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Ko JMY, Guo C, Liu C, Ning L, Dai W, Tao L, Lo AWI, Wong CWY, Wong IYH, Chan FSY, Wong CLY, Chan KK, Law TT, Lee NPY, Liu Z, Jiang H, Li Z, Law S, Lung ML. Clonal relationship and alcohol consumption-associated mutational signature in synchronous hypopharyngeal tumours and oesophageal squamous cell carcinoma. Br J Cancer 2022; 127:2166-2174. [PMID: 36261585 PMCID: PMC9726980 DOI: 10.1038/s41416-022-01995-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/09/2022] [Accepted: 09/21/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The patients with dual oesophageal squamous cell carcinoma (ESCC) and hypopharyngeal cancer (HPC) have poor prognosis; their underlying genetic pathogenesis is unclear. We hypothesise that development of synchronous ESCC/HPC depends on multicentricity or independent origin, rather than multifocality due to local or lateral spreading. METHOD Multiple region whole-exome sequencing (M-WES) and clonality analysis were used to assess clonal relationship and spatial inter- or intra-tumour heterogeneity (ITH) in 62 tumour regions from eight dual ESCC/HPC and ten ESCC patients. RESULTS All synchronous ESCC/HPC patients had COSMIC 16 mutation signatures, compared to only 40% ESCC in the current study (p = 0.013) and public data set (n = 165, p = 0.003). This alcohol consumption-related mutation signature 16, commonly involved in multiple alcohol-related cancers, was significantly associated with drinking and alcohol metabolism-related ADH1B rs1229984. The mutational landscape and copy number profiles were completely distinct between the two primary tumours; clonality analysis further suggested the two primary tumours shared no or only one clone accompanying independent subclone evolution. M-WES strategy demonstrated higher sensitivity and accuracy for detection of mutational prevalence and the late branch mutations among different regions in the ESCC tumours, compared to traditional sequencing analysis based on single biopsy strategy. Patients with high ITH assessed by cancer cell fraction analysis after M-WES were significantly associated with both relapse and survival. CONCLUSIONS Our hypothesis-generating M-WES ITH assessment data have implications for prognostication. Collectively, our findings support multicentric independent clonal evolution, the field cancerisation theory, and suggest novel insights implicating an aetiologic role of alcohol metabolism in dual ESCC/HPC carcinogenesis.
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Affiliation(s)
- Josephine Mun-Yee Ko
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Chen Guo
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Conghui Liu
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Lvwen Ning
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Wei Dai
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Lihua Tao
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Anthony Wing-Ip Lo
- grid.415550.00000 0004 1764 4144Division of Anatomical Pathology, Queen Mary Hospital, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Carissa Wing-Yan Wong
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Ian Yu-Hong Wong
- grid.194645.b0000000121742757Department of Surgery, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Fion Siu-Yin Chan
- grid.194645.b0000000121742757Department of Surgery, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Claudia Lai-Yin Wong
- grid.194645.b0000000121742757Department of Surgery, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Kwan Kit Chan
- grid.194645.b0000000121742757Department of Surgery, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Tsz Ting Law
- grid.194645.b0000000121742757Department of Surgery, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Nikki Pui-Yue Lee
- grid.194645.b0000000121742757Department of Surgery, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Zhichao Liu
- grid.16821.3c0000 0004 0368 8293Department of Thoracic Surgery, Section of Esophageal Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Haoyao Jiang
- grid.16821.3c0000 0004 0368 8293Department of Thoracic Surgery, Section of Esophageal Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Zhigang Li
- grid.16821.3c0000 0004 0368 8293Department of Thoracic Surgery, Section of Esophageal Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Simon Law
- grid.194645.b0000000121742757Department of Surgery, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
| | - Maria Li Lung
- grid.194645.b0000000121742757Department of Clinical Oncology, University of Hong Kong, Hong Kong (Special Administrative Region), People’s Republic of China
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2
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Nguyen-Tran BS, Tran-Thi NP, Ngo QT, LE-Trong L, Nguyen-Thanh T, Dang-Cong T. Synchronous esophageal squamous cell carcinoma and hepatocellular carcinoma: A rare case report. Radiol Case Rep 2022; 17:863-868. [PMID: 35059090 PMCID: PMC8760396 DOI: 10.1016/j.radcr.2021.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 12/04/2022] Open
Abstract
Multiple primary malignancies in general and synchronous cancers, in particular, are relatively rare but have increased in recent decades. We report a case of a 62-year-old Vietnamese male who visited our hospital with the chief symptom was mild dysphagia. An irregular lesion causing the total luminal obstruction was detected at the low third part of the esophagus via endoscopy and two suspicious nodules in the segment V of the liver were incidentally encountered through the Computed tomography (CT). Multiple biopsies from the lesions were then performed. Histopathology and immunohistochemistry results demonstrated Squamous cell carcinoma of the esophagus and Hepatocellular carcinoma of the liver, which verified the existence of synchronous cancers in the patient.
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Affiliation(s)
- Bao-Song Nguyen-Tran
- Department of Histology, Embryology, Pathology and Forensic, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam
| | - Nam-Phuong Tran-Thi
- Department of Histology, Embryology, Pathology and Forensic, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam
| | - Quy-Tran Ngo
- Department of Histology, Embryology, Pathology and Forensic, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam
| | - Lan LE-Trong
- Department of Histology, Embryology, Pathology and Forensic, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam
| | - Tung Nguyen-Thanh
- Faculty of Basic Science, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam.,Institute of Biomedicine, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam
| | - Thuan Dang-Cong
- Department of Histology, Embryology, Pathology and Forensic, Hue University of Medicine and Pharmacy, Hue University, Hue 49000, Vietnam
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3
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Woods JFC, Woods RSR, Lennon P, Timon C, Kinsella J, Ravi N, Beausang E, Theopold CFP. Analysis of Outcomes of Pharyngo-laryngo-esophagectomy and Reconstruction with Longitudinal Comparison in a Single Institution. J Plast Reconstr Aesthet Surg 2021; 75:1567-1572. [PMID: 34955400 DOI: 10.1016/j.bjps.2021.11.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/14/2021] [Indexed: 11/25/2022]
Abstract
Advanced hypopharyngeal tumours present complex clinical challenges, and where resection is attempted, there is a requirement for major reconstruction. Despite advances in surgical technique, outcomes remain poor for this patient group, and optimum treatment has yet to be established. We aimed to assess the treatment and outcomes of patients in our institution in the context of previous studies. All patients from 2008 to 2018 who underwent surgical management for hypopharyngeal tumours with pharyngo-laryngo-esophagectomy and flap-based reconstruction were included in the study. Demographic and outcome data were collected, and patient-reported outcomes were solicited from surviving patients using the EORTC QLQ H&N 43 questionnaire. Thirty patients were assessed, in which 12 had gastric pull-ups, 16 had free jejunum flaps, and 2 had free anterolateral thigh flaps. There was a 38% five-year survival rate. Overall, the rates of stricture (10.7%) and fistula (7.1%) were low. The majority of patients (53.6%) returned to a normal diet within three months with a soft or puree diet in 35.7% of patients. Some form of speech was possible in 92.9% of patients. The average questionnaire score for surviving patients was 87.3, with good outcomes related to eating and swallowing, but poorer outcomes for speech and communication. This study showed that outcomes for patients receiving complex reconstruction following hypopharyngeal tumour resection are improving over time. There is still scope for improvement of patient outcomes and refinement of optimum surgical management strategies.
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Affiliation(s)
- Jack F C Woods
- Department of Surgery, St James's Hospital, Dublin, Ireland.
| | | | - Paul Lennon
- Department of Surgery, St James's Hospital, Dublin, Ireland
| | - Conrad Timon
- Department of Surgery, St James's Hospital, Dublin, Ireland
| | - John Kinsella
- Department of Surgery, St James's Hospital, Dublin, Ireland
| | | | - Eamon Beausang
- Department of Surgery, St James's Hospital, Dublin, Ireland
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4
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Yoshida N, Doyama H, Yano T, Horimatsu T, Uedo N, Yamamoto Y, Kakushima N, Kanzaki H, Hori S, Yao K, Oda I, Katada C, Yokoi C, Ohata K, Yoshimura K, Ishikawa H, Muto M. Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging. Gut 2021; 70:67-75. [PMID: 32241898 PMCID: PMC7788198 DOI: 10.1136/gutjnl-2019-319631] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Early detection of gastric cancer has been the topic of major efforts in high prevalence areas. Whether advanced imaging methods, such as second-generation narrow band imaging (2G-NBI) can improve early detection, is unknown. DESIGN This open-label, randomised, controlled tandem trial was conducted in 13 hospitals. Patients at increased risk for gastric cancer were randomly assigned to primary white light imaging (WLI) followed by secondary 2G-NBI (WLI group: n=2258) and primary 2G-NBI followed by secondary WLI (2G-NBI group: n=2265) performed by the same examiner. Suspected early gastric cancer (EGC) lesions in both groups were biopsied. Primary endpoint was the rate of EGC patients in the primary examination. The main secondary endpoint was the positive predictive value (PPV) for EGC in suspicious lesions detected (primary examination). RESULTS EGCs were found in 44 (1.9%) and 53 (2.3%; p=0.412) patients in the WLI and 2G-NBI groups, respectively, during primary EGD. In a post hoc analysis, the overall rate of lesions detected at the second examination was 25% (n=36/145), with no significant differences between groups. PPV for EGC in suspicious lesions was 13.5% and 20.9% in the WLI (50/371 target lesions) and 2G-NBI groups (59/282 target lesions), respectively (p=0.015). CONCLUSION The overall sensitivity of primary endoscopy for the detection of EGC in high-risk patients was only 75% and should be improved. 2G-NBI did not increase EGC detection rate over conventional WLI. The impact of a slightly better PPV of 2G-NBI has to be evaluated further. TRIAL REGISTRATION NUMBER UMIN000014503.
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Affiliation(s)
- Naohiro Yoshida
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Hisashi Doyama
- Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Ishikawa, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan
| | - Takahiro Horimatsu
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoshinobu Yamamoto
- Department of Gastrointestinal Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Naomi Kakushima
- Department of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiromitsu Kanzaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shinichiro Hori
- Department of Endoscopy, National Hospital Organization Shikoku Cancer Center, Ehime, Japan
| | - Kenshi Yao
- Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Ichiro Oda
- Department of Endoscopy, National Cancer Center Hospital, Tokyo, Japan
| | - Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Chizu Yokoi
- Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ken Ohata
- Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Kenichi Yoshimura
- Innovative Clinical Research Center, Kanazawa University Hospital, Ishikawa, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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5
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Co-Occurrence of Hotspot Point Mutation and Novel Deletion Mutation of TERT Promoter in Solid Variant Papillary Thyroid Carcinoma in a Patient with Synchronous Esophageal Cancer. Diagnostics (Basel) 2020; 11:diagnostics11010004. [PMID: 33375021 PMCID: PMC7822032 DOI: 10.3390/diagnostics11010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/10/2020] [Accepted: 12/20/2020] [Indexed: 11/17/2022] Open
Abstract
(1) Introduction: Telomerase reverse transcriptase (TERT) promoter mutations are associated with unfavorable clinical outcomes in papillary thyroid carcinomas (PTCs). Two substitution mutations, C228T (c.1-124C>T) and C250T (c.1-146C>T), make up most of the mutations and occur in a mutually exclusive manner. (2) Case presentation: A 72-year-old man was initially referred to a tertiary hospital for treatment of esophageal cancer. Preoperative imaging revealed a 3.2 cm thyroid nodule pathologically diagnosed as PTC on needle biopsy. The patient underwent thyroid lobectomy with esophagectomy and was finally diagnosed with synchronous solid variant PTC (SVPTC) and esophageal squamous cell carcinoma. Sanger sequencing using DNA from the thyroid tumor showed an indel mutation, c.1-132_1-124delinsT, composed of a deletion (c.1-132_1-125del) as well as a hotspot mutation (c.1-124C>T(C228T)) in the TERT promoter. (3) Conclusions: This is the first report of PTC harboring a novel deletion along with a hotspot mutation in the TERT promoter in a patient with synchronous esophageal squamous cell carcinoma.
