Ueda Tomoya, Ishihara Ryu, Tani Yasuhiro, Ando Yoshiaki, Tanabe Gentaro, Fujimoto Yuta, Ito Noriaki, Tsukuda Nobutoshi, Matsuyama Kazuki, Morita Muneshin, Kato Minoru, Yoshii Shunsuke, Shichijo Satoki, Kanesaka Takashi, Yamamoto Sachiko, Higashino Koji, Uedo Noriya, Michida Tomoki, Fujii Takashi
Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan.
Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan.
J Gastroenterol. 2025 Apr;60(4):397-407. doi: 10.1007/s00535-024-02201-z. Epub 2024 Dec 11.
Patients with esophageal squamous cell carcinoma (ESCC) frequently develop synchronous head and neck squamous cell carcinoma (HNSCC). With advances in endoscopic technology and widespread screening of synchronous cancers, the detection of synchronous HNSCC and superficial ESCC (SESCC) is increasing. We aimed to evaluate the impact of preceding HNSCC treatment on synchronous SESCC.
This single-center retrospective study enrolled patients with synchronous HNSCC and SESCC who were treated between January 2010 and December 2023. Tumor size and depth of SESCC before and after HNSCC treatment were evaluated. The factors associated with SESCC progression were investigated.
Of the 299 patients with synchronous HNSCC and SESCC, 134 who underwent preceding HNSCC treatment with follow-up esophagogastroduodenoscopy (EGD) for SESCC were evaluated. Chemoradiotherapy was the most common treatment for HNSCC (56.0%), followed by surgery (17.2%), radiotherapy (14.9%), local resection (7.5%), and chemotherapy (4.5%). The tumor size of SESCC increased after HNSCC treatment in 18 patients (13.4%). Multivariate analysis revealed that an EGD interval of ≥ 120 days was significantly associated with increased tumor size in SESCC (odds ratio, 6.64; 95% confidence interval, 1.91-23.1). Tumor regrowth was observed in 70.6% of SESCCs that shrank with HNSCC treatment, mostly within six months. Tumor depth aggravation was rare (2.2%), but progression to advanced ESCC was observed in two patients.
Timely endoscopic follow-up, preferably within 120 days, is crucial for managing synchronous SESCC after HNSCC treatment to prevent tumor progression. Tumor regrowth should be monitored when SESCC shrinks with HNSCC treatment.
食管鳞状细胞癌（ESCC）患者常并发同步性头颈部鳞状细胞癌（HNSCC）。随着内镜技术的进步和同步性癌症筛查的广泛开展，同步性HNSCC和浅表性ESCC（SESCC）的检出率不断增加。我们旨在评估先行HNSCC治疗对同步性SESCC的影响。
这项单中心回顾性研究纳入了2010年1月至2023年12月期间接受治疗的同步性HNSCC和SESCC患者。评估了HNSCC治疗前后SESCC的肿瘤大小和深度。研究了与SESCC进展相关的因素。
在299例同步性HNSCC和SESCC患者中，对134例先行HNSCC治疗并接受SESCC随访食管胃十二指肠镜检查（EGD）的患者进行了评估。放化疗是HNSCC最常用的治疗方法（56.0%），其次是手术（17.2%）、放疗（14.9%）、局部切除（7.5%）和化疗（4.5%）。18例患者（13.4%）的SESCC肿瘤大小在HNSCC治疗后增大。多因素分析显示，EGD间隔≥120天与SESCC肿瘤大小增加显著相关（比值比，6.64；95%置信区间，1.91-23.1）。在接受HNSCC治疗后缩小的SESCC中，70.6%观察到肿瘤复发，大多在六个月内。肿瘤深度加重罕见（2.2%），但有两名患者进展为晚期ESCC。
及时进行内镜随访，最好在120天内，对于HNSCC治疗后同步性SESCC的管理以预防肿瘤进展至关重要。当SESCC因HNSCC治疗而缩小时，应监测肿瘤复发。
