Synchronous Minimally Invasive Resection of Carcinomas of Lung and Esophagus After Downstaging by Palliative Immunotherapy

We report a case of an elderly patient with synchronous locally advanced bilateral lung and esophageal adenocarcinomas downstaged by atypical multimodality induction therapy. A short course of palliative immunotherapy (stopped for complications after 2 cycles), followed by stereotactic lung irradiation and later neoadjuvant fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy, allowed subsequent synchronous minimally invasive combined esophagectomy and anatomical lung resection with excellent outcome. This report further illustrates the technical feasibility of minimally invasive synchronous anatomical lung and esophagus resection after multimodal therapy, including immunotherapy.