Successful resection after neoadjuvant chemotherapy for esophageal cancer with posterior thoracic paraaortic lymph node metastasis: a case report and literature review

Gen Thorac Cardiovasc Surg. 2017 Sep;65(9):542-548. doi: 10.1007/s11748-017-0802-0. Epub 2017 Jul 24.

Abstract

Metastasis to the posterior thoracic paraaortic lymph nodes rarely occurs in esophageal cancer, and a treatment strategy has not been established. We treated two cases of esophageal cancer with this type of metastasis; in both cases, we successfully performed surgical resection after neoadjuvant chemotherapy. In case 1, the patient received neoadjuvant chemotherapy, which consisted of docetaxel, cisplatin and 5-fluorouracil, and then underwent dissection of the posterior thoracic paraaortic lymph nodes. The left thoracic approach was used together with subtotal esophagectomy via a right thoracotomy. In case 2, the patient also received neoadjuvant chemotherapy and underwent dissection of the posterior thoracic paraaortic lymph nodes. The left thoracoscopic approach was used together with a subtotal esophagectomy and a right upper and middle pulmonary lobectomy (due to lung cancer) with a right thoracotomy. After 42 and 12 months' post-surgery, respectively, the patients were doing well without any evidence of recurrence.

Keywords: Case report; Esophageal cancer; Neoadjuvant chemotherapy; Posterior thoracic paraaortic lymph node metastasis; Surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / surgery*
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / surgery*
  • Esophagectomy
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Neoadjuvant Therapy*
  • Neoplasm Recurrence, Local / surgery*
  • Positron-Emission Tomography
  • Thoracotomy