title: Bronchoscopy screening in primary oral squamous cell carcinoma: a 10-year experience.
abstract: Squamous cell carcinoma (SCC) in the head and neck is associated with synchronous or metachronous carcinomas of the lung. Preoperative pulmonary screening is advocated and may be done by bronchoscopy, thoracic radiograph, computed tomography (CT), or positron emission tomography (PET) with CT (PET/CT fusion). We evaluated the role of bronchoscopy in patients with primary oral SCC to ascertain the incidence of synchronous malignancies of the lung. We retrospectively reviewed a decade's experience of screening by bronchoscopy in 570 pathologically confirmed and previously untreated patients with oral SCC (188 female, 382 male). Univariate and multivariate analyses were done after evaluating the incidence of synchronous lesions and the clinical and histological features of the index tumour. Investigation by bronchoscopy showed disease in 166 patients, and malignancy of the lung in 9 (2%). The Union International contre le Cancer (UICC) stages I and II oral SCC were significantly associated with a synchronous malignancy of the lung (p=0.038). We recommend the use of bronchoscopy even in early tumour stages. Some patients had their treatment altered because of its use, including upstaging, diagnosis of distant and unresectable disease, and investigation of second primary malignancies.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, München, Germany.
authors.forename: Marco Rainer
authors.initials: MR
authors.lastname: Kesting
authors.forename: Luisa
authors.initials: L
authors.lastname: Robitzky
authors.forename: Sammy
authors.initials: S
authors.lastname: Al-Benna
authors.forename: Lars
authors.initials: L
authors.lastname: Steinstraesser
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Baurecht
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
authors.forename: Frank
authors.initials: F
authors.lastname: Hölzle
authors.forename: Markus
authors.initials: M
authors.lastname: Nieberler
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.forename: Denys John
authors.initials: DJ
authors.lastname: Loeffelbein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000473:pathology*; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies