Surgical treatment in synchronous oesophageal cancers - A systematic review on survival outcomes.

OBJECTIVE

It is crucial to consider that other primary cancers may co-occur with synchronous oesophageal cancers when evaluating and deciding on treatment. This research aimed to assess available information on the viability and safety of synchronous resection of oesophageal carcinomas.

METHODS

A systematic literature search was conducted on PubMed, Scopus, Cochrane Central Register of Controlled Trials, and EMBASE to identify 34 peer-reviewed articles up to 2025. It included randomised controlled trials (RCTs), controlled clinical trials, observational studies, cohort studies, and case-control studies with adult patients (≥18 years) undergoing surgery.

RESULTS

Studies on the surgical management of oesophageal cancer metastasis revealed that the median overall survival within 1-3 years ranged from 21.% % to 32 %. In one study, the 5-year median survival was 38.8 % in TTE and 23 % in esophagectomy plus gastrectomy. Regarding data on case series, concomitant stomach and oesophageal neoplasms were present in 89 patients (76 % of the overall group). Seventy-five patients had adenocarcinomas, whereas the remaining 10 patients had gastrointestinal stromal tumours (GISTs). Eighty-seven patients had a transthoracic echocardiogram (TTE), one patient had a transhiatal esophagectomy (THE), and one patient had a thoracoabdominal approach. The remaining 59 patients had gastrectomies that left some stomach tissue intact. In 93 % of the patients, the second primary tumour could be diagnosed prior to surgery.

CONCLUSION

Concurrent resection of oesophageal and other primary solid organ cancers is safe, technically possible, and linked to acceptable perioperative death rates on an individual basis.