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6
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Definitive radiotherapy in patients of synchronous esophageal and head and neck cancer-treatment outcome and toxicity. Cancer Treat Res Commun 2020; 25:100248. [PMID: 33254043 DOI: 10.1016/j.ctarc.2020.100248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/09/2020] [Accepted: 11/20/2020] [Indexed: 12/31/2022]
Abstract
AIM The aim is to retrospectively evaluate the clinical outcomes and treatment related toxicities in patients of synchronous esophageal and head & neck cancer when treated with definitive radiotherapy with or without concurrent chemotherapy. BACKGROUND Patients of esophageal cancer with a synchronous second primary in head and neck region can be treated with definitive radiotherapy but the clinical outcome has been reported to be poor. METHOD AND DESIGN This is a single institutional retrospective study. Twenty-five patients fulfilling inclusion and exclusion criteria were evaluated. The survival was analysed using Kaplan-Meir method and their relations with various clinicopathologic parameters were compared. RESULTS After a median follow-up time of 14 months, the 1 year and 2 year survival was 60% and 17% respectively. Significant improvement in overall survival was observed in patients with early staged esophageal cancer then locally advanced disease (P = 0.03). Patients with locally advanced head and neck cancer had poor survival than with early stage disease (P = 0.06). Those who received concurrent chemotherapy had better survival than those with radiotherapy alone. 40% patients developed grade III & IV dermatitis and 48% patients developed grade III oral mucositis. CONCLUSION Chemoradiotherapy can safely be offered to patients with synchronous esophageal and head and neck cancer.
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7
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Near-focus magnification and second-generation narrow-band imaging for early gastric cancer in a randomized trial. J Gastroenterol 2020; 55:1127-1137. [PMID: 33021688 DOI: 10.1007/s00535-020-01734-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/16/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND Magnifying endoscopy with narrow-band imaging (NBI) is effective for the diagnosis of early gastric cancer (EGC). However, magnifying endoscopy is not yet popular globally because of the required level of skill and lack of availability. To overcome these problems, dual-focus endoscopy (standard- and near-focus (NF) modes) has been developed. In this study, we evaluated the diagnostic performance of NF with second-generation (2G)-NBI (NF-NBI) for the diagnosis of EGC. METHODS This was a secondary analysis of a multicenter randomized controlled trial of 4523 high-risk patients who underwent gastroscopies at 13 institutions in Japan. Patients were randomly assigned to white-light imaging (WLI) followed by 2G-NBI or to 2G-NBI followed by WLI. Lesions suspicious for EGC, newly detected by non-magnifying WLI or 2G-NBI, were subsequently observed with NF-NBI. All detected lesions were biopsied or resected. The diagnostic performance of NF-NBI was compared with the final histology. RESULTS A total of 870 detected lesions (145 EGC, 725 non-EGC) were analyzed. Overall diagnostic performance for EGC using NF-NBI was accuracy 87.7%, sensitivity 60.7%, specificity 93.1%, positive predictive value 63.8%, and negative predictive value 92.2%. There were no significant differences in diagnostic performance between lesions detected by WLI or 2G-NBI. For lesions diagnosed with high (333 lesions) and low (537 lesions) confidences, accuracy was 92.2% and 84.9%, sensitivity was 64.7% and 58.5%, and specificity was 90.5% and 88.8%, respectively. CONCLUSION The diagnostic performance of NF-NBI is good and acceptable for diagnosis of EGC in combination with either WLI or 2G-NBI.
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8
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Urabe M, Ueno M, Udagawa H. Incidental identification of cervical nodal metastases from papillary thyroid carcinoma: Experiences related to esophageal cancer surgery. Head Neck 2020; 42:3098-3099. [PMID: 32761686 DOI: 10.1002/hed.26392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/07/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Masayuki Urabe
- Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan
| | - Masaki Ueno
- Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.,Okinaka Memorial Institute for Medical Disease, Tokyo, Japan
| | - Harushi Udagawa
- Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.,Okinaka Memorial Institute for Medical Disease, Tokyo, Japan
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9
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Inaba A, Hori K, Yoda Y, Ikematsu H, Takano H, Matsuzaki H, Watanabe Y, Takeshita N, Tomioka T, Ishii G, Fujii S, Hayashi R, Yano T. Artificial intelligence system for detecting superficial laryngopharyngeal cancer with high efficiency of deep learning. Head Neck 2020; 42:2581-2592. [PMID: 32542892 DOI: 10.1002/hed.26313] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 04/18/2020] [Accepted: 05/15/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There are no published reports evaluating the ability of artificial intelligence (AI) in the endoscopic diagnosis of superficial laryngopharyngeal cancer (SLPC). We presented our newly developed diagnostic AI model for SLPC detection. METHODS We used RetinaNet for object detection. SLPC and normal laryngopharyngeal mucosal images obtained from narrow-band imaging were used for the learning and validation data sets. Each independent data set comprised 400 SLPC and 800 normal mucosal images. The diagnostic AI model was constructed stage-wise and evaluated at each learning stage using validation data sets. RESULTS In the validation data sets (100 SLPC cases), the median tumor size was 13.2 mm; flat/elevated/depressed types were found in 77/21/2 cases. Sensitivity, specificity, and accuracy improved each time a learning image was added and were 95.5%, 98.4%, and 97.3%, respectively, after learning all SLPC and normal mucosal images. CONCLUSIONS The novel AI model is helpful for detection of laryngopharyngeal cancer at an early stage.
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Affiliation(s)
- Atsushi Inaba
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.,Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Keisuke Hori
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Yusuke Yoda
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.,Medical Device Innovation Center, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Hiroaki Ikematsu
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.,Division of Science and Technology for Endoscopy, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center East, Kashiwa, Chiba, Japan
| | - Hiroaki Takano
- Medical Device Innovation Center, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Hiroki Matsuzaki
- Medical Device Innovation Center, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Yoshiki Watanabe
- Department of Medical Information, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Nobuyoshi Takeshita
- Medical Device Innovation Center, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Toshifumi Tomioka
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Genichiro Ishii
- Course of Advanced Clinical Research of Cancer, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.,Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center East, Kashiwa, Chiba, Japan
| | - Satoshi Fujii
- Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center East, Kashiwa, Chiba, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.,Medical Device Innovation Center, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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10
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High incidence of head and neck cancers after endoscopic resection for esophageal cancer in younger patients. J Gastroenterol 2020; 55:401-407. [PMID: 31813008 DOI: 10.1007/s00535-019-01653-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 11/28/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Second cancers in patients with esophageal cancer (EC) are common and have a poor prognosis. We evaluated the incidence of second cancers at different sites by patients' ages when their index ECs were diagnosed. METHODS This study included patients who underwent endoscopic resection for superficial EC at our hospital between September 1994 and September 2011. Patients' data, including sex, age at diagnosis, sequence of cancer incidence, cancer histology, and cancer site, were extracted from the cancer registry. RESULTS Of 544 patients, 255 developed second cancers. Simultaneous head and neck cancers (HNCs) and other organ cancers (OCs) were, respectively, present in 15% (80/544) and 9.6% (52/544) of patients; and 30% (162/544) developed metachronous second cancers over a median follow-up period of 79.5 months (range 2-120), including 44 metachronous HNCs and 70 OCs. The cumulative incidence of metachronous HNCs was significantly higher in younger patients (< 60 years) than in older patients (≥ 60 years; P = 0.001), whereas the cumulative incidence of OCs was significantly higher in older patients than in younger patients (P = 0.03). CONCLUSIONS The incidence of second HNC after index EC was higher in younger-onset patients than in older-onset patients. We suggest that younger patients with EC should be carefully monitored for early detection of second HNC.
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11
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Genetic Polymorphisms in the RAD51 Gene with a Risk of Head and Neck Cancer and Esophageal Cancer: A Meta-Analysis. Int J Genomics 2019; 2019:2789035. [PMID: 31886162 PMCID: PMC6915143 DOI: 10.1155/2019/2789035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 11/19/2019] [Indexed: 01/17/2023] Open
Abstract
Background The role of RAD51 gene polymorphisms with the development of head and neck cancer (HNC) and esophageal cancer (EC) remains controversial. This meta-analysis was conducted to evaluate the correlation between the RAD51 polymorphisms and these two cancers quantitatively. Methods Databases of PubMed, Web of Science, and Embase were used to search relevant papers prior to August 17, 2019. STATA 11.0 was performed to observe the correlation. Results Ten relevant papers were enrolled in our analysis. Overall, a significant correlation was observed between the rs1801320 polymorphism and the increased risk of these two cancers (OR = 1.32, 95%CI = 1.03-1.71 for C vs. G; OR = 1.50, 95%CI = 1.03-2.19 for CG vs. GG; and OR = 1.44, 95%CI = 1.05-1.99 for CC+CG vs. GG). In subgroup analyses, an increased risk was found for EC (OR = 2.07, 95%CI = 1.01-4.25 for C vs. G; OR = 2.08, 95%CI = 1.17-3.71 for CC vs. GG; and OR = 1.78, 95%CI = 1.00-3.15 for CC vs. CG+GG), but not for HNC. Moreover, our analysis revealed that no statistical evidence of correlation was discovered between the polymorphism of rs1801321 and the increased risk of HNC. However, stratified analysis based on ethnicity suggested that rs1801321 polymorphism was related to the decreased risk of HNC among Caucasians (OR = 0.82, 95%CI = 0.72-0.95 for T vs. G). Conclusions rs1801320 polymorphism was strongly associated with the risk of these two associated cancers, especially with esophageal cancer. Moreover, our results revealed that rs1801321 polymorphism was correlated to the decreased risk of HNC among Caucasians.
