Secondary Esophageal Cancer After Hematopoietic Stem Cell Transplant: An Institutional Case Series

Abstract

BackgroundDevelopment of secondary esophageal cancer after hematopoietic stem cell transplantation has been described; however, there is little consensus on treatment and surveillance for these patients. The objective of this study was to describe our experience treating patients with secondary esophageal cancer. MethodsA retrospective chart review of prospectively collected data was performed to identify patients who underwent hematopoietic stem cell transplantation from 1997 to 2012 and in whom esophageal cancer developed later. ResultsA total of 5066 patients underwent hematopoietic stem cell transplantation, and esophageal cancer developed in 11 (0.2%) of these patients. The median time to diagnosis of esophageal cancer after hematopoietic stem cell transplantation was 11 years (interquartile range, 8.5 to 14 years). Four patients received a diagnosis of stage III or IV disease. Seven patients underwent esophagectomy, 6 patients after neoadjuvant treatment. Three patients experienced adverse events postoperatively, all grades II and IIIa. Two surgical patients died of distant recurrence 2 years and 3 years, respectively, after their esophageal cancer diagnosis. The other 5 surgical patients have not experienced recurrence of their esophageal cancer. ConclusionsFor patients with secondary esophageal cancer, esophagectomy after neoadjuvant treatment has acceptable morbidity and may be a viable option for this cohort.