Multiple primary cancers in esophageal squamous cell carcinoma: Incidence and implications
Multiple primary cancers in esophageal squamous cell carcinoma: Incidence and implications
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DOI：
10.1016/s0003-4975(98)00177-5
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发表时间：
1998-06-01
影响因子：
4.6
通讯作者：
Wong, J
中科院分区：
文献类型：
--
作者：
Poon, RTP;Law, SYK;Wong, J
背景呼吸消化道多原发癌的发生是一个众所周知的现象。本研究旨在阐明食管鳞状细胞癌患者中非食管原发癌的发生率及其治疗和预后意义。在1982年至1996年期间，1,055例食管鳞状细胞癌患者在我们的机构进行了审查的存在额外的原发癌。分析非食管癌对食管癌治疗效果及生存率的影响。在1,055例患者中，100例患者（9.5%）记录了114例非食管原发性癌症，其中70%为呼吸消化道癌症。47例患者有先行肿瘤，43例有同步肿瘤。这些患者的食管癌治疗策略与无多发性肿瘤的患者相似，除6例患者外不受非食管肿瘤的影响。有先行肿瘤、同步肿瘤和无多发肿瘤患者的总生存期相似（中位生存期分别为8.6、8.5和8.8个月）（p = 0.84）。10例（0.9%）患者发生继发原发癌，其中9例曾行食管癌根治性切除术，均死于继发癌。食管癌患者中多原发癌的发生率较高，但这些患者的治疗和预后主要取决于食管癌本身。然而，在食管癌治愈的患者中，后续癌症是死亡的重要原因。(C)1998年，美国胸外科医师协会（Society of Thoracic Surgeons）
Background. The occurrence of multiple primary cancers in the aerodigestive tract is a well-known phenomenon. This study aims to elucidate the incidence and the therapeutic and prognostic implications of a nonesophageal primary cancer in patients with squamous cell carcinoma of the esophagus.Methods. Between 1982 and 1996, 1,055 patients with esophageal squamous cell carcinoma treated at our institution were reviewed for the presence of an additional primary cancer. The effects of the nonesophageal cancer on treatment of the esophageal carcinoma and survival were analyzed.Results. Among 1,055 patients, 114 nonesophageal primary cancers were documented in 100 patients (9.5%), 70% of which were aerodigestive tract cancers. Forty-seven patients had antecedent tumors and 43 had synchronous tumors. Treatment strategies for esophageal carcinoma in these patients were similar to patients without multiple tumors, not influenced by the nonesophageal tumor except in 6 patients. The overall survival of patients with antecedent tumors, synchronous tumors, and without multiple tumors was similar (median survival, 8.6, 8.5, and 8.8 months, respectively) (p = 0.84). Subsequent primary cancers developed in 10 patients (0.9%), 9 of them with previous curative resection of esophageal cancer, and all died of the subsequent cancer.Conclusions. There is a high incidence of multiple primary cancers in patients with esophageal carcinoma but the treatment and prognosis of these patients are primarily determined by the esophageal carcinoma itself. Subsequent cancer is, however, a significant cause of death among patients cured of esophageal carcinoma. (C) 1998 by The Society of Thoracic Surgeons.