With the advancement of these drugs, cases of long-term survival and profound responses in ESCC with distant metastases have been observed. Furthermore, the KEYNOTE-590 and CheckMate 648 trials showed the superiority of the anti-PD-1 antibody and chemotherapy combination group over the chemotherapy alone.
In recent years, the efficacy of immune checkpoint inhibitors has been reported in several cancer types, and the efficacy of nivolumab, an anti-programmed death (PD)-1 antibody, has been demonstrated in the second-line treatment of esophageal cancer. Particularly, the add-on effects of anti-epidermal growth factor receptor (EGFR) antibodies, such as cetuximab and panitumumab, have been studied however, no superiority has been shown. To date, efficacy drugs in combination with FP therapy have been studied in several clinical trials. The combination of cisplatin and 5-fluorouracil (FP) has been considered the standard treatment for chemotherapy in cases of ESCC with distant metastasis. Ĭhemotherapy is the standard of care in cases of ESCC with distant metastasis, where the performance status is good and there is no obstruction. Conversion surgery following chemotherapy or chemoradiotherapy has been considered a promising strategy for improving the prognosis of patients with locally advanced ESCC. The primary treatment for esophageal squamous cell carcinoma (ESCC) without distant metastasis is surgery, which can include esophagectomy, radiation therapy, and chemotherapy. Squamous cell carcinoma accounts for the majority of the histological classification of esophageal cancer in Japan. It is the ninth most common cancer worldwide and the sixth leading cause of cancer-related death. ConclusionsĬonversion surgery following preoperative therapy, including immunotherapy, may be an effective treatment strategy for improving survival in patients with esophageal squamous cell carcinoma even among older adult patients.Įsophageal cancer is a highly aggressive disease and is often diagnosed at a locally advanced or metastatic stage. The patient had no recurrence 10 months postoperatively without adjuvant chemotherapy. Histological examination revealed complete response with no residual tumor or lymph node metastasis. The lymph node at the dorsal side of the IVC was not resected, and the left supraclavicular lymph node was removed. The patient underwent thoracoscopic subtotal esophagectomy and regional lymph node dissection. After four pharmacotherapy courses, primary tumor and metastatic lymph node shrinkage was observed. She was treated with pembrolizumab, cisplatin, and 5-fluorouracil. She was diagnosed with esophageal squamous cell carcinoma with distant metastasis of the lymph node at the dorsal side of the IVC and the left supraclavicular lymph node. Case presentationĪn 80-year-old woman presenting with difficulty swallowing was referred to our hospital. Here, we report a case of an older adult patient with esophageal squamous cell carcinoma who underwent surgery following combined treatment of immunotherapy and chemotherapy and achieved pathological complete response. Chemotherapy and chemoradiotherapy are common treatments for esophageal squamous cell carcinoma with distant metastasis however, the prognosis remains poor, and complete remission is difficult to achieve.
0 kommentar(er)
