A comparative study of isolated and metachronous oesophageal squamous cell carcinoma with antecedent upper aerodigestive tract cancer

Eur J Cardiothorac Surg. 2013 Nov;44(5):860-5. doi: 10.1093/ejcts/ezt112. Epub 2013 Mar 7.

Abstract

Objectives: Metachronous oesophageal squamous cell carcinoma (OSCC) has been increasing in long-term survivors of upper aerodigestive tract (UADT) cancers in recent years, but the treatment of such cases is not well established. The aim of this study was to compare the prognosis between patients with metachronous OSCC who had antecedent UADT cancers and patients with isolated OSCC.

Methods: From January 1995 to December 2009, we retrospectively compared the data from 84 patients with metachronous OSCC who had antecedent UADT cancers (metachronous group) with the data from 527 patients with isolated OSCC (isolated group) according to their treatment modalities at Kaohsiung Chang Gung Memorial Hospital.

Results: Overall, the metachronous group had significantly (P = 0.03) worse overall survival than the isolated group. For patients receiving surgery or preoperative chemoradiotherapy followed by surgery, the overall survival rates and incidence of postoperative complications were not significantly different. For patients receiving definite chemoradiotherapy or radiotherapy alone, the metachronous group had significantly (P = 0.02) inferior overall survival compared with the isolated group.

Conclusions: Offering a radical approach for the treatment of patients with metachronous OSCC who had antecedent UADT cancers is justifiable, with survival rates similar to those of patients with isolated OSCC.

Keywords: Metachronous cancer; Oesophageal squamous cell carcinoma; Oesophagectomy; Radiotherapy; Upper aerodigestive tract cancer.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / therapy*
  • Esophageal Neoplasms / secondary*
  • Esophageal Neoplasms / therapy*
  • Esophageal Squamous Cell Carcinoma
  • Esophagectomy
  • Female
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasms, Second Primary / pathology*
  • Neoplasms, Second Primary / therapy*
  • Retrospective Studies
  • Taiwan