title: Screening for oesophageal neoplasia in patients with head and neck cancer.
abstract: Due to advanced disease at the time of diagnosis the prognosis of oesophageal cancer is generally poor. As mass screening for oesophageal cancer is neither feasible nor reasonable, high-risk groups should be identified and surveilled. The aim of this study was to define the risk of oesophageal cancer in patients with (previous) head and neck cancer. A total of 148 patients with (previous) head and neck cancer were prospectively screened for oesophageal cancer by video-oesophagoscopy and random oesophageal biopsies. Even in a macroscopically normal looking oesophagus, four biopsy specimens were taken every 3 cm throughout the entire length of the squamous oesophagus. Low- or high-grade squamous cell dysplasia was detected histologically in 10 of the 148 patients (6.8%). All but one dysplasias were diagnosed synchronously with the head and neck cancers. In addition, oesophageal squamous cell carcinoma was diagnosed in 11 of the 148 patients (7.4%). Most invasive cancers (63.6%) occurred metachronously. The risk of squamous cell neoplasia of the oesophagus is high in patients with (previous) head and neck cancer. Surveillance is recommended in this high-risk group.
authors.affiliation: Medical Clinic I, University Hospital Benjamin Franklin, Free University of Berlin, Hindenburgdamm 30, 12200 Berlin, Germany. hscher@zedat.fu-berlin.de
authors.forename: H
authors.initials: H
authors.lastname: Scherübl
authors.forename: B
authors.initials: B
authors.lastname: von Lampe
authors.forename: S
authors.initials: S
authors.lastname: Faiss
authors.forename: P
authors.initials: P
authors.lastname: Däubler
authors.forename: P
authors.initials: P
authors.lastname: Bohlmann
authors.forename: T
authors.initials: T
authors.lastname: Plath
authors.forename: H-D
authors.initials: HD
authors.lastname: Foss
authors.forename: H
authors.initials: H
authors.lastname: Scherer
authors.forename: A
authors.initials: A
authors.lastname: Strunz
authors.forename: B
authors.initials: B
authors.lastname: Hoffmeister
authors.forename: H
authors.initials: H
authors.lastname: Stein
authors.forename: M
authors.initials: M
authors.lastname: Zeitz
authors.forename: E-O
authors.initials: EO
authors.lastname: Riecken
mesh_terms: D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000209:etiology; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D016609:Neoplasms, Second Primary; D011230:Precancerous Conditions / Q000175:diagnosis*; D011446:Prospective Studies; D018570:Risk Assessment