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Deng M, Li X, Mu H, Wei M, Sun L. Case report: Efficacy of icotinib treatment in lung adenocarcinoma with esophageal squamous cell carcinoma: a rare case of double primary malignant tumors. Front Med (Lausanne) 2024; 11:1266062. [PMID: 38606154 PMCID: PMC11006962 DOI: 10.3389/fmed.2024.1266062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/14/2024] [Indexed: 04/13/2024] Open
Abstract
Background Lung adenocarcinoma with esophageal squamous cell carcinoma is rare and the prognosis is poor, therefore there is an urgent need to improve this situation. The objective of this study was to explore the effect of first-generation tyrosine kinase inhibitors (TKIs) in the patient of the double primary malignant tumors. Case report We report a case of lung adenocarcinoma with esophageal squamous cell carcinoma treated by icotininb after five-year follow-up. A 71-year-old Chinese woman complaining of swallowing obstruction, heartburn, regurgitation of gastric acid for more than 2 months. An esophageal lesion was found by chest CT scans in T7 vertebral level. The diagnosis by gastroscopic biopsy was squamous cell carcinoma (SCC) with EGFR over-expression. Simultaneously, chest CT showed a 2 cm x 1 cm solitary lesion in the right superior pulmonary. The histological diagnosis by percutaneous lung Biopsy was "adenocarcinoma." Epidermal growth factor receptor (EGFR) gene mutation status was evaluated by Sanger sequencing, and an exon 21 point mutation (L858R) was identified. When the double primary malignant tumors were diagnosed, the patient refused operation and received a tyrosine kinase inhibitor (TKI), icotinib, at the dose of 125 mg, three times per day. All serum tumor biomarkers such as CEA and cancer antigen 125 (CA125) were in the normal range during the treatment period. After five-year follow-up, the patient has no evidence of recurrence or metastasis. The lung cancer was stable, meanwhile the esophageal lesion was almost cured. Conclusion Icotininb is an effective treatment in the patients of the double primary malignant tumors of lung adenocarcinoma with EGFR gene mutation and esophageal squamous cell carcinoma with EGFR over-expression.
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Affiliation(s)
| | | | | | | | - Lan Sun
- Department of Oncology, Bishan Hospital of Chongqing Medical University, Chongqing, China
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Komatsu H, Furukawa N, Kinoshita H, Aratame A, Baba T, Okabe K. Combined resection of lung cancer and thoracic aortic wall with simultaneous thoracic aortic endografting: a case report. Surg Case Rep 2024; 10:55. [PMID: 38453764 PMCID: PMC10920603 DOI: 10.1186/s40792-024-01855-4] [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: 01/21/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Combined resection of lung cancer and the thoracic aortic wall with thoracic aortic endografting has been reported. However, whether the resection and endografting should be performed simultaneously or in two steps remains controversial. CASE PRESENTATION A 68-year-old man was referred to our hospital because of left chest pain. Chest contrast-enhanced computed tomography revealed a huge tumor of the left lower lung lobe, and invasion to the aortic wall was suspected. Bronchoscopic examination was performed, revealing squamous cell carcinoma with a programmed death ligand 1 expression level of 90%. The clinical stage was T4N0M0 stage 3A. After neoadjuvant chemotherapy and radiotherapy, we performed one-stage surgery with the patient in the right lateral decubitus position and the left inguinal region exposed for femoral vessel isolation. Posterolateral thoracotomy was performed with making a latissimus dorsi muscle flap. The pulmonary artery, vein, and left lower bronchus were cut with a stapler. After hilar isolation, we evaluated the involvement of the descending aorta and marked the area of the involved aortic wall by a surgical clip. Using the left femoral artery approach, a GORE TAG conformable thoracic stent graft was delivered to the descending aorta. After thoracic aortic endografting, the involved aortic wall was resected and the left lower lobe of the lung and resected aortic wall were resected en bloc. The adventitial defect was covered by the latissimus dorsi muscle flap. The operating time was 474 min, and the blood loss volume was 330 mL. The postoperative pathological diagnosis was adenocarcinoma with an epidermal growth factor receptor mutation of exon 19 deletion. The residual viable tumor was 7 mm in diameter and close to the resected aortic wall. The patient's postoperative course was uneventful. Five days after surgery, chest contrast-enhanced computed tomography revealed no endoleak or stent migration. Three months after surgery, he was alive with neither recurrence nor stent graft-related complications. CONCLUSIONS One-stage surgery involving combined resection of lung cancer and the thoracic aortic wall with simultaneous thoracic aortic endografting in the right lateral decubitus position with the left inguinal region exposed is safe and acceptable.
