Gut Liver.  2015 Mar;9(2):159-166. 10.5009/gnl13401.

Clinical Significance of Early Detection of Esophageal Cancer in Patients with Head and Neck Cancer

Affiliations
  • 1Department of Gastroenterology, Asan Medical Center, and Asan Digestive Disease Research Institute, University of Ulsan College of Medicine, Seoul, Korea. hwoonymd@gmail.com

Abstract

BACKGROUND/AIMS
The efficacy of surveillance for esophageal squamous cell neoplasia (ESCN) in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Our study aimed to provide clinical data concerning the necessity of surveillance for detecting early ESCN in patients with HNSCC.
METHODS
We retrospectively reviewed the data from 714 patients who were pathologically confirmed as having HNSCC (n=236 oral cavity cancers, 137 oropharyngeal cancers, 87 hypopharyngeal cancers, and 254 laryngeal cancers).
RESULTS
Of 714 patients, during a median follow-up of 31 months, 48 ESCNs (37 synchronous and 11 metachronous) were detected in 36 patients (5%). Fifteen synchronous lesions (40.3%) were early ESCN, whereas nine metachronous lesions (81.8%) were early ESCN. The 3-year survival rates of HNSCC only and HNSCC combined with ESCN were 71.2% and 48.2%, respectively (p<0.001). Among 36 patients with ESCN, the 3-year survival rates for early and advanced ESCN were 77.7% and 21.7%, respectively (p=0.01). In the multivariate analysis, alcohol consumption and hypopharyngeal cancer were significant factors associated with the development of ESCN.
CONCLUSIONS
HNSCC patients with early ESCN were similar in prognosis with patients without ESCN, in contrast to patients with advanced ESCN. Therefore, surveillance for the early detection of ESCN in patients with HNSCC, especially in alcohol drinkers and those with hypopharyngeal cancer, is warranted.

Keyword

Esophageal neoplasms; Head and neck neoplasms; Early detection of cancer; Prognosis

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Alcohol Drinking/adverse effects
Carcinoma, Squamous Cell/*diagnosis/mortality/*pathology/*secondary
Early Detection of Cancer/*statistics & numerical data
Esophageal Neoplasms/*diagnosis/mortality/*secondary
Female
Head and Neck Neoplasms/mortality/*pathology
Humans
Male
Middle Aged
Multivariate Analysis
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Young Adult
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