A 91-year-old man with thoracic esophageal cancer(pT3N1M0, pStage Ⅲ)and gastric cancer(pT1b2N0M0, pStage ⅠA)underwent esophagectomy. Three years and 4 months postoperatively, chest computed tomography revealed a mass shadow near the aortic arch. Upper gastrointestinal endoscopy revealed a submucosal tumor-like lesion on the left wall of the gastric tube, which was identified as recurrent esophageal cancer. The patient and his family strongly requested nivolumab administration and initiated treatment. The tumor shrank remarkably after 6 months of nivolumab therapy. Although an immune-related adverse event(irAE)was observed, no other adverse events occurred. After 1 year of administration, the tumor did not increase, and remained under control. We suggest that nivolumab therapy is an effective regimen for older patients with recurrent or inoperable esophageal cancer that is difficult to treat with conventional anticancer drugs, provided that strong irAEs do not occur.

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