Department of Radiation Oncology, Tumor Hospital of Shantou University Medical College Shantou, China.
Thorac Cancer. 2014 Jan;5(1):25-30. doi: 10.1111/1759-7714.12047. Epub 2014 Jan 2.
To retrospectively analyze the clinical characteristics and prognostic factors of 52 cases of synchronous multiple primary esophageal carcinoma (SMPEC), in order to provide a reference for treatment strategy.
Clinical and survival data of 52 patients with SMPEC were analyzed retrospectively. The rates of overall survival (OS), depending on the different factors, were calculated using Kaplan-Meier analysis. A log-rank test was used for univariate survival analysis and Cox's proportional hazards regression model was used for multivariate survival analysis.
Clinical and survival data of 52 patients with SMPEC, hospitalized from 1 January 2003 to 31 October 2011, were analyzed. Twelve patients underwent surgical resection, five received adjuvant radiotherapy and one received adjuvant radiochemotherapy. Thirty-seven of the 40 non-operative patients received external beam radiation therapy and 20 of them received platinum-based chemotherapy. Another three non-operative patients were given platinum-based chemotherapy alone. The one, three, and five-year OS and the median survival time (MST) were 65.4%, 17.3%, 7.7%, respectively, and 15.0 months for the whole cohort. Tumor length and M stage were independent prognostic factors for the whole cohort by multivariate survival analysis (P = 0.010 and 0.047, respectively). For the radiotherapy subgroup, multivariate analysis of prognostic factors identified that shorter tumor length, M0 stage, and chemotherapy were the predominant independent predictors of long-term survival (P = 0.039, 0.022 and 0.010, respectively).
SMPEC is a relatively rare and aggressive tumor. Combined radiotherapy with chemotherapy seemed to bring a survival benefit and may be a better management choice for unresectable and non-operative SMPEC.
为了回顾性分析 52 例同时性多原发食管癌（SMPEC）的临床特征和预后因素，为治疗策略提供参考。
回顾性分析 52 例 SMPEC 患者的临床和生存资料。采用 Kaplan-Meier 分析法计算总生存（OS）率，根据不同因素进行单因素生存分析，采用 Cox 比例风险回归模型进行多因素生存分析。
分析了 2003 年 1 月 1 日至 2011 年 10 月 31 日期间收治的 52 例 SMPEC 患者的临床和生存资料。12 例患者接受了手术切除，5 例接受了辅助放疗，1 例接受了辅助放化疗。40 例非手术患者中，37 例接受了外照射放疗，其中 20 例接受了铂类化疗。另外 3 例非手术患者单独接受了铂类化疗。整个队列的 1、3、5 年 OS 率和中位生存时间（MST）分别为 65.4%、17.3%、7.7%和 15.0 个月。多因素生存分析显示，肿瘤长度和 M 分期是整个队列的独立预后因素（P = 0.010 和 0.047）。对于放疗亚组，多因素预后因素分析表明，较短的肿瘤长度、M0 期和化疗是长期生存的主要独立预测因素（P = 0.039、0.022 和 0.010）。
SMPEC 是一种相对罕见且侵袭性强的肿瘤。联合放化疗可能为不可切除和非手术性 SMPEC 带来生存获益，可能是更好的治疗选择。
