A clinical analysis of 30 patients with synchronous head and neck and esophageal cancer

Abstract

Objective To examine the clinical characteristics, treatment, and prognosis of patients with synchronous head and neck and esophageal cancer (SHNEC). Methods The clinical data of 30 SHNEC patients treated in the Department of Radiotherapy of the First Affiliated Hospital of China Medical University from 2010 to 2014 were retrospectively reviewed. The patients were followed up and survival was calculated using the Kaplan-Meier method. Differences between survival curves were analyzed by the log-rank test, and prognostic analysis was performed using the Cox regression model. At the same and different time, the comprehensive diagnosis were 24 cases and 6 cases.21 patients were treated with radiochemotherapy, 9 patients were treated by surgery and radiotherapy±chemotherapy. Results SHNEC was frequently found in elderly men with heavy drinking and smoking habits. Hypopharyngeal cancer with middle esophageal cancer was most common among the patients; of the 30 patients, 23(77%) had hypopharyngeal cancer, and 12(40%) had hypopharyngeal cancer with middle esophageal cancer. The median survival time of the patients was 20 months, and the 1-and 2-year overall survival (OS) rates were 83% and 37%, respectively. Univariate analysis showed that the stage of esophageal cancer, heavy smoking and drinking habits, and a family history of cancer were significantly associated with patient prognosis (P=0.009, 0.044, 0.012). In addition, the Cox analysis also demonstrated that the stage of esophageal cancer (HR=3.53, P=0.008), heavy smoking and drinking habits (HR=2.33, P=0.049), and a family history of cancer (HR=2.78, P=0.026) were independent prognostic factors. Conclusions Hypopharyngeal and middle esophageal cancer is the most common type of SHNEC, and the stage of esophageal cancer and heavy smoking and drinking habits are significantly associated with the prognosis of SHNEC patients. In addition, patients with stage Ⅰ and Ⅱ esophageal cancer can also achieve acceptable survival after receiving radiotherapy-based comprehensive treatment. Key words: Head and neck neoplasms/radiochemotherapy; Esophageal neoplasms/radiochemotherapy; Prognosis