Singh Anupama, McAllister Miles, Deeb Ashley L, Wang Sue X, Rizza Kristen, Ho Vincent T, Mamon Harvey, Enzinger Peter C, Jaklitsch Michael T, Wee Jon O
Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Division of Cellular Therapies, Dana-Farber Cancer Institute, Boston, Massachusetts.
Ann Thorac Surg Short Rep. 2024 Mar 22;2(3):535-539. doi: 10.1016/j.atssr.2024.02.014. eCollection 2024 Sep.
Development of secondary esophageal cancer after hematopoietic stem cell transplantation has been described; however, there is little consensus on treatment and surveillance for these patients. The objective of this study was to describe our experience treating patients with secondary esophageal cancer.
A retrospective chart review of prospectively collected data was performed to identify patients who underwent hematopoietic stem cell transplantation from 1997 to 2012 and in whom esophageal cancer developed later.
A total of 5066 patients underwent hematopoietic stem cell transplantation, and esophageal cancer developed in 11 (0.2%) of these patients. The median time to diagnosis of esophageal cancer after hematopoietic stem cell transplantation was 11 years (interquartile range, 8.5 to 14 years). Four patients received a diagnosis of stage III or IV disease. Seven patients underwent esophagectomy, 6 patients after neoadjuvant treatment. Three patients experienced adverse events postoperatively, all grades II and IIIa. Two surgical patients died of distant recurrence 2 years and 3 years, respectively, after their esophageal cancer diagnosis. The other 5 surgical patients have not experienced recurrence of their esophageal cancer.
For patients with secondary esophageal cancer, esophagectomy after neoadjuvant treatment has acceptable morbidity and may be a viable option for this cohort.
造血干细胞移植后发生继发性食管癌的情况已有报道；然而，对于这些患者的治疗和监测几乎没有共识。本研究的目的是描述我们治疗继发性食管癌患者的经验。
对前瞻性收集的数据进行回顾性病历审查，以确定1997年至2012年间接受造血干细胞移植且后来发生食管癌的患者。
共有5066例患者接受了造血干细胞移植，其中11例（0.2%）发生了食管癌。造血干细胞移植后诊断食管癌的中位时间为11年（四分位间距，8.5至14年）。4例患者被诊断为III期或IV期疾病。7例患者接受了食管切除术，6例在新辅助治疗后进行。3例患者术后出现不良事件，均为II级和IIIa级。2例手术患者分别在食管癌诊断后2年和3年死于远处复发。其他5例手术患者未出现食管癌复发。
对于继发性食管癌患者，新辅助治疗后进行食管切除术具有可接受的发病率，可能是该队列的一个可行选择。
