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. 2023 Aug 17:13:1219451.
doi: 10.3389/fonc.2023.1219451. eCollection 2023.

Clinicopathological characteristics of synchronous multiple primary early esophageal cancer and risk factors for multiple lesions

Jing Su  1   2 , Shuchun Wei  1 , Wenjie Li  1 , Han Chen  1 , Lurong Li  1 , Lijuan Xu  1 , Ping Zhao  1 , Guoxin Zhang  1 , Jin Yan  1
Affiliations

Clinicopathological characteristics of synchronous multiple primary early esophageal cancer and risk factors for multiple lesions

Jing Su et al. Front Oncol. .

Abstract

Background: With the development of endoscopic technology, the detection rate of synchronous multiple primary early esophageal cancer (SMPEEC) is increasing; however, the risk factors remain unclear. We aimed to assess the clinicopathological characteristics of patients with SMPEEC and investigate the risk factors contributing to the development of multiple lesions.

Methods: A retrospective cohort study was conducted on 911 consecutive patients who underwent Endoscopic submucosal dissection (ESD) for primary esophageal neoplasms from January 2013 to June 2021. The patients were divided into the SMPEEC group and the solitary early esophageal cancer (SEEC) group. We compared the differences in clinicopathological characteristics between the two groups and investigated the risk factors linked to multiple lesions. Additionally, we investigated the relationship between the main and accessory lesions.

Results: A total of 87 SMPEEC patients were included in this study, and the frequency of synchronous multiple lesions was 9.55% in patients with early esophageal cancer. The lesions in the SMPEEC group were mainly located in the lower segment of the esophagus (46[52.9%]), whereas those in the SEEC group were in the middle segment (412[50.0%]). The pathology type, tumor location, and circumferential rate of lesions were independent risk factors(P<0.05) for SMPEEC by logistic regression analysis. Significant positive correlations were observed between the main and accessory lesions in terms of morphologic type (r=0.632, P=0.000), tumor location(r=0.325, P=0.037), pathologic type (r=0.299, P=0.003), and depth of invasion (r=0.562, P=0.000).

Conclusion: Pathology type, tumor location, and circumferential rate of lesions were identified as independent risk factors for SMEPPC. Understanding these risk factors and the correlation between the main and accessory lesions could significantly improve the detection rate of SMPEEC.

Keywords: accessory lesions; endoscopic submucosal dissection (ESD); main lesions; risk factors; synchronous multiple primary early esophageal cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of enrolled patients.
Figure 2
Figure 2
Correlation of tumor diameter between main and accessory lesions of SMPEEC.
Figure 3
Figure 3
A cumulative incidence of local recurrence by the Kaplan–Meier curves. (A) a cumulative incidence of local recurrence in all patients. (B) a cumulative incidence of local recurrence of lesions in different locations. (C) a cumulative incidence of local recurrence of different pathological types. (D) a cumulative incidence of local recurrence with invasion depth.
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