ArticleESMO gastrointestinal oncology2026
Incidence, treatment variation, and survival of synchronous head and neck and esophageal carcinomas: a descriptive nationwide cohort study in the Netherlands.
Article in ESMO gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Patients with head and neck squamous cell carcinoma (HNSCC) or esophageal carcinoma (EC) face elevated risk for developing second primary tumors (SPTs) in the other site. This study aimed to describe the cumulative incidence, treatment approaches and survival of these patients in the Netherlands. Patients and methods: This nationwide, retrospective cohort study used National Cancer Registry data. Patients with synchronously discovered (<6 months apart), potentially curable SPTs [M0 HNSCC and c-T1-4aN0-3M0 EC (UICC version 7 and 8)] were included (2012-2023). Results: We included 134 patients with 278 tumors (144 HNSCC, 134 EC). The cumulative incidence of SPTs was 0.46% in patients with HNSCC and 0.82% in patients with EC. Of the 103 patients (median age 66 years, 73% men) treated simultaneously (i.e., had a unified treatment plan addressing both tumors), 51.5% received treatment with curative intent, most often definitive chemoradiotherapy with carboplatin/paclitaxel (74%). Other curative treatments included radiotherapy, surgery, or radiation with cetuximab for HNSCC, and (endoscopic) resection for EC. The remaining 48.5% received palliative treatment only, mostly with radiotherapy or best supportive care. Median overall survival was 16 months (95% CI: 10-19). The 1- and 3-year survival rates were 74% and 31% for curative treatment versus 35% and 8% for palliative treatment. Conclusions: Synchronous HNSCC-EC SPTs are rare in the Netherlands, and treatment strategies vary. Despite theoretical curability, half of the patients received only palliative treatment. All patients demonstrated poor survival, regardless of the treatment approach. Multidisciplinary evaluation and individualized decision-making are essential for optimizing treatment selection in this vulnerable patient population.
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