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Affiliation(s)
- Hiroaki Komatsu
- Department of Thoracic Surgery, Bell-Land General Hospital, 500-3, Higashiyama, Naka-ku, Sakai-shi, Osaka, 599-8247, Japan.
| | - Nao Furukawa
- Department of Thoracic Surgery, Bell-Land General Hospital, 500-3, Higashiyama, Naka-ku, Sakai-shi, Osaka, 599-8247, Japan
| | - Hirotaka Kinoshita
- Department of Thoracic Surgery, Bell-Land General Hospital, 500-3, Higashiyama, Naka-ku, Sakai-shi, Osaka, 599-8247, Japan
| | - Atsutaka Aratame
- Department of Cardiovascular Surgery, Bell-Land General Hospital, 500-3, Higashiyama, Naka-ku, Sakai-shi, Osaka, 599-8247, Japan
| | - Toshio Baba
- Department of Cardiovascular Surgery, Bell-Land General Hospital, 500-3, Higashiyama, Naka-ku, Sakai-shi, Osaka, 599-8247, Japan
| | - Kazunori Okabe
- Department of Thoracic Surgery, Bell-Land General Hospital, 500-3, Higashiyama, Naka-ku, Sakai-shi, Osaka, 599-8247, Japan
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Liu Y, Zhou J, Gu Y, Hu W, Lin H, Shang Q, Zhang H, Yang Y, Yuan Y, Chen L. Will synchronous esophageal and lung resection increase the incidence of anastomotic leaks? A multicenter retrospective study. Int J Surg 2024; 110:1653-1662. [PMID: 38181122 PMCID: PMC10942245 DOI: 10.1097/js9.0000000000001018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2024] [Accepted: 12/11/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Reports on combined resection for synchronous lung lesions and esophageal cancer (CRLE) cases are rare and mostly individual cases. Furthermore, the feasibility of CRLE has always been a controversial topic. In the current study, the authors retrospectively analyzed the feasibility of CRLE and established an individualized prediction model for esophageal anastomotic leaks after CRLE by performing a multicenter retrospective study. METHODS Patients who underwent esophagectomy between January 2009 and June 2021 were extracted from a four-center prospectively maintained database, and those with CRLE at the same setting were matched in a 1:2 propensity score-matched (PSM) ratio to esophagectomy alone (EA) patients. A nomogram was then established based on the variables involved in multivariate logistic regression analysis. Internal validation of the nomogram was conducted utilizing Bootstrap resampling. Decision and clinical impact curve analysis were computed to assess the practical clinical utility of the nomogram. A prognosis analysis for CRLE and EA patients by Kaplan-Meier curves was conducted. RESULTS Of the 7152 esophagectomies, 216 cases of CRLE were eligible, and 1:2 ratio propensity score-matched EA patients were matched. The incidence of anastomotic leaks following CRLE increased significantly ( P =0.035). The results of the multivariate analysis indicated the leaks varied according to the type of lung resection (anatomic>wedge resection, P =0.016) and site of resected lobe (upper>middle/low lobe; P =0.027), and a nomogram was established to predict the occurrence of leaks accurately (area under the curve=0.786). Although no statistically significant difference in overall survival (OS) was observed in the CRLE group ( P =0.070), a trend toward lower survival rates was noted. Further analysis revealed that combined upper lobe anatomic resection was significantly associated with reduced OS ( P =0.027). CONCLUSION Our study confirms that CRLE is feasible but comes with a significantly increased risk of anastomotic leaks and a concerning trend of reduced survival, particularly when upper lobe anatomic resections are performed. These findings highlight the need for careful patient selection and surgical planning when considering CRLE.
