Clinical and prognostic features of the patients with esophageal squamous cell carcinomas as a first primary malignancy

doi:10.12047/j.cjap.6020.2021.008

Abstract

Abstract: Objective: To retrospectively analyze the clinical characters and prognosis of the patients with Esophageal Squamous Cell Carcinomas as First Primary Malignancy (ESCCFPM), which will help us better understand the relationship between Esophageal Squamous Cell Carcinoma (ESCC) and other cancers, and to provide appropriate research evidence for the clinical diagnosis and treatment. Methods: The clinicopathological and follow-up data of 540 Patients with ESCCFPM between January 1, 2004 and December 31, 2016 were collected from the Surveillance, Epidemiology and End Results (SEER) database of National Cancer Institute. The Kaplan-Meier method was used to determine Overall Survival (OS) curves of ESCC patients, and the Log-Rank test was used to estimate differences in survival. The Cox proportional hazards models were adopted for the prognosis analyses. Results: Regarding the number of multiple primary malignancies (MPMs), 491 had two malignancies, 42 had three malignancies and 7 had four malignancies. ESCCFPM is more common among males. The high incidence age is between 61 and 80 years old. Tumors of the respiratory system (36.9%), were the most common MPMs followed by digestive system (35.2%) and reproductive system (8.9%). The 1-year, 3-year, 5-year OS rates for patients with ESCCFPM were 76.9%, 50.4% and 38.9%, respectively. The age of the ESCC diagnosed, T stage, time of occurrence, carcinoma number, lymph node dissection, surgery, radiotherapy and chemotherapy were the prognostic factor of overall survival for ESCCFPM patients. Age, race, T stage, time of occurrence surgery and radiotherapy were independent prognostic factors for the whole cohort by multivariate survival analysis. Conclusion: ESCCFPM,mainly two-lesion cancer, is most commonly found in respiratory system and digestive systems. Enhanced follow-up of respiratory and digestive tumors in ESCCFPM patients aged 61-80 may help identify multiple primary malignancies. Surgery, radiotherapy and chemotherapy may improve overall survival for ESCCFPM patients.

Key words: esophageal squamous cell carcinoma, multiple primary cancers, SEER, synchronous primary malignancy, metachronous primary malignancy

CLC Number:

R735.1

WEN Zhen, ZHANG Yan-qiu, WU Rong, PENG Xue-mei, CHEN Bin, LENG Ai-min. Clinical and prognostic features of the patients with esophageal squamous cell carcinomas as a first primary malignancy[J]. CJAP, 2021, 37(4): 407-414.

References 22

[1]	Natsugoe S, Matsumoto M, Okumura H, et al. Multiple primary carcinomas with esophageal squamous cell cancer: clinicopathologic outcome[J]. World J Surg, 2005, 29: 46-49.
[2]	Yilmaz A, Ertugrul M, Yagci Tuncer L, et al. Multiple primary malignancies involving lung: an analysis of 40 cases[J]. Ups J Med Sci, 2008, 113: 193-200.
[3]	Rosso S, De Angelis R,Ciccolallo L, et al. Multiple tumours in survival estimates[J]. Eur J Cancer, 2009, 45: 1080-1094.
[4]	Kobayashi Y, Arimoto H, Watanabe S. Occurrence of multiple primary cancer at the National Cancer Center Hospital, 1962-1989[J]. Jpn J Clin Oncol, 1991, 21: 233-251.
[5]	李麦冬, 胡长路. 多原发癌176例临床分析[J].安徽医药, 2017, 21(12): 2222-2224.
[6]	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015 [J]. CA Cancer J Clin, 2016, 66: 115-132.
[7]	澹会芳, 赵学科, 高社干, 等. 食管癌核心家系患者临床病理特征及术后预后分析[J].郑州大学学报(医学版), 2019, 54(2): 164-168.
[8]	Lee GD, Kim YH, Kim JB, et al. Esophageal cancer associated with multiple primary cancers:Surgical approaches and long—term survival[J]. Ann Surg Oncol, 2013, 20(13): 4260-4266.
[9]	Pan Y, Chen D, Hu T, et al. Characteristics and prognostic factors of patients with osteosarcoma older than 60 years from the SEER database[J]. Cancer Control, 2019, 26: 1-6.
[10]	Li M, Lin ZX. Characteristics and prognostic factors of synchronous multiple primary esophageal carcinoma: a report of 52 cases[J]. Thorac Cancer, 2014, 5: 25-30.
[11]	Chen ZQ, Li SH, He Z, et al. Clinical analysis of 117 cases with synchronous multiple primary esophageal squamous cell carcinomas[J]. Korean J Intern Med, 2018, Epub ahead of print.
[12]	王肖飞, 张国庆, 吴彬, 等. 基于竞争风险的食管腺癌与食管鳞癌患者第二原发癌预测模型的建立与评价[J].中国临床研究, 2019, (3): 302-308.
[13]	吴彬, 徐志飞, 孙耀昌, 等. 食管癌的侵犯深度及分化程度与区域淋巴结转移的关系[J].第二军医大学学报, 2000, 21(8): 771-773.
[14]	Baba Y, Yoshida N, Kinoshita K, et al. Clinical and prognostic features of patients with esophageal cancer and multiple primary cancers: A retrospective single-institution study[J]. Ann Surg, 2018, 267: 478-483.
[15]	Kim C, Chon H, Kang B, et al. Prediction of metachronous multiple primary cancers following the curative resection of gastric cancer [J]. BMC cancer, 2013, 13: 394.
[16]	Chuang SC, Hashibe M, Scelo G, et al. Risk of second primary cancer among esophageal cancer patients: a pooled analysis of 13 cancer registries[J]. Cancer Epidemiol Biomarkers Prev, 2008, 17: 1543-1549.
[17]	Strong MS, Incze J, Vaughan CW, et al. Field cancerization in the aerodigestive tract- its etiology, manifestation and significance[J]. J Otolaryngol, 1984, 13(1): 1-6.
[18]	Morita M, Yoshida R, Ikeda K, et al. Advances in esophageal cancer surgery in Japan: an analysis of 1000 consecutive patients treated at a single institute[J]. Surgery, 2008, 143: 499-508.
[19]	Otowa Y, Nakamura T, Takiguchi G, et al. Safety and benefit of curative surgical resection for esophageal squamous cell cancer associated with multiple primary cancers[J]. Eur J Surg Oncol, 2016, 42: 407-411.
[20]	Shirai K, Tamaki Y, Kitamoto Y, et al. Prognosis was not deteriorated by multiple primary cancers in esophageal cancer patients treated by radiotherapy[J]. J Radiat Res, 2013, 54: 706-711.
[21]	Shinoto M, Shioyama Y, Sasaki T, et al. Clinical results of definitive chemoradiotherapy for patients with synchronous head and neck squamous cell carcinoma and esophageal cancer[J]. Am J Clin Oncol, 2011, 34: 362-366.
[22]	Yamaguchi T, Kato K, Nagashima K, et al. Type of second primary malignancy after achieving complete response by definitive chemoradiation therapy in patients with esophageal squamous cell carcinoma[J]. Int J Clin Oncol, 2018, 23: 652-658.