Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, China.
Korean J Intern Med. 2021 Nov;36(6):1356-1364. doi: 10.3904/kjim.2017.280. Epub 2020 Apr 29.
BACKGROUND/AIMS: We aimed to study the clinical characteristics, treatment modality, and the prognosis of synchronous multiple primary esophageal squamous cell carcinomas (SMPESCC).
A total of 117 SMPESCC cases were evaluated retrospectively from 2010 to 2015.
The most common locations of SMPESCC were mid- and lower thoracic segments (n = 208, 84.9%). The 1-, 2-, and 3-year overall survival rates were 53.8%, 30.8%, and 15.4%, respectively; the median survival time (MST) was 12.5 months. With definitive radiotherapy and surgery, respectively, the MST of stage I/II patients were 34.2 and 26.7 months, of stage III patients were 8.3 and 13.2 months (p = 0.163), and of stage IV patients were and 8 and 12.6 months (p = 0.379). Clinical stage, family history of cancer, and Karnofsky performance status were independent prognostic factors for the whole cohort by Cox multivariate regression analysis (hazard ratio [HR] = 0.859, p < 0.001; HR = 0.579, p = 0.032; and HR = 0.586, p = 0.013).
Although the prognosis of SMPESCC is poor, stage I/II patients can achieve long-term survival with aggressive treatment, especially those with a Karnofsky performance score 90 or higher and who have no family history of cancer. Definitive radiotherapy could achieve a similar survival rate to definitive surgery at different clinical stages.
背景/目的：本研究旨在探讨同步性多原发食管鳞状细胞癌（SMPESCC）的临床特征、治疗方式及预后。
回顾性分析 2010 年至 2015 年间共 117 例 SMPESCC 患者的临床资料。
SMPESCC 最常见的部位为中下段（n = 208，84.9%）。1、2、3 年总生存率分别为 53.8%、30.8%和 15.4%，中位生存时间（MST）为 12.5 个月。行根治性放疗和根治性手术的Ⅰ/Ⅱ期、Ⅲ期和Ⅳ期患者 MST 分别为 34.2、26.7 和 8.3 个月（p = 0.163）、13.2 和 8.3 个月（p = 0.379）。Cox 多因素回归分析显示，临床分期、癌症家族史和 Karnofsky 体能状态是影响总人群预后的独立因素（风险比 [HR] = 0.859，p < 0.001；HR = 0.579，p = 0.032；HR = 0.586，p = 0.013）。
SMPESCC 患者预后较差，但积极治疗可使Ⅰ/Ⅱ期患者获得长期生存，特别是 Karnofsky 体能状态评分 90 分以上、无癌症家族史的患者。不同临床分期患者行根治性放疗与根治性手术的生存获益相似。
