title: Initial staging of squamous cell carcinoma of the oral cavity, larynx and pharynx (excluding nasopharynx). Part 2: Remote extension assessment and exploration for secondary synchronous locations outside of the upper aerodigestive tract. 2012 SFORL guidelines.
abstract: OBJECTIVE
  This report presents the French Society of ORL (SFORL) guidelines for exploration for remote metastasis and synchronous second cancer in initial staging of head and neck squamous cell carcinoma.
  
  
  METHODS
  An exhaustive literature review was analyzed by a multidisciplinary work-group.
  
  
  RESULTS
  The thorax is the most frequent location of remote metastases and synchronous second cancer outside of the upper aerodigestive tract. Thoracic CT is recommended as first-line examination in all cases (grade B). 18-FDG PET/CT is recommended when the thoracic CT image is doubtful or in case of high metastatic risk (grade B), for the detection of non-pulmonary remote metastasis. Esophageal exploration is recommended in case of significant risk of synchronous esophageal cancer (hypopharyngeal or oropharyngeal tumor, chronic alcohol intoxication) (grade B). The reference examination is flexible endoscopy of the upper digestive tract (grade B).
  
  
  CONCLUSIONS
  The present grade B recommendations rationalize the roles of the various first-line radiological and endoscopic examinations for remote metastasis and synchronous second cancer, so as to limit the number of examinations performed, thereby reducing the time needed for initial staging.
authors.affiliation: Service d'ORL et de Chirurgie Cervico-Faciale, Groupe Hospitalier Pellegrin, Centre François-Xavier-Michelet, CHU, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France. erwan.de-mones-del-pujol@chu-bordeaux.fr
authors.forename: E
authors.initials: E
authors.lastname: de Monès
authors.forename: C
authors.initials: C
authors.lastname: Bertolus
authors.forename: P Y
authors.initials: PY
authors.lastname: Salaun
authors.forename: F
authors.initials: F
authors.lastname: Dubrulle
authors.forename: J C
authors.initials: JC
authors.lastname: Ferrié
authors.forename: S
authors.initials: S
authors.lastname: Temam
authors.forename: D
authors.initials: D
authors.lastname: Chevalier
authors.forename: S
authors.initials: S
authors.lastname: Vergez
authors.forename: F
authors.initials: F
authors.lastname: Lagarde
authors.forename: P
authors.initials: P
authors.lastname: Schultz
authors.forename: M
authors.initials: M
authors.lastname: Lapeyre
authors.forename: B
authors.initials: B
authors.lastname: Barry
authors.forename: S
authors.initials: S
authors.lastname: Tronche
authors.forename: D
authors.initials: D
authors.lastname: de Raucourt
authors.forename: S
authors.initials: S
authors.lastname: Morinière
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects; D001984:Bronchial Neoplasms / Q000473:pathology / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary*; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000473:pathology / Q000556:secondary; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging; D009062:Mouth Neoplasms / Q000473:pathology*; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000473:pathology*; D010610:Pharyngeal Neoplasms / Q000473:pathology*; D049268:Positron-Emission Tomography; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013899:Thoracic Neoplasms / Q000556:secondary*; D014057:Tomography, X-Ray Computed