Abstract
The aim of this research was to provide data from a single-center study of the treatment of synchronous hypopharyngeal cancer (HPC) and esophageal cancer (EC) with different treatment modalities. A total of 61 patients with synchronous HPC and EC were included in this study. Patients were treated with radiotherapy/chemoradiotherapy (28 cases), surgery (9 cases), palliative radiotherapy and/or chemotherapy (17 cases), or supportive care (7 cases). The median radiotherapy doses for EC and HPC in the radiotherapy/chemoradiotherapy group were 64.5 Gy (range, 0–70) and 70 Gy (range, 60–75.2), respectively. Seven patients in the surgery group received pharyngoesophagectomy with gastric pull-up reconstruction, and two received esophagectomy followed by radiotherapy at the hypopharynx. Cox proportional hazard analysis revealed that the outcome of active treatments, including surgery and radiotherapy/chemoradiotherapy, was better than that of conservative care. In survival analysis, patients in the surgery group tended to have a better 3-year overall survival rate than those in the radiotherapy/chemoradiotherapy group (55.6% vs 30.9%); however, this difference was not statistically different (P = 0.493). The two groups had similar 3-year progression-free survival rates (30.6% and 33.3%, P = 0.420). The current study suggested that radiotherapy/chemoradiotherapy should be considered as an important treatment modality in addition to surgery for synchronous HPC and EC.
Highlights
Hypopharyngeal cancer (HPC) and esophageal cancer (EC) are frequently observed as combined malignancies in the upper digestive tract
The current study suggested that radiotherapy/chemoradiotherapy should be considered as an important treatment modality in addition to surgery for synchronous hypopharyngeal cancer (HPC) and EC
A total of 86 cases of HPC–EC double malignancies were found in the patient database and 67 cases of synchronous diseases were identified
Summary
Hypopharyngeal cancer (HPC) and esophageal cancer (EC) are frequently observed as combined malignancies in the upper digestive tract. In a study that included 368 Japanese patients with EC, 41 had HPC either synchronously or metachronously [1]. Wang et al performed esophageal endoscopic screening for 139 HPC patients in Taiwan and confirmed that 40 patients (28.8%) had synchronous esophageal lesions (high-grade dysplasia and invasive tumor) [2]. EC with HPC is not rare in Caucasian patients, but may not occur as frequently in patients living in Eastern Asia [3]. The 5-year overall survival (OS) is ~40% for HPC [4] and 18% for EC [5]. When both diseases are present in the same patient, the prognosis is even poorer.
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