Oesophageal cancer associated with other primary cancers: A study of 31 patients

Abstract

The aim of this study was to investigate the characteristics of oesophageal cancer associated with other primary cancers and the survival rate after surgery for the patients with these cancers. Of 202 patients with oesophageal cancer treated in the Second Department of Surgery, Shinshu University School of Medicine between 1981 and 1995, 31 patients (15.3%) had oesophageal cancer associated with other primary cancers. Twenty-one synchronous and 10 metachronous associated cancers were found and 25 of them were resected. Early-stage oesophageal cancer was much more frequent in the associated cases than in the non-associated cases. The stomach was the most frequently associated organ. The numbers of cases with triple and quadruple cancers were three and one, respectively. Three of these cases had intervals of over 6 years between tumours. Three cases with other primary cancers which had intervals of over 7 years after oesophagectomy were found, and two were carcinomas of the reconstructed gastric tube. In the outcome after surgery for oesophageal cancer, there was no difference between the associated and the non-associated cases, and also no difference between the synchronous and metachronous associated cases. Regarding the five-year and 10-year survival rates after surgery for the first cancers, the synchronous cases had a poorer outcome than did the metachronous cases. In conclusion, oesophageal cancer with other primary cancers is not always rare, and its outcome is not poor compared with that of the non-associated cases. These patients may achieve survival by early detection of both lesions and positive treatment. It is important to consider the risk of other primary cancers after oesophagectomy, and the success of the reconstructed gastric tube should be followed by endoscopy.

Multiple Primary Cancers Associated with Esophageal Carcinoma

“…The stages of esophageal cancer among the MPC and NPC cases were distinct, with a higher incidence of stage I disease and a lower incidence of stage IV disease in the MPC group than in the NPC group. Based on the Japanese criteria for staging, 14 stage 0 disease, defined as a tumor invading the mucosa with no lymph node metastasis, was seen more frequently in the patients with MPC than in those with NPC, in accordance with the report of Koide et al 5 Thus, MPC tended to be associated with relatively early stage esophageal cancers. Another primary cancer tended to arise during the early stage of esophageal cancer, and these patients had longer term survival.…”

“…[1][2][3][4][5][6] Although esophageal cancer is generally accepted to be associated with a poor prognosis, its clinical outcome after surgery is gradually improving. [7][8][9][10] This prompts us to examine the incidence of a second malignant tumor in patients who have had their first tumor successfully treated and complicates the therapeutic strategies for dealing with the second primary cancer.…”

Surveillance and treatment for second primary cancer in the gastric tube after radical esophagectomy

“…Many earlier studies showed poor prognosis of GTC, especially in tumors that were found at a symptomatic stage, and stressed the importance of early detection of GTC by endoscopic surveillance [8,10,20,29]. Kise et al [7] reported that an increase in the number of screening endoscopic examinations leads to increased early detection of GTC, which suggests that endoscopic surveillance is vital to improving GTC detection.…”

Frequent microsatellite instability in primary esophageal carcinoma associated with extraesophageal primary carcinoma

“…10 Patients with ESCC frequently develop other primary cancers, such as gastric cancer and head and neck cancer. [11][12][13] In a comprehensive registry of 2,991 patients with ESCC, 18% developed carcinoma in another organ either synchronously or metachronously, with gastric cancer the most frequent followed by head and neck cancer and colorectal cancer. 14 Details of carcinogenesis in patients with multiple primaries that include esophageal carcinoma with other primary carcinoma (ECOPC) remain uncertain.…”