Esophageal Cancer Associated with Multiple Primary Cancers: Surgical Approaches and Long-term Survival

Lee, Geun Dong; Kim, Yong Hee; Kim, Joon Bum; Choi, Se Hoon; Kim, Hyeong Ryul; Kim, Dong Kwan; Park, Seung-Il

doi:10.1245/s10434-013-3183-3

Cited by 24 publications

(51 citation statements)

References 16 publications

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“…Regarding associated neoplasms, meanwhile SCC is known to be frequently associated with oropharingeal tumors (probably because of field cancerization), it seems that EA is associated with gastric adenocarcinoma -the incidence of gastric adenocarcinoma in patients with EA was 500:10 000 and in the general Brazilian population it is about 1:10 000. This finding is also in accordance with literature (4,10) . In this study, familial history of esophageal cancer did not correlate to increased risk of EC.…”

Section: Discussionsupporting

confidence: 94%

ESOPHAGEAL CARCINOMA: IS SQUAMOUS CELL CARCINOMA DIFFERENT DISEASE COMPARED TO ADENOCARCINOMA? A transversal study in a quaternary high volume hospital in Brazil

Tustumi

Takeda

Kimura

et al. 2016

Arq. Gastroenterol.

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-Background -Esophageal cancer is one of the leading causes of mortality among the neoplasms that affect the gastrointestinal tract. There are several factors that contribute for development of an epidemiological esophageal cancer profile in a population.Objective -This study aims to describe both clinically and epidemiologically the population of patients with diagnosis of esophageal cancer treated in a quaternary attention institute for cancer from January, 2009 to December, 2011, in Sao Paulo, Brazil. Methods -The charts of all patients diagnosed with esophageal cancer from January, 2009, to December, 2011, in a Sao Paulo (Brazil) quaternary oncology institute were retrospectively reviewed. Results -Squamous cell cancer made up to 80% of the cases of esophageal cancer. Average age at diagnosis was 60.66 years old for esophageal adenocarcinoma and 62 for squamous cell cancer, average time from the beginning of symptoms to the diagnosis was 3.52 months for esophageal adenocarcinoma and 4.2 months for squamous cell cancer. Average time for initiating treatment when esophageal cancer is diagnosed was 4 months for esophageal adenocarcinoma and 4.42 months for squamous cell cancer. There was a clear association between squamous cell cancer and head and neck cancers, as well as certain habits, such as smoking and alcoholism, while adenocarcinoma cancer showed more association with gastric cancer and gastroesophageal reflux disease. Tumoral bleeding and pneumonia were the main causes of death. No difference in survival rate was noted between the two groups. Conclusion -Adenocarcinoma and squamous cell carcinoma are different diseases, but both are diagnosed in advanced stages in Brazil, compromising the patients' possibilities of cure. HEADINGS -Adenocarcinoma. Squamous cell carcinoma. Epidemiologic factors. Period analysis.

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Section: Discussionsupporting

confidence: 94%

ESOPHAGEAL CARCINOMA: IS SQUAMOUS CELL CARCINOMA DIFFERENT DISEASE COMPARED TO ADENOCARCINOMA? A transversal study in a quaternary high volume hospital in Brazil

Tustumi

Takeda

Kimura

et al. 2016

Arq. Gastroenterol.

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“…Some authors figured out, even if the rate of radical resection of esophageal lesion was comparable, the presence of additional head and neck tumors was associated with a worse long-term prognosis 8. According to Lee et al, when half of the resections were radical, 5-year survival was only 9.2% in patients receiving surgery for esophageal and head-and-neck cancer 9. However, Otowa, Y. et al addressed no differences in OS in patients with or without MPC receiving surgery in a non-randomized controlled study, but the extraordinarily high 5-year survival indicated possible strict selection of participants 10.…”

Section: Discussionmentioning

confidence: 99%

Chemoradiotherapy for Synchronous Multiple Primary Cancers with Esophageal Squamous Cell Carcinoma: a Case-control Study