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12
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Chen D, Fan N, Mo J, Wang W, Wang R, Chen Y, Hu J, Wen Z. Multiple primary malignancies for squamous cell carcinoma and adenocarcinoma of the esophagus. J Thorac Dis 2019; 11:3292-3301. [PMID: 31559032 DOI: 10.21037/jtd.2019.08.51] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Patients with esophageal cancer (EC) frequently have multiple primary cancers. We conducted the present study to assess the risk of multiple primary malignancies for patients with squamous cell carcinoma (SCC) and adenocarcinoma (AC) of the esophagus and to investigate the influence of multiple primary tumors on the prognosis of EC patients. Methods Using the data of 44,091 EC patients from the Surveillance Epidemiology and End Results (SEER) database, we calculated the standardized incidence ratios (SIRs) for overall multiple primary cancers and cancers at particular sites among EC survivors. The SIRs of esophageal SCC and AC patients were compared using Poisson regression. The Kaplan-Meier (KM) method was used for survival analysis. Results Multiple primary cancer risk was significantly increased among both esophageal SCC and AC survivors (SIR: 2.28 and 1.57, respectively; P<0.001). Among SCC patients, the highest SIRs were found in the oral cavity and pharynx (SIR: 16.54), esophagus (SIR: 10.02), and larynx (SIR: 10.34). Also, the highest SIRs following AC cases were observed in the esophagus (SIR: 8.81), stomach (SIR: 9.29), and small intestine (SIR: 4.95). SIRs for the oral cavity and pharynx, lung, and larynx were significantly higher among SCC survivors than AC survivors (all P<0.05). KM analysis revealed no significant difference of overall survival (OS) for multiple primary cancers, including those of the esophagus, stomach, oral cavity and pharynx, and lung among EC patients (log rank =2.04; P=0.564), except for prostate cancer (log rank =96.65; P<0.001). Conclusions Multiple primary malignancy risk differed by the histological type of esophageal SSC and AC survivor. However, no significant relationship between survival and the multiple primary cancer sites, except for prostate cancer, was observed.
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Affiliation(s)
- Dongni Chen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Ningbo Fan
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Junxian Mo
- Department of Cardio-Thoracic Surgery, The Seventh Affiliated Hospital of Guangxi Medical University, Wuzhou 543001, China
| | - Weidong Wang
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Ruiqi Wang
- Department of Experimental Research, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Youfang Chen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Jia Hu
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Zhesheng Wen
- Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
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13
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Iwatsubo T, Ishihara R, Nakagawa K, Ohmori M, Iwagami H, Matsuno K, Inoue S, Nakahira H, Matsuura N, Shichijo S, Maekawa A, Kanesaka T, Yamamoto S, Takeuchi Y, Higashino K, Uedo N, Higuchi K. Pharyngeal observation via transoral endoscopy using a lip cover-type mouthpiece. J Gastroenterol Hepatol 2019; 34:1384-1389. [PMID: 30561830 DOI: 10.1111/jgh.14574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/12/2018] [Accepted: 12/12/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIM Simultaneous and metachronous head and neck cancers are likely to develop in patients with current or previous esophageal cancer. The Valsalva maneuver facilitates the visualization of the hypopharyngeal area during endoscopic observation, but it requires transnasal endoscopy. We developed a novel Valsalva maneuver using transoral endoscopy with a lip cover-type mouthpiece. METHODS Between March 2018 and July 2018, 107 patients with current or previous esophageal cancer who were scheduled to undergo upper gastrointestinal endoscopy were included in our pilot study. We performed the Valsalva maneuver using our newly developed mouthpiece and transoral endoscopy in the patients and evaluated the hypopharyngeal region, including the postcricoid area and the posterior wall of the hypopharynx. The outcome measure was procedural success rate, which was graded as "complete," "incomplete," and "none." RESULTS Observation of the hypopharyngeal area was "complete" in 81 patients (76%) using the Valsalva maneuver. However, in 25 patients and in 1 patient, observation was "incomplete" and "none," respectively. Seven lesions were newly detected in seven patients during the study period. CONCLUSIONS The Valsalva maneuver using transoral endoscopy with a lip cover-type mouthpiece is feasible for the visualization of the postcricoid area and the posterior wall of the hypopharynx. Particularly, this technique would contribute to early detection of head and neck cancers.
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Affiliation(s)
- Taro Iwatsubo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan.,Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Kentaro Nakagawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Masayasu Ohmori
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroyoshi Iwagami
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Kenshi Matsuno
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Shuntaro Inoue
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Hiroko Nakahira
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Noriko Matsuura
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Satoki Shichijo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Akira Maekawa
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Sachiko Yamamoto
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Koji Higashino
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Kazuhide Higuchi
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
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14
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Risk Factors Linking Esophageal Squamous Cell Carcinoma With Head and Neck Cancer or Gastric Cancer. J Clin Gastroenterol 2019; 53:e164-e170. [PMID: 29498952 DOI: 10.1097/mcg.0000000000001019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
GOALS To investigate retrospectively the risk factors for synchronous and metachronous cancers in the upper gastrointestinal tract in patients with superficial esophageal squamous cell carcinoma (ESCC). BACKGROUND In patients who have received endoscopic resection (ER) for ESCC, synchronous and metachronous cancers are frequently detected not only in the esophagus but also in the head and neck area and the stomach. STUDY A total of 285 patients who received ER for superficial ESCC were enrolled in this analysis. These patients were periodically followed-up endoscopically. Cumulative occurrence rates of the metachronous second primary cancers were determined by Kaplan-Meier method. Risk factors for synchronous and metachronous cancers in the head and neck area and the stomach were determined by logistic regression analyses. RESULTS During a mean follow-up period of 76 months, the 5-year cumulative occurrence of metachronous esophageal, head and neck, and stomach cancer was 14.0%, 2.8%, and 4.1%, respectively. Although the presence of multiple lugol-voiding lesions in the esophagus was a significant risk factor for synchronous and metachronous head and neck cancers (odds ratio, 3.8; 95% confidence interval, 1.7-9.0), older age (>65 y) was a significant risk factor for synchronous and metachronous gastric cancer (odds ratio, 3.1; 95% confidence interval, 1.2-9.3). CONCLUSIONS The risk factors for the cooccurrence of head and neck cancer and that of gastric cancer in patients with ESCC differ. This information will likely be useful for managing patients who have been treated with ER for ESCC and who possess carcinogenic potential throughout the upper gastrointestinal tract.
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15
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Matsui T, Okada T, Kawada K, Okuda M, Ogo T, Nakajima Y, Kume Y, Ryotokuji T, Hoshino A, Tokairin Y, Michi Y, Harada H, Nakajima Y, Kawano T. Detection of Second Primary Malignancies of the Esophagus and Hypophraynx in Oral Squamous Cell Carcinoma Patients. Laryngoscope Investig Otolaryngol 2018; 3:263-267. [PMID: 30186956 PMCID: PMC6119782 DOI: 10.1002/lio2.179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 05/06/2018] [Accepted: 05/25/2018] [Indexed: 12/11/2022] Open
Abstract
Objective To assess the usefulness of modified esophagogastroduodenoscopy (EGD) for the detection of second primary malignancies of the esophagus or hypopharynx in patients with oral squamous cell carcinoma and determine the association between the oral lesion subsite and esophageal or hypopharyngeal lesion occurrence. Study Design Retrospective review. Methods In total, 166 patients with oral squamous cell carcinoma without any established symptoms of esophageal or hypopharyngeal squamous cell carcinoma underwent modified EGD based on the Valsalva maneuver and U-turn method, image-enhanced endoscopy, and chromoendoscopy using Lugol's iodine for diagnosis. All suspected lesions were biopsied to determine the clinical stages and duplication rates. Odds ratios for the occurrence of duplicate lesions according to the oral lesion subsite were determined. Results In total, 37 esophageal and 16 hypopharyngeal lesions were detected. According to the Union for International Cancer Control/American Joint Committee on Cancer classification (2009), 75.7% and 5.4% esophageal lesions were classified as stage IA and IB, respectively, and 50% and 18.8% hypopharyngeal lesions as stage II and stage I, respectively. Approximately 59.1% and 50% esophageal and hypopharyngeal lesions, respectively, were successfully treated by endoscopic resection. Oral lesions involving the floor of the mouth were more frequently accompanied by second primary malignancies of the esophagus or hypopharynx. Conclusions Modified EGD is an effective noninvasive technique for early diagnosis and treatment of second primary malignancies of the esophagus and hypopharynx in patients with oral squamous cell carcinoma. In particular, patients with floor of the mouth lesions need close monitoring for hypopharyngeal and esophageal lesions. Level of Evidence 3b.
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Affiliation(s)
- Toshihiro Matsui
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Takuya Okada
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Kenro Kawada
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Masahumi Okuda
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Taichi Ogo
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yutaka Nakajima
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yuichiro Kume
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Tairo Ryotokuji
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Akihiro Hoshino
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yutaka Tokairin
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
| | - Yasuyuki Michi
- Department of Maxillofacial Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Tokyo Japan
| | - Hiroyuki Harada
- Department of Oral & Maxillofacial Surgery Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University Tokyo Japan
| | - Yasuaki Nakajima
- Department of Gastrointestinal Surgery Tokyo Medical and Dental University Tokyo Japan
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16
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Petroianu A, Sabino KR, Nunes MB. Synchronous triple squamous cell carcinoma of the esophagus. Int J Surg Case Rep 2018; 49:34-36. [PMID: 29966947 PMCID: PMC6039883 DOI: 10.1016/j.ijscr.2018.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 05/28/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Synchronous multiple primary malignancies of the esophagus and other organs are relatively unusual, but only five articles have published two synchronous cancers, both in the esophagus. This is the first published case of a triple esophageal carcinoma. CASE REPORT A 43-year-old man was referred to our hospital with severe progressive dysphagia and epigastric pain for almost one year. Endoscopy and imaging exams revealed three tumors located in upper, middle and lower esophagus. The upper and middle esophageal cancers were irresectable, and the patient was treated with radio- and chemotherapy. He survived 11 months after the diagnosis and died due to severe undernutrition and bilateral pneumonia. CONCLUSION In presence of squamous cell carcinoma of the esophagus, propedeutics should be carefully performed in order to verify the occurrence of other synchronous tumors in the esophagus and other organs, mainly head and neck and bronchial regions.
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Affiliation(s)
- Andy Petroianu
- Department of Surgery, School of Medicine, Federal University, Minas Gerais, Brazil.
| | - Kelly Renata Sabino
- Department of Surgery, School of Medicine, Federal University, Minas Gerais, Brazil
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17
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Okamoto T, Katada C, Komori S, Yamashita K, Miyamoto S, Kano K, Seino Y, Hosono H, Matsuba H, Moriya H, Sugawara M, Azuma M, Ishiyama H, Tanabe S, Hayakawa K, Koizumi W, Okamoto M, Yamashita T. A retrospective study of treatment for curative synchronous double primary cancers of the head and neck and the esophagus. Auris Nasus Larynx 2018; 45:1053-1060. [PMID: 29752155 DOI: 10.1016/j.anl.2017.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/25/2017] [Accepted: 12/13/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Curative synchronous double primary cancers of the head and neck and the esophagus (CSC-HE) are frequently detected, but a standard treatment remains to be established. We studied the clinical course to explore appropriate treatment strategies. METHODS We retrospectively studied consecutive 33 patients who had CSC-HE. The disease stage was classified into 4 groups: group A, early head and neck cancer (HNC) and early esophageal cancer (EC); group B, early HNC and advanced EC; group C, advanced HNC and early EC; and group D, advanced HNC and advanced EC. As induction chemotherapy, the patients received 3 courses of TPF therapy (docetaxel 75mg/m2 on day 1, cisplatin 75mg/m2 on day 1, and 5-fluorouracil 750mg/m2 on days 1-5) at 3-week intervals. The clinical courses and treatment outcomes were studied according to the disease stage of CSC-HE. RESULTS The disease stage of CSC-HE was group A in 1 patient (3%), group B in 9 patients (27.3%), group C in 3 patients (9.1%), and group D in 20 patients (60.6%). The median follow-up was 26months, and the 2-year overall survival rate was 67.4%. In groups A, B, and C, the 2-year overall survival rate was 83.3%. In group D, the 2-year overall survival rate was 62.6%. Ten of 20 patients in group D received induction chemotherapy with TPF, and 6 patients were alive and disease free at the time of this writing. CONCLUSION The treatment outcomes of patients with CSC-HE were relatively good. TPF induction chemotherapy might be an effective treatment for patients with advanced HNC and advanced EC.
