Outcomes of simultaneous resection of synchronous esophageal and extraesophageal carcinomas.

BACKGROUND

Adequate extent of surgical resection of simultaneous primary esophageal and extraesophageal carcinomas is controversial.

STUDY DESIGN

Clinicopathologic records and treatment outcomes of 57 patients undergoing simultaneous resection of both synchronous esophageal and extraesophageal carcinomas (SC group) were reviewed and compared with those of 316 patients receiving esophagectomy for solitary esophageal carcinoma (EC group).

RESULTS

Mortality and morbidity rates were 3.5% and 45.6% in the SC group, and 3.2% and 44.3% in the EC group, respectively. No significant difference was detected in either of the rates between the two patient groups. The overall 5-year survival rate of the SC group was 40%. Survival of the patients undergoing curative resection of both esophageal and extraesophageal tumors (n = 30) was significantly better than that of the patients receiving palliative resection of at least one of the two tumors in the SC group (n=27)(5-year survival, 54.2% versus 19.9%, respectively)(p < 0.01). Survival of the SC group patients undergoing curative resection of both tumors (n = 30) did not differ from that of the EC group patients receiving curative esophagectomy (n = 182)(5-year survival rates, 54.2% versus 60.0%, respectively).

CONCLUSIONS

Simultaneous resection of synchronous esophageal and extraesoprhageal carcinomas can be safely performed, and complete tumor clearance of both tumors is needed for favorable long-term results.