Secondary Esophageal Cancer after Hematopoietic Stem Cell Transplant: an Institutional Case Series

BACKGROUNDDevelopment of secondary esophageal cancer after hematopoietic stem cell transplantation has been described; however, there is little consensus on treatment and surveillance for these patients. Our objective was to describe our experience treating patients with secondary esophageal cancer.METHODSA retrospective chart review of prospectively collected data was performed to identify patients who underwent hematopoietic stem cell transplantation from 1997 – 2012 and later developed esophageal cancer.RESULTS5,066 patients underwent hematopoietic stem cell transplantation, 11 (0.2%) of whom developed esophageal cancer. The median time to diagnosis of esophageal cancer after hematopoietic stem cell transplantation was 11 years (IQR 8.5 – 14 years). Four patients were diagnosed with stage III or IV disease. Seven patients underwent an esophagectomy, six after neoadjuvant treatment. Three experienced adverse events post-operatively, all grades II and IIIa. Two surgical patients died from distant recurrence 2 years and 3 years after their esophageal cancer diagnosis. The other five surgical patients have not developed recurrence of their esophageal cancer.CONCLUSIONSFor patients with secondary esophageal cancer, esophagectomy post neoadjuvant treatment has acceptable morbidity and might be a viable option for this cohort.