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Affiliation(s)
- Tabito Okamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Chikatoshi Katada
- Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan.
| | - Shouko Komori
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Keishi Yamashita
- Department of Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Shunsuke Miyamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Koichi Kano
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Yutomo Seino
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Hiroshi Hosono
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Hiroki Matsuba
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Hiromitsu Moriya
- Department of Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Mitsuhiro Sugawara
- Department of Pharmacy, Kitasato University Hospital, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Mizutomo Azuma
- Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Hiromichi Ishiyama
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Satoshi Tanabe
- Department of Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Kazushige Hayakawa
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Wasaburo Koizumi
- Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Makito Okamoto
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
| | - Taku Yamashita
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0374, Japan
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18
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Lee KD, Wang TY, Lu CH, Huang CE, Chen MC. The bidirectional association between oral cancer and esophageal cancer: A population-based study in Taiwan over a 28-year period. Oncotarget 2017; 8:44567-44578. [PMID: 28562351 PMCID: PMC5546502 DOI: 10.18632/oncotarget.17818] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/23/2017] [Indexed: 01/17/2023] Open
Abstract
Previous studies have revealed that patients with oral or esophageal cancer are at higher risk for subsequently developing a second primary malignancy. However, it remains to be determined what association exists between oral cancer and esophageal cancer particularly in Asian countries where squamous cell carcinoma is the predominant type of esophageal cancer. A population-based study was carried out in Taiwan, where the incidence rates of both oral and esophageal squamous cell carcinomas are high, to test the hypothesis that oral cancer or esophageal cancer predisposes an individual to developing the other form of cancer. Our results showed that patients with primary oral cancer (n=45,859) had ten times the risk of second esophageal cancer compared to the general population. Within the same cohort, the reciprocal risk of oral cancer as a second primary in primary esophageal cancer patients (n=16,658) was also increased seven-fold. The bidirectional relationship suggests common risk factors between these two cancers. The present study is not only the first population-based study in Asia to validate the reciprocal relationship between oral and esophageal squamous cell carcinomas, but also will aid in the appropriate selection of high-risk patients for a future follow-up surveillance program.
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Affiliation(s)
- Kuan-Der Lee
- Division of Hematology and Oncology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ting-Yao Wang
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chang-Hsien Lu
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Cih-En Huang
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Min-Chi Chen
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Public Health and Biostatistics Consulting Center, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
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19
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Butskiy O, Rahmanian R, White RA, Durham S, Anderson DW, Prisman E. Revisiting the gastric pull-up for pharyngoesophageal reconstruction: A systematic review and meta-analysis of mortality and morbidity. J Surg Oncol 2016; 114:907-914. [PMID: 27774626 DOI: 10.1002/jso.24477] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/29/2016] [Indexed: 02/07/2023]
Abstract
Gastric pull-up (GPU) is among the oldest techniques for reconstructing the pharyngoesophageal junction following cancer resection. This review examines morbidity and mortality rates following GPU pharyngoesophageal junction reconstruction from 1959 until present: 77 studies, 2,705 patients. The odds of mortality, anastomotic complications, and other complications decreased by 37.2% (95%CI = 28.0-45.3%; P < 0.0001), 8.0% (95%CI = -2.1 to 17.1%; P = 0.12), 21.0% (95%CI 3.5-35.2%; P = 0.021) per decade respectively. J. Surg. Oncol. 2016;114:907-914. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Oleksandr Butskiy
- Division of Otolaryngology-Head and Neck Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
| | - Ronak Rahmanian
- Division of Otolaryngology-Head and Neck Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
| | - Richard A White
- Statistical Consulting and Research Laboratory, Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott Durham
- Division of Otolaryngology-Head and Neck Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
| | - Donald W Anderson
- Division of Otolaryngology-Head and Neck Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
| | - Eitan Prisman
- Division of Otolaryngology-Head and Neck Surgery, Vancouver General Hospital, Vancouver, British Columbia, Canada.,University of British Columbia, Vancouver, British Columbia, Canada
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20
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Lee JS, Ahn JY, Choi KD, Song HJ, Kim YH, Lee GH, Jung HY, Ryu JS, Kim SB, Kim JH, Park SI, Cho KJ, Kim JH. Synchronous second primary cancers in patients with squamous esophageal cancer: clinical features and survival outcome. Korean J Intern Med 2016; 31:253-9. [PMID: 26864297 PMCID: PMC4773710 DOI: 10.3904/kjim.2014.182] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 11/15/2014] [Accepted: 12/11/2014] [Indexed: 12/12/2022] Open
Abstract
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/m(2) vs. 22.8 kg/m(2), 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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Affiliation(s)
- Jin Seo Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Yong Ahn
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho June Song
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Correspondence to Ho June Song, M.D. Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3916 Fax: +82-2-485-5782 E-mail:
| | - Yong Hee Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gin Hyug Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hwoon-Yong Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin-Sook Ryu
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Hoon Kim
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seung-Il Park
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung-Ja Cho
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin-Ho Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Akiyama Y, Iwaya T, Shioi Y, Endo F, Ishida K, Kashiwaba M, Otsuka K, Nitta H, Koeda K, Mizuno M, Kimura Y, Sasaki A. Successfully treated advanced esophageal cancer with left axillary lymph node metastasis and synchronous right breast cancer: a case report. Surg Case Rep 2015; 1:94. [PMID: 26943418 PMCID: PMC4595409 DOI: 10.1186/s40792-015-0102-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 10/01/2015] [Indexed: 11/18/2022] Open
Abstract
The incidence of double cancer of the esophagus and breast is rare, and axillary lymph node metastasis (ALM) in esophageal cancer is also very rare. We report a case of advanced esophageal cancer with left ALM and synchronous right breast cancer. A 64-year-old woman was admitted to our hospital with dysphagia. The clinical diagnosis was esophageal cancer (T3N0M1 stage IV) and right breast cancer (T1cN0M0 stage I). She was initially treated with triple chemotherapy with docetaxel, cisplatin, and 5-fluorouracil. The primary lesion in the esophagus achieved almost complete response as assessed by esophageal endoscopy. A computed tomography scan showed that the left ALM reduced in size and that stable disease was achieved for the right breast cancer. She underwent partial mastectomy of the right breast and bilateral axillary lymph node dissection. The histopathological diagnosis of the breast cancer was T1cN1M0 stage IIA. The lymph nodes from the left axilla contained metastatic cells from the squamous cell carcinoma of the esophagus. Complete response was achieved for the primary lesion in the esophagus following chemoradiotherapy (CRT), and the patient has been relapse free 2 years after treatment. Thus, we report the successful treatment of synchronous double cancers of the esophagus with left ALM and right breast by combination therapy with chemotherapy, CRT, and surgery.
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Affiliation(s)
- Yuji Akiyama
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Takeshi Iwaya
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Yoshihiro Shioi
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Fumitaka Endo
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Kazushige Ishida
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Masahiro Kashiwaba
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Koki Otsuka
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Hiroyuki Nitta
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Keisuke Koeda
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Masaru Mizuno
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Yusuke Kimura
- Department of Palliative Care Medicine, Iwate Medical University School of Medicine, Iwate, Japan.
| | - Akira Sasaki
- Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
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22
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Li X, Lin S, Zhang Y, Wang H. Synchronous primary esophageal squamous cell carcinoma and gastric adenocarcinoma: analysis of 41 cases treated in a single institution. Sci Rep 2015; 5:13335. [PMID: 26290280 PMCID: PMC4542160 DOI: 10.1038/srep13335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 07/21/2015] [Indexed: 02/05/2023] Open
Abstract
The present study investigated the treatment and survival outcomes of patients with synchronous primary esophageal squamous cell carcinoma and gastric adenocarcinoma. The medical records of 10,783 patients with primary esophageal squamous cancer treated at our institution between 1995 and 2012 were retrospectively reviewed. Overall survival (OS) rates were calculated using the Kaplan-Meier method. The incidence was 0.38% (41/10,783). Of these 41 patients, 26 underwent curative surgery, ten received palliative chemotherapy or radiotherapy, and five received no treatment. The median OS of the surgery, palliative-therapy, and treatment-free groups was 17.1, 9.0, and 3.8 months, respectively. The 1-, 3-, 5-, and 10-year OS rates for the surgery group were 77%, 45%, 33%, and 19%, respectively. No significant differences in median OS were observed between the surgery group and the historical cohort of isolated esophageal cancer (n = 186) (17.1 vs. 21.0 months, P = 0.061) or isolated gastric cancer (n = 51) (17.1 vs. 28.9 months, P = 0.875), or between the palliative-therapy group and its corresponding historical cohort (n = 30) (9.0 vs. 8.3 months, P = 0.862). The survival outcomes of patients with synchronous primary esophageal squamous and gastric cancers were not worse than those of patients with isolated esophageal cancer or isolated gastric cancer.
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Affiliation(s)
- Xuyan Li
- Department of Internal Medicine, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Suiling Lin
- Department of prevention and health care, Cancer Hospital of Shantou University MedicalCollege, Shantou, Guangdong, China
| | - Yuling Zhang
- Department of quality control, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Hongbiao Wang
- Department of Internal Medicine, Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
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23
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Narrow-Band Imaging Magnifying Endoscopy versus Lugol Chromoendoscopy with Pink-Color Sign Assessment in the Diagnosis of Superficial Esophageal Squamous Neoplasms: A Randomised Noninferiority Trial. Gastroenterol Res Pract 2015; 2015:639462. [PMID: 26229530 PMCID: PMC4502310 DOI: 10.1155/2015/639462] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/10/2015] [Indexed: 12/16/2022] Open
Abstract
Previous studies have shown the high diagnostic accuracy of narrow-band imaging magnifying endoscopy (NBI-ME) and Lugol chromoendoscopy with pink-color sign assessment (LCE-PS) for superficial esophageal squamous cell carcinoma (SESCC). However, there has been no controlled trial comparing these two diagnostic techniques. We conducted a randomized noninferiority trial to compare the diagnostic accuracy of NBI-ME and LCE-PS. We recruited patients with, or with a history of, squamous cell carcinoma in the head and neck region or in the esophagus. They were randomly assigned to either NBI-ME or LCE-PS. When lesions > 5 mm in diameter were found as brownish areas on NBI or as Lugol-voiding lesions (LVL), they were evaluated to determine whether they are SESCC on the basis of the findings of NBI-ME or PS in the LVL. NBI-ME and LCE-PS were completed in 147 patients each. There was no significant difference in all diagnostic values between the two techniques. Compared with LCE-PS, NBI-ME showed a significantly shorter examination time but a larger number of misdiagnosed lesions especially in patients with many irregularly shaped multiform LVLs. Compared with LCE-PS, NBI-ME might be similarly accurate and less invasive, but less reliable in patients with many LVLs, in the diagnosis of SESCC.
