ASSOCIATED PRIMARY ESOPHAGEAL AND LUNG-CARCINOMA - A STUDY OF 39 PATIENTS

From 1979 to 1992, of 1,294 patients with esophageal squamous cell car cinoma, 39 patients (3.2%) (38 male patients, 1 female patient; mean a ge, 58 years) had associated primary lung carcinoma. Criteria for the diagnosis of primary lung carcinoma were: (1) non-squamous cell carcin oma tumors, (2) tumors existing before the esophageal squamous cell ca rcinoma, and (3) solitary squamous cell carcinoma presenting with endo bronchial involvement. The two tumors were observed synchronously in 2 2 patients (56%) and metachronously in 17, with a mean tumor-free inte rval of 46 months (range, 18 to 77 months). In patients with synchrono us disease, 10 underwent nonoperative treatment or a palliative surgic al procedure, and 12 (55%) underwent a curative operation. In patients with metachronous disease, a curative operation was performed in all for the first tumor and in 9 (53%) for the second tumor. The overall p ostoperative mortality rate was 15%. Two patients (10%) died after the curative operation. None of the patients died who underwent curative esophagectomy combined with lobectomy. For the patients with synchrono us disease, the 5-year survival rate was 11% in those who underwent a curative operation, and the longest survival in those who received pal liative treatment was 18 months. For the patients with metachronous di sease, the 5-year survival rates from the date of the diagnosis of the second tumor were 17% for those who had a curative operation and 11% for those who received palliative treatment. We conclude that a curati ve surgical procedure for the management of associated primary esophag eal squamous cell and lung carcinoma can be performed in approximately 50% of the patients, and is associated with a low operative mortality and an acceptable long-term survival.