Korean J Intern Med.
2016 Mar;31(2):253-259. 10.3904/kjim.2014.182.
Synchronous second primary cancers in patients with squamous esophageal cancer: clinical features and survival outcome
- Affiliations
-
- 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. hjsong@amc.seoul.kr
- 2Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 3Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 4Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 5Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- KMID: 2373800
- DOI: http://doi.org/10.3904/kjim.2014.182
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/m2 vs. 22.8 kg/m2, 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.
Keyword
MeSH Terms
-
Aged
Carcinoma, Squamous Cell/diagnostic imaging/mortality/*pathology/therapy
Esophageal Neoplasms/diagnostic imaging/mortality/*pathology/therapy
Esophagectomy
Esophagoscopy
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Staging
Neoplasms, Multiple Primary/diagnostic imaging/mortality/*pathology/therapy
Positron Emission Tomography Computed Tomography
Predictive Value of Tests
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome
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