AUTHOR=Li Xiaoyu , Ai Dashan , Chen Yun , Liu Qi , Deng Jiaying , Zhu Hongcheng , Wang Ying , Wan Yue , Xie Yue , Chen Yanan , Chen Weiwei , Fan Jianhong , Wang Xiaoshen , Lu Xueguan , Ying Hongmei , He Xiayun , Hu Chaosu , Zhao Kuaile 

TITLE=Cancer of Pharyngoesophageal Junction: A Different Subtype From Hypopharyngeal and Cervical Esophageal Cancer?

JOURNAL=Frontiers in Oncology

VOLUME=Volume 11 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.710245

DOI=10.3389/fonc.2021.710245

ISSN=2234-943X

ABSTRACT=Background
Squamous cell cancers in hypopharynx (HP) and cervical esophagus (CE) are different diseases with different staging systems and treatment approaches. Pharyngoesophageal junction (PEJ) tumor involves both the hypopharynx and the cervical esophagus simultaneously but few reports focused on PEJ tumors. This study aimed to clarify clinical characteristics and the treatment approaches of PEJ tumors.
Patients and Methods 
A total of 222 patients with squamous cell carcinoma in the HP, PEJ and CE were collected between January 2008 and June 2018 in Fudan University Shanghai Cancer Center. We compared different lymph node metastatic patterns of three diseases above and the survival of different tumor locations, different lymph node metastasis and different radiotherapy approaches.
Results
For HP, PEJ and CE cancer, upper and middle cervical lymph node metastatic rate were 85.7%, 47.1% and 5.8%, respectively, lower cervical lymph node metastatic rate were 36.7%, 42.9% and 35.0%, respectively and mediastinal lymph node metastatic rate were 2.0%, 72.9% and 80.6%, respectively. The 3-year overall survival rates were 69.5% in HP group, 52.0% in PEJ group, and 69.6% in CE group (P=0.024). No survival differences were found between involved-field-irradiation and elective-node-irradiation subgroups among PEJ tumors (P=0.717 for OS and P=0.454 for PFS, respectively).
Conclusion
HP cancers had a high prevalence in all cervical lymph node metastasis while CE cancers in lower cervical and mediastinal lymph node metastasis. PEJ cancer had the combined metastatic patterns of both HP and CE cancers. Involved field irradiation was feasible in chemoradiotherapy for PEJ cancers.