Ono Kenji, Takenaka Masaru, Yokoyama Erina, Oka Soichi, Baba Tetsuro, So Tetsuya, So Tomoko, Uramoto Hidetaka, Takenoyama Mitsuhiro, Hanagiri Takeshi, Yasumoto Kosei
Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan.
Kyobu Geka. 2011 Feb;64(2):93-6; discussion 97-8.
This study aims to investigate the therapeutic and prognostic implications of esophageal cancer in patients with other primary cancer. Between April 1992 and December 2008, in 83 patients underwent surgery for esophageal cancer at our department. Among them, 24 patients (28.9%) had medical history of additional primary cancer. There were 16 metachronous cancers and 8 synchronous cancers. Six patients had antecedent other primary cancers, and subsequent primary cancers developed in 10 patients. The other primary cancers included head and neck cancer in 8 patients, gastric cancer in 8, lung cancer in 6, colorectal cancer in 3, and other cancer in 3. The patients with other primary cancers were both heavy smokers and heavy drinkers in comparison to those without other primary cancers. The post-operative 5-year survival rate in patients with subsequent cancers, antecedent cancers, and synchronous cancers were 100%, 70.0%, and 46.9%. The 5-year survival rate was 33.4% in patients without other primary cancers. A high incidence of multiple primary cancers was observed in patients with esophageal carcinoma but the prognosis of these patients with metachronous cancers are better than that of patient with synchronous cancers and patients without other primary cancers. Post-operative follow up is considered to be necessary for early detection of multiple occurrences of carcinoma, especially in the upper aerodigestive tract.
本研究旨在探讨食管癌患者合并其他原发性癌症时的治疗及预后情况。1992年4月至2008年12月期间，我科83例患者接受了食管癌手术。其中，24例患者（28.9%）有其他原发性癌症病史。有16例异时性癌和8例同时性癌。6例患者有既往其他原发性癌症，10例患者出现后续原发性癌症。其他原发性癌症包括8例头颈部癌、8例胃癌、6例肺癌、3例结直肠癌和3例其他癌症。与无其他原发性癌症的患者相比，有其他原发性癌症的患者既是重度吸烟者又是重度饮酒者。后续癌症、既往癌症和同时性癌症患者的术后5年生存率分别为100%、70.0%和46.9%。无其他原发性癌症患者的5年生存率为33.4%。食管癌患者中多原发性癌症的发生率较高，但这些异时性癌患者的预后优于同时性癌患者和无其他原发性癌症的患者。术后随访被认为对于早期发现多处癌变是必要的，尤其是在上呼吸消化道。
