Two Cases of Salvage Esophagectomy for Locally Recurrent Esophageal Cancer after Photodynamic Therapy

Abstract

Case 1 : A 77-year-old man with cancer of the middle thoracic esophagus (Mt type0-IIc T1bN0M0 cStage IA) underwent chemoradiotherapy that achieved a complete response. Four years later, an esophagogastroduodenoscopy (EGD) revealed local recurrence, which was treated by photodynamic therapy (PDT). Two months after PDT, local re-recurrence was observed, and he underwent salvage subtotal esophagectomy under right thoracotomy and laparotomy. He has been alive without recurrence as of 3 years and 8 months after the operation.
Case 2 : A 56-year-old man with cancer of the middle thoracic esophagus (Mt type0-IIa+IIc T1bN0M0 Stage IA) underwent chemoradiotherepy that achieved a complete response. Five years later, an EGD showed local recurrence, which was treated by endoscopic submucosal dissection (ESD) with concurrent PDT. A year and a half after ESD and PDT, local re-recurrence appeared near the ESD scar, and salvage subtotal esophagectomy under right thoracotomy and laparotomy was performed. He has been recurrence free as of 3 months after the salvage surgery. We present two cases of esophageal cancer in which salvage esophagectomy for local recurrence after PDT was helpful.