Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case–control study

BMC Gastroenterology

Tzong-Hsi Lee⁵  Pei-Wei Shueng⁷  Wei-Fan Hsu⁵  Yu-Chin Lin⁶  Yi-Chen Chang⁴  Yueh-Hung Chou²  Wu-Chia Lo¹  Li-Jen Liao³  Chen-Shuan Chung⁵ 

[1]Otolaryngology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan

[2]Anatomical Pathology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan

[3]Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

[4]Surgery, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan

[5]Departments of Internal Medicine, Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, No. 21, Nan-Ya South Road, Section 2, Ban-Ciao, 22060 New Taipei City, Taiwan

[6]Medical Oncology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan

[7]Radiation Oncology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan

关键词: Head and neck cancer;    Esophageal cancer;    Second primary tumor;    Narrow-band imaging;    Image-enhanced endoscopy;   

Others  :  857507
DOI  :  10.1186/1471-230X-13-154

 received in 2013-01-27, accepted in 2013-10-21,  发布年份 2013

【 摘 要 】

Background

The prevalence of esophageal neoplasia in head and neck (H&N) cancer patients is not low; however, routine esophageal surveillance is not included in staging of newly-diagnosed H&N cancers. We aimed to investigate the risk factors for synchronous esophageal neoplasia and the impact of endoscopy on management of H&N cancer patients.

Methods

A total of 129 newly diagnosed H&N cancer patients who underwent endoscopy with white-light imaging, narrow-band imaging (NBI) with magnifying endoscopy (ME), and chromoendoscopy with 1.5% Lugol’s solution, before definite treatment were enrolled prospectively.

Results

60 esophageal lesions were biopsied from 53 (41.1%) patients, including 11 low-grade, 14 high-grade intraepithelial neoplasia and 12 invasive carcinoma in 30 (23.3%) patients. Alcohol consumption [odds ratio (OR) 5.90, 95% confidence interval (CI) 1.23-26.44], advanced stage (stage III and IV) of index H&N cancers (OR 2.98, 95% CI 1.11-7.99), and lower body mass index (BMI) (every 1-kg/m² increment with OR 0.87, 95% CI 0.76-0.99) were independent risk factors for synchronous esophageal neoplasia. NBI with ME was the ideal screening tool (sensitivity, specificity, and accuracy of 97.3%, 94.1%, and 96.3%, respectively, for detection of dysplastic and cancerous esophageal lesions). The treatment strategy was modified after endoscopy in 20 (15.5%) patients. The number needed to screen was 6.45 (95% CI 4.60-10.90).

Conclusions

NBI-ME surveillance of esophagus should be done in newly-diagnosed H&N cancer patients, especially those with alcohol drinking, lower BMI, and advanced stage of primary tumor.

【 授权许可】

   
2013 Chung et al.; licensee BioMed Central Ltd.

【 图 表 】

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