Salvage endoscopic submucosal dissection for recurrent esophageal squamous-cell carcinoma after definitive chemoradiotherapy.

Although concurrent definitive chemoradiotherapy (CRT) is considered a standard treatment for unresectable esophageal carcinoma, CRT is associated with local failure (40-50%), and further interventions are needed in these cases. However, morbidity and mortality rates remain high among patients undergoing salvage esophagectomy for recurrent tumors. Here, we report a rare experience of salvage endoscopic submucosal dissection (ESD) for recurrent esophageal squamous-cell carcinoma (SCC) after definitive CRT. A 55-year-old male was diagnosed with unresectable advanced mid-thoracic esophageal SCC with lymph node metastases involving the trachea. After definitive CRT with cis-diamminedichloroplatinum (CDDP)/5-fluorouracil (5-FU) and 60 Gy irradiation was performed, complete response was obtained. However, a recurrent esophageal SCC was detected in the mid-thoracic esophagus on endoscopy performed 6 months after CRT. The tumor was resected en bloc using ESD without any complications. There was no recurrence for 4 months after ESD. Salvage ESD may be a safe and effective treatment for recurrent esophageal SCC after CRT.