Synchronous resection of esophageal cancer and other organ malignancies: A systematic review

Table 1 Summary of included studies

Author	Year	Number of patients	Esophageal tumor location	Esophageal tumor histology	Second primary tumor location	Second primary tumor histology
Kato et al[26]	1994	71	Upper (n = 4),	N/A	Stomach (n = 71)	Adenocarcinoma
			Middle (n = 46),
			Lower (n = 21)
Isohata et al[24]	2008	1	Double tumor (lower and middle)	Adenocarcinoma	Stomach	Adenocarcinoma
Songping et al[40]	2013	1	Middle	SCC	Stomach	Adenocarcinoma
Kanda et al[42]	2011	1	Middle	SCC	Stomach	Adenocarcinoma
Zhou et al[41]	2013	1	Lower	SCC	Stomach	Adenocarcinoma and GIST
I H et al[38]	2013	4	Middle (n = 3),	SCC	Stomach	Adenocarcinoma
			Lower (n = 1)
Chan et al[36]	2013	5	Proximal (n = 1),	SCC (n = 1),	Stomach	GIST
			Middle (n = 1),
				Adenocarcinoma (n = 4)
			Lower (n = 3)
Fukaya et al[37]	2014	1	Middle	SCC	Stomach and Ampulla of Vater	Adenocarcinoma and small cell carcinoma
Mafune et al[31]	1995	1	Lower	SCC	Ampulla of Vater	Adenocarcinoma
Kurosaki et al[29]	2000	1	Middle	SCC	Pancreatic Head	Adenocarcinoma
Jayaprakash et al[25]	2009	1	GEJ	Adenocarcinoma	Ampulla of Vater	Adenocarcinoma
Kim et al[27]	2011	1	Lower	Adenocarcinoma	Pancreatic Head	Adenocarcinoma
Gyorki et al[22]	2011	1	Middle	Adenocarcinoma	Pancreatic Head	Neuroendocrine carcinoma
Fekete et al[21]	1994	12	N/A	SCC	Lung	N/A
Lindeman et al[30]	2007	1	Middle	SCC	Lung	SCC
Ishii et al[23]	2008	2	Middle (n = 1),	SCC	Lung	Adenocarcinoma
			Lower (n = 1)
Wang et al[39]	2012	3	Middle (n = 1),	SCC	Lung	SCC (n = 1), Adenocarcinoma (n = 2)
			Lower (n = 2)
Motoori et al[32]	2001	1	Middle	SCC	Rectum	Adenocarcinoma
Akiyama et al[35]	2015	1	Middle	SCC	Colon & Liver	Adenocarcinoma and HCC
Kobayashi et al[28]	2000	2	Middle (n = 1),	SCC	Kidney	Clear cell carcinoma
			Lower (n = 1)
Liano et al[20]	2007	1	Lower	SCC	Kidney	Clear cell carcinoma
De Hingh et al[19]	2007	1	N/A	Adenocarcinoma	Kidney	Renal cell carcinoma
Vilcea et al[34]	2010	1	Middle	SCC	Kidney	Urothelial
Nagahama et al[33]	1996	2	Middle (n = 2)	SCC	Liver	HCC

N/A: Non-available; SCC: Squamous cell carcinoma; HCC: Hepatocellular carcinoma; GIST: Gastrointestinal stromal tumors.

Table 2 Characteristics of patients undergoing simultaneous resection of esophageal and other organ neoplasms

