Experiences with nutritional support in cancer patients treated with chemotherapy, radiotherapy and surgery -

esophageal cancer case report

The prognosis of esophageal cancer is unfavourable even in patients in the operable stage of the disease. In the well-conditioned patients

the pre-operative concurrent chemoradiotherapy followed by resection is considered a treatment standard, which increases the

probability of two-year survival by 13 percent in compare to surgery alone. This multimodal approach belongs to most challenging

ones in oncology, with operative mortality rate being about 10 percent. The risk of surgery complications including death is greater in

patients with unfavourable nutritional status with body weight decrease higher than 10 percent, while about 50 percent of esophageal

cancer patients belong to this category. Perioperative nutritional support of these patients is unambiguously beneficial. The case-report

presented here demonstrates succesfull course of multimodal treatment of squamous cell esophageal cancer using pre-operative

concurrent chemoradiotherapy followed by resection accompanied by three-field lymphadenectomy (including cervical dissection).

Despite of several unfavourable prognostic indicators (serious premorbid body weight decrease, necessity of nasojejunal tube insertion

because of temporary severe dysphagia, peroperative lymph-node positivity) the patient is in clinical remission more than two years

after the start of treatment. We suppose that systematic and intensive nutritional support could in this case favourably influence the

course of the disease.

Keywords: esophageal cancer, concurrent chemoradiotherapy, nutritional support