Roullet M H, Wind P, Zinzindohoué F, Laccourreye O, Berger A, Chevallier J M, Bonfils P, Brasnu D, Cugnenc P H
Service de chirurgie digestive, hôpital européen Georges-Pompidou, 20, rue Leblanc, 750015 Paris, France.
Ann Chir. 2001 Jul;126(6):526-34. doi: 10.1016/s0003-3944(01)00562-4.
Esophageal squamous cell carcinomas are frequently associated with head and neck cancers. This retrospective study was conducted to compare the long-term outcome of the patients with a double cancer and of the patients with a solitary esophageal cancer after curative management.
From 1989 to 1999, 114 patients with an esophageal carcinoma were included in the study. Among them, 52 had an associated head and neck cancer (metachronous: n = 17 and synchronous: n = 35). Curative treatment was achieved in all patients. The patients were divided in "solitary" and "associated" group.
Age, sex distribution, tumor location and histological findings were similar in the two groups. The esophageal resection was an esopharyngolaryngectomy (n = 13), a subtotal esophagectomy with cervical anastomosis (n = 92) and a Lewis-Santy esophagectomy with thoracic anastomosis (n = 9). Operative mortality (8 versus 7.7%), anastomotic leaks rate (14.5 versus 21%) and pneumonia rate (21 versus 9.6%) were not significantly different in the two groups. The mean hospital stay was 27 days. The mean follow-up was 85 +/- 50 months. Five-year survival rates were not significantly different in the two groups (p = 0.6411). In univariate survival analysis the only significant predictive factors were the depth of esophageal tumor invasion (p = 0.0002) and node involvement (p = 0.0373). The presence of head and neck cancer did not affect survival after esophagectomy.
With an aggressive therapeutic plan, the survival of patients with an esophageal cancer associated to head and neck cancer was similar to the survival of patients with an isolated esophageal carcinoma. Long term esophageal survey seems to be useful to detect more superficial esophageal carcinomas in patients with head and neck cancer.
食管鳞状细胞癌常与头颈部癌症相关。本回顾性研究旨在比较经根治性治疗的双原发癌患者和孤立性食管癌患者的长期预后。
1989年至1999年，114例食管癌患者纳入本研究。其中，52例伴有头颈部癌症（异时性：n = 17，同时性：n = 35）。所有患者均接受了根治性治疗。患者分为“孤立性”和“相关性”两组。
两组患者的年龄、性别分布、肿瘤位置和组织学结果相似。食管切除术包括食管咽喉切除术（n = 13）、颈段吻合的次全食管切除术（n = 92）和胸段吻合的Lewis-Santy食管切除术（n = 9）。两组患者的手术死亡率（8%对7.7%）、吻合口漏发生率（14.5%对21%）和肺炎发生率（21%对9.6%）无显著差异。平均住院时间为27天。平均随访时间为85±50个月。两组患者的5年生存率无显著差异（p = 0.6411）。单因素生存分析中，唯一显著的预测因素是食管肿瘤浸润深度（p = 0.0002）和淋巴结受累情况（p = 0.0373）。头颈部癌症的存在并不影响食管癌切除术后的生存。
采用积极的治疗方案，食管癌合并头颈部癌症患者的生存率与孤立性食管癌患者相似。长期食管检查似乎有助于检测头颈部癌症患者中更浅表的食管癌。
