Long -term survival in stage IV esophageal adenocarcinoma with chemoradiation and serial endoscopic cryoablation

• Type of Material: Article
• Authors: Zachary Spiritos, Emory University; Parit Mekaroonkamol, Emory University; Bassel El-Rayes, Emory University; Seth Force, Emory University; Steven Keilin, Emory University; Qiang Cai, Emory University; Field Willingham, Emory University
• Language: English
• Date: 2017-09-01
• Publisher: Korean Society of Gastrointestinal Endoscopy
• Publication Version: Final Published Version
• Copyright Statement: © 2017 Korean Society of Gastrointestinal Endoscopy.
• License: Creative Commons Attribution-Noncommercial 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.5946/ce.2017.006
• Title of Journal or Parent Work: Clinical Endoscopy
• ISSN: 2234-2400
• Volume: 50
• Issue: 5
• Start Page: 491
• End Page: 494
• Grant/Funding Information: This report was supported in part by a development grant from the Department of Medicine at Emory University School of Medicine.
• Keywords: Adenocarcinoma; Cryosurgery; Esophageal neoplasms
• Research Categories: Health Sciences, Oncology; Health Sciences, Medicine and Surgery

Abstract

Esophageal cancer has a poor overall prognosis and is frequently diagnosed at a late stage. Conventional treatment for metastatic esophageal cancer involves chemotherapy and radiation. Local disease control plays a significant role in improving survival. Endoscopic spray cryotherapy is a novel modality that involves freezing and thawing to produce local ablation of malignant tissue via ischemic mechanisms. Spray cryotherapy has been shown to be effective, particularly for early T-stage, superficial esophageal adenocarcinomas. We present the case of a 72-year-old-male with locally recurrent stage IV esophageal adenocarcinoma and long-term survival of 7 years to date, with concurrent chemoradiation and serial cryoablation. He remains asymptomatic and continues to undergo chemotherapy and sequential cryoablation. The findings highlight the long-term safety and efficacy of cryotherapy in combination with chemoradiation, and suggest that cryoablation may have an additive role in the treatment of advanced stage esophageal adenocarcinoma.