Separate primary carcinomas of the esophagus and head and neck region in the same patient

Abstract

From 1949 to 1972 at Memorial Sloan-Kettering Cancer Center, 60 patients with primary cancers of both the oral cavity, pharynx, larynx (OPL) and esophagus were studied. I n 15, the cancers occurred synchronously, and in 68% they occurred within 2 years of each other, the longest interval being 27 years. T h e tongue and extrinsic larynx were the most common sites of origin together with the middle third of the esophagus. During the same period, over 7000 patients with OPL and over 1000 patients with esophageal cancers were seen at this institution. The majority of patients had a history of excessive smoking and alcohol intake. Four out of nine who had previous radiation therapy for their OPL cancer developed esophageal cancer within the therapeutic field (three after 16, 25, and 27 years). Thirty percent (18/60) had three primary cancers; one had four, of which two were in the head and neck region. Two patients survived more than 5 years; both also had a third primary cancer of the lung. There are broader implications in this study: multiple primary cancers in general, and this group in particular, give us especially valuable clues as to the oncogenic influence of environmental factors as well as cellular, organ, and also systemic susceptibility. With one cancer, one can anticipate formation in other related organs. This provides an opportunity for early diagnosis, more effective management, and improved survival. The cause and effect relationship of tobacco and alcohol must be emphasized at every opportunity and most particularly to those who have developed one cancer in the oropharyngeal-laryngeal region.Cancer 37935-89, 1976.

Routine Endoscopy for Esophageal Cancer Is Suggestive for Patients with Oral, Oropharyngeal and Hypopharyngeal Cancer

“…Many epidemiological studies have attributed drinking and smoking to the phenomenon of field cancerization for more than five decades [3], [25]–[29]. In brief, field cancerization of the mucous membranes of the aerodigestive tract frequently develops in response to tobacco and alcohol usage.…”

Angiotensin-converting enzyme gene insertion/deletion polymorphism is associated with risk of oral precancerous lesion in betel quid chewers

“…As previous reports have indicated that smoking status acts as a contributing factor for OPL (Cahan et al, 1976), we further subgrouped our study subjects according to their smoking status to examine whether if affects the impact of ACE I/D polymorphism with risk for OPL. The ACE gene I/D polymorphism was not statistically different between smoking betel quid chewers with or without OPL ( Adjusted by sex, age, body mass index, systolic blood pressure, and drinking status by conditional logistic regression analysis.…”

Squamous cell carcinoma of the esophagus and multiple primary tumors of the upper aerodigestive tract

“…The reported incidence of esophageal carcinoma associated with multiple primary squamous cell carcinomas of the upper aerodigestive tract in series of head and neck tumor patients varies from 0% to 6.3% (1,2,3,4,5,7,8,9,10,11,12,13,14,17,18,19,22,25) ( Table 2). Furthermore, the incidence of multiple primary tumors in series of patients with squamous cell carcinoma of the esophagus ranged from 3.3% to 12.4% (2,4,9,20,21,24) ( Table 3). This wide range in incidence can be partially explained by the site of the initial tumor, type of treatment, ethnic or racial differences, increasing awareness of such tumors, more accurate evaluation and improved survival rates following treatment of the initial primary (1,3,11,20,25) .…”