Analysis of 9 patients with synchronous double cancer of the lung and esophagus who underwent surgical resection

Abstract

Patients with synchronous double cancer of the lung and esophagus who undergo surgical resection are rare, and the therapeutic strategy for such patients is unclear. Therefore, we retrospectively evaluated the surgical outcomes of 9 patients with synchronous double cancer of the lung and esophagus resected at Osaka City University Hospital from January 2008 to December 2014. The median age of the patients was 67 years. There were 6 males and 3 females. Five patients underwent one-stage surgery for the right lung and esophagus, and 4 patients underwent two-stage surgery. Regarding surgery for lung cancer, 5 patients underwent lobectomy, and 4 patients underwent segmentectomy. All patients underwent complete resection, and the in-hospital mortality rate was 0%. Among the 5 patients who underwent one-stage surgery, postoperative complications occurred in 2 patients (40%). In the patient who underwent right lower lobectomy, aspiration pneumonia, anastomotic leak of the reconstructed gastric tube, chylothorax, and pyothorax with bronchial stump fistula developed. In the other patient who underwent S6 segmentectomy, bronchial fistula developed following pneumonia and acute respiratory distress syndrome (ARDS). Among the 4 patients who underwent two-stage surgery, there were no postoperative complications. The overall 3-year survival rate was 76.2%, and the median survival period was 67.1 months. Surgical resection should be considered in patients with synchronous double cancer of the lung and esophagus who can undergo complete resection. When one-stage surgery is performed in patients with synchronous double cancer of the right lung and esophagus, the simultaneous occurrence of pulmonary complication and anastomotic leak should be noted.