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Akiyama Y, Iwaya T, Konosu M, Shioi Y, Endo F, Katagiri H, Nitta H, Kimura T, Otsuka K, Koeda K, Kashiwaba M, Mizuno M, Kimura Y, Sasaki A. Curative two-stage resection for synchronous triple cancers of the esophagus, colon, and liver: Report of a case. Int J Surg Case Rep 2015; 13:1-4. [PMID: 26074482 PMCID: PMC4529638 DOI: 10.1016/j.ijscr.2015.05.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 04/27/2015] [Accepted: 05/25/2015] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Cases of synchronous triple cancers of the esophagus and other organs curatively resected are rare. PRESENTATION OF CASE A 73-year-old man was admitted to our hospital with bloody feces. He was diagnosed with synchronous triple cancers of the esophagus, colon, and liver. We selected a two-stage operation to safely achieve curative resection for all three cancers. The first stage of the operation comprised a laparoscopy-assisted sigmoidectomy and partial liver resection via open surgery. The patient was discharged without complications. Thirty days later, he was readmitted and thoracoscopic esophagectomy was performed. Although pneumonia-induced pulmonary aspiration occurred as a postoperative complication, it was treated conservatively. The patient was discharged on postoperative day 24. DISCUSSION Esophagectomy is a highly invasive procedure; thus, simultaneous surgery for plural organs, including the esophagus, may induce life-threatening, severe complications. Two-stage surgery is useful in reducing surgical stress in high-risk patients. For synchronous multiple cancers, the planning of two-stage surgery should be considered for each cancer to maintain organ function and reduce the stress and difficulty of each stage. CONCLUSION We successfully treated synchronous triple cancers, including esophageal cancer, by a two-stage operation.
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Affiliation(s)
- Yuji Akiyama
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
| | - Takeshi Iwaya
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Masafumi Konosu
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Yoshihiro Shioi
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Fumitaka Endo
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Hirokatsu Katagiri
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Hiroyuki Nitta
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Toshimoto Kimura
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Koki Otsuka
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Keisuke Koeda
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Masahiro Kashiwaba
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Masaru Mizuno
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Yusuke Kimura
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Akira Sasaki
- Department of Surgery, Department of Palliative Care Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
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Takeuchi D, Koide N, Komatsu D, Suzuki A, Miyagawa S. Prevalence and management of colorectal neoplasia in surgically treated esophageal cancer patients. Int J Surg 2015; 17:60-6. [PMID: 25794438 DOI: 10.1016/j.ijsu.2015.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 02/17/2015] [Accepted: 02/28/2015] [Indexed: 10/23/2022]
Abstract
AIMS The existence of other primary tumors during the treatment of esophageal cancer patients has been an important issue. Our aim is to investigate the prevalence and management of colorectal neoplasia (CRN) in surgically treated esophageal cancer patients. METHODS Between 2002 and 2008, 93 patients with esophageal cancer were surgically treated. Seventy-three patients underwent subtotal esophagectomy and 20 underwent lower esophagectomy for esophageal cancer. Colonoscopy was available for detecting CRN before and after surgery. RESULTS Eighty-nine (95.7%) of the 93 patients were screened by colonoscopy preoperatively or within a year from the operation. Thirty-nine patients (43.8%) with CRN were synchronously identified: adenoma in 34 (38.2%) and adenocarcinoma in 5 patients (5.6%). Eleven adenomas with high grade-dysplasia and 8 adenomas with low grade-dysplasia were removed endoscopically. Three superficial adenocarcinomas were endoscopically removed before surgery, and 2 adenocarcinomas were surgically removed. Seventy-four patients (83.1%) were followed using colonoscopy, and 11 subsequent CRN, including 2 superficial adenocarcinomas, were endoscopically detected in 8 patients (10.8%). The size of esophageal cancer was larger in the patients with than without CRN (p = 0.036). The body mass index in esophageal cancer patients with CRN tended to be higher than in those without CRN (p = 0.065). CONCLUSIONS We noted that esophageal cancer is frequently associated with synchronous and/or metachronous colorectal cancer and adenomas. Colonoscopy is useful to detect and manage CRN before and after esophagectomy, although a few limitations exist.
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Affiliation(s)
- Daisuke Takeuchi
- Department of Surgery, Shinshu University School of Medicine, Japan.
| | - Naohiko Koide
- Department of Surgery, Shinshu University School of Medicine, Japan
| | - Daisuke Komatsu
- Department of Surgery, Shinshu University School of Medicine, Japan
| | - Akira Suzuki
- Department of Surgery, Shinshu University School of Medicine, Japan
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26
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Chen SC, Teng CJ, Hu YW, Yeh CM, Hung MH, Hu LY, Ku FC, Tzeng CH, Chiou TJ, Chen TJ, Liu CJ. Secondary primary malignancy risk among patients with esophageal cancer in Taiwan: a nationwide population-based study. PLoS One 2015; 10:e0116384. [PMID: 25635388 PMCID: PMC4312084 DOI: 10.1371/journal.pone.0116384] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 12/05/2014] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND To evaluate the risk and sites of metachronous secondary primary malignancies (SPMs) among patients with esophageal cancer. METHODS Newly diagnosed esophageal cancer patients between 1997 and 2011 were recruited. To avoid surveillance bias, SPMs that developed within one year were excluded. Standardized incidence ratios (SIRs) of metachronous SPMs in these patients were calculated by comparing to the cancer incidence in the general population. Risk factors for SPM development, included age, sex, comorbidities and cancer-related treatments, were estimated by Cox proportional hazards models. RESULTS During the 15-year study period, 870 SPMs developed among 18,026 esophageal cancer patients, with a follow-up of 27,056 person-years. The SIR for all cancers was 3.53. The SIR of follow-up period ≥ 10 years was 3.56; 5-10 years, 3.14; and 1-5 years, 3.06. The cancer SIRs of head and neck (15.83), stomach (3.30), lung and mediastinum (2.10), kidney (2.24) and leukemia (2.72), were significantly increased. Multivariate analysis showed that age ≥ 60 years (hazard ratio [HR] 0.74), being male (HR 1.46) and liver cirrhosis (HR 1.46) were independent factors. According to the treatments, major surgery (HR 1.24) increased the risk, but chemotherapy was nearly significant. CONCLUSIONS Patients with esophageal cancer were at increased risk of developing metachronous SPMs. The SIR remained high in follow-up > 10 years, so that close monitoring may be needed for early detection of SPM among these esophageal cancer patients.
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Affiliation(s)
- San-Chi Chen
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chung-Jen Teng
- Division of Hematology and Oncology, Department of Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Wen Hu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chiu-Mei Yeh
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Man-Hsin Hung
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Li-Yu Hu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Fan-Chen Ku
- Division of Hematology and Oncology, Department of Medicine, Changhua Show-Chwan Memorial Hospital, Changhua, Taiwan
| | - Cheng-Hwai Tzeng
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeon-Jye Chiou
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Jen Liu
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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27
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Ida S, Morita M, Hiyoshi Y, Ikeda K, Ando K, Kimura Y, Saeki H, Oki E, Kusumoto T, Yoshida S, Nakashima T, Watanabe M, Baba H, Maehara Y. Surgical Resection of Hypopharynx and Cervical Esophageal Cancer with a History of Esophagectomy for Thoracic Esophageal Cancer. Ann Surg Oncol 2014; 21:1175-81. [PMID: 24380922 DOI: 10.1245/s10434-013-3454-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Indexed: 12/17/2022]
Affiliation(s)
- Satoshi Ida
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Goda K, Dobashi A, Tajiri H. Perspectives on narrow-band imaging endoscopy for superficial squamous neoplasms of the orohypopharynx and esophagus. Dig Endosc 2014; 26 Suppl 1:1-11. [PMID: 24372999 DOI: 10.1111/den.12220] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 11/01/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Narrow-band imaging (NBI) is widely available and over the last decade has been applied as a detection and characterization technique for superficial neoplasms of the aerodigestive tract. The aims of the present study were to systematically review clinical trials of NBI endoscopy and to investigate an upgraded NBI system using a novel endoscope for superficial squamous neoplasms in the orohypopharynx and esophagus. METHODS Studies on the diagnostic use of NBI endoscopy for superficial squamous neoplasms in the orohypopharynx and esophagus were retrieved from MEDLINE and PubMed and reviewed. An upgraded NBI system using a novel endoscope was investigated with our clinical cases. RESULTS In many clinical trials, NBI endoscopy with or without magnification had high diagnostic value for superficial squamousneoplasms in the orohypopharynx and esophagus. An upgraded NBI system can produce a significantly brighter endoscopic view than conventional endoscopes with high-quality magnified images that could be used to diagnose superficial squamous neoplasms. CONCLUSIONS NBI endoscopy with or without magnification has diagnostic utility for superficial squamous neoplasms in the orohypopharynx and esophagus. The upgraded NBI endoscopic system is expected to facilitate the use of NBI and magnifying endoscopic diagnosis.
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Affiliation(s)
- Kenichi Goda
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
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29
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Li M, Lin ZX. Characteristics and prognostic factors of synchronous multiple primary esophageal carcinoma: A report of 52 cases. Thorac Cancer 2014; 5:25-30. [PMID: 26766968 PMCID: PMC4704272 DOI: 10.1111/1759-7714.12047] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/06/2013] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To retrospectively analyze the clinical characteristics and prognostic factors of 52 cases of synchronous multiple primary esophageal carcinoma (SMPEC), in order to provide a reference for treatment strategy. METHODS Clinical and survival data of 52 patients with SMPEC were analyzed retrospectively. The rates of overall survival (OS), depending on the different factors, were calculated using Kaplan-Meier analysis. A log-rank test was used for univariate survival analysis and Cox's proportional hazards regression model was used for multivariate survival analysis. RESULTS Clinical and survival data of 52 patients with SMPEC, hospitalized from 1 January 2003 to 31 October 2011, were analyzed. Twelve patients underwent surgical resection, five received adjuvant radiotherapy and one received adjuvant radiochemotherapy. Thirty-seven of the 40 non-operative patients received external beam radiation therapy and 20 of them received platinum-based chemotherapy. Another three non-operative patients were given platinum-based chemotherapy alone. The one, three, and five-year OS and the median survival time (MST) were 65.4%, 17.3%, 7.7%, respectively, and 15.0 months for the whole cohort. Tumor length and M stage were independent prognostic factors for the whole cohort by multivariate survival analysis (P = 0.010 and 0.047, respectively). For the radiotherapy subgroup, multivariate analysis of prognostic factors identified that shorter tumor length, M0 stage, and chemotherapy were the predominant independent predictors of long-term survival (P = 0.039, 0.022 and 0.010, respectively). CONCLUSIONS SMPEC is a relatively rare and aggressive tumor. Combined radiotherapy with chemotherapy seemed to bring a survival benefit and may be a better management choice for unresectable and non-operative SMPEC.
