Esophageal carcinoma with respiratory tract fistula.

An experience with 27 patients with malignant respiratory tract fistula (RTF) is presented. The RTF was related to carcinoma of the thoracic esophagus in all the patients, involved the trachea in 11, left main bronchus in 7, right main bronchus in 3, and was more distal in 6 patients. Metastases were detectable in only four patients (15%) at the time of RTF diagnosis. Bronchoscopy examination in 13 patients prior to RTF development showed tracheobronchial invasion or impingement in all. The RTF was present at initial presentation in 11 patients (Group I), and developed after/during radiation therapy (RT) in 16 patients (Group II). Median survival from tumor diagnosis was 17 weeks in Group I and 37 weeks in Group II, while survival from RTF diagnosis was 16 weeks in Group I and II weeks in Group II.