Endoscopic Screening for Second Primary Tumors of the Esophagus Among Head and Neck Cancer Patients

Chen-Shuan Chung; Li-Jen Liao; Chia-Yun Wu; Wu-Chia Lo; Chen-Hsi Hsieh; Tzong-His Lee; Chao-Yu Liu; Deng-Yu Kuo; Pei-Wei Shueng

doi:10.3389/fonc.2022.906125

Endoscopic Screening for Second Primary Tumors of the Esophagus Among Head and Neck Cancer Patients

Front Oncol. 2022 Jun 7:12:906125. doi: 10.3389/fonc.2022.906125. eCollection 2022.

Authors

Chen-Shuan Chung^{1

2

3}, Li-Jen Liao^{3

4

5}, Chia-Yun Wu^{3

6}, Wu-Chia Lo^{3

4

7}, Chen-Hsi Hsieh^{3

8

9

10}, Tzong-His Lee¹, Chao-Yu Liu^{3

10

11}, Deng-Yu Kuo⁹, Pei-Wei Shueng^{3

9

10

12}

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
² College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
³ Head and Neck Cancer Surveillance & Research Group, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁴ Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁵ Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
⁶ Division of Medical Oncology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁷ Graduate Institute of Medicine, Yuan Ze University, Taoyuan, Taiwan.
⁸ Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁹ Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
¹⁰ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
¹¹ Division of Thoracic Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
¹² Medical Device Innovation and Translation Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Abstract

Malignancies of the head and neck (HN) region and esophagus are among the most common cancers worldwide. Due to exposure to common carcinogens and the theory of field cancerization, HN cancer patients have a high risk of developing second primary tumors (SPTs). In our review of 28 studies with 51,454 HN cancer patients, the prevalence of SPTs was 12%. The HN area is the most common site of SPTs, followed by the lungs and esophagus, and 13% of HN cancer patients have been reported to have esophageal high-grade dysplasia or invasive carcinoma. The prognosis of HN cancer patients with concomitant esophageal SPTs is poor, and therefore identifying esophageal SPTs as early as possible is of paramount importance for risk stratification and to guide the treatment strategy. Image-enhanced endoscopy, especially using narrow-band imaging endoscopy and Lugol's chromoendoscopy, has been shown to improve the diagnostic performance in detecting esophageal neoplasms at an early stage. Moreover, the early detection and minimally invasive endoscopic treatment of early esophageal neoplasm has been shown to improve the prognosis. Well-designed prospective studies are warranted to establish appropriate treatment and surveillance programs for HN cancer patients with esophageal SPTs.

Keywords: Lugol’s chromoendoscopy; cancer screening; esophageal cancer; head neck cancer; image-enhanced endoscopy; narrow-band imaging; second primary tumor.

Publication types

Review