Two cases of superficial esophageal cancer after chemoradiation treatment for lung cancer

We report two cases of superficial esophageal cancer after chemoradiation treatment (CRT) for lung cancer. A 74-year-old man had a type 0-IIc cancer of the upper thoracic esophagus 12 years after CRT, including 45-Gy irradiation, for left lung small cell cancer. Transthoracic esophagectomy was performed, and pathological examination revealed that the tumor was squamous cell carcinoma invading the submucosal layer (SM3) without nodal metastasis. He has had no recurrence of esophageal cancer for more than 3.5 years since the operation. A 61-year-old man had a type 0-IIc cancer of the upper thoracic esophagus 20 years after CRT, including 60-Gy irradiation, for left lung small cell cancer. Transthoracic esophagectomy was performed, and pathological examination revealed that the tumor was squamous cell carcinoma invading the submucosal layer (SM2) without nodal metastasis. He has had no recurrence of esophageal cancer for more than 2 years. A possible causal relationship between the previous CRT and the two esophageal cancers was suspected. The treatment strategy for patients after CRT should be carefully decided based on the patient's general status. In surgery, scarring and blood circulation disorders of the organs in the irradiated field should be taken into consideration. (author)