Screening for synchronous esophageal second primary tumors in patients with head and neck cancer. Issue 10 (1st June 2021)

• Record Type: Journal Article
• Authors: van de Ven, Steffi E M; de Graaf, Wilmar; Bugter, Oisín; Spaander, Manon C W; Nikkessen, Suzan; de Jonge, Pieter Jan F; Hardillo, Jose A; Sewnaik, Aniel; Monserez, Dominiek A; Mast, Hetty; Keereweer, Stijn; Bruno, Marco J; Baatenburg de Jong, Robert J; Koch, Arjun D
• Is Part Of: Diseases of the esophagus. Volume 34:Issue 10(2021)
• Publication Date: 2021-06-01
• Subjects: esophageal cancer -- esophageal second primary tumor -- esophageal squamous cell carcinoma -- head and neck cancer -- head and neck squamous cell carcinoma -- lugol chromoendoscopy; Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doab037
• Languages: English
• ISSNs: 1120-8694

Abstract

Summary: Patients with head and neck squamous cell carcinoma (HNSCC) have an increased risk of developing esophageal second primary tumors (ESPTs). We aimed to determine the incidence, stage, and outcome of synchronous ESPTs in patients with HNSCC in a Western population. We performed a prospective, observational, and cohort study. Patients diagnosed with HNSCC in the oropharynx, hypopharynx, any other sub-location in combination with alcohol abuse, or patients with two synchronous HNSCCs, between February 2019 and February 2020 underwent screening esophagogastroduodenoscopy (EGD). ESPT was defined as presence of esophageal squamous cell carcinoma (ESCC) or high grade dysplasia (HGD). Eighty-five patients were included. A lesion suspected for ESPT was detected in 14 of 85 patients, which was pathologically confirmed in five patients (1 ESCC and 4 HGD). The radiotherapy field was extended to the esophagus in two of five patients, HGD was treated with endoscopic resection in three of five patients. None of the ESPTs were detected on MRI and/or CT-scan prior to EGD. Of the remaining nine patients, three had low grade dysplasia on histology whereas the other six patients had benign lesions. Incidence of synchronous ESPT was 5.9% in our cohort of HNSCC patients. All ESPTs were diagnosed at an early stage and treated with curative intent. We recommend that screening for synchronous ESPTs should be considered in a selected group of patients with HNSCC.