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Affiliation(s)
- Yixin Liu
- Department of Thoracic Surgery, West China Hospital of Sichuan University
| | - Jianfeng Zhou
- Department of Thoracic Surgery, West China Hospital of Sichuan University
| | - Yimin Gu
- Department of Thoracic Surgery, West China Hospital of Sichuan University
- Department of Thoracic Surgery, Shangjin Nanfu hospital of Chengdu
| | - Weipeng Hu
- Department of Thoracic Surgery, West China Hospital of Sichuan University
- Department of Thoracic Surgery, Sanya People’s Hospital
| | - Haonan Lin
- Department of Thoracic Surgery, West China Hospital of Sichuan University
- Department of Thoracic Surgery, West China Tianfu Hospital, Sichuan, People’s Republic of China
| | - Qixin Shang
- Department of Thoracic Surgery, West China Hospital of Sichuan University
| | - Hanlu Zhang
- Department of Thoracic Surgery, West China Hospital of Sichuan University
| | - Yushang Yang
- Department of Thoracic Surgery, West China Hospital of Sichuan University
| | - Yong Yuan
- Department of Thoracic Surgery, West China Hospital of Sichuan University
| | - Longqi Chen
- Department of Thoracic Surgery, West China Hospital of Sichuan University
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Lianyong J, Fengqing H, Xiao X, Xuefeng Z, Rui B. Single-Stage Surgical Procedure for Patients with Primary Esophageal and Lung Cancers. Thorac Cardiovasc Surg 2023. [PMID: 37935427 DOI: 10.1055/a-2205-2479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the safety and feasibility of simultaneous surgery for patients with primary esophageal and lung cancers. METHODS Patients with primary esophageal and lung cancers who underwent simultaneous surgical procedures between January 2016 and January 2022 were retrospectively analyzed. The data of patients who underwent esophagectomy and lobectomy (group EL) were compared with those of patients who underwent esophagectomy and sublobar resection (group ES). RESULTS A total of 21 patients were included with an average age of 64.62 ± 5.24 years. Group EL contained 8 patients and group ES contained 13 patients. All procedures were completed uneventfully with a mean operative time of 251.19 ± 66.93 minutes. Pulmonary complications occurred in six (28.57%) patients. Other complications included anastomotic leakage in 1 patient, pleural effusion requiring drainage in 8 patients, atrial fibrillation in 2 patients, and incision infection in 1 patient. All patients were followed up for 30.23 ± 21.82 months. During the follow-up period, nine patients had a recurrence of cancer and died of tumor progression, and one patient died of a tracheothoracogastric fistula. Complications and mortality in group EL did not increase when compared to those in group ES. CONCLUSION It is safe and feasible to perform a single-stage surgical procedure for patients with primary esophageal and lung cancers. Simultaneous esophagectomy and lobectomy did not increase postoperative complications or mortality compared with esophagectomy and sublobar resection.
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Affiliation(s)
- Jiang Lianyong
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hu Fengqing
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xie Xiao
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhang Xuefeng
- Department of Radiology, The First Affiliated Hospital, Naval Medical University, Shanghai, China
| | - Bi Rui
- Department of Cardiothoracic Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Treatment options for synchronous lung and esophagus tumors: A difficult decision to make. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2023; 31:136-142. [PMID: 36926163 PMCID: PMC10012991 DOI: 10.5606/tgkdc.dergisi.2023.21233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/13/2021] [Indexed: 03/18/2023]
Abstract
Synchronous lung and esophageal carcinomas are rare clinical entities. Curative resection with lymph node dissection is the most optimal treatment approach for both tumors. However, due to the high potential risk of postoperative complications, the right approach is to make a patient-specific decision via a multidisciplinary approach at all stages. In this article, we present three cases of synchronous lung and esophageal tumors treated with different approaches due to their specific circumstances and discuss their pre-, intra-, and postoperative stages.
