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Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502
BACKGROUND: Previous studies have suggested that patients with esophageal squamous cell carcinoma (ESCC) are still at a high risk of developing second primary malignancies (SPMs) after definitive therapies. We evaluated the development of SPMs and explored its risk factors in patients with clinical...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Nature Singapore
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232445/ https://www.ncbi.nlm.nih.gov/pubmed/35546373 http://dx.doi.org/10.1007/s00535-022-01870-y |
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author | Mitani, Seiichiro Kato, Ken Daiko, Hiroyuki Ito, Yoshinori Nozaki, Isao Kojima, Takashi Yano, Masahiko Nakagawa, Satoru Ueno, Masaki Watanabe, Masaya Tsunoda, Shigeru Abe, Tetsuya Kadowaki, Shigenori Kadota, Tomohiro Sasaki, Keita Machida, Ryunosuke Kitagawa, Yuko |
author_facet | Mitani, Seiichiro Kato, Ken Daiko, Hiroyuki Ito, Yoshinori Nozaki, Isao Kojima, Takashi Yano, Masahiko Nakagawa, Satoru Ueno, Masaki Watanabe, Masaya Tsunoda, Shigeru Abe, Tetsuya Kadowaki, Shigenori Kadota, Tomohiro Sasaki, Keita Machida, Ryunosuke Kitagawa, Yuko |
author_sort | Mitani, Seiichiro |
collection | PubMed |
description | BACKGROUND: Previous studies have suggested that patients with esophageal squamous cell carcinoma (ESCC) are still at a high risk of developing second primary malignancies (SPMs) after definitive therapies. We evaluated the development of SPMs and explored its risk factors in patients with clinical T1bN0 ESCC. METHODS: JCOG0502 prospectively compared esophagectomy with definitive chemo-radiotherapy for clinical T1bN0 ESCC. Here, we reviewed all JCOG0502 patients’ data for SPMs and investigated the risk factors for SPMs using uni-variable and multivariable analyses by Fine and Gray model. RESULTS: Among 379 enrolled patients, 213 underwent esophagectomy and 166 received chemo-radiotherapy. Patient characteristics were male (85%); median age [63 (range 41–75) years; location of the primary tumor (upper/middle/lower thoracic esophagus, 11%/63%/27%, respectively]; alcohol consumption history (79%); smoking history (66%); prevalence of no/several/many/unknown Lugol-voiding lesions (LVLs) (45%/36%/8%/11%, respectively). In a median follow-up of 7.1 years, 118 SPMs occurred in 99 (26%) patients. Cumulative incidences of SPMs after 3, 5, and 10 years were 9%, 15%, and 36%, respectively. The most common primary tumor sites were the head and neck (35%), stomach (20%) and lungs (14%). In multivariable analyses, compared to no LVLs, several LVLs [hazard ratio (HR) 2.24, 95% confidential interval (CI) 1.32–3.81] and many LVLs (HR 2.88, 95% CI 1.27–6.52) were significantly associated with the development of SPMs. Sixteen patients died due to the SPMs. CONCLUSION: The incidence of SPMs was high. The presence of LVLs, which was a predictive factor for SPMs, may be useful for surveillance planning. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00535-022-01870-y. |
format | Online Article Text |
id | pubmed-9232445 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Nature Singapore |
record_format | MEDLINE/PubMed |
spelling | pubmed-92324452022-06-26 Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502 Mitani, Seiichiro Kato, Ken Daiko, Hiroyuki Ito, Yoshinori Nozaki, Isao Kojima, Takashi Yano, Masahiko Nakagawa, Satoru Ueno, Masaki Watanabe, Masaya Tsunoda, Shigeru Abe, Tetsuya Kadowaki, Shigenori Kadota, Tomohiro Sasaki, Keita Machida, Ryunosuke Kitagawa, Yuko J Gastroenterol Original Article—Alimentary Tract BACKGROUND: Previous studies have suggested that patients with esophageal squamous cell carcinoma (ESCC) are still at a high risk of developing second primary malignancies (SPMs) after definitive therapies. We evaluated the development of SPMs and explored its risk factors in patients with clinical T1bN0 ESCC. METHODS: JCOG0502 prospectively compared esophagectomy with definitive chemo-radiotherapy for clinical T1bN0 ESCC. Here, we reviewed all JCOG0502 patients’ data for SPMs and investigated the risk factors for SPMs using uni-variable and multivariable analyses by Fine and Gray model. RESULTS: Among 379 enrolled patients, 213 underwent esophagectomy and 166 received chemo-radiotherapy. Patient characteristics were male (85%); median age [63 (range 41–75) years; location of the primary tumor (upper/middle/lower thoracic esophagus, 11%/63%/27%, respectively]; alcohol consumption history (79%); smoking history (66%); prevalence of no/several/many/unknown Lugol-voiding lesions (LVLs) (45%/36%/8%/11%, respectively). In a median follow-up of 7.1 years, 118 SPMs occurred in 99 (26%) patients. Cumulative incidences of SPMs after 3, 5, and 10 years were 9%, 15%, and 36%, respectively. The most common primary tumor sites were the head and neck (35%), stomach (20%) and lungs (14%). In multivariable analyses, compared to no LVLs, several LVLs [hazard ratio (HR) 2.24, 95% confidential interval (CI) 1.32–3.81] and many LVLs (HR 2.88, 95% CI 1.27–6.52) were significantly associated with the development of SPMs. Sixteen patients died due to the SPMs. CONCLUSION: The incidence of SPMs was high. The presence of LVLs, which was a predictive factor for SPMs, may be useful for surveillance planning. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00535-022-01870-y. Springer Nature Singapore 2022-05-11 2022 /pmc/articles/PMC9232445/ /pubmed/35546373 http://dx.doi.org/10.1007/s00535-022-01870-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article—Alimentary Tract Mitani, Seiichiro Kato, Ken Daiko, Hiroyuki Ito, Yoshinori Nozaki, Isao Kojima, Takashi Yano, Masahiko Nakagawa, Satoru Ueno, Masaki Watanabe, Masaya Tsunoda, Shigeru Abe, Tetsuya Kadowaki, Shigenori Kadota, Tomohiro Sasaki, Keita Machida, Ryunosuke Kitagawa, Yuko Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502 |
title | Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502 |
title_full | Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502 |
title_fullStr | Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502 |
title_full_unstemmed | Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502 |
title_short | Second primary malignancies in patients with clinical T1bN0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the JCOG trial: JCOG0502 |
title_sort | second primary malignancies in patients with clinical t1bn0 esophageal squamous cell carcinoma after definitive therapies: supplementary analysis of the jcog trial: jcog0502 |
topic | Original Article—Alimentary Tract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232445/ https://www.ncbi.nlm.nih.gov/pubmed/35546373 http://dx.doi.org/10.1007/s00535-022-01870-y |
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