Abstract
BackgroundSurgical treatment for pulmonary metastases is known to be a safe and potentially curative procedure for various primary malignancies. However, there are few reports regarding the prognostic role of surgical treatment for pulmonary metastases from esophageal carcinoma, especially after definitive chemoradiotherapy (CRT).MethodsWe retrospectively reviewed 5 patients who underwent surgical treatment for pulmonary metastases from esophageal carcinoma at our institution. The primary treatment for esophageal carcinoma was definitive CRT, and a complete response (CR) was achieved in all patients.ResultsThe surgical procedure for pulmonary metastases was wedge resection, and pathological complete resection was achieved in all 5 patients. The disease free interval after definitive CRT varied from 7 to 36 months, with a median of 19 months. There were no perioperative complications, but postoperative respiratory failure occurred in 1 patient. The postoperative hospital stay varied from 4 to 7 days, with a median of 6 days. Three patients are now alive with a good performance status (PS) and are disease free. The other 2 patients died of primary disease. The overall survival after surgical treatment varied from 20 to 90 months, with a median of 29 months.ConclusionsSurgical treatment should be considered for patients with pulmonary metastases from esophageal carcinoma who previously received CRT and achieved a CR, because it provides not only a longer survival, but also a good postoperative PS for some patients.
Highlights
Surgical treatment for pulmonary metastases is known to be a safe and potentially curative procedure for various primary malignancies
We report our institutional experience with surgical treatment for pulmonary metastases from esophageal carcinoma after definitive chemoradiotherapy (CRT)
Esophageal carcinoma was located in cervical esophagus (Ce) in 3 patients, and in the upper thoracic esophagus (Ut) in 2 patients
Summary
Surgical treatment for pulmonary metastases is known to be a safe and potentially curative procedure for various primary malignancies. Surgical treatment for pulmonary metastases is known to be a safe and potentially curative procedure for various epithelial tumors, germ cell tumors, and sarcomas. Esophageal carcinoma can cause systemic spread at an early stage [8], and esophageal pulmonary metastases are often detected as multiple lesions, accompanied with other sites of metastasis. Reflecting these lethal propensities of esophageal carcinoma, surgical treatment for pulmonary metastases from esophageal carcinoma is rarely performed. This is presumably the main reason why there have so far been few reports
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