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Multidisciplinary therapeutic approach for maintaining long-term nutritional status for patient with advanced esophageal carcinoma confounded by dermatomyositis

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Abstract

We report a patient with advanced esophageal carcinoma associated with dermatomyositis who successfully maintained long-term good nutritional status by chemoradiation therapy and continuous enteral nutrition. A 64-year-old Japanese man was admitted to our hospital because of dysphagia and systemic edema. Because of debilitated status and malnutrition, intravenous corticosteroid infusion was first performed. Continuous enteral nutrition was performed through percutaneous endoscopic gastrostomy, and chemoradiation therapy was then performed. Although the endoscopic examination revealed complete regression of esophageal carcinoma, an esophagobronchial fistula was formed. The patient was periodically followed up by a multidisciplinary team for appropriate nutritional management; as a result, nutritional status was markedly improved and well maintained. A covered, selfexpandable metallic stent was placed in the esophagus to conceal the esophagobronchial fistula. This case highlights the importance of multidisciplinary therapeutic approach for maintaining good nutritional status and quality of life in patients with advanced esophageal carcinoma confounded by debilitating disorders.

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References

  1. Cheng S, Iannettoni M, Koshy M, Suntharalinam M, Urba S. Squamous cell carcinoma of the esophagus: treat with how many modalities? Semin Oncol 2009;36:493–497.

    Article  PubMed  Google Scholar 

  2. Kikuchi K, Seto Y, Matsubara T, Yamada K, Tamaki K. Amyopathic dermatomyositis associated with esophageal cancer. Int J Dermatol 2008;47:310–311.

    Article  PubMed  Google Scholar 

  3. Siloka SS, Ribeiro U, Kane JM III, Landreneau RJ, Lembersky B, Posner MC. Role of nutritional support during induction chemoradiation therapy in esophageal cancer. JPEN J Parenter Enteral Nutr 1998;22:18–21.

    Article  Google Scholar 

  4. Nozoe T, Kimura Y, Ishida M, Saeki H, Korenaga D, Sugimachi K. Correlation of pre-operative nutritional condition with postoperative complications in surgical treatment for oesophageal carcinoma. Eur J Surg Oncol 2002;28:396–400.

    Article  CAS  PubMed  Google Scholar 

  5. Skipworth J, Foster J, Raptis D, Hughes F. The effect of preoperative weight loss and body mass index on postoperative outcome in patients with esophagogastric carcinoma. Dis Esophagus 2009;22:559–563.

    Article  CAS  PubMed  Google Scholar 

  6. Duclos A, Di Fiore F, Lecleire S, Michel P. Predictive and prognostic factors in patients with an esophageal carcinoma treated with chemoradiotherapy: the key role of nutritional parameters. Gastroenterol Clin Biol 2009;33:491–492.

    Article  CAS  PubMed  Google Scholar 

  7. Sakurai Y, Kanaya S, Komori Y, Uyama I. Is postoperative early enteral nutrition with regular or disease-specific enteral formula really beneficial in patients undergoing esophagectomy? Esophagus 2009;6:149–154.

    Article  Google Scholar 

  8. Japanese Society for Esophageal Diseases. Guidelines for clinical and pathologic studies on carcinoma of the esophagus. 9th edn. Tokyo: Kanehara; 2001.

    Google Scholar 

  9. Callen JP. Cutaneous aspects of internal disease. Chicago: Yearbook Medical; 1981. p. 21–35.

    Google Scholar 

  10. Barnes BE, Mawr B. Dermatomyositis and malignancy. A review of the literature. Ann Intern Med 1976;84:68–76.

    CAS  PubMed  Google Scholar 

  11. Callen JP, Hyla JF, Bole GG, Kay DR. The relationship of dermatomyositis and polymyositis to internal malignancy. Arch Dermatol 1980;116:295–298.

    Article  CAS  PubMed  Google Scholar 

  12. Callen JP. Dermatomyositis and malignancy. Clin Rheum Dis 1982;8:369–381.

    CAS  PubMed  Google Scholar 

  13. Bohan A, Peter JB. Polymyositis and dermatomyositis (first two parts). N Engl J Med 1975;292:344–347.

    Article  CAS  PubMed  Google Scholar 

  14. Bohan A, Peter JB. Polymyositis and dermatomyositis (second two parts). N Engl J Med 1975;292:403–407.

    Article  CAS  PubMed  Google Scholar 

  15. de Marieux P, Verity MA, Clements PJ, Paulus HE. Esophageal abnormalities and dysphagia in polymyositis and dermatomyositis. Arthritis Rheum 1983;26:961–968.

    Article  Google Scholar 

  16. Ohnmacht GA, Allen MS, Cassivi SD, Deschamps C, Nichols FC III, Pairolero PC. Percutaneous endoscopic gastrostomy risks rendering the gastric conduit unusable for esophagectomy. Dis Esophagus 2006;19:311–312.

    Article  CAS  PubMed  Google Scholar 

  17. Gonçalves F, Mozes M, Saraiva I, Ramos C. Gastrostomies in palliative care. Support Care Cancer 2006;14:1147–1151.

    Article  PubMed  Google Scholar 

  18. Lecleire S, Di Fiore F, Antonietti M, Ben Soussan E, Hellot MF, Grigioni S, et al. Undernutrition is predictive of early mortality after palliative self-expanding metal stent insertion in patients with inoperable or recurrent esophageal cancer. Gastrointest Endosc 2006;64:479–484.

    Article  PubMed  Google Scholar 

  19. Bethge N, Sommer A, Vakil N. Treatment of esophageal fistulas with a new polyurethane-covered, self-expanding mesh stent: a prospective study. Am J Gastroenterol 1995;90:2143–2146.

    CAS  PubMed  Google Scholar 

  20. Song H-Y, Lung H-Y, Park S, Kim S-B, Lee D, Kang S-G, et al. Covered retrievable expandable nitinol stents in patients with benign esophageal strictures: initial experience. Radiology 2000;217:551–557.

    CAS  PubMed  Google Scholar 

  21. Russell HM, de Hoyos AL, Blum MG. Successful management of recurrent Actinomyces esophagobronchial fistula with selfexpanding covered esophageal stent. J Thorac Cardiovasc Surg 2007;134:1086–1087.

    Article  PubMed  Google Scholar 

  22. Sarper A, Oz N, Cihangir C, Derircan A, Isin E. The efficacy of self-expanding metal stents for palliation of malignant esophageal strictures and fistulas. Eur J Cardiothorac Surg 2003;23:794–798.

    Article  PubMed  Google Scholar 

  23. Miwa K, Mitsoka M, Tayama K, Tomita N, Takamori S, Hayashi A, et al. Successful airway stenting using silicone prosthesis for esophagobronchial fistula. Chest 2002;122:1485–1487.

    Article  PubMed  Google Scholar 

  24. Sakurai Y, Ishiwatari A, Nishida T, Inaba K, Isogaki J, Uyama I, et al. Long-term clinical outcome in patients with percutaneous endoscopic gastrostomy. Jpn J Nutr Assess 2010;27:60–67.

    Google Scholar 

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Correspondence to Yoichi Sakurai.

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Sakurai, Y., Yoshimura, F., Furuta, S. et al. Multidisciplinary therapeutic approach for maintaining long-term nutritional status for patient with advanced esophageal carcinoma confounded by dermatomyositis. Esophagus 7, 157–164 (2010). https://doi.org/10.1007/s10388-010-0240-x

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  • DOI: https://doi.org/10.1007/s10388-010-0240-x

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