2ND PRIMARY-CARCINOMA IN THE RESIDUAL CERVICAL ESOPHAGUS AFTER THORACIC ESOPHAGECTOMY - REPORT OF 5 CASES

Background and Objectives: Development of second primary carcinomas af ter thoracic esophagectomy has become of much concern, because recentl y the prognosis of thoracic esophageal carcinoma after esophagectomy w ith extended lymph node dissection has been improving. We report our e xperience of diagnosing and treatment second primary carcinomas arisin g in the remaining esophagus after thoracic esophagectomy. Methods: Am ong 253 patients who underwent esophagectomy for thoracic esophageal c arcinoma more than 2 years previously, second primary esophageal carci nomas developed in five (2.0%), and these five patients were examined. Results: All second primary carcinomas were found by endoscopy, and w ere diagnosed as superficial carcinoma (Tis or T1) of the residual cer vical esophagus. One patient underwent laser irradiation, another endo scopic mucosal resection, two had surgical mucosectomy, and one segmen tal resection of the esophagus. After the second treatment, three pati ents were disease free for 37-38 months, one died of recurrent disease of the first carcinoma 36 months later, and one died of distant metas tases of the second carcinoma 8 months later. There have been no local recurrences after treatments for the second primaries. Conclusions: A variety of low-trauma treatments were employed for the second carcino mas because they were found at an early stage. Endoscopic follow-up is proposed to detect second lesions at an early stage. (C) 1997 Wiley-L iss, Inc.