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Esophageal cancer, ranked as the seventh most common cancer globally, encompasses squamous cell carcinoma and adenocarcinoma. Despite advancements in treatment modalities like surgery, chemotherapy, radiotherapy, and immunotherapy, radiotherapy, while crucial for enhancing local control and survival, poses risks for long-term side effects and the development of second primary malignancies (SPM), notably Second primary lung cancer (SPLC). This study aims to analyze the incidence of second primary lung cancer (SPLC) among esophageal cancer survivors, with a focus on the influence of radiotherapy, analyze variations across different demographic and clinical subgroups, and assess patient survival outcomes. Using data from the Surveillance, epidemiology, and end results (SEER) program on 56,493 esophageal cancer patients (2000–2020), we compared SPLC incidence in those with and without prior radiotherapy. We applied a competing risks framework, propensity score matching (PSM), and survival analyses to assess SPLC risk and radiotherapy's impact. The study showed that patients treated with radiotherapy have a significantly higher long-term risk of SPLC compared to those without it. Radiotherapy significantly raised SPLC risk (HR 1.41, 95% CI 1.06–1.88), with higher SIRs particularly in younger patients and females. Post-PSM, there were significant differences in cancer-specific survival between esophageal cancer survivors with post-radiotherapy SPLC and those with only primary lung cancer. This cohort study shows that radiotherapy in esophageal cancer survivors increases SPLC risk but does not worsen survival compared to those with OPLC, highlighting the need for long-term monitoring and management. [ABSTRACT FROM AUTHOR]

To investigate whether the application of intravenous indocyanine green fluorescence imaging(ICG-FI) had advantage in intersegmental plane visualization and perioperative outcome than using traditional inflation-deflation method(control group) in thoracoscopic segmentectomy. We searched PubMed, Embase, Cochrane Library, EMBASE, Wanfang Database, VIP Database, and CNKI Database to include comparative studies focusing on the comparisons of ICG-FI and control, up to December 2022. We used standard mean differences (SMD, continuous variables) or risk ratios (RR, categorical variables) with their corresponding 95 % confidence interval (CI) were used to assess pooled effects. This analysis was conducted according to the PRISMA guideline. Total, seven published studies with 905 patients (ICG-FI group n = 428, control group n = 477) were included for further analysis. The ICG-FI group was significantly associated with less bleeding during the surgery (SMD = -0.23,95 % CI: -0.08∼-0.38, P < 0.05), shorter surgery time (SMD = -0.87, 95 % CI: -1.75∼-0.17, P < 0.05) and intersegmental boundary line (IBL) presentation time (SMD = -4.50, 95 % CI: -4.97∼-4.07, P < 0.01). The ICG-FI group had shorter postoperative hospitalization time (SMD = -0.18, 95 % CI: -0.34∼-0.03), P < 0.05), and the drainage duration (SMD = -0.18, 95 % CI: -0.34∼-0.03,P < 0.05) than that in the control group. The ICG-FI group also showed the less postoperative complications (RR = 0.75, 95 % CI: 0.64-0.88). There were no significant differences in the number of lymph node resection. No significant publication bias were found in this analysis. Compared with inflation-deflation method, application of ICG-FI in thoracoscopic segmentectomy could reduce operation time, IBL presentation time, length of hospital stay, intraoperative blood loss, and overall complication incidence., (Copyright © 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Published by Elsevier B.V. All rights reserved.)