title: Long Term Outcome of Routine Image-enhanced Endoscopy in Newly Diagnosed Head and Neck Cancer: a Prospective Study of 145 Patients.
abstract: Synchronous second primary tumors (SPTs), especially esophageal squamous cell neoplasia (ESCN), in patients with head and neck squamous cell carcinoma (HNSCC) are not uncommon. Image-enhanced endoscopy (IEE) screening may identify SPTs while there is no evidence to support its benefit. We prospectively recruited an adult cohort with newly-diagnosed HNSCC for IEE screening of upper gastrointestinal (UGI) tract neoplasia. 145 HNSCC patients were recruited. 22 (15.2%) patients had synchronous UGI tract neoplasia, including 20 ESCNs and 2 gastric adenocarcinoma. At a median follow-up of 2.72 (±1.73) years, the 3-year overall survival (OS) rate was 0.71. HNSCC patients with synchronous ESCN/UGI tract neoplasia had poorer prognosis than those without (multivariate analysis, hazard ratio [HR] 2.75/2.79, 95% confidence interval [CI] 1.11~6.82/1.15~6.80, p = 0.03/0.02). HNSCC patients with advanced (stage III&IV) ESCN had worst survivals (p < 0.001). Among those with synchronous ESCNs, hypopharyngeal cancers were associated with poorer prognosis when compared with oral cancers (HR 2.36, 95% CI 1.08~5.15, p = 0.03). IEE screening for UGI SPTs in HNSCC patients could be used for risk stratification and prognosis prediction. HNSCC patients with advanced ESCN had the worst prognosis. Further studies are needed to demonstrate the survival benefits from IEE screening.
authors.affiliation: Departments of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.|College of Medicine, Far Eastern Memorial Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Chen-Shuan
authors.initials: CS
authors.lastname: Chung
authors.affiliation: Departments of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Wu-Chia
authors.initials: WC
authors.lastname: Lo
authors.affiliation: Departments of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Ming-Hsun
authors.initials: MH
authors.lastname: Wen
authors.affiliation: Departments of Radiation Oncology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.|Department of Medicine, Far Eastern Memorial Hospital, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Departments of Medical Oncology and Hematology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Yu-Chin
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Departments of Otolaryngology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.|Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan.
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Liao
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D004724:Endoscopy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000453:epidemiology; D018307:Neoplasms, Squamous Cell / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D041742:Upper Gastrointestinal Tract / Q000000981:diagnostic imaging