Abstract
Background
The presence of multiple primary cancers (MPCs) in patients with esophageal cancer often presents physicians with a difficult therapeutic decision, because little is known about the appropriate treatment and long-term survival. The purpose of this study was to evaluate appropriate surgical approaches and long-term survival after surgery for esophageal cancer associated with MPCs.
Methods
Data from 622 patients who underwent surgery for primary esophageal cancer between 1989 and 2008 were reviewed retrospectively to identify the presence of MPCs.
Results
A total of 96 MPCs were identified in 90 (14.5 %) patients. The three leading MPCs were stomach cancer (n = 36, 37.5 %), head and neck cancer (n = 18, 18.8 %), and lung cancer (n = 18, 18.8 %). The rate of curative resections for both esophageal cancer and MPCs was 87.5 % (28/32) in patients with stomach cancer, 47.1 % (8/17) in head and neck cancer, and 52.9 % (9/17) in lung cancer (P = 0.006). The 5-year survival rates after surgery for esophageal cancer in patients associated with stomach, lung, and head and neck cancer were 52.7, 27.0, and 9.2 %, respectively (P = 0.011).
Conclusions
A range of surgical approaches for esophageal cancer is available in patients associated with MPCs. However, curative resections for primary esophageal cancer associated with MPCs are feasible in highly selected patients. Therefore, a multidisciplinary team management approach is essential for customized treatment strategies in patients with esophageal cancer associated with MPCs.
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References
Poon RT, Law SY, Chu KM, Branicki FJ, Wong J. Multiple primary cancers in esophageal squamous cell carcinoma: incidence and implications. Ann Thorac Surg. 1998;65:1529–34.
Nagasawa S, Onda M, Sasajima K, Takubo K, Miyashita M. Multiple primary malignant neoplasms in patients with esophageal cancer. Dis Esophagus. 2000;13:226–30.
Kumagai Y, Kawano T, Nakajima Y, Nagai K, Inoue H, Nara S, Iwai T. Multiple primary cancers associated with esophageal carcinoma. Surg Today. 2001;31:872–6.
Noguchi T, Kato T, Takeno S, Wada S, Yanagisawa S, Suzuki M. Necessity of screening for multiple primary cancers in patients with esophageal cancer. Ann Thorac Cardiovasc Surg. 2002;8:336–42.
Natsugoe S, Matsumoto M, Okumura H, et al. Multiple primary carcinomas with esophageal squamous cell cancer: clinicopathologic outcome. World J Surg. 2005;29:46–9.
Strong MS, Incze J, Vaughan CW. Field cancerization in the aerodigestive tract–its etiology, manifestation, and significance. J Otolaryngol. 1984;13:1–6.
Edge SB, editor. AJCC cancer staging manual, 7th edn. New York: Springer, 2010.
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.
Hall SF. A user’s guide to selecting a comorbidity index for clinical research. J Clin Epidemiol. 2006;59:849–55.
Waren S, Gates O. Multiple primary malignant tumors: a survey of the literature and statistical study. Am J Cancer. 1932;51:1358–40.
Cahan WG, Castro EB, Rosen PP, Strong EW. Separate primary carcinomas of the esophagus and head and neck region in the same patient. Cancer. 1976;37:85–9.
Ajani JA, Barthel JS, Bentrem DJ, et al. Esophageal and esophagogastric junction cancers. J Natl Compr Cancer Netw. 2011;9:830–87.
Shin HR, Won YJ, Jung KW, Park JG. 2001 annual report of the Korea Central Cancer Registry: based on registered data from 134 hospitals. Cancer Res Treat. 2004;36:19–30.
Shin HR, Jung KW, Won YJ, Park JG, Hospitals K-a. 2002 annual report of the Korea Central Cancer Registry: based on registered data from 139 hospitals. Cancer Res Treat. 2004;36:103–14.
Shields TW. General thoracic surgery, 7th edn. Philadelphia: Lippincott Williams & Wilkins, 2009.
Swisher SG, Hofstetter WL, Miller MJ. The supercharged microvascular jejunal interposition. Semin Thorac Cardiovasc Surg. 2007;19:56–65.
Lo OS, Law S, Wei WI, Ng WM, Wong KH, Tong KH, Wong J. Esophageal cancers with synchronous or antecedent head and neck cancers: a more formidable challenge? Ann Surg Oncol. 2008;15:1750–6.
Triboulet JP, Mariette C, Chevalier D, Amrouni H. Surgical management of carcinoma of the hypopharynx and cervical esophagus: analysis of 209 cases. Arch Surg. 2001;136:1164–70.
Ishii H, Sato H, Tsubosa Y, Kondo H. Treatment of double carcinoma of the esophagus and lung. Gen Thorac Cardiovasc Surg. 2008;56:126–30.
Matsubara T, Ueda M, Takahashi T, Nakajima T, Nishi M. Surgical treatment of cancer of the thoracic esophagus in association with a major pulmonary operation. J Am Coll Surg. 1997;185:520–4.
Wind P, Roullet MH, Quinaux D, Laccoureye O, Brasnu D, Cugnenc PH. Long-term results after esophagectomy for squamous cell carcinoma of the esophagus associated with head and neck cancer. Am J Surg. 1999;178:251–5.
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Lee, G.D., Kim, YH., Kim, J.B. et al. Esophageal Cancer Associated with Multiple Primary Cancers: Surgical Approaches and Long-term Survival. Ann Surg Oncol 20, 4260–4266 (2013). https://doi.org/10.1245/s10434-013-3183-3
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DOI: https://doi.org/10.1245/s10434-013-3183-3