Detection of synchronous lung tumors in patients presenting with squamous cell carcinoma of the head and neck.
BACKGROUND
Screening for synchronous pulmonary tumors in patients presenting with squamous cell carcinoma of the head and neck (SCCHN) is important, because detection may alter subsequent management.


METHODS
We conducted a retrospective review, comparing effectiveness of pulmonary screening using thoracic CT or chest X-ray, in 1882 patients presenting with SCCHN.


RESULTS
The overall rate of synchronous pulmonary tumors was 4.3%. The number needed to scan, ie, the number of thoracic CTs required to detect 1 pulmonary tumor, is reported for recurrent primary tumors, primary disease load (T and N classification), and individual primary sites. The incidence of pulmonary metastases is related to locoregional disease load while the incidence of bronchogenic carcinoma is sporadic.


CONCLUSIONS
Although it is possible to propose a pragmatic screening protocol for pulmonary metastases, this is not possible for bronchogenic carcinomas. Therefore, we recommend that thoracic CT is used in all cases to screen for coexistent pulmonary pathology.
Ghosh
Samit K
SK
Department of Otolaryngology/Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom.
Roland
Nicholas J
NJ
Kumar
Aman
A
Tandon
Sankalap
S
Lancaster
Jeffrey L
JL
Jackson
Shaun R
SR
Jones
Andrew
A
Lewis Jones
Huw
H
Hanlon
Rebecca
R
Jones
Terry M
TM
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology / Q000556:secondary*; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000556:secondary* / Q000628:therapy; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011379:Prognosis; D013902:Radiography, Thoracic / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult