Successful treatment of quintuple primary cancer, including esophageal cancer: A case report

Abstract

Abstract. The present study reports the rare case of a patient with quintuple primary cancer that underwent systematic treatment, including surgical intervention. A 63-year-old male patient was initially diagnosed with primary esophageal cancer and hypopharyngeal cancer. The patient underwent total pharyngolaryngoesophagectomy using a thoracoscopic method and reconstruction using the free jejunal flap and gastric tube and was subsequently administered adjuvant chemotherapy (80 mg/m 2 intravenously on day 1, cisplatin; 800 mg/m 2 continuous intravenous administration on days 1-5, 5-fluorouracil). At 66 years old, the patient was diagnosed with left maxillary sinus cancer and underwent chemoradiotherapy (four 100 mg/m 2 arterial cisplatin injections; 70 Gy/35 f radiotherapy, 2 Gy per day over 35 days). At 68 years old, the patient was diagnosed with gastric tube cancer and underwent gastric tube resection followed by pedicled jejunum flap reconstruction. At 69 years old, the patient was diagnosed with tongue cancer and underwent resection and reconstruction of the tongue by pectoralis major myocutaneous flap. Six years subsequent to the primary surgery, the patient remains alive, without metastasis of the lesions. To the best of our knowledge, the present study is the first report of a patient that underwent a curative procedure for the treatment of five primary multiple cancers in five organs, including esophageal cancer. IntroductionAlcohol is carcinogenic in humans, and the occurrence of malignant tumors of the oral cavity, pharynx, larynx, esophagus, liver, colorectum and female breast are causally associated with alcohol consumption (1). Approximately 17,000 cases of esophageal cancer and 22,220 cases of gastric cancer are diagnosed every year in the USA (2). The incidence rate of head and neck cancers is 20 cases in every 100,000 persons (3). According to the National Cancer Institute, the number of second-or higher-order malignancies is increasing, accounting for ~16% of all cases registered in 2003 in the Surveillance Epidemiology and End Results database (4). However, patients with more than five primary cancers that have previously undergone esophagetomy are rarely encountered, since the five-year overall survival rate of esophageal cancer is 48.0%. This is particularly relevant for stage III lesions, as the five-year overall survival rate deteriorates to 32.0% (5). The standard treatment for stage II hypopharyngeal cancer is surgery with or without radiation treatment with a 5-year overall survival rate of 71% (6). The treatment for stage II oral cavity cancer is surgery either with or without radiation treatment with a 5-year overall survival rate of 54% (6). The treatment for stage II gastric cancer is surgery with a five-year overall survival rate of 65% (7). There are only a small number of studies that report more than five malignancies occurring in the same patient and in five different organs (8). In the present study, PubMed (National Center for Biotechnology Information, US National Library of ...

Second primary malignancy in patients with esophageal adenocarcinoma and squamous cell carcinoma

“…[2,3] Combined with other facts such as the advancement of early detection techniques, surgical procedures, and perioperative adjuvant therapies, the number of long-term cancer survivors continues to increase, which has resulted in an increased incidence of SPMs in patients with esophageal cancer. Previous studies have shown that 4.0% to 37.4% of esophageal cancer survivors developed a SPM during their follow-up period, [4–11] which will result in an even heavier burden related to the survival of patients with esophageal cancer.…”

Multiple primary malignancies for squamous cell carcinoma and adenocarcinoma of the esophagus

“…A previous study reported that the number of second malignancies accounted for ~16% of all cases registered in 2003 based on the Surveillance Epidemiology and End Results (SEER) database (11). Also, Otowa et al demonstrated that approximately 36.2% of ECs were observed with multiple primary cancers (12). However, the risk factors related to second cancer differ between SCC and AC and have not been discussed separately (13,14).…”