食道と他臓器の重複癌症例の検討

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  • Study on esophageal cancer associated with other primary cancers.

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During the 22 years up to 1989, 814 patients with esophageal cancer were treated in our institution. Among these, 64 patients (7.9%) had other primary malignancies in various organs. Of the 64 patients, 37 had synchronous double cancers, 21 has metachronouse double cancers and 6 had three or more. In patients with metachronous double cancers, the esophageal cancer preceded the other in 10, while the associated cancer was before the esophageal cancer in the remaining 11. Of the 37 synchronous double cancers, coexistence of stomach cancer was the most frequent: 25 including 10 superficial lesions. In patients with simultaneous esophageal and gastric cancers, we used gastric tube as an esophageal substitute in cases where the latter was in the neighborhood of the esophagogastric junction. However, in the other cases, total gastrectomy and colonic interposition was adopted. The patients with synchronous double cancers undergoing resection of both the main tumors showed a significantly better outcome than the others. In particular, the outcome for the synchronous group undergoing curative surgery for the esophageal cancer was favorable, with a 5-year survival rate of 58.3%. In dealing with patients with esophageal cancer associated with other primary cancers, aggressive resection of both cancers should be performed for improving their prognosis.

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