Risk factors for developing synchronous esophageal neoplasia in patients with head and neck cancer.
BACKGROUND
This study investigated the risk factors for synchronous esophageal neoplasia in patients with head and neck squamous cell carcinoma (HNSCC).


METHODS
All 315 consecutive patients with newly diagnosed HNSCC received endoscopic esophageal screening with image-enhanced endoscopy.


RESULTS
Sixty-nine patients (21.9%) had synchronous esophageal neoplasia, 37 (53.6%) with superficial neoplasia and 21 (30.4%) with multiple esophageal lesions. Univariate analysis revealed age <50 years, drinking alcohol, and location of index HNSCC were significant risk factors for developing synchronous esophageal neoplasia. In multivariate analysis, drinking alcohol (odds ratio [OR], 3.792; p = .0035), index oropharynxgeal cancers (OR, 3.618; p = .0045) and hypopharyngeal cancers (OR, 2.627; p = .0029) were independent risk factors. Drinking alcohol was clearly dose-response related (p = .001).


CONCLUSIONS
Alcohol consumption and index tumor location are associated with the development of synchronous esophageal neoplasia in patients with HNSCC. Because of the high prevalence, routine endoscopic examination of the esophagus should be recommended, especially in patients with the risk factors identified.
Wang
Wen-Lun
WL
Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung County, Taiwan, Republic of China.
Lee
Ching-Tai
CT
Lee
Yi-Chia
YC
Hwang
Tzer-Zen
TZ
Wang
Chih-Chun
CC
Hwang
Jau-Chung
JC
Tai
Chi-Ming
CM
Chang
Chi-Yang
CY
Tsai
Shang-Shyue
SS
Wang
Cheng-Ping
CP
Ko
Jenq-Yuh
JY
Lin
Jaw-Town
JT
D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D016001:Confidence Intervals; D055088:Early Detection of Cancer; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009378:Neoplasms, Multiple Primary / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology