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Ann Thorac Surg 2003;76:1699-1705
© 2003 The Society of Thoracic Surgeons

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Original article: general thoracic

Periodic pharyngolaryngoscopy detects early head and neck cancer and improves survival in esophageal cancer

^a Departments of Otolaryngology and Surgery, Keiyukai Sapporo Hospital, Sapporo, Japan
^b Division of Medical Science, Health Sciences University of Hokkaido, Hokkaido, Japan

Accepted for publication May 28, 2003.

^* Address reprint requests to Dr Watanabe, Department of Otolaryngology, Keiyukai Sapporo Hospital, Kita 1-1, Hondori 14-chome, Shiroishi-ku, Sapporo 003-0027, Japan.
e-mail: akihito-watanabe{at}hokkaido.med.or.jp

BACKGROUND: Multiple squamous cell carcinomas (SCCs) frequently arise in the upper aerodigestive tract. The purposes of this study were to identify risk factors for SCC of the head and neck in patients with esophageal cancer (EC) and to investigate the value of periodic pharyngolaryngoscopic screening in detecting early SCCs of the head and neck and improving survival.

METHODS: We reviewed the cases of 754 patients with EC treated surgically (n = 545) or nonsurgically (n = 209) from May 1995 to December 1999 in our institution. Of these patients, 541 underwent periodic pharyngolaryngoscopic screening after treatment of EC, whereas 213 did not because of hospital death, dropout from the program, and distance from the hospital. Data were compared between patients in whom SCCs of the head and neck developed synchronously or metachronously (EC + SCC group, n = 70) and patients without SCCs (EC group, n = 684). Survival rates were compared between patients receiving periodic pharyngolaryngoscopy and those followed without endoscopic screening.

RESULTS: In the EC + SCC group, younger patients (p < 0.05), male patients (p < 0.05), and patients with a higher alcohol intake (p < 0.01) were more common than in the EC group. The 5-year survival rate was 40.9% in the EC group and 44.8% in the EC + SCC group (p = not significant). The survival rate of patients receiving periodic pharyngolaryngoscopy was significantly higher than that of patients followed without endoscopic screening (p < 0.001). Periodic pharyngolaryngoscopy was effective in detecting early SCCs of the head and neck and was beneficial for patients with EC in stages I to IV.

CONCLUSIONS: Periodic pharyngolaryngoscopy can provide early detection of SCCs of the head and neck, which arose in 9.3% of patients with EC. Such screening particularly benefits male patients and heavy drinkers, who are at high risk for multiple SCCs. Periodic pharyngolaryngoscopy may prevent reduced survival resulting from associated SCCs of the head and neck and improve overall survival in patients with EC.

This article has been cited by other articles:

				O. S.-H. Lo, S. Law, W. I. Wei, W.-M. Ng, K.-H. Wong, K.-H. Tong, and J. Wong Esophageal Cancers with Synchronous or Antecedent Head and Neck Cancers: A More Formidable Challenge? Ann. Surg. Oncol., June 1, 2008; 15(6): 1750 - 1756. [Abstract] [Full Text] [PDF]