Objective: To explore the clinical features and prognosis of the patients with synchronous double primary malignancy of esophagus and cardia.
Methods: The clinical data of patients with synchronous primary esophageal and cardiac carcinomas undergoing surgery at our hospital between April 1988 and April 2009 were retrospectively reviewed. All data were analyzed by the SPSS 15.0 software. The overall survival rates (OS) were calculated and compared with the Kaplan-Meier method and the Log-rank test. The prognostic factors were identified by Cox's hazard regression model.
Results: Among all 47 cases, esophageal carcinoma was missed preoperatively in 1 patients and cardiac carcinoma in 12. The 1-, 3- and 5-year overall survival rates (OS) of the whole group were 81.5%, 49.1% and 34.3% respectively. And the median survival time was 33 months. The univariate analysis of prognostic factors showed that radical resection, N stage of esophageal carcinoma (2009), N stage of cardiac carcinoma (2009) and TNM stage of cardiac carcinoma (both 2002 and 2009) might influence the long-term survival. However, according to the multivariate analysis, only radical resection and N stage of cardiac carcinoma (2009) were independent prognostic factors.
Conclusion: With preoperative combined examination of esophagography and esophagoscopy and thorough intraoperative detection, the clinicians may reduce the rate of missed diagnosis for synchronous double primary esophageal and cardiac carcinomas. Radical resection of primary lesions and thorough dissection of locoregional lymph nodes may improve the patient survival.