Comprehensive Analysis of Multiple Primary Cancers in Patients With Esophageal Squamous Cell Carcinoma Undergoing Esophagectomy

Abstract

Objective: The aim of this study was to elucidate the latest epidemiology and risk factors for multiple primary cancers (MPCs), and the association between neoadjuvant chemotherapy (NAC) and postoperative metachronous cancer (PMC) in patients with esophageal squamous cell carcinoma (ESCC) who underwent esophagectomy. Summary of Background Data: Background data to derive appropriate screening strategies are insufficient. Methods: This study consisted of 3 retrospective investigations. A total of 766 consecutive patients with ESCC who underwent esophagectomy between April 2005 and December 2019 were eligible for epidemiological analysis. Of these, 688 patients without missing data were analyzed for the risk of MPCs. In total, 364 patients who underwent NAC (115) and no preoperative treatments (249) were investigated for the association between NAC and PMC. Results: Of 766 patients, 288 (38%) patients experienced 357 MPCs in their life. PMCs identified after the completion of 5-year postoperative follow-up were significantly more advanced (P = 0.019). Male sex [hazard ratio (HR) = 3.04, P = 0.038], older age (HR = 2.39, P < 0.001), and diabetes mellitus (HR = 1.76, P = 0.034) were risk factors for preoperative metachronous cancers. Heavy smoking (HR = 1.70, P = 0.014) and drinking (HR = 1.61, P = 0.029) were risk factors for synchronous cancers. NAC significantly reduced PMC incidence (P = 0.043). NAC showed a trend to contribute to improved survival via reduced deaths from PMCs, although this did not reach significance (P = 0.082). Conclusions: ESCC is associated with a high risk of MPCs. Continuing follow-up for PMCs after the completion of 5-year postoperative followup is important. NAC may reduce PMCs, representing a novel mechanism for improving survival in patients with locally advanced ESCC.

Prevalence of lung tumors in patients with esophageal squamous cell carcinoma and vice versa: a systematic review and meta-analysis

“…. In this study, 6 LSPTs were detected in 172Ven et al 2020;Poon et al 1998;Motoyama et al 2003;Yoshida et al 2020;Hu et al 2015;Lee et al 2013;Yamaguchi et al 2018;Otowa et al 2016;Natsugoe et al 2005;Kumagai et al 2001;Kokawa et al …”

“…Twelve studies reported the tumor stage of ESCC (Ven et al 2020;Poon et al 1998;Yoshida et al 2020;Hu et al 2015;Lee et al 2013;Yamaguchi et al 2018;Otowa et al 2016;Natsugoe et al 2005;Kumagai et al 2001;Kokawa et al 2001;Nagasawa et al 2000;Chen et al 2019). However, only the study of Lee et al reported the numbers of LSPTs for each ESCC tumor stage (Lee et al 2013) Nagasawa et al 2000;Voormolen et al 1995;Chen et al 2019;Chuang et al 2008;Ribeiro Júnior et al 1999;Fogel et al 1985).…”

“…However, only the study of Lee et al reported the numbers of LSPTs for each ESCC tumor stage (Lee et al 2013) Nagasawa et al 2000;Voormolen et al 1995;Chen et al 2019;Chuang et al 2008;Ribeiro Júnior et al 1999;Fogel et al 1985). Nine studies only included patients with ESCC treated with curative intent (Motoyama et al 2003;Yoshida et al 2020;Hu et al 2015;Lee et al 2013;Yamaguchi et al 2018;Otowa et al 2016;Natsugoe et al 2005;Kumagai et al 2001;Kokawa et al 2001). The follow-up time of patients with ESCC was not reported in eight studies and median shorter than 1.5 years after ESCC diagnosis in two studies (Yoshida et al 2020;Kumagai et al 2001;Kokawa et al 2001;Nagasawa et al 2000;Fekete et al 1994;Chen et al 2019;Ribeiro Júnior et al 1999;Fogel et al 1985).…”

Long non-coding RNA small nucleolar RNA host gene 7 facilitates the proliferation, migration, and invasion of esophageal cancer cells by regulating microRNA-625

“…Esophageal cancer (EC) is an extremely aggressive malignancy with high rates of morbidity and mortality (1). There are 2 types of EC, esophageal adenocarcinoma and esophageal squamous cell carcinoma (ESCC) (2). In China and other East Asian countries, ESCC accounts for as many as 90% of EC cases (3).…”

Prognostic Prediction, Immune Microenvironment, and Drug Resistance Value of Collagen Type I Alpha 1 Chain (COL1A1) in Pan-Cancer Analysis

“…However, it is found that gastrointestinal cancer patients might experience multiple primary tumors in the digesting tract. Yoshida et al reported that 38% of esophageal squamous cell carcinoma patients experienced multiple primary cancers, of which 15% underwent gastrointestinal cancer, mainly in the stomach and colorectal [53] . Moreover, Ste et al found that approximately one in 20 patients with primary esophageal squamous cell carcinoma had a second primary tumor in the upper digestive tract or stomach [50] .…”