Esophageal pathology in patients after treatment for head and neck cancer.
OBJECTIVE
To determine the prevalence of esophageal pathology following treatment for primary head and neck cancer (HNCA).


METHODS
Case series with planned data collection.


METHODS
Academic medical practice.


METHODS
Subjects comprised HNCA survivors. Esophagoscopy was prospectively performed on 100 patients at least three months after treatment for HNCA. Patient demographics including cancer stage, cancer treatment, use of reflux medications, symptoms surveys, and esophageal findings were prospectively determined.


RESULTS
The mean age of the cohort was 64 (+/- 10) years; 75 percent were male. The mean time between the end of treatment and endoscopy was 40 (+/- 51) months. Eighty-one percent of HNCA was advanced stage (3 or 4). The distribution of site of the primary HNCA was as follows: oropharynx (38%), larynx (33%), oral cavity (17%), unknown primary (10%), hypopharynx (1%), and nasopharynx (1%). Treatment modalities included surgery alone (15%), surgery with radiation (34%), radiation alone (6%), chemoradiation alone (24%), and chemoradiation with surgery (20%). The findings on esophagoscopy included peptic esophagitis (63%), stricture (23%), candidiasis (9%), Barrett metaplasia (8%), gastritis (4%), and carcinoma (4%). Only 13 percent had a normal esophagoscopy.


CONCLUSIONS
Esophageal pathology is extremely common in patients treated for HNCA. These findings support routine esophageal screening after HNCA treatment.
Farwell
D Gregory
DG
Department of Otolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA, USA. gregory.farwell@ucdmc.ucdavis.edu
Rees
Catherine J
CJ
Mouadeb
Debbie A
DA
Allen
Jacqueline
J
Chen
Allen M
AM
Enepekides
Danny J
DJ
Belafsky
Peter C
PC
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004935:Esophageal Diseases / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use
D054328:Proton Pump Inhibitors