High incidence of head and neck cancers after endoscopic resection for esophageal cancer in younger patients

Abstract

Background: Second cancers in patients with esophageal cancer (EC) are common and have a poor prognosis. We evaluated the incidence of second cancers at different sites by patients' ages when their index ECs were diagnosed.

Methods: This study included patients who underwent endoscopic resection for superficial EC at our hospital between September 1994 and September 2011. Patients' data, including sex, age at diagnosis, sequence of cancer incidence, cancer histology, and cancer site, were extracted from the cancer registry.

Results: Of 544 patients, 255 developed second cancers. Simultaneous head and neck cancers (HNCs) and other organ cancers (OCs) were, respectively, present in 15% (80/544) and 9.6% (52/544) of patients; and 30% (162/544) developed metachronous second cancers over a median follow-up period of 79.5 months (range 2-120), including 44 metachronous HNCs and 70 OCs. The cumulative incidence of metachronous HNCs was significantly higher in younger patients (< 60 years) than in older patients (≥ 60 years; P = 0.001), whereas the cumulative incidence of OCs was significantly higher in older patients than in younger patients (P = 0.03).

Conclusions: The incidence of second HNC after index EC was higher in younger-onset patients than in older-onset patients. We suggest that younger patients with EC should be carefully monitored for early detection of second HNC.

Keywords: Cancer registry data; Field cancerization; Second cancer surveillance after esophageal cancer.