Experience in the treatment of synchronous and metachronous carcinoma of the oesophagus and the head and neck

Wind, Philippe; Roullet, M; Douard, Richard; Laccoureye, Ollivier; Brasnu, Daniel; Cugnenc, Paul-Henri

doi:10.1002/(sici)1096-9098(200003)73:3<138::aid-jso5>3.0.co;2-0

Cited by 11 publications

(9 citation statements)

References 18 publications

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“…On the other hand, patients must be carefully evaluated before the decision of operation, because extremely invasive and complicated surgical technique, i.e. pharyngogastric or colonic anastomosis, microvascular anastomosis, myocutaneous flaps, or free jejunal grafts was sometimes required for R0 resection 22, which may induce increased risk of morbidity 23. Thus, the decision of surgical resection should be made cautiously.…”

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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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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“…Oesophageal squamous cell carcinoma has been reported to be frequently associated with multiple primary neoplasms (MPN) such as cancers of the head and neck or stomach [1][2][3][4][5][6]. MPN that occur concurrently or within 6 months of identification of the primary lesion are defined as synchronous tumours based on the criteria proposed by Warren and Gates: malignancy should be confirmed by histological examination, the tumours must be separated by normal mucosa and the possibility that the second neoplasm represents a metastasis must be excluded [3,4,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…MPN that occur concurrently or within 6 months of identification of the primary lesion are defined as synchronous tumours based on the criteria proposed by Warren and Gates: malignancy should be confirmed by histological examination, the tumours must be separated by normal mucosa and the possibility that the second neoplasm represents a metastasis must be excluded [3,4,7,8]. Kobayashi et al report an incidence of 7.3% of synchronous multiple primary cancers in patients with oesophageal neoplasm and an occurrence rate of 1.6% for simultaneous oesophageal and renal cell carcinoma [2].…”

Section: Discussionmentioning

confidence: 99%

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Simultaneous presentation of oesophageal and renal cancer

et al. 2007

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“…Nevertheless, nursing care can prevent the obstruction of the tracheal canula. The low incidence of death after upper airway obstruction (0-0.4% [4][5][6][7][8][9]25]) may be explained by the high number of patients with a tracheotomy (36.5-100% [11,24,27,33,38]). A tracheotomy tube mucus plug is a very rare event after major ENT surgery [18 • ,23].…”

Section: Pulmonary Complicationsmentioning

confidence: 99%

Sudden death after major head and neck surgery

Guéret

Bourgain

Luboinski

2006

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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In more recent studies, the mortality rate after neck dissection was below 4%, which is at a lower value than reported in previous studies. Sudden deaths have been described, however, mainly during the first three postoperative days. Alcoholism and perioperative hypotension are two predictive factors for cardiac complications. Careful follow-up of these patients during the early postoperative period should be performed to reduce the mortality by shortening the delay of care.

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Experience in the treatment of synchronous and metachronous carcinoma of the oesophagus and the head and neck

Cited by 11 publications

References 18 publications

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

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

Simultaneous presentation of oesophageal and renal cancer

Sudden death after major head and neck surgery

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