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Patel DC, Bhandari P, Shrager JB, Berry MF, Backhus LM, Lui NS, Liou DZ. Perioperative Outcomes After Combined Esophagectomy and Lung Resection. J Surg Res 2021; 270:413-420. [PMID: 34775148 DOI: 10.1016/j.jss.2021.09.037] [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: 03/01/2021] [Revised: 08/27/2021] [Accepted: 09/21/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The impact of concomitant lung resection during esophagectomy on short-term outcomes is not well characterized. This study tests the hypothesis that lung resection at the time of esophagectomy is not associated with increased perioperative morbidity or mortality. METHODS Perioperative outcomes for esophageal cancer patients who underwent esophagectomy alone (EA) were compared to patients who had concurrent esophagectomy and lung resection (EL) using the NSQIP database between 2006-2017. Predictors of morbidity and mortality, including combined surgery, were evaluated using multivariable logistic regression. RESULTS Among the 6,225 study patients, 6,068 (97.5%) underwent EA and 157 (2.5%) underwent EL. There were no differences in baseline characteristics between the two groups. Operating time for EL was longer than EA (median 416 versus 371 minutes, P < 0.01). Median length of stay was 10 d for both groups. Perioperative mortality was not significantly different between EL and EA patients (5.1% versus 2.8%, P = 0.08). EL patients had higher rates of postoperative pneumonia (22.3% versus 16.2%, P = 0.04) and sepsis (11.5% versus 7.1%, P = 0.03), however major complication rates overall were similar (40.8% versus 35.3%, P = 0.16). Combining lung resection with esophagectomy was not independently associated with increased postoperative morbidity (AOR 1.21 [95% CI 0.87-1.69]) or mortality (AOR 1.63 [95% CI 0.74-3.58]). CONCLUSIONS Concurrent lung resection during esophagectomy is not associated with increased mortality or overall morbidity, but is associated with higher rates of pneumonia beyond esophagectomy alone. Surgeons considering combined lung resection with esophagectomy should carefully evaluate the patient's risk for pulmonary complications and pursue interventions preoperatively to optimize respiratory function.
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Affiliation(s)
- Deven C Patel
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University Medical Center, Stanford, California
| | - Prasha Bhandari
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University Medical Center, Stanford, California
| | - Joseph B Shrager
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University Medical Center, Stanford, California; VA Palo Alto Health Care System, Palo Alto, California
| | - Mark F Berry
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University Medical Center, Stanford, California; VA Palo Alto Health Care System, Palo Alto, California
| | - Leah M Backhus
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University Medical Center, Stanford, California; VA Palo Alto Health Care System, Palo Alto, California
| | - Natalie S Lui
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University Medical Center, Stanford, California
| | - Douglas Z Liou
- Department of Cardiothoracic Surgery, Division of Thoracic Surgery, Stanford University Medical Center, Stanford, California.
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Papaconstantinou D, Tsilimigras DI, Moris D, Michalinos A, Mastoraki A, Mpaili E, Hasemaki N, Bakopoulos A, Filippou D, Schizas D. Synchronous resection of esophageal cancer and other organ malignancies: A systematic review. World J Gastroenterol 2019; 25:3438-3449. [PMID: 31341367 PMCID: PMC6639548 DOI: 10.3748/wjg.v25.i26.3438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/01/2019] [Accepted: 06/01/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neoplasms arising in the esophagus may coexist with other solid organ or gastrointestinal tract neoplasms in 6% to 15% of patients. Resection of both tumors synchronously or in a staged procedure provides the best chances for long-term survival. Synchronous resection of both esophageal and second primary malignancy may be feasible in a subset of patients; however, literature on this topic remains rather scarce.