Li¹,

Zhu²,

Zhang³

et al. 2017

J. Cancer

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Objective: To evaluate the efficacy and toxicity of concurrent chemoradiotherapy (CRT) in multiple primary cancers (MPC) of the upper digestive tract in esophageal squamous cell carcinoma (ESCC).Methods: In a screening of 1193 consecutive patients diagnosed with ESCC and received radiotherapy, 53 patients presenting synchronous MPC in the upper digestive tract were retrospectively investigated. 53 consecutive patients with esophageal non-multiple primary cancer (NPC), matched by stage, age and sex, served as control. All of the patients received concurrent CRT. The median radiation dose was 60 Gy. Chemotherapy regimens were based on platinum and/or 5-fluorouracil. Clinical outcomes and treatment toxicities were compared.Results: Clinic-pathologic characteristics were well balanced between groups. MPC mostly located in esophagus (43, 81.8%), followed by hypopharynx (8, 15.1%) and stomach (2, 3.8%). In MPC and NPC patients, 94.3% and 96.2% completed the intended treatment. The immediate response rate was 73.6% vs 75.5%, with complete response rate of 11.3% vs 24.5% and partial response rate of 62.3% vs 51.0%. Two-year overall survival (OS), progression-free survival (PFS), locoregional progression-free survival (LRPFS) and distant progression-free survival (DPFS) were 52.2% vs 68.9% (p=0.026), 32.9% vs 54.0% (p=0.032), 60.8% vs 87.8% (p=0.002) and 64.0% vs 70.8% (p=0.22), respectively. Acute grade 3-4 toxicities were observed in 64.2% vs 54.7%, significantly higher in radiation esophagitis (49.1% vs 28.3%, p<0.001), and mucositis (11.3% vs 00p=0.027).Conclusions: Compared with matched NPC, ESCC accompanied with synchronous MPC was related to significantly impaired survival, elevated risk of locoregional disease progression and higher incidence of severe esophagitis and mucositis, following concurrent chemoradiotherapy. Future study on reasons for decreased efficacy of chemoradiotherapy will help to optimize treatment. Advanced radiation techniques may play a role in protecting normal tissues and reduce acute toxicities.

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“…Our study reported poor survival outcomes for these patients: 3- and 5-year survival rates were 25.0% and 10.6%, respectively. A recent study proposed surgical treatment should be considered for select EC patients with synchronous SPC [ 22 ]. The rate of curative resections for both EC and SPC was 87.5% in patients with gastric cancer, 52.9% in lung cancer and 47.1% in head and neck cancer.…”

Section: Discussionmentioning

confidence: 99%

Synchronous second primary cancers in patients with squamous esophageal cancer: clinical features and survival outcome

Lee

Ahn

Choi

et al. 2016

Korean J Intern Med

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Background/Aims:Unexpected diagnosis of synchronous second primary cancers (SPC) complicates physicians’ decision-making because clinical details of squamous esophageal cancer (EC) patients with SPC have been limited. We evaluated clinical features and treatment outcomes of patients with synchronous SPC detected during the initial staging of squamous EC.Methods:We identified a total of 317 consecutive patients diagnosed with squamous EC. Relevant clinical and cancer-specific information were reviewed retrospectively.Results:EC patients with synchronous SPC were identified in 21 patients (6.6%). There were significant differences in median age (70 years vs. 63 years, p = 0.01), serum albumin level (3.3 g/dL vs. 3.9 g/dL, p < 0.01) and body mass index (20.4 kg/m2 vs. 22.8 kg/m2, p = 0.01) between EC patients with and without SPC. Head and neck, lung and gastric cancers accounted for 18.2%, 22.7%, and 18.2% of SPC, respectively. Positron emission tomography-computed tomography (PET-CT) detected four cases (18.2%) of SPC that were missed on CT. Management plans were altered in 13 of 21 patients (61.9%) with detected SPC. Curative esophagectomy was attempted in 28.6% of EC patients with SPC (vs. 59.1% of patients without SPC; p = 0.006). EC patients with SPC had significantly lower 5-year survival than patients without SPC (10.6% vs. 36.7%, p = 0.008).Conclusions:Synchronous SPC were found in 6.6% of squamous EC patients, and PET-CT contributed substantially to the detection of synchronous SPC. EC patients with SPC had poor survival due to challenges of providing stage-appropriate treatment.

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Esophageal Cancer Associated with Multiple Primary Cancers: Surgical Approaches and Long-term Survival

Cited by 24 publications

References 16 publications

ESOPHAGEAL CARCINOMA: IS SQUAMOUS CELL CARCINOMA DIFFERENT DISEASE COMPARED TO ADENOCARCINOMA? A transversal study in a quaternary high volume hospital in Brazil

ESOPHAGEAL CARCINOMA: IS SQUAMOUS CELL CARCINOMA DIFFERENT DISEASE COMPARED TO ADENOCARCINOMA? A transversal study in a quaternary high volume hospital in Brazil

Chemoradiotherapy for Synchronous Multiple Primary Cancers with Esophageal Squamous Cell Carcinoma: a Case-control Study

Synchronous second primary cancers in patients with squamous esophageal cancer: clinical features and survival outcome

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