A Clinical Study of Multiple Carcinoma of the Esophagus

Seiji Mega, Masao Hosokawa, Takaya Kusumi, Tatsuya Abe, Masanobu Kusano, Yasunobu Nishida and Masahiro Fujita*

Department of Surgery and Department of Pathology*, Keiyuukai Sapporo Hospital

Purpose: We clinicopathologically evaluated multiple carcinoma of the esophagus. Methods: Among 574 patients with esophageal cancer undergoing esophagectomy or endoscopic mucosal resection (EMR) without preoperative treatment at Keiyuukai Sapporo Hospital between 1995 and 2001, 116 (19.7%) had multiple carcinoma of the esophagus. All such patients underwent esophagectomy with 3 field lymph node resection. Results: Multiple carcinoma of the esophagus is characterized by (1) an incidence of pharyngeal malignancy significantly higher in patients with multiple carcinoma (P<0.001); (2) a statistically significant difference in overall 5-year survival rate; (3) no significant difference between groups in the extent of lymph node metastasis or alcohol and smoking index or male-to-female ratio. Secondary lesions were characterized by (1) Mucosal cancer in 83.6%; (2) Endoscopic type 0-IIb or 0-IIc lesions in 89.7%; (3) a maximum lesion length of <1 cm in 58.8%; (4) a distance between the main tumor and the secondary lesion of <3 cm in 73.3%. Conclusions: Multiple and multifocal tumors should be considered in the diagnosis, treatment, and follow-up of cancer of the esophagus.

Key words
multiple carcinoma of the esophagus, squamous cell carcinoma of the esophagus

Reprint requests
Seiji Mega Second Department of Surgery, School of Medicine, Hokkaido University
N-15, W-7, Kita-ku, Sapporo, 060-8638 JAPAN

Accepted
December 19, 2003

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