AIM To analyze the operative techniques employed in esophageal resections combined with gastric, pancreatic, lung, colorectal, kidney and liver resections and define postoperative outcomes in each case.
METHODS We conducted a systematic review according to PRISMA guidelines. We searched the Medline database for cases of patients with esophageal tumors coexisting with a second primary tumor located in another organ that underwent synchronous resection of both neoplasms. All English language articles deemed eligible for inclusion were accessed in full text. Exclusion criteria included: (1) Hematological malignancies; (2) Head/neck/pharyngeal neoplasms; (3) Second primary neoplasms in the esophagus or the gastroesophageal junction; (4) Second primary neoplasms not surgically excised; and (5) Preclinical studies. Data regarding the operative strategy employed, perioperative outcomes and long-term outcomes were extracted and analyzed using descriptive statistics.
RESULTS The systematic literature search yielded 23 eligible studies incorporating a total of 117 patients. Of these patients, 71% had a second primary neoplasm in the stomach. Those who underwent total gastrectomy had a reconstruction using either a colonic (n = 23) or a jejunal (n = 3) conduit while for those who underwent gastric preserving resections (i.e., non-anatomic/wedge/distal gastrectomies) a conventional gastric pull-up was employed. Likewise, in cases of patients who underwent esophagectomy combined with pancreaticoduodenectomy (15% of the cohort), the decision to preserve part of the stomach or not dictated the reconstruction method (whether by a gastric pull-up or a colonic/jejunal limb). For the remaining patients with coexisting lung/colorectal/kidney/liver neoplasms (14% of the entire patient population) the types of resections and operative techniques employed were identical to those used when treating each malignancy separately.
CONCLUSION Despite the poor quality of available evidence and the great interstudy heterogeneity, combined procedures may be feasible with acceptable safety and satisfactory oncologic outcomes on individual basis.
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Affiliation(s)
- Dimitrios Papaconstantinou
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens 12462, Greece
| | - Diamantis I Tsilimigras
- Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, Columbus, OH 43210, United States
| | - Dimitrios Moris
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, United States
| | | | - Aikaterini Mastoraki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Efstratia Mpaili
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Natasha Hasemaki
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
| | - Anargyros Bakopoulos
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens 12462, Greece
| | - Dimitrios Filippou
- Department of Anatomy and Surgical Anatomy, National and Kapodistrian University of Athens, Medical School, Athens 11527, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens 11527, Greece
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Abstract
Synchronous lung and esophageal cancers are rare but represent a unique challenge to thoracic surgeons. The literature is limited but series describe long-term survival with curative surgery for concomitant esophageal and lung cancer. Preoperative risk assessment is critical because surgical resection of both cancers requires adequate cardiopulmonary function and performance status. Chemotherapy and radiation are used as adjuvant therapy or as primary treatment of unresectable lesions. Although long-term survival for patients with concomitant lung and esophageal cancer is lower than that of patients with either one alone, survival with curative surgery is higher than that of patients with metastatic disease of either primary.
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Affiliation(s)
- Amar N Mukerji
- Department of Surgery, Bronx Lebanon Hospital Center, 1650 Selwyn Avenue, Suite 4A, New York, NY 10457, USA
| | - Andrea Wolf
- Department of Thoracic Surgery, The Icahn School of Medicine at Mount Sinai, 1190 Fifth Avenue, Box 1022, New York, NY 10029, USA.
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Song X, Shen H, Li J, Wang F. Minimally invasive resection of synchronous triple primary tumors of the esophagus, lung, and thymus: A case report. Int J Surg Case Rep 2016; 29:59-62. [PMID: 27816689 PMCID: PMC5099273 DOI: 10.1016/j.ijscr.2016.10.048] [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: 08/16/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 12/25/2022] Open
Abstract
We firstly report a patient of synchronous esophagus and lung cancer with thymoma. The video-assisted esophagectomy and VATS lobectomy and thymomectomy in a single operation are feasible and safe. Our case illustrates a dilemma: what to do and what to expect when managing a patient with triple primary tumors. Good clinical outcomes could be achieved with minimally invasive surgery.
