Abstract
The incidence of multiple primary in patients with head and neck cancer was increased in a period of recent 10 years. Recent reports descrived the frequency of second primary as over 10 per cent of index. Second primaries has developed frequently in upper aerodigestive tract including stomach.
New screening program to identify additional cancer was performed on the patients with head and neck cancer. Flexible fiberscopy of upper digestive tract was able to make diagnosis of the early cancer of esophagus or stomach. Simultaneous second primaries was detected in esophagus of 25 patients and in stomach of 12 patients during eleven year period. This observed number of esophageal cancer estimated in 673 index patients of head and neck cancer was 180 times of incidence expected in general population in Japan. High incidence of simultaneous 2nd primary of esophugus was identified among patients with risks which were male aged over 50 years old, primary sites in oral or pharyngeal mucosa and alcoholic abusers.
Twenty-two of 25 esophageal cancer was classified as T1 (UICC 1987) surgically or endoscopically. Sixteen of 25 patients have received treatment with curative intent of both head and neck/esophageal lesions. Six of 13 cases with curative therapy are alive without disease after at least 2 year follow-up period. Endoscopic mucosal resection of esophagus is a new method indicated in cases with early thin cancer without invasion into submucosal layer. This modality may be useful for patients with early cancer of esophagus with head and neck cancer.
