Comparison of synchronous versus staged surgeries for patients with synchronous double cancers of the esophagus and head-and-neck

Dis Esophagus. 2017 Jan 1;30(1):1-6. doi: 10.1111/dote.12509.

Abstract

Esophageal and head and neck (H&N) cancers often occur synchronously, this study aimed to clarify the benefits and disadvantages of synchronous and staged operations for double H&N/esophagus cancers. We retrospectively reviewed 43 patients with synchronous double cancer of H&N and esophagus treated between July 2005 and July 2014, of whom 33 patients underwent synchronous operation (SYN) and 10 underwent staged operations (STG). We compared the short-term outcomes between the groups. Operation time was longer, amount of blood loss was larger, and hospital stay was longer in the SYN group than in each single surgery of the STG group. Incidence of postoperative complications did not differ between the groups. Tracheal necrosis was observed only in the SYN group. One patient died because of postoperative bleeding in the SYN group, whereas no mortality was seen in the STG group. Both the peripheral white blood cell counts and serum CRP levels during postoperative period were significantly higher in the SYN group than each single surgery of STG group. The staged surgery strategy for patients with synchronous esophagus/H&N cancers can attenuate surgical stress and thus may increase safety.

Keywords: esophageal cancer; head and neck cancer; staged operation; synchronous operation.

MeSH terms

  • Adult
  • Aged
  • Blood Loss, Surgical
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophageal Squamous Cell Carcinoma
  • Esophagectomy / methods*
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / surgery*
  • Incidence
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods*
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neoplasms, Multiple Primary / pathology
  • Neoplasms, Multiple Primary / surgery*
  • Operative Time
  • Pharyngectomy / methods*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck