Surgical Treatment in Synchronous Oesophageal Cancers - A Systematic Review on Survival Outcomes

Abstract

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.