[Risk factors and survival analysis for synchronous esophageal carcinoma in patients with hypopharyngeal carcinoma].

Objective: To investigate the risk factors and survival status of hypopharyngeal carcinoma with synchronous second primary carcinoma of the esophagus. Methods: One hundred and sixty patients with newly diagnosed hypopharyngeal carcinoma from January 2009 to December 2012 were retrospectively reviewed. The clinical data, tumor-related information and follow-up results were collected and analyzed. Results: Forty-three synchronous esophageal carcinomas (27%) were detected in 160 patients with hypopharyngeal carcinoma, and most patients (72%) were at an early stage. On univariate analysis, the median age of less than 55 years old (χ(2)=4.525, P=0.033), excessive alcohol consumption (χ(2)=6.942, P=0.008) and invasion site more than 3 anatomical regions (χ(2)=21.503, P=0.000) had a significant correlation with the occurrence of synchronous esophageal carcinomas. Multivariate analysis showed that excessive alcohol consumption (OR=4.787, P=0.029) and invasion site more than 3 anatomical regions (OR=14.391, P=0.000) were independent risk factors. The median survival time was 26 months in 43 patients with synchronous esophageal carcinomas, which was significantly lower than that (58 months) in patients without secondary primary esophageal carcinomas (χ(2)=11.981, P=0.001). Conclusions: There is a high incidence of synchronous esophageal carcinoma in hypopharyngeal carcinoma patients, affecting the prognosis of hypopharyngeal carcinoma. Surveillance for esophageal carcinomas in patients with hypopharyngeal carcinoma, especially in excessive alcohol drinkers, is warranted.目的： 探讨下咽癌伴有同时性食管第二原发癌的危险因素和生存状况。 方法： 回顾性分析2009年1月至2012年12月中国医学科学院肿瘤医院收治的160例下咽癌患者的临床资料、肿瘤相关信息及随访结果。单因素分析中定量资料采用t检验，定性资料采用卡方检验，对单因素分析中P<0.05者进行Logistic回归多因素分析，并计算比值比(OR)及95%可信区间(CI)。生存率通过Kaplan－Meier法进行计算，Log－rank检验比较组间生存时间的差异。 结果： 160例下咽癌伴有同时性食管癌43例(占27%)，72%为早期食管癌。单因素分析显示中位年龄≤55岁(χ(2)＝4.525, P＝0.033)、重度饮酒(χ(2)＝6.942，P＝0.008)和侵犯部位≥3个解剖分区(χ(2)＝21.503, P＝0.000)与发生同时性食管癌有显著相关性。多因素分析显示，重度饮酒(OR＝4.787, P＝0.029)和侵犯部位≥3个解剖分区(OR＝14.391, P＝0.000)是发生同时性食管癌的独立危险因素。伴有同时性食管癌的43例下咽癌患者的中位生存时间为26个月，明显低于不伴有同时性食管癌的下咽癌患者(中位生存时间为58个月，χ(2)＝11.981，P＝0.001)。 结论： 下咽癌伴发同时性食管癌的风险较高，是影响下咽癌预后的一个重要因素，要重点监测过度饮酒的下咽癌患者，对下咽癌侵犯范围推荐窄带成像内镜检查，食管病变推荐碘染色检查，有助于对食管第二原发癌作出预测及食管早期癌的检出。.