Adenocarcinoma of the proximal esophagus: Report of 9 patients and review of the literature

Salvatore Marano, Alberto Ruol, Carlo Castoro, Giuseppe Portale, Matteo Cagol, Rita Alfieri, Silvia Michieletto, Ermanno Ancona

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Adenocarcinoma of the proximal esophagus is a rare clinical entity, with only 28 cases described in the literature. We report our experience with 9 patients and a review of the literature on this topic. Methods: Between 1980 and 2004, 1010 patients with esophageal or gastroesophageal junction adenocarcinoma (from a total of 4655 cancers, 3510 squamous and 1145 adeno) presenting at our department were retrospectively evaluated. Results: Nine patients (0.9%) had adenocarcinoma located in the proximal esophagus. Four patients (Group A) were considered unfit for surgery due to severe comorbidities and/or advanced stage disease. Three of them received endoscopic yttrium-aluminum-garnet (YAG)-laser therapy; 1 patient had feeding gastrostomy. Their median survival was 6 months (range, 3-9 months). The other 5 patients (Group B) were given a first-line cytoreductive treatment: 4 had complete response, and 1 patient did not complete chemotherapy due to toxicity and underwent surgery for residual disease. The median survival for these 5 patients receiving cytoreductive therapy was 36 months (range, 24-132 months). For the 4 patients with complete clinical response to cytoreductive treatment, the median survival was 54 months (range, 24-132 months). Conclusion: First-line chemoradiotherapy is an effective treatment for adenocarcinoma of the proximal esophagus. Salvage surgery may be reserved for patients with incomplete response or recurrent disease.

Original languageEnglish
Pages (from-to)2910-2914
Number of pages5
JournalAnnals of Surgical Oncology
Volume15
Issue number10
DOIs
Publication statusPublished - Oct 2008

Keywords

  • Chemoradiotherapy
  • Esophageal adenocarcinoma
  • Proximal esophagus
  • Salvage surgery

ASJC Scopus subject areas

  • Surgery
  • Oncology

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