Abstract
It is well known that multiple primary cancers frequently occur in the upper aerodigestive tract. In this study, we evaluated the incidence of multiple primary cancer of the upper aerodigestive tract and patient survival. From January 1995 to September 2001, 285 patients with head & neck cancer, 136 patients with esophageal cancer and 652 patients with lung cancer underwent surgical resection and/or chemoradiotherapy at our institute. Multiple primary cancers were found in 12 patients: head & neck and esophagus cancer in 6, head & neck and lung cancer in 2, and lung and esophagus cancer in 4. All of the patients were male, heavy smokers, and drinkers. Synchronous multiple cancer was found in one patient and metachronous multiple cancer in 11. The second cancer was found at a mean interval of 4 years (range: 0-10 years) after the onset of the first cancer. In two patients, an early-stage cancer was found in the esophagus and hypopharynx by screening fiberscopy. Ten patients complained of symptoms due to their second cancer. The TNM stage of the second cancer was I or II in 7 patients, and III or IV in 5 patients. The 5 year survival rate was 100% in patients with cancer of the head & neck and lung, 65% in patients with cancer of the head & neck and esophagus, and 50% in patients with cancer of the lung and esophagus after the first cancer treatment. In conclusion, the prognosis for patients with multiple primary cancers in the upper aerodigestive tract is determined in part by the presence or absence of esophageal cancer. It is important that esophageal cancer be found in its early stages.
