Prediction of simultaneous esophageal lesions in head and neck squamous cell carcinoma: a multivariate analysis.
OBJECTIVE
To evaluate the frequency of concomitant esophageal lesions detected by esophagoscopy in squamous cell carcinoma (SCC) in the head and neck (HNSCC) and to identify the risk factors.


METHODS
Retrospective medical record analysis.


METHODS
Regional hospital.


METHODS
From March 2000 to March 2006, 118 patients with HNSCC had undergone esophagoscopy as part of the disease workup. Three patients had double head and neck primary tumors. Sixty-five patients also underwent chromoendoscopy with Lugol's iodine solution.


METHODS
The incidence of simultaneous esophageal cancer diagnosed on esophagoscopy. Additional esophageal lesions of clinical significance discovered during chromoendoscopy were also evaluated.


RESULTS
Clinically important esophageal lesions were found in 12 patients (10%)-9 carcinomas and 3 dysplastic lesions. Chromoendoscopy was useful in 5 of these 12 cases, detecting 3 dysplastic lesions not visualized by ordinary esophagogastroduodenoscopy and additional lesions in 2 patients with esophageal carcinoma. Of the patients in whom isolated oral cavity SCC was considered, the incidence of synchronous esophageal lesions was only 1.5%. Sex (P = .02), younger age (P = .04), alcohol drinking (P = .047), and tumor sites (P = .002) were significant predictors of synchronous esophageal lesions on univariate analysis. On multivariate analysis, only tumor site remained a significant risk factor (P = .009).


CONCLUSIONS
Clinically important esophageal lesions rarely coexists with oral cavity SCC, for which the benefit of routine esophagogastroduodenoscopy is questionable. Chromoendoscopy enhances the identification of early but clinically important esophageal abnormalities if esophagoscopy is performed for SCC in the larynx, hypopharynx, and oropharynx.
Chow
Tam-Lin
TL
Department of Surgery, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong SAR. tamlinc@yahoo.com
Lee
Daniel Tai-Yam
DT
Choi
Chi-Yee
CY
Chan
Tony Tung-Fei
TT
Lam
Siu-Ho
SH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D004396:Coloring Agents; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology / Q000473:pathology*; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis
D004396:Coloring Agents