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Affiliation(s)
- Mei Li
- Department of Radiation Oncology, Tumor Hospital of Shantou University Medical CollegeShantou, China
| | - Zhi-xiong Lin
- Department of Radiation Oncology, Tumor Hospital of Shantou University Medical CollegeShantou, China
- Correspondence, Zhi-xiong Lin, Department of Radiation Oncology, Cancer Hospital of Shantou University Medical College, 7 Raoping Road, Shantou 515041, China., Tel: +86 754 8855 5844 1137, Fax: +86 754 8856 0352,
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30
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Huguenin JFL, Azevedo VVZD, Almeida HIB, Oliveira IMD, Pinto CE. Synchronous esophageal squamous cell carcinoma and gastric adenocarcinoma. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2013; 26:246-7. [PMID: 24190388 DOI: 10.1590/s0102-67202013000300019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Nandy N, Dasanu CA. Incidence of second primary malignancies in patients with esophageal cancer: a comprehensive review. Curr Med Res Opin 2013; 29:1055-65. [PMID: 23777310 DOI: 10.1185/03007995.2013.816276] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Development of a second primary malignancy (SPM) after an index esophageal cancer is fairly rare, primarily due to decreased survival in patients with esophageal cancer. However, with advances in early detection and therapy, the number of long-term survivors is increasing, as is the incidence of SPMs in this population. SCOPE We review herein the published literature on the incidence of SPMs after an index esophageal cancer as well as its associated risk factors, prognosis and surveillance. We discuss predisposing factors that may contribute to the development of SPMs, epidemiology and attempts at chemoprevention. FINDINGS Data from population-based studies, retrospective reviews and case reports indicate an increased risk of SPMs in patients with esophageal cancer with reported incidence rates between 8.3 and 27.1%. Index esophageal squamous cell carcinomas have a higher association with other tobacco-related cancers such as those of the head and neck and lung. They have also shown an association with second primary cancers of the breast, stomach, thyroid, and kidney. Individuals with esophageal adenocarcinomas are at a higher risk of developing second cancers of the stomach, oropharynx and lung/bronchus. Other primary cancer sites involved include the kidney, colorectum and pancreas. Common risk factors including lifestyle and genetic alterations may explain the increased incidence of second primary cancers in this patient population. CONCLUSIONS Risk of developing a second malignancy should be anticipated after curative treatment of esophageal cancer, and raises concerns for optimal surveillance and therapy of these patients. Recent literature suggests similar survival rates in esophageal cancer patients with and without SPMs. With the increasing incidence of SPMs in subjects with esophageal cancer, there may be benefit to close screening for and aggressive therapy of SPMs. However, further studies are needed to elucidate optimal management strategies.
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Affiliation(s)
- Nina Nandy
- University of Connecticut, Internal Medicine, Hartford, CT 06103, USA.
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Hung SH, Tsai MC, Liu TC, Lin HC, Chung SD. Routine endoscopy for esophageal cancer is suggestive for patients with oral, oropharyngeal and hypopharyngeal cancer. PLoS One 2013; 8:e72097. [PMID: 23977217 PMCID: PMC3744481 DOI: 10.1371/journal.pone.0072097] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 07/07/2013] [Indexed: 02/06/2023] Open
Abstract
Background This study attempted to reveal the incidence and risk of synchronous and metachronous esophageal cancer in subjects with oral, oropharyngeal and hypopharyngeal cancer based on a population-wide database in Taiwan. Methods We retrieved data for this cross-sectional study from the Taiwanese Longitudinal Health Insurance Database 2000. The study group included 2,965 subjects who had received their first-time diagnosis of oral/oropharyngeal/hypopharyngeal cancer in 2002∼2009. We assigned the date of their first diagnosis of oral/oropharyngeal/hypopharyngeal cancer as the index date. We also randomly retrieved 29,650 comparison subjects matched with the study subjects in terms of gender and age group. We assigned their first medical utilization that occurred in the index year as the index date for the comparison group. We further performed a conditional logistic regression to investigate the association between esophageal cancer and oral cancer. Results Results showed that prevalences of esophageal cancer within 3 months before and after the index date were respectively 2.19% and 0.04% for the study and comparison groups. A conditional logistic regression revealed that the odds ratio (OR) of esophageal cancer for subjects with oral/oropharyngeal/hypopharyngeal cancer was 55.33 (95% confidence interval (CI): 29.86∼102.52) compared to comparison subjects. Furthermore, compared to comparison subjects, ORs for esophageal cancer were respectively 18.41 (95% CI: 8.50–39.85), 40.49 (95% CI: 15.11∼108.64), and 240.96 (95% CI: 125.49–462.69) for study subjects with a malignancy of the oral cavity, oropharynx, and hypopharynx. Conclusion We concluded that there were relatively high chances for synchronous and metachronous esophageal cancers being detected through panendoscopy in patients with oral, oropharyngeal, and hypopharyngeal cancers. The routine use of panendoscopy in such patients should be encouraged with a higher priority.
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Affiliation(s)
- Shih-Han Hung
- Department of Otolaryngology, Taipei Medical University Hospital, Taipei, Taiwan
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33
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I H, Kim GH, Park DY, Kim YD, Lee BE, Ryu DY, Kim DU, Song GA. Management of gastric epithelial neoplasia in patients requiring esophagectomy for esophageal cancer. Dis Esophagus 2013; 26:603-8. [PMID: 23237403 DOI: 10.1111/dote.12010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Esophageal squamous cell carcinoma is occasionally associated with malignancies located in other regions of the alimentary tract, as well as in the head, neck, and upper respiratory tract. The stomach is most commonly used for reconstruction of the alimentary tract after esophagectomy for esophageal cancer. When synchronous tumors are located in the stomach, it is often unsuitable for use in esophageal reconstruction. In such cases, an invasive procedure involving anastomosis between the esophagus and the colon must be performed. However, this procedure is associated with a high incidence of mortality and morbidity. Seven patients with synchronous esophageal cancer and gastric epithelial neoplasia were encountered. First, endoscopic submucosal dissection (ESD) was performed for the gastric epithelial neoplasia. Then, following successful ESD, Ivor-Lewis esophagectomy for esophageal cancer was planned 1 to 2 weeks later. A total of 11 gastric epithelial lesions were found in seven patients. En bloc resection by ESD was possible in all 11 lesions and histologically complete resection was achieved in all 11 lesions. Follow-up endoscopy was done 1-2 weeks after ESD; six patients with well-healing ulcers underwent esophagectomy the next day (8 or 15 days after ESD). In one patient with a poorly healed ulcer, a second follow-up endoscopy was done 1 week later and then esophagectomy was performed the next day (22 days after ESD). Post-surgical complications related to ESD, such as bleeding or mediastinal leak, were not seen in any of the seven patients. In patients with synchronous esophageal cancer and gastric epithelial neoplasia, ESD for gastric epithelial neoplasia followed by Ivor-Lewis esophagectomy 1 to 2 weeks later is an effective choice of treatment.
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Affiliation(s)
- H I
- Department of Chest Surgery, Pusan National University School of Medicine, Busan, Korea
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Fukaya M, Abe T, Yokoyama Y, Itatsu K, Nagino M. Two-stage operation for synchronous triple primary cancer of the esophagus, stomach, and ampulla of Vater: report of a case. Surg Today 2013; 44:967-71. [PMID: 23504004 DOI: 10.1007/s00595-013-0549-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 10/26/2012] [Indexed: 02/06/2023]
Abstract
A 69-year-old man with jaundice was diagnosed with cancer of the ampulla of Vater by endoscopic retrograde cholangiopancreatography and abdominal computed tomography. A screening gastrointestinal endoscopy showed middle thoracic esophageal cancer and early gastric cancer on the anterior wall of the lower gastric body. We chose a two-stage operation for synchronous triple primary cancer of the esophagus, stomach, and ampulla of Vater, in order to safely perform the curative resection of these three cancers. The first-stage operation consisted of a right transthoracic subtotal esophagectomy with mediastinal and cervical lymph node dissection, an external esophagostomy in the neck, and a gastrostomy. Thirty-five days after the first surgery, a total gastrectomy with regional lymph node dissection, and a pancreatoduodenectomy with Child's reconstruction were performed as the second-stage surgery. Esophageal reconstruction was achieved using the ileocolon via the percutaneous route without vascular anastomosis.
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Affiliation(s)
- Masahide Fukaya
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan,
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Ikawa H, Tonogi M, Yamane GY, Yamauchi T, Tanaka Y, Sato M, Matsui J, Ando N, Katakura A. Upper gastrointestinal tract cancers as double-cancers in elderly patients with oral squamous cell carcinoma. THE BULLETIN OF TOKYO DENTAL COLLEGE 2012; 53:9-16. [PMID: 22452886 DOI: 10.2209/tdcpublication.53.9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Against a background of a rapidly aging society, the number of patients with oral cancers in Japan is increasing yearly. The number of double-cancers with oral cancer as the first malignancy is also reportedly on the rise. Esophageal and gastric cancers are the most common second malignancies. At our institution, our policy is to proactively perform upper gastrointestinal (GI) fiberscopy (GIF) in patients with oral cancer. In anticipation of a probable further increase in the number of patients with double-cancers consisting of oral and GI tract malignancies, we retrospectively analyzed the occurrence of upper GI tract cancers in patients with oral squamous cell carcinoma (OSCC). The cohort consisted of 171 patients in whom OSCC had been diagnosed and who had undergone upper GIF between March 1996 and August 2008. Multivariate analysis was performed. Upper GIF identified 8 patients (7 men, 1 woman, totaling 4.7% of 171 patients) with double-cancer in the upper GI tract. One patient had a triple malignancy consisting of oral, esophageal and gastric cancers. Seven patients had esophageal cancer, while two had gastric cancer. An age of over 65 years was significantly higher in patients with double-cancers including esophageal cancer than in patients without esophageal cancer (OR=10.454, 95% CI=1.143-95.621). None of the other analyzed patient factors (sex, smoking habit, drinking habit, site of OSCC, TNM classification, staging results) showed a significant difference. These results indicate that, when treating elderly patients with oral cancers, physicians need to devise suitable treatment plans which take into account the possibility of upper GI tract cancer, particularly esophageal cancer, as a double-cancer.
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Affiliation(s)
- Hiroaki Ikawa
- Department of Oral Medicine, Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba, Japan.
