Cryospray ablation (CSA) in the palliative treatment of squamous cell carcinoma of the esophagus
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Cryospray ablation (CSA) in the palliative treatment of squamous cell carcinoma of the esophagus Brooks D Cash*1, Lavonne R Johnston2 and Mark H Johnston2 Address: 1Department of Gastroenterology, National Naval Medical Center, Bethesda, MD 8901 Wisconsin Avenue, Bldg 9, Department of Gastroenterology, Bethesda, MD 20889, USA and 2Lancaster Gastroenterology, Inc., 2112 Harrisburg Pike, Suite 202, PO Box 3200, Lancaster, PA 17604-3200, USA Email: Brooks D Cash* - [email protected]; Lavonne R Johnston - [email protected]; Mark H Johnston - [email protected] * Corresponding author
Published: 16 March 2007 World Journal of Surgical Oncology 2007, 5:34
doi:10.1186/1477-7819-5-34
Received: 22 November 2006 Accepted: 16 March 2007
This article is available from: http://www.wjso.com/content/5/1/34 © 2007 Cash et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Esophageal carcinoma is the ninth most prevalent cancer worldwide with squamous cell carcinoma (SCCA) and adenocarcinoma accounting for the vast majority of new cases (13,900 in 2003). Cure rates in the U.S. are less than 10%, similar to lung cancer. More than 50% of patients with esophageal carcinoma present with unresectable or metastatic disease, are not surgical candidates, or display disease progression despite the addition of neoadjuvant chemoradiotherapy to surgery. Need for improved palliation exits. Case presentation: This case describes a 73-year-old African American male who presented with recurrent squamous cell carcinoma (SCCA) of the esophagus who has a achieved complete remission for 24 months via endoscopic cryospray ablation. Conclusion: Endoscopic cryo spray ablation warrants further investigation as a palliative treatment modality for esophageal cancer. This is the first reported case in the medical literature.
Background Esophageal carcinoma is the ninth most prevalent cancer worldwide with squamous cell carcinoma (SCCA) and adenocarcinoma accounting for the vast majority of new cases (13,900 in 2003 in the USA) [1,2]. Cure rates in the U.S. are less than 10%, similar to lung cancer [3]. The definitive surgical therapy, esophagectomy, can provide 10–26%, 5-year, disease-free, all-stage survival rates [3,4]. However, more than 50% of patients with esophageal carcinoma present with unresectable or metastatic disease and are not surgical candidates, or display disease progression despite the addition of neoadjuvant chemoradiotherapy to surgery [3-5].
Cryospray ablation (CSA) using liquid nitrogen sprayed through a low pressure device has recently been described to be effective and safe in the treatment of Barrett's esophagus including high-grade dysplasia [6-12]. This case report describes the first use of CSA in a
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