Clinical analysis of 117 cases with synchronous multiple primary esophageal squamous cell carcinomas

Abstract

Background/Aims: We aimed to study the clinical characteristics, treatment modality, and the prognosis of synchronous multiple primary esophageal squamous cell carcinomas (SMPESCC).Methods: A total of 117 SMPESCC cases were evaluated retrospectively from 2010 to 2015.Results: The most common locations of SMPESCC were mid- and lower thoracic segments (n = 208, 84.9%). The 1-, 2-, and 3-year overall survival rates were 53.8%, 30.8%, and 15.4%, respectively; the median survival time (MST) was 12.5 months. With definitive radiotherapy and surgery, respectively, the MST of stage I/II patients were 34.2 and 26.7 months, of stage III patients were 8.3 and 13.2 months (<i>p</i> = 0.163), and of stage IV patients were and 8 and 12.6 months (<i>p</i> = 0.379). Clinical stage, family history of cancer, and Karnofsky performance status were independent prognostic factors for the whole cohort by Cox multivariate regression analysis (hazard ratio [HR] = 0.859, <i>p</i> < 0.001; HR = 0.579, <i>p</i> = 0.032; and HR = 0.586, <i>p</i> = 0.013).Conclusions: Although the prognosis of SMPESCC is poor, stage I/II patients can achieve long-term survival with aggressive treatment, especially those with a Karnofsky performance score 90 or higher and who have no family history of cancer. Definitive radiotherapy could achieve a similar survival rate to definitive surgery at different clinical stages.