Second primary tumor in stomach
Author	Number of cases	Age (mean)	Type of surgery			Anastomotic leaks	Perioperative deaths
			Esophagus	Stomach	Esophageal substitute
Kato et al[26]	n = 71	64	TTE (n = 70)	Non-anatomic resection (n = 46)	Stomach (n = 46)	N/A	n = 3
			THE (n = 1)	Total gastrectomy (n = 25)	Colon (n = 22)		n = 1
					Jejunum (n = 3)
Isohata et al[24]	n = 1	70	TTE (n = 1)	Non-anatomic resection (n = 1)	Stomach (n = 1)	n = 0	n = 0
Songping et al[40]	n = 1	65	TAB (n = 1)	Distal gastrectomy (n = 1)	Stomach (n = 1)	n = 0	n = 0
Kanda et al[42]	n = 1	57	TTE (n = 1)	Distal gastrectomy (n = 1)	Stomach (n = 1)	n = 1	n = 0
Zhou et al[41]	n = 1	77	TTE (n = 1)	Non-anatomic resection (n = 1)	Stomach (n = 1)	N/A	N/A
I H et al[38]	n = 4	65	TTE (n = 4)	ESD (n = 4)	Stomach (n = 4)	n = 0	n = 0
Chan et al[36]	n = 5	69	TTE (n = 5)	Non-anatomic resection (n = 5)	Stomach (n = 5)	N/A	n = 0
1Fukaya et al[37]	n = 1	69	TTE (n = 1)	Total gastrectomy (n = 1)	Colon (n = 1)	n = 12	n = 0
Second primary tumor in pancreas/ampulla of Vater
			Esophagus	Pancreas /ampullary	Esophageal substitute
Mafune et al[31]	n = 1	64	TTE (n = 1)	PD (n = 1)	Colon (n = 1)	n = 1	n = 0
Kurosaki et al[29]	n = 1	72	THE (n = 1)	PPPD (n = 1)	Stomach (n = 1)	n = 0	n = 0
Jayaprakash et al[25]	n = 1	62	TTE (n = 1)	PD (n = 1)	Jejunum (n = 1)	n = 0	n = 0
Kim et al[27]	n = 1	65	THE (n = 1)	PD (n = 1)	Jejunum (n = 1)	n = 0	n = 0
1Gyorki et al[22]	n = 1	58	TTE (n = 1)	PPPD (n = 1)	Colon (n = 1)	N/A	N/A
1Fukaya et al[37]	n = 1	69	TTE (n = 1)	PD (n = 1)	Colon (n = 1)	n = 1	n = 0
Second primary tumor in lung
			Esophagus	Lung	Esophageal substitute
Fekete et al[21]	n = 12	N/A	TTE (n = 12)	Pneumonectomy (n = 1)	Stomach (n = 12)	n = 1	n = 1
				Bilobectomy (n = 1)
				Lobectomy (n = 9)
				Segmentectomy (n = 1)
Lindeman et al[30]	n = 1	60	TTE (n = 1)	Lobectomy (n = 1)	Stomach (n = 1)	n = 0	n = 0
1Ishii et al[23]	n = 2	57	TTE (n = 2)	Segmentectomy (n = 1)	Stomach (n = 2)	n = 1	n = 0
Wang et al[39]	n = 3	65	TTE (n = 3)	Bilobectomy (n = 1)	Stomach (n = 3)	n = 0	n = 0
				Lobectomy (n = 2)
Second primary tumor in colon/rectum
			Esophagus	Colon/rectum	Esophageal substitute
Motoori et al[32]	n = 1	75	N/A	AR (n = 1)	N/A	N/A	N/A
1Akiyama et al[35]	n = 1	73	TTE (n = 1)	AR (n = 1)	Stomach (n = 1)	n = 0	n = 0
Second primary tumor in kidney
			Esophagus	Kidney	Esophageal substitute
Kobayashi et al[28]	n = 2	61	TTE (n = 2)	Nephrectomy (n = 2)	Stomach (n = 2)	n = 1	n = 0
Liano et al[20]	n = 1	64	TTE (n = 1)	Nephrectomy (n = 1)	Stomach (n = 1)	n = 0	n = 0
De Hingh et al[19]	n = 1	69	THE (n = 1)	Nephrectomy (n = 1)	Stomach (n = 1)	n = 0	n = 0
1Vilcea et al[34]	n = 1	56	TTE (n = 1)	Nephrectomy (n = 1)	Stomach (n = 1)	n = 1	n = 0
Second primary tumor in liver
			Esophagus	Liver	Esophageal substitute
Nagahama et al[33]	n = 2	75	TTE (n = 2)	Right posterior sectionectomy (n = 2)	Stomach (n = 2)	n = 0	n = 0
1Akiyama et al[35]	n = 1	73	TTE (n = 1)	Bisegmentectomy (n = 1)	Stomach (n = 1)	n = 0	n = 0

¹Patients undergoing a two-stage procedure;

²Anastomotic leak from pancreaticojejunal anastomosis. TTE: Transthoracic esophagectomy; THE: Transhiatal esophagectomy; TAB: Thoracoabdominal esophagectomy; PD: Pancreaticoduodenectomy; PPPD: Pylorus preserving pancreaticoduodenectomy; AR: Anterior resection; ESD: Endoscopic submucosal dissection.

Table 3 Postoperative deaths from tumor recurrences (Follow-up period ranged from 8 mo to 7 years)

Author	Number of patients		Death from esophageal recurrence (%)	Death fromsecond primary recurrence (%)
Second primary in stomach
Kato et al[26]		n = 71	n = 32 (45)	n = 8 (11)
Isohata et al[24]		n = 1	n = 0	n = 0
I H et al[38]		n = 4	n = 1 (25)	n = 0
Chan et al[36]		n = 5	n = 2 (40)	n = 0
Fukaya et al[37]		n = 1	n = 0	n = 01
Kanda et al[42]		n = 1	n = 0	n = 0
Total		n = 83	n = 35 (42)	n = 8 (10)
Second primary in pancreas/ampulla of Vater
Mafune et al[31]		n = 1	n = 0	n = 0
Kurosaki et al[29]		n = 1	n = 0	n = 0
Jayaprakash et al[25]		n = 1	n = 0	n = 0
Fukaya et al[37]		n = 1	n = 0	n = 1 (100)1
Total		n = 4	n = 0	n = 1 (25)
Second primary in lung
Lindeman et al[30]		n = 1	n = 0	n = 0
Ishii et al[23]		n = 2	n = 0	n = 0
Total		n = 3	n = 0	n = 0
Second primary in colon/rectum
Motoori et al[32]		n = 1	n = 0	n = 0
Akiyama et al[35]		n = 1	n = 0	n = 0
Total		n = 2	n = 0	n = 0
Second primary in kidney
Kobayashi et al[28]		n = 2	n = 0	n = 0
Liano et al[20]		n = 1	n = 0	n = 0
Total		n = 3	n = 0	n = 0
Second primary in liver
Nagahama et al[33]		n = 2	n = 1 (50)	n = 0
Akiyama et al[35]		n = 1	n = 0	n = 0
Total		n = 3	n = 1 (33)	n = 0

¹Recurrence and death from ampullary carcinoma.