title: Impact of the early detection of esophageal neoplasms in hypopharyngeal cancer patients treated with concurrent chemoradiotherapy.
abstract: OBJECTIVE
  We examined the risk factors and prognostic factors for synchronous esophageal neoplasia (SEN) by comparing the characteristics of hypopharyngeal cancer (HPC) patients with and without SEN.
  
  
  METHODS
  We examined 183 patients who were treated with definitive radiotherapy for HPC. Lugol chromoendoscopy screening of the esophagus was performed in all patients before chemoradiotherapy.
  
  
  RESULTS
  Thirty-six patients had SEN, 49 patients died of HPC and two died of esophageal cancer. The patients with SEN exhibited significantly higher alcohol consumption than those without SEN (P = 0.018). The 5-year overall survival (OS) rate of the 36 patients with SEN was lower than that of the other patients (36.2% vs 63.4%, P = 0.006). The SEN patients exhibited significantly shorter HPC cause-specific survival than the other patients (P = 0.039). Both the OS (P = 0.005) and the HPC cause-specific survival (P = 0.026) of the patients with SEN were significantly shorter than those of the patients without SEN in multivariate analysis. Category 4/T1 stage esophageal cancer was treated with concurrent chemoradiotherapy (CCRT), endoscopic treatment or chemotherapy. The 5-year survival rates for esophageal cancer recurrence for CCRT, endoscopic treatment and chemotherapy were 71.5, 43.7 and 0%, respectively. The median (range) survival time (months) of CCRT, endoscopic treatment and chemotherapy was 22.7 (7.5-90.6), 46.44 (17.3-136.7) and 7.98 (3.72-22.8), respectively.
  
  
  CONCLUSIONS
  Advanced HPC patients with SEN might have a poorer prognosis than those without SEN even when the esophageal cancer is detected early and managed appropriately.
authors.affiliation: Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ogino
authors.affiliation: Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inayama
authors.affiliation: Department of Radiation Oncology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Madoka
authors.initials: M
authors.lastname: Sugiura
authors.affiliation: Department of Otorhinolaryngology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sakuma
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kokawa
authors.affiliation: Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Chikara
authors.initials: C
authors.lastname: Kunisaki
authors.affiliation: Department of Radiology, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D059248:Chemoradiotherapy; D055088:Early Detection of Cancer; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000188:drug therapy / Q000532:radiotherapy; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D015996:Survival Rate
keywords: Lugol chromoendoscopy; concurrent chemoradiotherapy; hypopharyngeal cancer; risk factor; synchronous esophageal neoplasia