[Oesophageal cancer in patients with head and neck cancers: therapeutic implications].
OBJECTIVE
To determine therapeutic and prognostic implications of an associated head and neck primary cancer in patients undergoing oesophagectomy for squamous cell carcinoma of the oesophagus.


METHODS
Between 1982 and 2000, 868 patients with oesophageal cancer were operated in our institution, including 78 (9%) who underwent oesophagectomy for associated oesophageal and head and neck cancers; the latter was synchronous (n = 52) or anterior metachronous (n = 26). Influence of head and neck cancer on the treatment of oesophageal carcinoma was analysed retrospectively in terms of surgical therapeutic strategy and survival.


RESULTS
Oesophageal resection consisted of oeso-pharyngolaryngectomy (n = 14, 17.9%), subtotal oesophagectomy (n = 62, 79.5%) and cervical oesophagectomy (n = 2, 2.6%). Radical resection (R0) was obtained in 85% of cases. Postoperative mortality rate was 5 % (4/78). Main complications were pulmonary (18% = 14/78) and anastomotic leaks (14% = 11/78), all of them cervical. Follow-up (mean = 25 +/- 27 months) was complete for all 78 patients. Five-year survival after R0 resection was 25%. Survival pronostic factors were denutrition, complete resection, and pT status of oesophageal tumor.


CONCLUSIONS
In patients with associated carcinomas of oesophagus and head and neck, agressive treatment -including an oesophagectomy- allowed a 5-year survival rate more than 25% without increased mortality or morbidity rates, compared with patients operated on for isolated oesophageal carcinoma.
Mariette
C
C
Service de chirurgie digestive et générale, hôpital Claude-Huriez, CHRU, place de Verdun, 59037 Lille cedex, France.
Fabre
S
S
Balon
J M
JM
Finzi
L
L
Chevalier
D
D
Triboulet
J P
JP
D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications; D011379:Prognosis; D013534:Survival