P1.126. Synchronous Head and Neck Squamous Cell Carcinoma and Esophageal Squamous Cell Carcinoma Treatment Experience From CMUH

Abstract

Abstract Topic Esophageal Cancer: Oncology/Radiation Therapy Background Esophageal squamous cell carcinoma account for 53% of esophageal tumor has high mortality due to exposure of carcinogens in Asian country. Head and neck cancer had high synchronous association with esophageal cancer due to “field-cancerization” to the upper aerodigestive tract. 15–20% of patients with HNC (head and neck squamous cell carcinoma had a secondary EC (esophageal squamous cell carcinoma) in Taiwan. Treatment choice and outcomes of synchronous HNC and EC were limited. Methods We retrospectively enrolled 123 patients from 2015 to 2017 with synchronous head and neck cancer and esophageal cancer newly diagnosed and been treated in China medical university hospital in Taiwan. The individual treatment process including date of diagnosis, clinical presentation, lab data, pathology, surgery process, chemotherapy regiment, radiation dose, treatment outcome and adverse effects were reviewed. We excluded those patients with metastatic disease or those who had a history of malignancy prior to first being treated for the EC. The pathologies of all the cases of esophageal cancer and head/neck cancer were all squamous cell carcinoma. The tumor stages were determined according to the 8th American Joint Committee on Cancer (AJCC) staging system. Results Of all 123 patients with locally advanced synchronous HNC and EC, all the patients were male and the mean age was 54.29 years. For the EC, 48 patients (39.02%) were found to have a stage I tumor, 71 patients (57.73%) were found to have a stage II tumor, and 4 patients (3.25%) were found to have a stage III tumor, while for the HNC patients, 44 patients (35.77%) were found to have a stage I tumor, 33 patients (26.83%) were found to have stage II tumor, 22 patients (17.89%) were found to have a stage III tumor, and 24 patients (19.61%) were found to have a stage IVA or stage IVB tumor. 15 patients (12.2%) with early HNC and early EC; 24 patients (19.5%) with early HNC and late EC; 49 patients (39.8%) with late HNC and early EC; and 35 patients with late HNC and EC. Conclusion In our study, we found that in early HNC and EC patient 53.33% (n=8) received one-stage concurrent surgical resection and reconstruction of synchronous cancer. 2 patients in early HNC and late EC group; 23 patients in late HNC and early EC group; and 11 patients in late HNC and late EC group had operation followed by induction therapy. Although the procedures are highly invasive, and complicated, the outcomes can be promising. Our findings indicate that patients with late stage synchronous HNC and EC experienced poorer treatment outcomes than those with early stage synchronous HNC and EC, characterized by inferior prognoses.