Multimodal treatments for patients with locally advanced synchronous esophageal and head and neck cancer.

Background: Head and neck squamous cell carcinoma (HNSCC) and esophageal squamous cell carcinoma (ESCC) sometimes synchronously exist. In this study, we aim to investigate survival outcome and late adverse events (AEs) in patients with locally advanced synchronous ESCC and HNSCC (LA-SEHNC).

Methods: We retrospectively analyzed consecutive patients with LA-SEHNC who underwent curative-intent surgery or chemoradiotherapy (CRT) for HNSCC and ESCC between 2007 and 2024. Patients were classified into 3 groups: group A, surgery for both HNSCC and ESCC; group B, CRT for both HNSCC and ESCC; group C, CRT for either HNSCC or ESCC.

Results: Forty-two patients with LA-SEHNC were identified, consisting of 7 in group A, 28 in B, and 7 in C. There were no differences in overall survival and recurrence-free survival among groups. Late AEs occurred more frequently in group B and C than A, including stenosis (51.9%/57.1% vs 0%; p = 0.04), dysphagia (59.3%/42.9% vs 0% vs.; p = 0.02), and xerostomia (74.1%/57.1% vs 14.3%; p = 0.01). The median duration of feeding tube dependency was significantly longer in group B than A (80 days vs 0 day; p < 0.01). PS ≥ 1 and irradiation at head and neck region was significantly associated with long-term feeding tube dependency (odds ratio [OR] 9.10, p = 0.005, OR 7.71e + 7, p = 0.024, respectively).

Conclusion: Although no significant difference in survival was found among patients with LA-SEHNC regardless of treatment modalities, the use of radiotherapy may be associated with increased late AEs.