Assessing downgrading of esophageal adenocarcinoma after neoadjuvant chemotherapy: a case report
Abstract: Esophageal
carcinoma, squamous cell carcinoma, and adenocarcinoma, are a deadly serious
malignancy. The delay in diagnosis due to the lack of specific symptoms in the
early stages of the disease and the nature of esophageal cancer is very
aggressive lead to a poor prognosis with a survival rate of small. Current
management of esophageal cancer is recommended multimodal approach in the form
of neoadjuvant chemotherapy or combined radiochemotherapy (CRT) and with
surgery. In this article, multimodality treatment using chemotherapy and
surgery on esophageal adenocarcinoma was reported. A 52-year-old male presented
with a total obstruction of the esophagus and was planned to perform temporary
gastrostomy for chemotherapy preparation. Gastrostomy found a solid and fixed
tumor located in the gastroesophageal junction, with the size of 7 x 6 x 5 cm3.
He underwent a chemotherapy using the regimen of 8 cycles paclitaxel without
radiotherapy due to the long queue of radiotherapy schedule. After
chemotherapy, we re-evaluated and planned to perform surgical removal of the
tumor. During surgery, we found a total obstruction along with fibrosis of the
esophagus but found no tumor/mass. We performed partial esophagectomy and end
to side anastomosis using anastomosis end to side using the CDH25 circular
stapler. Surgery was carried out by the thoracoabdominal approach. The patient
was discharged on day 12 in a stable condition and was undergoing soft diet. We
planned to evaluate the patient using Carcinoembryonic Antigen (CEA) test and
Positron Emission Tomography (PET) scan. In conclusion, multimodality treatment
using chemotherapy and surgery on a case of one-third distal esophageal
adenocarcinoma provides good results.
Author: Adeodatus Yuda Handaya
Journal Code: jpkedokterangg170284
