Department of Gastroenterology and Hepatology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Pulmonary Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Cancer Res Clin Oncol. 2023 May;149(5):1811-1823. doi: 10.1007/s00432-022-04103-0. Epub 2022 Jun 23.
Recent reports suggest an increased prevalence of lung second primary tumors (LSPTs) in esophageal squamous cell carcinoma (ESCC) patients and vice versa. However, the exact prevalence of SPTs remains unclear and screening for these SPTs is currently not routinely performed in western countries. We aimed to report on the prevalence of LSPTs in patients with ESCC and esophageal second primary tumors (ESPTs) in patients with lung cancer (LC).
Databases were searched until 25 March 2021 for studies reporting the prevalence of LSPTs in ESCC or vice versa. Pooled prevalences with 95% confidence intervals (CI) of SPTs were calculated with inverse variance, random-effects models and Clopper-Pearson.
Nineteen studies in ESCC patients and 20 studies in LC patients were included. The pooled prevalence of LSPTs in patients with ESCC was 1.8% (95% CI 1.4-2.3%). For ESPTs in LC patients, the pooled prevalence was 0.2% (95% CI 0.1-0.4%). The prevalence of LSPTs in ESCC patients was significantly higher in patients treated curatively compared to studies also including palliative patients (median 2.5% versus 1.3%). This difference was consistent for the ESPT prevalence in LC patients (treated curatively median 1.3% versus 0.1% for all treatments). Over 50% of the detected SPTs were squamous cell carcinomas and were diagnosed metachronously.
Patients with ESCC and LC have an increased risk of developing SPTs in the lungs and esophagus. However, the relatively low SPT prevalence rates do not justify screening in these patients. Further research should focus on risk stratification to identify subgroups of patients at highest risk of SPT development.
最近的报告表明，食管鳞状细胞癌（ESCC）患者中肺第二原发肿瘤（LSPTs）和反之亦然的发病率有所增加。然而，确切的 SPT 患病率仍不清楚，目前在西方国家并未常规进行这些 SPT 的筛查。我们旨在报告 ESCC 患者中 LSPTs 的患病率，以及肺癌（LC）患者中食管第二原发肿瘤（ESPTs）的患病率。
截至 2021 年 3 月 25 日，我们检索了数据库，以获取报告 ESCC 中 LSPTs 或反之亦然的研究。使用逆方差、随机效应模型和 Clopper-Pearson 计算 SPT 的汇总患病率和 95%置信区间（CI）。
纳入了 19 项 ESCC 患者的研究和 20 项 LC 患者的研究。ESCC 患者中 LSPTs 的汇总患病率为 1.8%（95%CI 1.4-2.3%）。对于 LC 患者的 ESPTs，汇总患病率为 0.2%（95%CI 0.1-0.4%）。与同时纳入姑息治疗患者的研究相比，接受根治性治疗的 ESCC 患者中 LSPTs 的患病率明显更高（中位数 2.5%比 1.3%）。对于 LC 患者的 ESPT 患病率，这一差异也是一致的（根治性治疗的中位数为 1.3%，而所有治疗的中位数为 0.1%）。超过 50%的检测到的 SPT 为鳞状细胞癌，且为异时性诊断。
ESCC 和 LC 患者发生肺部和食管 SPT 的风险增加。然而，相对较低的 SPT 患病率并不支持对这些患者进行筛查。进一步的研究应集中于风险分层，以确定 SPT 发展风险最高的亚组患者。
