| Objective:This study investigated the clinical characteristics and prognosis of esophagus with head and neck multiple carcinomas.The esophagus with hypopharyngeal double carcinomas and esophagus with head and neck triple carcinomas were analyzed.Also,we explore the clinical value of peripheral blood circulation tumor cells detection in locally advanced head and neck squamous cell carcinomas(including esophagus with head and neck multiple carcinomas).Methods:1)100 cases of esophageal cancer and 104 cases of esophageal with hypopharyngeal cancer were screened.we compared the clinical features and prognosis between synchronous carcinoma and metachronous carcinoma.2)A retrospective analysis was made of the distribution of cancers in 30 patients with three primary cancers of the head and neck accompanied with esophagus cancer.The incidence of synchronous carcinoma and metachronous carcinoma was compared.The clinical characteristics and prognosis of the two cancers were compared.The effects of different hospitalization times and treatment methods on survival were also compared.3)31 patients with locally advanced squamous cell carcinoma of the head and neck(including 5 cases of esophagus with multiple carcinomas of the head and neck),12 healthy volunteers and 6 patients with benign tumors were examined as controls.Circulating tumor cells(CTCs)are enriched by the microfluidic-based immune capture system CytoSorter.CTCs was detected before and after induction chemotherapy and after surgery and/or radiotherapy.we evaluate the correlation between CTCs count at different time points and survival outcome with recurrence risk.we evaluate the correlation between CTCs and clinicopathological features of patients.The patients were followed up until March 201 9.Results:1)There were 100 cases of simple esophageal cancer,32 cases of synchronous cancer and 72 cases of metachronous cancer.The 1-year,3-year and 5-year survival rates were 38.56%and 73.79%,29.99%and 60.37%,14.99%and 53.66%respectively.The prognosis of metachronous cancer was significantly better than that of synchronous cancer(P=0.006).Simple esophageal cancer group and esophageal+hypopharyngeal concurrent cancer compared,the two have statistical significance(P=0.014).2)The highest incidence of hypopharynx+esophagus+lung and hypopharynx+esophagus+oropharynx was 20.0%in 30 cases of three primary carcinomas of head and neck with esophagus.The second is hypopharynx+esophagus+larynx.In the comparison of clinical characteristics,the operation rate and hospitalization times of metachronous cancer were higher than synchronous cancer,which has statistical difference(P<0.05).The 1-,3-and 5-year survival rates of synchronous cancer were 39.9%,19.9%and 0%,respectively.The metachronous cancers were 78.7%,77.8%and 59.1%.There was significant difference between the two groups(P=0.001).3)CTCs were detected in 24 of 31 locally advanced head and neck squamous cell carcinomas,but not in the control group(P<0.0001).CTCs were significantly different from age(P=0.037)and lymph node metastasis(P=0.034).Patients with high CTCs count before treatment had a higher risk of local recurrence after treatment(p=0.0187).Most patients had a significant decreasing in CTCs at the end of treatment.Conclusion:Among the patients with esophageal cancer and hypopharyngeal double primary cancer,the overall survival rate of metachronous cancer is higher through active comprehensive treatment,but the prognosis of synchronous cancer was the worst.More effective treatments were needed to explore.Similarly,three primary cancers of the head and neck associated with esophagus,metachronous cancers still have a high survival rate through multidisciplinary and comprehensive treatment.In locally advanced head and neck squamous cell carcinomas,the CytoSorter system can isolate circulating tumor cells CTCs.CTCs can be used to monitoring patients' response to treatment and predicting local recurrence after treatment.At baseline,the CTCs detection has a great influence on the prognosis. |
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