104例食管伴下咽双原发癌与单发食管癌的临床特点比较及预后分析

Comparison of clinical and prognostic characteristics of 104 cases of double primary carcinoma of esophagus with hypopharynx and simple esophageal carcinoma

目的探讨食管伴下咽双原发癌(简称双发癌组)的同时性癌与异时性癌和单发食管癌患者(简称单发癌组)的临床特点及预后分析。方法100例单发癌组的数据来自浙江省肿瘤医院同时期治疗的食管癌数据库资料,同时收集2007年1月〜2016年12月浙江省肿瘤医院头颈外科及胸外科诊治的双发癌组患者104例。了解同时性癌和异时性癌的占比情况,并比较和单发癌组的临床特点和预后。结果单发癌组100例,双发癌组104例(同时性癌32例,异时性癌72例),两组患者1、3、5年生存率分别为59.52%和64.42%、44.28%和52.36%、41.23%和44.51%。同时性癌组和异时性癌组患者1、3、5年的生存率分别为38.56%和73.79%、29.99%和60.37%、14.99%和53.66%。异时性癌组患者预后明显优于同时性癌组患者,两者比较差异有统计学意义(P=0.006)。而单发癌组与异时性癌组比较中,中位生存时间异时性癌更高,差异无统计学意义(P=0.294)。单发癌组和双发癌组比较生存曲线区分良好,差异有统计学意义(P=0.014)。结论异时性癌患者通过积极的综合治疗,总体生存率较高,但同时性癌的预后最差,需要探究更多有效的治疗方式。

OBJECTIVE To investigate the clinical and prognostic characteristics of synchronous and metachronous esophageal and hypopharyngeal carcinoma.METHODS A total of 104 cases of hypopharyngeal carcinoma with esophagus cancer were collected from Head and Neck and Thoracic Surgery Departments between January 2007 to December 2016 in Zhejiang Cancer Hospital.The incidence of synchronous and metachronous cancer were described.The clinical characteristics and prognosis were also compared in synchronous and metachronous cancer.RESULTS There were 100 cases of simple esophageal cancer,32 cases of synchronous cancer and 72 cases of metachronous cancer.Among the patients with simple esophageal cancer and the total group of esophageal+hypopharyngeal cancer,the 1-year,3-year and 5-year survival rates were 59.52% and 64.42%,44.28% and 52.36%,41.23% and 44.51%,respectively.There was no statistical difference(P=0.072).The 1-year,3-year and 5-year survival rates were 38.56% and 73.79%,29.99% and 60.37%,14.99% and 53.66% in synchronousand metachronous cancer group respectively.The prognosis of metachronous cancer was significantly better than that of synchronous cancer,and there was significant statistical difference between the two groups(P=0.006).The median survival time of esophageal cancer group was higher than that of double primary metachronous cancer group,but the difference was not significant(P=0.294).The survival rates of the simple esophageal cancer group and esophageal+hypopharyngeal concurrent cancer group had statistical significance(P=0.014).CONCLUSION Among the patients with double primary esophageal and hypopharyngeal cancer,the overall survival rate of metachronous cancer is higher through active comprehensive treatment,but the prognosis of synchronous cancer is the worst.More effective treatment methods need to be explored.