title: Regular screening of esophageal cancer for 248 newly diagnosed hypopharyngeal squamous cell carcinoma by unsedated transnasal esophagogastroduodenoscopy.
abstract: OBJECTIVE
  Esophageal squamous cell carcinoma (ESCC) is common in hypopharyngeal squamous cell carcinoma (HSCC) patients. This prospective study is to reveal the prevalence of simultaneous ESCC in newly diagnosed HSCC patients by unsedated transnasal esophagogastroduodenoscopy (EGD) and to analyze the clinical predictors for simultaneous esophageal lesions and their survival.
  
  
  METHODS
  248 patients with newly diagnosed HSCC and without previous head and neck cancer between 2007 and 2014 were prospectively evaluated for HSCC and simultaneous esophageal lesions by unsedated transnasal EGD. The clinical factors for simultaneous esophageal lesions were evaluated. Survival analysis of the HSCC patients receiving complete treatment was done.
  
  
  RESULTS
  The mean age was 58years. 170 HSCC (68.5%) were classified as T3-T4. The procedures were successfully performed (98.4%), except 4 huge tumors. 174 HSCC (85.7%, out of 203 tumors biopsied) were pathologically proved malignancy by this technique. Regarding esophageal lesions (45.5%), ESCC occurred in 36 patients (14.8%), dysplasia without ESCC occurred in 23 (9.4%) and Lugol voiding lesion without ESCC or dysplasia occurred in 52 (21.3%). Alcohol drinking (adjusted OR: 6.95, p<0.05) and N3 classification (adjusted OR: 2.41, p<0.05) of HSCC were the independent risk factors for the presence of esophageal lesions. The overall survival of the HSCC patients with ESCC was significantly lower than those without ESCC (p=0.013).
  
  
  CONCLUSIONS
  Unsedated transnasal EGD is a promising technique for diagnosis of HSCC and simultaneous ESCC. Simultaneous esophageal lesions including ESCC (15%) are common in newly diagnosed HSCC patients, especially with alcohol drinking or N3 disease.
authors: Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; Department of Otolaryngology, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin, Taiwan.
authors: Yen-Chieh
authors: YC
authors: Huang
authors: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Yi-Chia
authors: YC
authors: Lee
authors: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Ping-Huei
authors: PH
authors: Tseng
authors: Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; Graduate Institute of Pathology, National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Tseng-Cheng
authors: TC
authors: Chen
authors: Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Tsung-Lin
authors: TL
authors: Yang
authors: Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Pei-Jen
authors: PJ
authors: Lou
authors: Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Jenq-Yuh
authors: JY
authors: Ko
authors: Department of Otolaryngology, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors: Li-Jen
authors: LJ
authors: Liao
authors: Genomics Research Center, Academia Sinica, Taipei, Taiwan.
authors: Wan-Lun
authors: WL
authors: Hsu
authors: Graduate Institute of Pathology, National Taiwan University, College of Medicine, Taipei, Taiwan; Department of Pathology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
authors: Yih-Leong
authors: YL
authors: Chang
authors: Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan; Graduate Institute of Pathology, National Taiwan University, College of Medicine, Taipei, Taiwan. Electronic address: wangcp@ntu.edu.tw.
authors: Cheng-Ping
authors: CP
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016145:Endoscopy, Digestive System / Q000379:methods*; D004938:Esophageal Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
keywords: Esophageal cancer; Esophagogastroduodenoscopy; Esophagoscopy; Hypopharyngeal cancer; Screening; Second primary cancer