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

BMC Gastroenterology

Research Article

Yueh-Hung Chou¹  Chen-Shuan Chung²  Wei-Fan Hsu²  Tzong-Hsi Lee²  Yu-Chin Lin³  Wu-Chia Lo⁴  Li-Jen Liao⁵  Pei-Wei Shueng⁶  Yi-Chen Chang⁷ 

[1] Anatomical Pathology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan;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;Medical Oncology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan;Otolaryngology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan;Otolaryngology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan;Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan;Radiation Oncology, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan;Surgery, Far Eastern Memorial Hospital, Banciao District, New Taipei City, Taiwan;

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

DOI  :  10.1186/1471-230X-13-154

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

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsA 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.Results60 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).ConclusionsNBI-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】

Unknown   
© Chung et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.