PS01.141: Treatment Strategy for Thoracic Esophageal Carcinoma Complicated With Head and Neck Cancer

Abstract

Background The frequency of complication of head and neck cancer to thoracic esophageal cancer is high, and treatment methods and their order will be determined from the viewpoints of curability and quality of life. Methods We review the course of three cases we experienced and give some consideration. Results [Case 1] A 68-year-old man with cT2N0M0 Mt esophageal cancer and cT2N0M hypopharyngeal cancer. Two courses of DCF (DOC + CDDP + 5 FU) made the hypopharyngeal lesion CR. After thoracoscopic subtotal esophagectomy with three fields lymph nodes dissection, one course of DCF was added, and CRT (60 Gy/30 fr) combined with weekly CBDCA was administered to the neck. The case is alive without recurrence for 5 years and 9 months from the start of treatment. [Case 2] A 72-year-old man with cT2N0M0 Mt esophageal cancer and cT3N2bM0 hypopharyngeal cancer. Three courses of TCS (DOC + CBDCA + TS-1) made the hypopharyngeal lesion CR. After thoracoscopic subtotal esophagectomy, CRT (60 Gy) combined with biweekly CDDP was administered to the neck. The case is alive without recurrence for 5 years and 7 months. [Case 3] A 63-year-old man with LtMt multiple esophageal cancer (4 lesions, cT3N2M0) and cT2N1M0 hypopharyngeal cancer, and cT1bN0M0 gastric cancer. Though the hypopharyngeal cancer remained in PR after 2 courses of DCF, aiming at larynx preservation, thoracoscopic subtotal esophagectomy was performed, and gastric lesion was excised at the time of creating the stomach tube. After the operation, CRT (70 Gy) combined with weekly CBDCA made the hypopharyngeal lesion CR. Another cancer was demonstrated in the residual esophagus in 1 year and 3 months and surgical resection of the residual esophagus and the larynx with reconstruction with free jejunal transplantation was performed. The case is alive without recurrence for 2 years and 5 months after reoperation. Conclusion Salvage surgery may be necessary for metachronous multiple cancer cases, non-CR cases, and local recurrence cases as in case 3. We think that we can aim at compatibility of curability and maintenance of quality of life by treatment method which aims at preservation of larynx, combining with chemoradiotherapy and esophagectomy. Disclosure All authors have declared no conflicts of interest.