title: Efficacy of Staged Treatment Strategy for Patients with Synchronous Double Cancers of the Esophagus and Head and Neck: A Retrospective Study.
abstract: BACKGROUND
  Synchronous occurrence of esophageal and head and neck (H&N) cancers is frequently observed.
  
  
  METHODS
  We retrospectively reviewed the records of 109 patients with synchronous double cancers of the esophagus and H&N treated between 2005 and 2011. Fifty-one patients underwent synchronous treatment and 58 underwent staged treatment. We measured the delay in treatment for the second cancer in the staged treatment group and evaluated how many patients experienced progression of the second cancer during the first cancer treatment. Overall survival (OS) was analyzed in 100 patients who underwent potentially curative treatment.
  
  
  RESULTS
  Synchronous treatment strategy was frequently selected for patients with both advanced cancers (77 %) compared with those who had early cancers in either or both organs (43 %) (P = 0.02). The median delay in the treatment for the second cancer was 80 days; 77.5 days in the H&N-first group and 96 days in the esophagus-first group. Only one patient experienced stage progression during the waiting period. There was no significant difference in OS between the synchronous treatment group and the staged treatment group (P = 0.73), and no significant difference in OS among patients who had advanced cancer in the H&N, esophagus, or both.
  
  
  CONCLUSIONS
  Prognosis of patients with synchronous cancers depends on that of the more advanced cancer, and waiting for treatment of early cancers may not influence survival. The staged treatment strategy is acceptable when either of the double cancers is at an early stage.
authors.forename: Akira
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hironobu
authors.initials: H
authors.lastname: Shigaki
authors.forename: Koujiro
authors.initials: K
authors.lastname: Nishida
authors.forename: Shinji
authors.initials: S
authors.lastname: Mine
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sano
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors