophageal Cancer (preSANO Trial): Rationale and Protocol. JMIR Res Protoc 2015; 4: e79
  • 11 Shapiro J, Wijnhoven BP, van Lanschot JJ. Reply to Letter: "Residual esophageal cancer after neoadjuvant chemoradiotherapy frequently involves the mucosa and submucosa". Ann Surg 2015; 262: e84-e85