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Abstract Definitive chemoradiotherapy (dCRT) for the esophageal squamous cell carcinoma (ESCC) is performed for patients with cT4 disease without distant metastasis and also for those with cStage I‐III who are unable to tolerate or who refuse surgery. The rates of clinical complete response (cCR) after dCRT differ depending on the cStage, and patients who once achieved cCR frequently experience tumor recurrence. For those with residual tumor or with recurrence, salvage treatment is performed to achieve a cure. Several procedures have been reported as salvage treatments. Salvage esophagectomy is associated with high rates of morbidity and mortality, but can offer long‐term survival. With R0 resection, with cCR to dCRT, pulmonary complications appear to be important prognostic factors affecting overall survival (OS). Lymphadenectomy is performed for the patients with lymph node metastasis without recurrence of primary lesions or distant metastasis, but the contribution to long‐term OS is unclear. Metastasectomy is performed when distant metastasis is limited to the lung and there are few lesions, possibly contributing to long‐term OS. Endoscopic resection and photodynamic therapy are indicated for cT1a and cT1‐2 residual or recurrent tumors, respectively, and can yield favorable outcomes. Re‐CRT and re‐radiotherapy are performed for the patients with contraindications for surgery, but neither appears to contribute to long‐term OS despite high incidences of esophageal fistula and perforation.

Definitive chemoradiotherapy (dCRT) for the esophageal squamous cell carcinoma (ESCC) is performed for patients with cT4 disease without distant metastasis and also for those with cStage I‐III who are unable to tolerate or who refuse surgery. The rates of clinical complete response (cCR) after dCRT differ depending on the cStage, and patients who once achieved cCR frequently experience tumor recurrence. For those with residual tumor or with recurrence, salvage treatment is performed to achieve a cure. Several procedures have been reported as salvage treatments. Salvage esophagectomy is associated with high rates of morbidity and mortality, but can offer long‐term survival. With R0 resection, with cCR to dCRT, pulmonary complications appear to be important prognostic factors affecting overall survival (OS). Lymphadenectomy is performed for the patients with lymph node metastasis without recurrence of primary lesions or distant metastasis, but the contribution to long‐term OS is unclear. Metastasectomy is performed when distant metastasis is limited to the lung and there are few lesions, possibly contributing to long‐term OS. Endoscopic resection and photodynamic therapy are indicated for cT1a and cT1‐2 residual or recurrent tumors, respectively, and can yield favorable outcomes. Re‐CRT and re‐radiotherapy are performed for the patients with contraindications for surgery, but neither appears to contribute to long‐term OS despite high incidences of esophageal fistula and perforation. This review article focused on salvage treatment, i.e. esophagectomy, lymphadenectomy, metastasectomy, endoscopic resection, photodynamic therapy, and re‐chemoradiotherapy/radiotherapy, after definitive chemoradiothrapy (dCRT) for esophageal squamous cell carcinoma. Among these procedures, salvage esophagectomy is associated with high mortality and morbidity, but offers long‐term survival for patients with R0 resection. [ABSTRACT FROM AUTHOR]

Radiotherapy (RT) or chemoradiotherapy (CRT) is a potentially curative, non-surgical treatment option for esophageal cancer, although the rate of local failure within the esophagus remains relatively high. Salvage esophagectomy is not regarded as a common treatment for esophageal cancer, since it is a high-risk surgery with a relatively high surgical mortality rate. Salvage endoscopic resection (ER) for local failure is used for treatment when esophageal cancer is localized and superficial. To evaluate to usefulness of salvage ER, the present study reviewed the clinicopathological records and follow-up data of 37 patients that underwent salvage ER for esophageal cancer, following initial treatment with RT or CRT. Salvage ER was conducted on a total of 78 lesions observed in the 37 patients. Since a thick epithelium and lack of normal vessels on the surface of the mucosa are characteristics of esophageal mucosa following RT or CRT, almost all the lesions were detected using iodine dyeing, and not by narrow band imaging. The growth rate of the detected lesions was relatively high, and early treatment was required. No particular complications occurred during the endoscopic treatment. A total of 11 patients survived for >5 years subsequent to initial endoscopic treatment. Only 4 patients succumbed to esophageal cancer. In conclusion, the present study demonstrated that salvage ER following CRT or RT for esophageal cancer is a minimally invasive, safe, adaptive and curative method for superficial lesions without distant metastases in patients with esophageal cancer with local failure following CRT or RT. [ABSTRACT FROM AUTHOR]

Chemotherapy for hemodialysis patients is not yet well codified, and the selection of individual patients remains difficult. We report the case of a 71-year-old hemodialyzed man who was successfully treated with docetaxel for squamous cell carcinoma of the esophagus. He had received radiotherapy for squamous cell carcinoma of the esophagus 6 years earlier. Metachronous esophageal cancer had developed at the upper third of the esophagus. He was treated tri-weekly with docetaxel at a dose of 60 mg/body in combination with hemodialysis three times a week. He achieved complete response after five cycles of chemotherapy. A small elevated lesion was diagnosed at the anal edge of the scar 26 months after initial treatment, and endoscopic mucosal resection and ablation was performed. Chemotherapy with docetaxel was continued up to 50 months without significant toxicity. The patient died of infection resulting from diabetic gangrene at 60 months after the initial chemotherapy, but no signs of recurrence have been observed until then. Docetaxel may be an effective anticancer agent for patients undergoing hemodialysis. [ABSTRACT FROM AUTHOR]