Esophagectomy for squamous cell carcinoma of the esophagus isolated or associated with head and neck cancer: long-term results.

Study aim: Esophageal squamous cell carcinomas are frequently associated wi th head and neck cancers. This retrospective study was conducted to compare the longterm outcome of the patients with a double cancer and of the patie nts with a solitary esophageal cancer after curative management. Patients and methods: From 1989 to 1999, 114 patients with an esophageal ca rcinoma were included in the study. Among them, 52 had an associated head a nd neck cancer (metachronous: n=17 and synchronous : n=35). Curative treatm ent was achieved in all patients. The patients were divided in "solitary" a nd "associated" group. Results: Age, sex distribution, tumor location and histological findings we re similar in the two groups. The esophageal resection was an esopharyngola ryngectomy (n=13), a subtotal esophagectomy with cervical anastomosis (n=92 ) and a Lewis-Santy esophagectomy with thoracic anastomosis (n=9). Operativ e mortality (8 versus 7.7%), anastomotic leaks rate (14,5 versus 21%) and p neumonia rate (21 versus 9,6%) were not significantly different in the two groups. The mean hospital stay was 27 days. The mean follow-up was 85 +/- 5 0 months. Five-year survival rates were not significantly different in the two groups (p=0.6411). In univariate survival analysis the only significant predictive factors were the depth of esophageal tumor invasion (p=0.0002) and node involvement (p=0.0373). The presence of head and neck cancer did n ot affect survival after esophagectomy. Conclusion: With an agressive therapeutic plan, the survival of patients wi th an esophageal cancer associated to head and neck cancer was similar to t he survival of patients with an isolated esophageal carcinoma. Long term es ophageal survey seems to be useful to detect more superficial esophageal ca rcinomas in patients with head and neck cancer. (C) 2001 Editions scientifi ques et medicales Elsevier SAS.