Regular screening of esophageal cancer for 248 newly diagnosed hypopharyngeal squamous cell carcinoma by unsedated transnasal esophagogastroduodenoscopy

Yen-Chieh Huang; Yi-Chia Lee; Ping-Huei Tseng; Tseng-Cheng Chen; Tsung-Lin Yang; Pei-Jen Lou; Jenq-Yuh Ko; Li-Jen Liao; Wan-Lun Hsu; Yih-Leong Chang; Cheng-Ping Wang

doi:10.1016/j.oraloncology.2016.01.008

Regular screening of esophageal cancer for 248 newly diagnosed hypopharyngeal squamous cell carcinoma by unsedated transnasal esophagogastroduodenoscopy

Oral Oncol. 2016 Apr:55:55-60. doi: 10.1016/j.oraloncology.2016.01.008. Epub 2016 Feb 1.

Authors

Affiliations

¹ Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; Department of Otolaryngology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.
² Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
³ Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; Graduate Institute of Pathology, National Taiwan University, College of Medicine, Taipei, Taiwan.
⁴ Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
⁵ Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.
⁶ Genomics Research Center, Academia Sinica, Taipei, Taiwan.
⁷ Graduate Institute of Pathology, National Taiwan University, College of Medicine, Taipei, Taiwan; Department of Pathology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
⁸ Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; Graduate Institute of Pathology, National Taiwan University, College of Medicine, Taipei, Taiwan. Electronic address: wangcp@ntu.edu.tw.

PMID: 26846732
DOI: 10.1016/j.oraloncology.2016.01.008

Abstract

Objectives: Esophageal squamous cell carcinoma (ESCC) is common in hypopharyngeal squamous cell carcinoma (HSCC) patients. This prospective study is to reveal the prevalence of simultaneous ESCC in newly diagnosed HSCC patients by unsedated transnasal esophagogastroduodenoscopy (EGD) and to analyze the clinical predictors for simultaneous esophageal lesions and their survival.

Materials and methods: 248 patients with newly diagnosed HSCC and without previous head and neck cancer between 2007 and 2014 were prospectively evaluated for HSCC and simultaneous esophageal lesions by unsedated transnasal EGD. The clinical factors for simultaneous esophageal lesions were evaluated. Survival analysis of the HSCC patients receiving complete treatment was done.

Results: The mean age was 58years. 170 HSCC (68.5%) were classified as T3-T4. The procedures were successfully performed (98.4%), except 4 huge tumors. 174 HSCC (85.7%, out of 203 tumors biopsied) were pathologically proved malignancy by this technique. Regarding esophageal lesions (45.5%), ESCC occurred in 36 patients (14.8%), dysplasia without ESCC occurred in 23 (9.4%) and Lugol voiding lesion without ESCC or dysplasia occurred in 52 (21.3%). Alcohol drinking (adjusted OR: 6.95, p<0.05) and N3 classification (adjusted OR: 2.41, p<0.05) of HSCC were the independent risk factors for the presence of esophageal lesions. The overall survival of the HSCC patients with ESCC was significantly lower than those without ESCC (p=0.013).

Conclusions: Unsedated transnasal EGD is a promising technique for diagnosis of HSCC and simultaneous ESCC. Simultaneous esophageal lesions including ESCC (15%) are common in newly diagnosed HSCC patients, especially with alcohol drinking or N3 disease.

Keywords: Esophageal cancer; Esophagogastroduodenoscopy; Esophagoscopy; Hypopharyngeal cancer; Screening; Second primary cancer.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell / epidemiology*
Endoscopy, Digestive System / methods*
Esophageal Neoplasms / epidemiology*
Female
Humans
Hypopharyngeal Neoplasms / epidemiology*
Male
Middle Aged
Prevalence
Prospective Studies
Risk Factors