[Esophageal carcinosarcoma treated with surgery and chemoradiotherapy-a report of 4 cases]

Esophageal carcinosarcoma is a rare malignant tumor. We report the cases of 4 patients treated with resection and chemoradiotherapy. All patients were men (mean age, 61 years) and presented with dysphagia. Endoscopic examination revealed type 1 tumors in all patients. We planned esophagectomy with extended lymphadenectomy for all patients; however, non-curative resection was performed in 1 patient with extended lymph node metastasis. Curative resection was performed in 3 patients, all of whom showed pT1 wall invasion, and 2 had lymph node metastasis; hence, 1 case was classified as stage I and 2 as stage II. Local recurrence developed in 1 patient at 13 months after curative resection. This patient was treated with chemoradiotherapy and showed a clinical complete response. The patient remains alive without recurrence. The other 2 patients showed no recurrence. Therefore, 3 patients who underwent curative resection survived for more than 5 years. The other patient who underwent non-curative resection died of multiple organ metastasis 111 days after surgery. Because protuberant esophageal carcinosarcoma causes symptoms such as dysphagia, this disease can be diagnosed earlier than esophageal cancer; however, lymph node metastasis at diagnosis is frequently encountered. Surgery with extended lymphadenectomy for esophageal carcinosarcoma results in better prognosis, and chemoradiotherapy is as effective for recurrence as for esophageal cancer.