Abstract
A retrospective evaluation of 334 patients with superficial squamous cell carcinoma of the esophagus, who underwent esophagectomy or endoscopic mucosal resection without pre-operativetreatment from 1962 to June 1997, revealed 94 cases (28.1%) of multiple superficial carcinoma ofthe esophagus. The male-to-female ratio within this group was 93: 1, versus 5: 1 for single superficial carcinoma of the esophagus (p<0.0001). The Brinkman index was significantly higher in patients with multiple carcinoma than in those with single carcinoma (p<0.05). The incidence of pharyngeal malignancy was also significantly higher in the patients with multiple carcinomas (p<0.001). There was no significant difference between those groups with regard to extent of lymph node metastasis orprognosis. We evaluated the characteristics of 140 secondary lesions in 94 patients with multiple carcinoma, with the following results: 1) 74.5% of the patients with multiple primary tumors had onlyone second lesion. 2) Endoscopic type 0-IIc or 0-IIb lesions were found in 90%. 3) Mucosal cancer was found in 90%. 4) The maximum length of a lesion was less than 1 cm in 65%. 5) The distance between themain tumor and the second lesion was less than 3 cm in 67%. It is important to keep multiple tumors and multifocal tumors in mind for diagnosis, treatment and follow-up of superficial carcinoma of the esophagus.
