Postresection chemoradiotherapy does not prevent second primary tumours in ESCC

In patients with early esophageal squamous cell carcinoma (ESCC), chemoradiotherapy (CRT) following endoscopic resection (ER) does not seem to reduce the incidence of developing second primary ESCC nor cancers in other organs when compared with ER alone, according to a study.

The study was a post hoc analysis of a prospective study involving 170 patients with clinical submucosal ESCC. Of these patients, 74 underwent ER alone and 96 underwent ER followed by CRT (ER + CRT) due to pathological results of submucosal or lympho-vascular invasion.

All patients were followed up with esophagogastroduodenoscopy and computerized tomography every 4 months for the first 3 years and every 6 months thereafter. Researchers compared the incidence of second primary cancers in esophagus and in other organs between two treatment groups.

During the follow-up, 61 ESCC were detected in 32 patients. This corresponded to a 3-year cumulative incidence of multiple ESCCs of 10.4 percent in the ER + CRT group and 13.5 percent in the ER group, with the difference not reaching statistical significance.

Meanwhile, 63 second primary cancers in other organs were detected in 45 patients. Likewise, there was no significant difference in the cumulative incidence between the two treatment groups.

Factors associated with the risk of multiple ESCCs were high alcohol consumption and grade C multiple Lugol-voiding lesions. Specifically, heavy drinkers and patients with grade C multiple Lugol-voiding lesion were more likely to develop second primary ESCC.