Introduction Reports of synchronous multiple primary tumors are very rare. We report a case of synchronous esophagus and lung cancer combined with thymoma treated with a minimally invasive approach. Presentation of case In a 63-year-old patient, cT2 esophageal squamous cell carcinoma was found. Chest computed tomography revealed a lesion in the right upper lobe combined with an antero-superior mediastinal mass. She was treated with one-stage bilateral video-assisted thoracoscopic + laparoscopic esophagectomy with lymph node dissection and lobectomy with complete lymphadenectomy followed by thymomectomy and demonstrated a favorable response at early follow-up, without severe adverse surgical complications and evidence of local recurrence or distant metastasis. But the long-term follow-up is still needed for the evaluation of therapeutic effects of surgery. Discussion In the diagnostic procedure we excluded the probability of esophageal carcinoma metastasizing to the lung. Considering the patient's physical condition permit, we performed a minimally invasive surgery for three tumors. Besides, suitable operative incisions are important for the success of surgery. Conclusion To our knowledge, this is the first case report in which simultaneous minimally invasive resection of esophagus and lung cancer combined with thymoma.
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Affiliation(s)
- Xiao Song
- Department of Thoracic Surgery, Ningbo No. 2 Hospital, Ningbo University, 40 Xi Bei Road, Ningbo 315000, China
| | - Haibo Shen
- Department of Thoracic Surgery, Ningbo No. 2 Hospital, Ningbo University, 40 Xi Bei Road, Ningbo 315000, China
| | - Jie Li
- Department of Thoracic Surgery, Ningbo No. 2 Hospital, Ningbo University, 40 Xi Bei Road, Ningbo 315000, China
| | - Fengmin Wang
- Department of Thoracic Surgery, Ningbo No. 2 Hospital, Ningbo University, 40 Xi Bei Road, Ningbo 315000, China.
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Lee GD, Kim YH, Kim JB, Choi SH, Kim HR, Kim DK, Park SI. Esophageal Cancer Associated with Multiple Primary Cancers: Surgical Approaches and Long-term Survival. Ann Surg Oncol 2013; 20:4260-6. [PMID: 23904006 DOI: 10.1245/s10434-013-3183-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND The presence of multiple primary cancers (MPCs) in patients with esophageal cancer often presents physicians with a difficult therapeutic decision, because little is known about the appropriate treatment and long-term survival. The purpose of this study was to evaluate appropriate surgical approaches and long-term survival after surgery for esophageal cancer associated with MPCs. METHODS Data from 622 patients who underwent surgery for primary esophageal cancer between 1989 and 2008 were reviewed retrospectively to identify the presence of MPCs. RESULTS A total of 96 MPCs were identified in 90 (14.5 %) patients. The three leading MPCs were stomach cancer (n = 36, 37.5 %), head and neck cancer (n = 18, 18.8 %), and lung cancer (n = 18, 18.8 %). The rate of curative resections for both esophageal cancer and MPCs was 87.5 % (28/32) in patients with stomach cancer, 47.1 % (8/17) in head and neck cancer, and 52.9 % (9/17) in lung cancer (P = 0.006). The 5-year survival rates after surgery for esophageal cancer in patients associated with stomach, lung, and head and neck cancer were 52.7, 27.0, and 9.2 %, respectively (P = 0.011). CONCLUSIONS A range of surgical approaches for esophageal cancer is available in patients associated with MPCs. However, curative resections for primary esophageal cancer associated with MPCs are feasible in highly selected patients. Therefore, a multidisciplinary team management approach is essential for customized treatment strategies in patients with esophageal cancer associated with MPCs.
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Affiliation(s)
- Geun Dong Lee
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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