Treatment outcomes for one-stage concurrent surgical resection and reconstruction of synchronous esophageal and head and neck squamous cell carcinoma

• Published in: European archives of oto-rhino-laryngology 2019-10, Vol.276 (10), p.2929-2940
• Main Authors: Lin, Yu-Hsuan, Ou, Chun-Yen, Lee, Wei-Ting, Lee, Yao ‐ Chou, Chang, Tzu ‐ Yen, Yen, Yi-Ting
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anastomosis, Surgical - adverse effects; Anastomosis, Surgical - methods; Anastomotic Leak - diagnosis; Anastomotic Leak - etiology; Dissection - methods; Esophageal Neoplasms - pathology; Esophageal Neoplasms - surgery; Esophageal Squamous Cell Carcinoma - pathology; Esophageal Squamous Cell Carcinoma - surgery; Female; Follow-Up Studies; Head and Neck; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - surgery; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Neoplasms, Multiple Primary - pathology; Neoplasms, Multiple Primary - surgery; Neurosurgery; Otorhinolaryngology; Outcome and Process Assessment, Health Care; Reconstructive Surgical Procedures - methods; Retrospective Studies; Taiwan; Treatment Outcome
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-019-05564-9

Purpose It is not uncommon to see the synchronous presentation of esophageal squamous carcinoma (ESCC) and head and neck cancer (HNC), and most patients were treated with staged interventions. This study retrospectively reported the outcomes of patients with synchronous ESCC and HNC treated with one-stage concurrent surgical resection and reconstruction. Methods We identified 17 consecutive patients with synchronous ESCC and HNC undergoing primary concurrent surgical resections between 2011 and 2017 at our hospital. All patients had received esophageal screenings prior to treatment. Results The HNC patients in this study had the following subsite involvements: oral cavity ( n  = 5), oropharynx ( n  = 4), larynx ( n  = 1), hypopharynx ( n  = 9), and thyroid gland ( n  = 1). Eighty percent of the HNC subsites (16/20) were treated in advanced stages, while most ESCCs were treated at early stages. The mean follow-up time was 3.2 ± 1.6 years. Surgery-associated morbidity and mortality were 94.1% and 0%, respectively, and the most common complication was anastomotic leakage. The two-year overall survival, 2-year loco-regional recurrence-free survival, and 2-year distant metastasis-free survival were 86.7%, 85.6%, and 78.7%, respectively. No significant difference was found between overall survival and HNC subsite or anastomotic leakage. Four patients (23.5%) developed secondary primary malignancies (SPMs) within a mean follow-up period of 2.9 years (standard deviation 1.6 years). Conclusion Although one-stage concurrent surgical resection and reconstruction of synchronous ESCC and HNC were highly invasive and complicated, survival was promising. Isolated distant metastasis remained the most common failure pattern. Vigilant follow-up strategy is mandatory to detect secondary primary malignancies (SPMs), especially within the first 3 years following initial treatment.