Significance of endoscopic screening and endoscopic resection for esophageal cancer in patients with hypopharyngeal cancer.
OBJECTIVE
The efficacy of endoscopic screening for esophageal cancer in patients with hypopharyngeal cancer remains controversial and its impact on prognosis has not been adequately discussed. We studied the use of endoscopic screening to detect esophageal cancer in hypopharyngeal cancer patients by analyzing the incidence, stage and prognosis.


METHODS
We included 64 patients with hypopharyngeal cancer who received radical radiotherapy at our institute. Chromoendoscopic esophageal examinations with Lugol dye solution were routinely performed at and after treatment for hypopharyngeal cancer.


RESULTS
Twenty-eight esophageal cancers were detected in 28 (41%) patients (18 synchronous and 10 metachronous cancers). Of the 28 cancers, 23 were stage 0 or I cancer and 15 of these were treated with endoscopic resection. Local control was achieved in all of these 23 stage 0 or I cancers. The 5-year overall survival rates with esophageal cancer were 83% in stage 0, 47% in stage I and 0% in stage IIA-IVB.


CONCLUSIONS
This study showed a strikingly high incidence of esophageal cancer in hypopharyngeal cancer patients. We suppose that the combination of early detection by chromoendoscopic examination and endoscopic resection for associated esophageal cancer in hypopharyngeal cancer patients improve prognosis and maintain quality of life.
Morimoto
Masahiro
M
Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan. morimoto-knk@umin.ac.jp
Nishiyama
Kinji
K
Nakamura
Satoaki
S
Suzuki
Osamu
O
Kawaguchi
Yoshifumi
Y
Nakajima
Aya
A
Imai
Atsushi
A
Ishihara
Ryu
R
Uemura
Hirokazu
H
Fujii
Takashi
T
Yoshino
Kunitoshi
K
Tomita
Yasuhiko
Y
D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000601:surgery; D011379:Prognosis