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Katada C, Muto M, Nakayama M, Tanabe S, Higuchi K, Sasaki T, Azuma M, Ishido K, Katada N, Yamashita K, Nemoto M, Shibata T, Masaki T, Okamoto M, Koizumi W. Risk of superficial squamous cell carcinoma developing in the head and neck region in patients with esophageal squamous cell carcinoma. Laryngoscope 2012; 122:1291-6. [DOI: 10.1002/lary.23249] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Han JS, Choi SR, Jang JS, Roh MH, Kim DC, Ryu SH, Woo SM, Hsing CT. A Case of Synchronous Esophagus and Stomach Cancer Successfully Treated by Combined Chemotherapy. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2012; 60:113-8. [DOI: 10.4166/kjg.2012.60.2.113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ji Sun Han
- Department of Gastroenterology, Dong-A University College of Medicine, Busan, Korea
| | - Seok Reyol Choi
- Department of Gastroenterology, Dong-A University College of Medicine, Busan, Korea
| | - Jin Seok Jang
- Department of Gastroenterology, Dong-A University College of Medicine, Busan, Korea
| | - Myung Hwan Roh
- Department of Gastroenterology, Dong-A University College of Medicine, Busan, Korea
| | - Dae Cheol Kim
- Department of Pathology, Dong-A University College of Medicine, Busan, Korea
| | - Seung Hee Ryu
- Department of Gastroenterology, Dong-A University College of Medicine, Busan, Korea
| | - Su Mi Woo
- Department of Gastroenterology, Dong-A University College of Medicine, Busan, Korea
| | - Chien Ter Hsing
- Department of Gastroenterology, Dong-A University College of Medicine, Busan, Korea
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Shinoto M, Shioyama Y, Sasaki T, Nakamura K, Ohura H, Toh Y, Higaki Y, Yamaguchi T, Ohnishi K, Atsumi K, Hirata H, Honda H. Clinical Results of Definitive Chemoradiotherapy for Patients With Synchronous Head and Neck Squamous Cell Carcinoma and Esophageal Cancer. Am J Clin Oncol 2011; 34:362-6. [DOI: 10.1097/coc.0b013e3181e84b4b] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Matsumoto S, Takayama T, Tamamoto T, Wakatsuki K, Enomoto K, Tanaka T, Migita K, Asakawa I, Hasegawa M, Nakajima Y. A comparison of surgery and radiation therapy for cT1 esophageal squamous cell carcinoma. Dis Esophagus 2011; 24:411-7. [PMID: 21309913 DOI: 10.1111/j.1442-2050.2010.01163.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Surgery and radiation therapy have been used to treat esophageal squamous cell carcinoma. However, treatment outcomes have not yet been extensively investigated. The aim of this study was to compare surgery and radiation therapy for clinical T1 esophageal squamous cell carcinoma. A total of 67 clinical T1 esophageal squamous cell carcinoma patients were treated between January 1997 and December 2005; 29 had undergone radical esophagectomy (surgery group) and 38 were treated with definitive radiation therapy (radiation group). The mean patient age was lower in the surgery group than in the radiation group. In surgery group, respiratory complications, anastomotic leaks, recurrent nerve palsies, and anastomotic stenosis occurred in 7, 8, 6, and 5 patients, respectively. In radiation group, leucopenia, esophagitis, pericarditis were observed in 15, 3, and 3 patients, respectively. The 5-year overall survival rate for the surgery group was 68.9%, and 74.3% for the radiation group. There were no significant difference between groups (P= 0.3780). The 5-year relapse-free survival rate in the surgery group was 61.8% and 38.8% in the radiation group. The relapse-free survival rate was significantly higher in the surgery group than in the radiation group (P= 0.0051). The 5-year overall and relapse-free survival rates for tumors invaded into but not through the muscularis mucosa were 83.3% and 75.0%, respectively, in the surgery group and 78.8% and 33.3%, respectively, in the radiation group. There were no significant differences. The 5-year overall survival rates for patients with tumors that invaded the submucosal layer was 64.9% in the surgery group and 66.5% in the radiation group. This difference was not significant (P= 0.8712). The 5-year relapse-free survival rate in the surgery group (56.0%) was significantly higher than that in the radiation group (41.8%; P= 0.0219). In conclusion, surgery may become a standard treatment for cT1 esophageal cancer that can offer longer relapse-free survival, particularly for patients with tumors that invade the submucosa.
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Affiliation(s)
- S Matsumoto
- Department of Surgery, Nara Medical University School of Medicine, Nara, Japan.
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40
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Morimoto M, Nishiyama K, Nakamura S, Suzuki O, Kawaguchi Y, Nakajima A, Imai A, Ishihara R, Uemura H, Fujii T, Yoshino K, Tomita Y. Significance of Endoscopic Screening and Endoscopic Resection for Esophageal Cancer in Patients with Hypopharyngeal Cancer. Jpn J Clin Oncol 2010; 40:938-43. [DOI: 10.1093/jjco/hyq068] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Zygoń JI, Skokowski J, Zieliński J, Drucis K, Golabek-Dropiewska K. Metachronous adenocarcinoma in a gastric tube after radical surgery for oesophageal cancer. BMJ Case Rep 2010; 2010:bcr07.2009.2116. [PMID: 22408648 DOI: 10.1136/bcr.07.2009.2116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
In recent years the prognosis for oesophageal squamous cell carcinoma patients has improved. Together with this improvement, the occurrence of second primary carcinoma, especially gastric carcinoma, in tubes constructed from the stomach after oesophagectomy must be taken into account. We report a case of a patient who had this clinical presentation, which was revealed not in the normal follow-up, but in a consecutive operation carried out because of an anastomotic problem.
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Affiliation(s)
- Justyna Izabela Zygoń
- Medical University of Gdańsk, Department of Surgical Oncology, Dębinki Street 7, Gdańsk, 80-211, Poland
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Nonaka S, Saito Y, Oda I, Kozu T, Saito D. Narrow-band imaging endoscopy with magnification is useful for detecting metachronous superficial pharyngeal cancer in patients with esophageal squamous cell carcinoma. J Gastroenterol Hepatol 2010; 25:264-9. [PMID: 19874445 DOI: 10.1111/j.1440-1746.2009.05993.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Head and neck cancers, especially pharyngeal cancers, as well as esophageal cancers frequently coexist either synchronously or metachronously, but most cases of pharyngeal cancer are detected at an advanced stage resulting in poor prognosis. The aim of this study is to evaluate the effectiveness of using narrow-band imaging (NBI) endoscopy with magnification for early detection of pharyngeal cancer on patients following their treatment for esophageal squamous cell carcinoma (SCC). METHODS This case series was conducted at the National Cancer Center Hospital in Tokyo between April and October 2005 and included 424 consecutive patients for surveillance endoscopy who had previously undergone chemoradiotherapy (CRT) and/or surgery for esophageal SCC. Observation of the pharyngeal region was randomly conducted on 91 patients using NBI endoscopy with magnification (NBI group) and 333 patients using conventional white light endoscopy (control group). RESULTS The detection rate for pharyngeal cancer was significantly higher using NBI endoscopy with magnification (10.9%; 10/91) compared with conventional endoscopy (1.2%; 4/333) (P < 0.0001). In particular, the detection rate in CRT patients was significantly higher in the NBI group (12.9%; 7/54) than the control group (0.5%; 1/191) (P < 0.0001). In addition, diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value for the NBI group were 100% (10/10), 97.5% (79/81), 97.8% (89/91), 83.3% (10/12) and 100% (79/79), respectively. CONCLUSION NBI endoscopy with magnification is a promising technique for detecting superficial pharyngeal cancer at an early stage in patients previously treated for esophageal SCC.
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Affiliation(s)
- Satoru Nonaka
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
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Lee KD, Lu CH, Chen PT, Chan CH, Lin JT, Huang CE, Chen CC, Chen MC. The incidence and risk of developing a second primary esophageal cancer in patients with oral and pharyngeal carcinoma: a population-based study in Taiwan over a 25 year period. BMC Cancer 2009; 9:373. [PMID: 19843324 PMCID: PMC2770571 DOI: 10.1186/1471-2407-9-373] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2009] [Accepted: 10/20/2009] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The incidence of oral and pharyngeal (including oral cavity, oropharynx and hypopharynx) carcinoma increases rapidly in Asia and South Pacific because of betel quid chewing. Thus far, large-scale epidemiological studies are not available yet to stratify these patients by their risks of developing a second primary cancer in the digestive tract including esophagus, stomach, colon, and rectum. METHODS A population-based study was conducted using the database from the Taiwan National Cancer Registry for the period 1979-2003. We quantified standardized incidence ratios (SIRs) and cumulative incidence of second primary cancers among 33,787 patients with initial diagnoses of oral and pharyngeal carcinoma. RESULTS Among these four digestive tract organs, the esophagus was the only site of second cancer with excess risk in patients with oral and pharyngeal carcinoma. The incidence and risk of developing a second primary esophageal cancer differed by the site of the primary index tumor, most frequently seen in hypopharyngeal cancer (71/4,218 = 1.68%, SIR = 22.76, 95% CI 17.77-28.70), followed by oropharyngeal cancer (30/3,403 = 0.88%, SIR = 14.29, 95% CI 9.64-20.39) and the least in oral cavity cancer (99/26,166 = 0.38%, SIR = 5.57, 95% CI 4.53-6.78). In addition, the risk was extraordinarily high for patients with a follow-up interval CONCLUSION The present study represents the first population-based study in Asia attempting to stratify the patients of oral and pharyngeal carcinoma by their risk of developing a second esophageal cancer. It helps identify patients at high risk and tailor the application of intense follow-up surveillance to the estimated risk in each individual case.
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Affiliation(s)
- Kuan-Der Lee
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan, Republic of China
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan
- Chang Gung Institute of Technology, Chia-yi Campus, Chiayi, Taiwan, Republic of China
| | - Chang-Hsien Lu
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan, Republic of China
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan
- Chang Gung Institute of Technology, Chia-yi Campus, Chiayi, Taiwan, Republic of China
| | - Ping-Tsung Chen
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan, Republic of China
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan
- Chang Gung Institute of Technology, Chia-yi Campus, Chiayi, Taiwan, Republic of China
| | - Chunghuang Hubert Chan
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan, Republic of China
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan
- Chang Gung Institute of Technology, Chia-yi Campus, Chiayi, Taiwan, Republic of China
| | - Jen-Tsun Lin
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan, Republic of China
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan
- Chang Gung Institute of Technology, Chia-yi Campus, Chiayi, Taiwan, Republic of China
| | - Cih-En Huang
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan, Republic of China
| | - Chih-Cheng Chen
- Department of Hematology and Oncology, Chang Gung Memorial Hospital at Chiayi, Taiwan, Republic of China
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, Chang Gung University, Tao-Yuan
- Chang Gung Institute of Technology, Chia-yi Campus, Chiayi, Taiwan, Republic of China
| | - Min-Chi Chen
- Department of Public Health and Biostatistics Consulting Center, School of Medicine, Chang Gung University, Tao-Yuan, Taiwan, Republic of China
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Spector R, Liphshitz I, Barchana M, Kundel Y, Wasserberg N, Lelcuk S, Sulkes A, Brenner B. High incidence of non-upper aerodigestive primary tumors in patients with esophageal cancer. Dis Esophagus 2008; 21:718-22. [PMID: 18564171 DOI: 10.1111/j.1442-2050.2008.00838.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Earlier reports have described an association between esophageal cancer (EC) and high incidence of other primary tumors (OPTs) of the upper aerodigestive tract and breast cancer. We evaluated the incidence of non-upper aerodigestive OPTs among Israeli EC patients; 2328 EC patients were retrieved from the Israeli National Cancer Registry between 1980 and 2004. The relative risk of OPTs for EC patients was measured using standardized incidence ratio (SIR). Two cohorts, Israeli National Cancer Registry registered colorectal cancer (CRC) patients and the general Israeli population, were used for reference; 297 EC patients (12.7%) had OPTs, including breast (18.9%), CRC (16.2%), prostate (8.8%), and bladder (8.4%) cancers. Upper aerodigestive OPTs were less common. Most OPTs were identified before (74.4%) or simultaneously with (13.8%) EC diagnosis. The median time interval between OPTs diagnoses and EC development was 6.0 years. The incidence of OPTs was significantly higher among EC patients compared with CRC patients (SIR: 2.05, P < 0.01) or the general Israeli population (SIR: 3.90, 95% CI: 3.46-4.34, P < 0.01) regardless of gender or tumor histology. Patients with EC have high incidence of non-upper aerodigestive malignancies. Unlike previous reports, the distribution of OPTs in EC seems to represent the relative incidences of these cancers in the western populations.
