Tachibana S, Moriichi K, Takahashi K, Sato M, Kobayashi Y, Sugiyama Y, Sasaki T, Sakatani A, Ando K, Ueno N, Kashima S, Tanabe H, Fujiya M. Curative endoscopic submucosal dissection for esophageal squamous cell carcinoma after chemoradiotherapy for pharyngeal cancer: A case report. World J Gastrointest Oncol 2025; 17(4): 101123 [DOI: 10.4251/wjgo.v17.i4.101123]
Corresponding Author of This Article
Kentaro Moriichi, MD, PhD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa 078-8510, Hokkaidō, Japan. morimori@asahikawa-med.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shion Tachibana, Kentaro Moriichi, Keitaro Takahashi, Masahiro Sato, Yu Kobayashi, Yuya Sugiyama, Takahiro Sasaki, Aki Sakatani, Katsuyoshi Ando, Shin Kashima, Hiroki Tanabe, Mikihiro Fujiya, Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa 078-8510, Hokkaidō, Japan
Nobuhiro Ueno, Department of General Medicine, Asahikawa Medical University, Asahikawa 078-8510, Hokkaidō, Japan
Author contributions: Tachibana S and Moriichi K drafted the manuscript; Tachibana S, Moriichi K, Takahashi K, Sato M, Kobayashi Y, Sugiyama Y, Sasaki T, Sakatani A, Ando K, Ueno N, Kashima S, and Tanabe H were involved in the clinical management and treatment of the patient; Moriichi K and Fujiya M reviewed and revised the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: Fujiya M received lecture fees from Olympus Corporation.
CARE Checklist (2016) statement: The authors have read the CARE Checklist statement, and the manuscript was prepared and revised according to the CARE Checklist statement.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kentaro Moriichi, MD, PhD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa 078-8510, Hokkaidō, Japan. morimori@asahikawa-med.ac.jp
Received: September 4, 2024 Revised: January 1, 2025 Accepted: January 21, 2025 Published online: April 15, 2025 Processing time: 202 Days and 1.8 Hours
Abstract
BACKGROUND
Esophageal squamous cell carcinoma (ESCC) is often managed with surgery, which is the first-line treatment option for stage I–III lesions. However, definitive chemoradiotherapy (dCRT) is associated with a recurrence rate of 30% in stage I ESCC and higher rates in advanced-staged lesions. However, several patients prefer dCRT because their general condition is poor. Salvage therapies, including esophagectomy and endoscopic resection [endoscopic submucosal dissection (ESD)/endoscopic mucosal resection], are important for residual or recurrent tumors that develop after dCRT. Esophagectomy can have curative potential. However, it has high complication and mortality rates. Therefore, ESD is a safer alternative.
CASE SUMMARY
A Japanese man in his 70s was concurrently diagnosed with right hypopharyngeal cancer (T2N1M0, cStage III), left oropharyngeal cancer (T1N0M0, cStage I), and left hard palate cancer (T1N0M0, cStage I). Esophagogastroduodenoscopy (EGD) revealed a 20 mm reddish 0-Is+IIb lesion in the upper thoracic esophagus, with an invasion depth of SM2. The lesion was diagnosed as an esophageal moderately differentiated squamous cell carcinoma (T1bN0M0, cStage I). As the pharyngeal cancers were in advanced stages, chemoradiotherapy (docetaxel and cisplatin with a radiation dose of 66 Gy) was prioritized. Post-chemoradiotherapy EGD showed that the lesion had flattened into a 0-IIb lesion, thereby indicating a reduced invasion depth (epithelium or lamina propria mucosa). ESD achieved en bloc and histologically confirmed curative resection. At 22 months after ESD, the patient did not present with signs of recurrence.
CONCLUSION
This case emphasizes that ESD can be successfully utilized as a salvage treatment for ESCC after chemoradiotherapy for otolaryngological cancers.
Core Tip: The current case highlights the successful application of endoscopic submucosal dissection (ESD) as a salvage therapy for esophageal squamous cell carcinoma after chemoradiotherapy for pharyngeal cancer. This case underscores the potential of ESD to achieve curative resection in patients with complex malignancies and emphasizes the importance of further research to validate its efficacy and safety in similar contexts.
