643. PRACTICAL IMAGING REVIEW OF EXPECTED FINDINGS AND POSSIBLE COMPLICATIONS RELATED TO MULTIMODAL TREATMENT OF ESOPHAGEAL CANCER

Abstract

Abstract Esophageal cancer has been a major health issue, representing the eighth most common cancer worldwide. In the last decades, esophageal cancer treatment has evolved rapidly and a multimodality approach has been increasingly used. Main treatment options for locally advanced tumors include surgery resection, neoadjuvant or definitive chemoradiotherapy and palliative endoscopic dilation/stenting. In that context, radiology plays an important role in the early identification and management of treatment related complications. Retrospective analysis of the radiological exams of esophageal cancer patients in the ICESP (Cancer Institute of Sao Paulo) followed by selection of several cases (more than 300 cases) illustrating the expected findings and the main complications related to each treatment modality (surgical, endoscopic and radiotherapy-related). Five main different complications were selected and the radiological findings were classified using the HARMS mnemonic: Hiatal hernia; Anastomotic fistula, Radiation-induced injury, Mediastinal and pleural-pulmonary abscess and stenting-related injuries. For each classification, several images were selected using the different methods of esophageal imaging - mainly upper gastrointestinal series and computed tomography. After categorization it is possible to recognize and familiarize with post-treatment complications using the “HARMS” mnemonic. Therefore, we present a review for the radiologists describing what is important to report as well as a compilation of possible image findings that oncologists, surgeons and endoscopists must be aware of.