Head and neck cancer associated with esophageal cancer.
BACKGROUND
Multiple squamous cell carcinomas (SCCs) frequently arise in the aerodigestive tract. This study aims to clarify the incidence of squamous cell carcinoma of the head and neck (SCCHN) in esophageal cancer (EC) and clinical features of SCCHN.


METHODS
We reviewed the records of 1118 EC patients treated from May 1995 to December 2001 in our institution. All patients with EC underwent otolaryngological examination and pharyngolaryngoscopy screening before and after its treatment periodically during their follow-up periods. The incidence, site and stage of SCCHNs were analyzed.


RESULTS
A total of 127 patients had associated SCCHNs among all patients with EC (11.4%). Of these, the index antecedent tumor was SCCHN in 49 and EC in 78 patients. One hundred and fifteen patients developed double cancers (SCCHN and EC), 9 patients developed triple cancers (2 SCCHNs and EC) and 3 patients developed fourth cancers (3 SCCHNs and EC). Of 49 patients with the index SCCHN, 30 ECs were detected metachronously after its treatment (Group A) and 20 were synchronously (Group B). Of 78 patients with index EC, 38 SCCHNs were detected synchronously (Group C) and 54 SCCHNs were metachronously (Group D). The stages of 54 SCCHNs in the Group D were 33, 14, 4, 3 (Stages I-IV, respectively), which was significantly earlier than that of 50 SCCHNs in the Groups A and B (p<0.001).


CONCLUSIONS
The incidence of SCCHN in our EC patients was 11.4%. Periodic otolaryngological examination and pharyngoscopy screening can detect SCCHNs early in patients with primary EC.
Watanabe
Akihito
A
Department of Otolaryngology, Keiyukai Sapporo Hospital, Sapporo, Japan. akihito-watanabe@keiyukaisapporo.or.jp
Hosokawa
Masao
M
Taniguchi
Masanobu
M
Tsujie
Hitoshi
H
Sasaki
Shigeyuki
S
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007828:Laryngoscopy; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D011379:Prognosis