Watanabe Shigenobu, Ogino Ichiro, Inayama Yoshiaki, Sugiura Madoka, Sakuma Yasunori, Kokawa Atsushi, Kunisaki Chikara, Inoue Tomio
Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan.
Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan.
Asia Pac J Clin Oncol. 2017 Apr;13(2):e3-e10. doi: 10.1111/ajco.12274. Epub 2014 Oct 31.
We examined the risk factors and prognostic factors for synchronous esophageal neoplasia (SEN) by comparing the characteristics of hypopharyngeal cancer (HPC) patients with and without SEN.
We examined 183 patients who were treated with definitive radiotherapy for HPC. Lugol chromoendoscopy screening of the esophagus was performed in all patients before chemoradiotherapy.
Thirty-six patients had SEN, 49 patients died of HPC and two died of esophageal cancer. The patients with SEN exhibited significantly higher alcohol consumption than those without SEN (P = 0.018). The 5-year overall survival (OS) rate of the 36 patients with SEN was lower than that of the other patients (36.2% vs 63.4%, P = 0.006). The SEN patients exhibited significantly shorter HPC cause-specific survival than the other patients (P = 0.039). Both the OS (P = 0.005) and the HPC cause-specific survival (P = 0.026) of the patients with SEN were significantly shorter than those of the patients without SEN in multivariate analysis. Category 4/T1 stage esophageal cancer was treated with concurrent chemoradiotherapy (CCRT), endoscopic treatment or chemotherapy. The 5-year survival rates for esophageal cancer recurrence for CCRT, endoscopic treatment and chemotherapy were 71.5, 43.7 and 0%, respectively. The median (range) survival time (months) of CCRT, endoscopic treatment and chemotherapy was 22.7 (7.5-90.6), 46.44 (17.3-136.7) and 7.98 (3.72-22.8), respectively.
Advanced HPC patients with SEN might have a poorer prognosis than those without SEN even when the esophageal cancer is detected early and managed appropriately.
通过比较有和无同步性食管肿瘤（SEN）的下咽癌（HPC）患者的特征，研究SEN的危险因素和预后因素。
我们检查了183例接受HPC根治性放疗的患者。所有患者在放化疗前均接受了食管卢戈氏染色内镜筛查。
36例患者有SEN，49例患者死于HPC，2例死于食管癌。有SEN的患者饮酒量显著高于无SEN的患者（P = 0.018）。36例有SEN的患者的5年总生存率低于其他患者（36.2%对63.4%，P = 0.006）。SEN患者的HPC病因特异性生存期显著短于其他患者（P = 0.039）。多因素分析显示，有SEN的患者的总生存期（P = 0.005）和HPC病因特异性生存期（P = 0.026）均显著短于无SEN的患者。4类/T1期食管癌采用同步放化疗（CCRT）、内镜治疗或化疗。CCRT、内镜治疗和化疗的食管癌复发5年生存率分别为71.5%、43.7%和0%。CCRT、内镜治疗和化疗的中位（范围）生存时间（月）分别为22.7（7.5 - 90.6）、46.44（17.3 - 136.7）和7.98（3.72 - 22.8）。
即使早期发现并适当处理食管癌，有SEN的晚期HPC患者的预后可能比无SEN的患者更差。
