ArticleCureus2025
Long-Term Survival of a Patient With Locally Advanced Esophageal Cancer Treated With Chemoradiotherapy Following Esophageal Bypass Surgery: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
Esophageal bypass surgery is a palliative option for patients with unresectable esophageal cancer who present with severe obstruction or esophago-respiratory fistula. Although it is highly invasive and associated with frequent postoperative complications, in selected cases, it may support completion of curative-intent therapies. We present a rare case of long-term survival after esophageal bypass performed prior to definitive chemoradiotherapy (CRT). A 55-year-old woman presented with progressive dysphagia. Endoscopy revealed a circumferential type 2 mass in the mid-esophagus, which could not be traversed. Biopsy confirmed squamous cell carcinoma. Computed tomography (CT) demonstrated a 4 cm mass just below the tracheal bifurcation with suspected bilateral bronchial invasion and multiple mediastinal nodal metastases, staged as cT4bN2M0 (stage IVA). Gastrostomy was initially performed due to poor oral intake, followed by two cycles of docetaxel, cisplatin, and 5-fluorouracil (DCF) as neoadjuvant chemotherapy. Although tumor shrinkage was achieved, residual bronchial invasion rendered the lesion unresectable. To secure oral intake and maintain performance status, laparoscope-assisted esophageal bypass with a cervical gastric tube and Roux-en-Y reconstruction (modified Kirschner procedure) was performed. The postoperative course was uneventful. One month later, the patient underwent definitive CRT (50 Gy with concurrent cisplatin and 5-fluorouracil), followed by four additional cycles of chemotherapy. A complete clinical response was confirmed, and the patient remains disease-free at five years after treatment. Esophageal bypass surgery, when carefully indicated in patients with good performance status, can enable continuation of CRT by stabilizing oral intake and preserving quality of life. Although bypass does not directly improve oncologic outcomes, in selected cases, it may indirectly contribute to long-term survival by supporting completion of curative treatment.
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