History of Surgical Intervention Is an Independent Prognostic Factor Among Patients With Synchronous Laryngeal/Pharyngeal and Supracarinal Esophageal Cancer

Che-Lin Kuo ； Hui-Ching Chuang ； Tai-Lin Huang ； Tai-Jan Chiu ； Hui Lu ； Fu-Min Fang ； Shau-Hsuan Li ； Ming-Hsien Tsai

《International Journal of Head and Neck Science》 4卷4期 (2020/12) Pp. 174-185

https://doi.org/10.6696/IJHNS.202012_4(4).0005

摘要

Background: Among synchronous head and neck cancer and esophageal cancer patients, supracarinal esophageal cancer often shows a much poorer prognosis than primary esophageal cancer. Clinical outcomes analysis would be interesting in this study. Methods: Thirty-six patients who had been diagnosed with synchronous laryngeal/pharyngeal cancer and supracarinal esophageal cancer and had undergone the treatment for curative intent in a tertiary referral center were enrolled retrospectively. Results: All 36 patients were able to tolerate and complete the treatment strategy. The 3-year overall survival (OS) and 5-year OS rates for all patients in this cohort were 27.8% and 15.4%, respectively. The 3-year disease-specific survival (DSS) and 5-year DSS rates were 30.5% and 22.6%, respectively. Significant prognostic factors for OS on univariate analysis were the pretreatment serum hemoglobin level, the laryngeal/ pharyngeal cancer clinical stage, and the history of surgical intervention. Significant prognostic factors for DSS on univariate analysis were the pretreatment body mass index, the pretreatment serum hemoglobin level, the laryngeal/pharyngeal cancer clinical stage, and the history of surgical intervention. Multivariate analysis of this cohort revealed that the laryngeal/pharyngeal cancer clinical stage and the history of surgical intervention were the only two significant prognostic factors for OS and DSS. Conclusions: The tumor stage of laryngeal/pharyngeal cancer and the history of the surgical excision of these tumors showed a prognostic impact among patients with synchronous laryngeal/pharyngeal cancer and supracarinal esophageal cancer. Long-term survival may be achievable for this cohort through aggressive treatment, including surgical intervention, although the survival outcomes are dismal.

關鍵字

head and neck squamous cell carcinoma ； hypopharyngeal cancer ； laryngeal cancer ； synchronous neoplasm ； esophageal cancer