• Naoya Yoshida, Yuka Tamaoki, Yoshifumi Baba, Yasuo Sakamoto, Yuji Miyamoto, Masaaki Iwatsuki, Takashi Shono, Hideaki Miyamoto, Masanori Imuta, Junji Kurashige, Hiroshi Sawayama, Ryuma Tokunaga, Masayuki Watanabe, Yutaka Sasaki, Yasuyuki Yamashita, and Hideo Baba.
• Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan.
• Int. J. Clin. Oncol. 2016 Dec 1; 21 (6): 1079-1084.

BackgroundThe precise incidence rates of multiple primary colorectal cancers in esophageal cancer patients are unknown.MethodsIn total, 480 consecutive patients with esophageal cancers surgically resected in the Kumamoto University Hospital received preoperative total colonoscopy for the assessment of colorectal disease between April 2005 and February 2016. We retrospectively investigated the occurrence of synchronous colorectal cancer with esophageal cancer. In addition, we examined the risk factors for the incidence of multiple primary colorectal cancers.ResultsOf the 480 patients, 14 (2.9 %) had synchronous colorectal cancers, 13 had well-differentiated tubular adenocarcinomas, and 1 had papillary adenocarcinoma. Other 14 patients had metachronous colorectal cancer. The current incidence rates of synchronous and total (both synchronous and metachronous) colorectal cancers outnumbered those in normal healthy population and those in esophageal cancer patients which previously reported by The Japan Esophageal Society. The age ≥70 years (hazard ratio 4.82, 95 % confidence interval 1.473-15.78; p = 0.009) and Brinkman index ≥800 (hazard ratio 3.47, 95 % confidence interval 1.056-11.37; p = 0.040) were the independent risk factors for the incidence of synchronous colorectal cancer. They were also the independent risk factors for the incidence of total colorectal cancer.ConclusionsThe results of the present study suggested that pretreatment screening with total colonoscopy is meaningful for patients with esophageal cancer, because the frequency of synchronous colorectal cancer was not negligible. Particularly, in patients >70 years and with history of heavy smoking, pretreatment colonoscopy might be necessary.

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