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Affiliation(s)
- R Spector
- Department of General Surgery, Tel Aviv University, Tel Aviv, Israel
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HORIUCHI M, MAKUUCHI H, MACHIMURA T, TAMURA Y, SAKAI M. Survival Benefit of Screening for Early Esophageal Carcinoma in Head and Neck Cancer Patients. Dig Endosc 2007. [DOI: 10.1111/j.1443-1661.1998.tb00546.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- Masatoshi HORIUCHI
- Department of Otolaryngology, Tokai University School of Medicine, Kanagaiva, Japan
| | - Hiroyasu MAKUUCHI
- Department of Surgery, Tokai University School of Medicine, Kanagaiva, Japan
| | - Takao MACHIMURA
- Department of Surgery, Tokai University School of Medicine, Kanagaiva, Japan
| | - Yoshiyuki TAMURA
- Department of Otolaryngology, Tokai University School of Medicine, Kanagaiva, Japan
| | - Makoto SAKAI
- Department of Otolaryngology, Tokai University School of Medicine, Kanagaiva, Japan
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Levi F, Randimbison L, Maspoli M, Te VC, La Vecchia C. Second neoplasms after oesophageal cancer. Int J Cancer 2007; 121:694-7. [PMID: 17417783 DOI: 10.1002/ijc.22744] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The authors considered the incidence of second neoplasms among 1,672 oesophageal cancers diagnosed between 1974 and 2004 in the Cancer Registries of the Swiss Cantons of Vaud and Neuchâtel, and followed-up to 2004. A total of 141 second neoplasms were observed versus 38.5 expected, corresponding to a standardized incidence ratio (SIR) of 3.7 (95% confidence interval: 3.1-4.3). The SIRs were statistically significant for cancers of the oral cavity and pharynx (57.3), larynx (24.3), lung (6.6) and intestines (2.6). The SIRs were higher in subjects diagnosed below age 50 and in the first year after diagnosis. The SIR of upper digestive and respiratory tract neoplasms was higher for oesophageal cancers diagnosed in the upper (87.5) and middle (68.1), as compared with the lower third (19.4). There was no rise of second oral, pharyngeal and laryngeal cancer with advancing age, and their incidence tended indeed to decline from 100/1,000 at age 40-49 to 25/1,000 at age 70-79. There was no tendency to rise with age in the incidence of first oesophageal cancer in subjects who subsequently developed another upper digestive or respiratory tract neoplasm. The excess risks of upper digestive and respiratory tract neoplasms are attributable to increased diagnosis and registration of second neoplasms following a diagnosis of oesophageal cancer, as well as to heavy tobacco and alcohol consumption in oesophageal cancer cases. The absence of rise in incidence with age is also compatible with the existence of a subset of the population of susceptible individuals.
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Affiliation(s)
- Fabio Levi
- Unité d'épidémiologie du cancer, Institut universitaire de médecine sociale et préventive, Université de Lausanne, Bugnon 17, 1005 Lausanne, Switzerland.
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Watanabe A, Hosokawa M, Taniguchi M, Tsujie H, Sasaki S. Head and neck cancer associated with esophageal cancer. Auris Nasus Larynx 2006; 34:207-11. [PMID: 17070004 DOI: 10.1016/j.anl.2006.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 06/30/2006] [Accepted: 07/21/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND Multiple squamous cell carcinomas (SCCs) frequently arise in the aerodigestive tract. This study aims to clarify the incidence of squamous cell carcinoma of the head and neck (SCCHN) in esophageal cancer (EC) and clinical features of SCCHN. METHOD We reviewed the records of 1118 EC patients treated from May 1995 to December 2001 in our institution. All patients with EC underwent otolaryngological examination and pharyngolaryngoscopy screening before and after its treatment periodically during their follow-up periods. The incidence, site and stage of SCCHNs were analyzed. RESULT A total of 127 patients had associated SCCHNs among all patients with EC (11.4%). Of these, the index antecedent tumor was SCCHN in 49 and EC in 78 patients. One hundred and fifteen patients developed double cancers (SCCHN and EC), 9 patients developed triple cancers (2 SCCHNs and EC) and 3 patients developed fourth cancers (3 SCCHNs and EC). Of 49 patients with the index SCCHN, 30 ECs were detected metachronously after its treatment (Group A) and 20 were synchronously (Group B). Of 78 patients with index EC, 38 SCCHNs were detected synchronously (Group C) and 54 SCCHNs were metachronously (Group D). The stages of 54 SCCHNs in the Group D were 33, 14, 4, 3 (Stages I-IV, respectively), which was significantly earlier than that of 50 SCCHNs in the Groups A and B (p<0.001). CONCLUSION The incidence of SCCHN in our EC patients was 11.4%. Periodic otolaryngological examination and pharyngoscopy screening can detect SCCHNs early in patients with primary EC.
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MESH Headings
- Aged
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/pathology
- Carcinoma, Squamous Cell/surgery
- Cross-Sectional Studies
- Early Diagnosis
- Esophageal Neoplasms/diagnosis
- Esophageal Neoplasms/epidemiology
- Esophageal Neoplasms/pathology
- Esophageal Neoplasms/surgery
- Female
- Follow-Up Studies
- Humans
- Incidence
- Laryngoscopy
- Male
- Mass Screening
- Middle Aged
- Neoplasm Staging
- Neoplasms, Multiple Primary/diagnosis
- Neoplasms, Multiple Primary/epidemiology
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/surgery
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/epidemiology
- Neoplasms, Second Primary/pathology
- Neoplasms, Second Primary/surgery
- Otorhinolaryngologic Neoplasms/diagnosis
- Otorhinolaryngologic Neoplasms/epidemiology
- Otorhinolaryngologic Neoplasms/pathology
- Otorhinolaryngologic Neoplasms/surgery
- Prognosis
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Affiliation(s)
- Akihito Watanabe
- Department of Otolaryngology, Keiyukai Sapporo Hospital, Sapporo, Japan.
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Muela Molinero A, Jorquera Plaza F, Ribas Ariño T, Malagón Rojo R, Santos Calderón JA, Espinel Díez V, Olcoz Goñi JL, Quiroga Prado L. [Analysis of the characteristics of patients with bladder cancer diagnosed of multiple neoplasms in the health district of León (Spain)]. Rev Clin Esp 2006; 206:422-7. [PMID: 17042983 DOI: 10.1157/13093466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE We analyzed the characteristics of the patients with bladder neoplasms who developed a multiple malignant primary neoplasm (MMPN) in the health district of León, the impact on survival and the prognostic variables. MATERIAL AND METHODS We have used the data from the Tumor Registry of the Hospital of León and selected all those patients who were diagnosed of a bladder tumor between 1993 and 2002. They were classified into two groups: the first with 71 patients with MMPN and a second group with 159 patients with single bladder tumors diagnosed between 1996 and 1997. RESULTS Incidence of MMPN was of 7.1 percent. More than half of the patients had familial oncologic background. The second most frequently diagnosed neoplasms were urologic, followed by gastrointestinal and respiratory. Survival of patients with MMPN was 21 percent lower than single neoplasms. Variables with prognosis significance were the stage of the second neoplasm, diagnosis of a second urologic neoplasm and surgery treatment for the second tumor. CONCLUSIONS MMPN in patients with bladder tumors are frequent in our geographic area. The high frequency of familial oncologic antecedents in these patients suggest a genetic background. Prognosis of MMPN patients is worse than single tumors patients, but no differences were observed regarding prognosis in patients with synchronous or metachronous MMPN.
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Affiliation(s)
- A Muela Molinero
- Servicios de a Medicina Interna, Hospital de León. León, España.
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McDowell JD. An Overview of Epidemiology and Common Risk Factors for Oral Squamous Cell Carcinoma. Otolaryngol Clin North Am 2006; 39:277-94. [PMID: 16580911 DOI: 10.1016/j.otc.2005.11.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Understanding the epidemiologic picture and the risk factors for oral cancer can help identify and treat patients at risk for oral cancers. Early diagnosis of an oral cancer continues to be important to achieving a favorable prognosis. Absent a diagnosis of oral/pharyngeal cancer, there clearly can-lot be an effective treatment plan. Discovering a potentially malignant or malignant lesion and through biopsy reaching a diagnosis for the lesion begins by performing an examination with the purpose of detecting oral/pharyngeal lesions. An oral cancer screening can be performed in less than five minutes without any expensive diagnostic aids. Despite the ease with which this exam can be performed and the noninvasive nature of the examination,most patients report that they have never had an oral cancer examination. Late stage diagnosis continues to be a common situation resulting in high rates of morbidity and mortality. Without early recognition it seems that the trend of late stage diagnosis will continue. Physicians, dentists, and other health care providers should be performing the oral cancer screening examination on a routine basis for all of their patients.Note: For the interested clinician, the author highly recommends an excellent comprehensive text on the subject of oral cancer. Sol Silverman's(with multiple contributors) The American Cancer Society's Atlas of Clinical Oncology Oral Cancer: Fifth Edition by BC Decker Publishers is an excellent overview of oral cancer covering in greater detail many of the subjects that could not be covered in this brief article. Additionally, there are excellent color photographs of the common presentations of oral malignancies that can be helpful in assessing oral/pharyngeal lesions.
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Affiliation(s)
- John D McDowell
- Department of Diagnostic and Biological Sciences, Division of Oral Diagnosis, Oral Medicine and Forensic Sciences, University of Colorado School of Dentistry, Mail Stop F844, PO Box 6508 Aurora, CO 80045 USA.
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Watanabe A, Hosokawa M, Taniguchi M, Tsujie H, Sasaki S. Impact of endoscopic screening on early detection of hypopharyngeal cancer. Head Neck 2006; 28:350-4. [PMID: 16284978 DOI: 10.1002/hed.20336] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The aim was to investigate whether periodic pharyngolaryngoscopy screening in high-risk patients with preceding carcinoma of the upper aerodigestive tract can detect early hypopharyngeal cancer and preserve the larynx. METHODS The records of 122 patients with hypopharyngeal cancer were retrospectively reviewed. Patients were divided into the following two groups: (1) the screening (SCR) group (n = 65), patients whose hypopharyngeal cancer was detected by pharyngolaryngoscopy screening; and (2) the symptom (SYMP) group (n = 57), patients whose cancer was discovered by any symptoms. Patients' demographics and larynx preservation were compared. RESULTS The number of patients with clinical stage I to IV disease at diagnosis was 44, 14, three, four for the SCR group, respectively, and six, six, 15, 30 for the SYMP group, which was significantly different (p < .0001). The rate of larynx preservation after radical treatment was 79.4% for the SCR group and 45.4% for the SYMP group (p < .001). CONCLUSIONS Periodic pharyngolaryngoscopy screening in high-risk patients may contribute to detecting early hypopharyngeal cancer. Early detection of hypopharyngeal cancer may enhance the rate of larynx preservation and improve the quality of life.
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Affiliation(s)
- Akihito Watanabe
- Department of Otolaryngology, Keiyukai Sapporo Hospital, Kita 1-1, Hondori 14-chome, Shiroishi-ku, Sapporo 003-0027, Japan.
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