Surgical Treatment of Patients with Adenocarcinoma of the Distal Esophageal Portion and Gastroesophageal Junction Performed After Neoadjuvant Chemotherapy and Combined Chemoradiation

Abstract

Esophageal carcinoma is an extremely aggressive cancer with an early distant spread, high rate of local recurrence, and low overall survival. Herewith we present 3 patients with advanced moderately and low differentiated adenocarcinomas, who underwent neoadjuvant chemotherapy (nCT) (two patients) and combined nCT with neoadjuvant radiation therapy (nRT) (one patient), followed by radical surgery. Subtotal esophageal resection, proximal gastric resection, and intrathoracic right gastroesophagoplasty a modo Ivor-Lewis were performed in the first two patients, while total gastrectomy, distal third esophageal resection, splenectomy and left intrathoracic esophagojejunoplasty a modo Roux were performed in the third one. A literature review of the role of neoadjuvant chemoradiotherapy (nCRT) as part of a trimodality therapy for advanced esophageal carcinoma is presented.

Keywords

• adenocarcinoma
• esophageal carcinoma
• neoadjuvant therapy
• gastrectomy
• gastroesophagoplasty
• esophagojejunoplasty