Korean J Gastroenterol.  2016 Jul;68(1):23-28. 10.4166/kjg.2016.68.1.23.

Is a Preoperative Gastrointestinal Endoscopy for Second Primary Cancer Detection in Head and Neck Cancer Necessary? Ten-year Registry Data

• Heo GM
• Kim MH
• Kim JH
• Rho YS
• Shin WG

• KMID: 2344488
• DOI: http://doi.org/10.4166/kjg.2016.68.1.23

Abstract

BACKGROUND/AIMS
In head and neck squamous cell carcinoma, second primary gastrointestinal tumors are not uncommon. However, it is unclear whether a screening endoscopy is needed for detecting gastrointestinal neoplasm in patients with head and neck cancer. Therefore, we analyzed the prevalence and independent risk factors for second primary gastrointestinal neoplasm in head and neck squamous cell carcinoma.
METHODS
A consecutive series of 328 patients with primary head and neck squamous cell carcinoma that underwent esophagogastroduodenoscopy or colonoscopy were included using our registry. An age- and sex-matched group of 328 control subjects was enrolled. We assessed risk factors of synchronous gastrointestinal cancer.
RESULTS
The prevalence of esophageal cancer with head and neck squamous cell carcinoma was significantly higher than that of the control group (1.5% vs. 0.0%, p=0.011). An age of 54 years or more (OR, 1.033; 95% CI, 1.008-1.059; p=0.009) and male gender (OR, 4.974; 95% CI, 1.648-15.013; p=0.004) were risk factors for concomitant colorectal cancer or adenomas in the head and neck squamous cell carcinoma patients.
CONCLUSIONS
Preoperative colonoscopy can be recommended for detecting synchronous second primary colorectal lesions in head and neck squamous cell carcinoma patients with male sex regardless of age, and esophagogastroduodenoscopy is necessary in all head and neck squamous cell carcinoma patients for detecting esophageal cancer.

Keyword

Head and neck neoplasms; Esophagogastroduodenoscopy; Colonoscopy; Diagnosis

MeSH Terms

Adenoma
Carcinoma, Squamous Cell
Colonoscopy
Colorectal Neoplasms
Diagnosis
Endoscopy
Endoscopy, Digestive System
Endoscopy, Gastrointestinal*
Esophageal Neoplasms
Gastrointestinal Neoplasms
Head and Neck Neoplasms*
Head*
Humans
Male
Mass Screening
Neck
Neoplasms, Second Primary*
Prevalence
Risk Factors

Reference

References

1. Chuang SC, Scelo G, Tonita JM, et al. Risk of second primary cancer among patients with head and neck cancers: a pooled analysis of 13 cancer registries. Int J Cancer. 2008; 123:2390–2396.

2. Guardiola E, Pivot X, Dassonville O, et al. Is routine triple endoscopy for head and neck carcinoma patients necessary in light of a negative chest computed tomography scan? Cancer. 2004; 101:2028–2033.

3. Jones AS, Morar P, Phillips DE, Field JK, Husband D, Helliwell TR. Second primary tumors in patients with head and neck squamous cell carcinoma. Cancer. 1995; 75:1343–1353.

4. Davidson J, Gilbert R, Irish J, et al. The role of panendoscopy in the management of mucosal head and neck malignancy-a prospective evaluation. Head Neck. 2000; 22:449–454. discussion 454–455.

5. McGarry GW, Mackenzie K, Finlay I. Colonic second primary cancers in patients with index tumours of the head and neck. Br J Surg. 1994; 81:1481.

6. Sikora AG, Morris LG, Sturgis EM. Bidirectional association of anogenital and oral cavity/pharyngeal carcinomas in men. Arch Otolaryngol Head Neck Surg. 2009; 135:402–405.

7. Yamamoto E, Shibuya H, Yoshimura R, Miura M. Site specific de-pendency of second primary cancer in early stage head and neck squamous cell carcinoma. Cancer. 2002; 94:2007–2014.

8. Sturgis EM, Miller RH. Second primary malignancies in the head and neck cancer patient. Ann Otol Rhinol Laryngol. 1995; 104:946–954.

9. Jung KW, Won YJ, Kong HJ, Oh CM, Lee DH, Lee JS. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2011. Cancer Res Treat. 2014; 46:109–123.

10. Pisani P, Bray F, Parkin DM. Estimates of the worldwide prevalence of cancer for 25 sites in the adult population. Int J Cancer. 2002; 97:72–81.

11. Ramos M, Benavente S, Giralt J. Management of squamous cell carcinoma of the head and neck: updated European treatment recommendations. Expert Rev Anticancer Ther. 2010; 10:339–344.

12. Shiozaki H, Tahara H, Kobayashi K, et al. Endoscopic screening of early esophageal cancer with the Lugol dye method in patients with head and neck cancers. Cancer. 1990; 66:2068–2071.

13. Makuuchi H, Tanaka H, Shimada H, et al. Esophageal cancer and multiple primary cancer. Gan To Kagaku Ryoho. 1997; 24:1–7.

14. Benninger MS, Shariff A, Blazoff K. Symptom-directed selective endoscopy: long-term efficacy. Arch Otolaryngol Head Neck Surg. 2001; 127:770–773.

15. Lo OS, Law S, Wei WI, et al. Esophageal cancers with synchronous or antecedent head and neck cancers: a more formidable challenge? Ann Surg Oncol. 2008; 15:1750–1756.

16. Slaughter DP, Southwick HW, Smejkal W. Field cancerization in oral stratified squamous epithelium; clinical implications of multicentric origin. Cancer. 1953; 6:963–968.

17. Lee BI, Hong SP, Kim SE, et al. Korean guidelines for colorectal cancer screening and polyp detection. Clin Endosc. 2012; 45:25–43.

18. Winawer SJ, Zauber AG, Ho MN, et al. Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993; 329:1977–1981.

19. Rabeneck L, Paszat LF, Saskin R, Stukel TA. Association between colonoscopy rates and colorectal cancer mortality. Am J Gastroenterol. 2010; 105:1627–1632.

20. Chow TL, Lee DT, Choi CY, Chan TT, Lam SH. Prediction of simultaneous esophageal lesions in head and neck squamous cell carcinoma: a multivariate analysis. Arch Otolaryngol Head Neck Surg. 2009; 135:882–885.

21. Watanabe A, Hosokawa M, Taniguchi M, Tsujie H, Sasaki S. Head and neck cancer associated with esophageal cancer. Auris Nasus Larynx. 2007; 34:207–211.

22. León X, Ferlito A, Myer CM 3rd, et al. Second primary tumors in head and neck cancer patients. Acta Otolaryngol. 2002; 122:765–778.

23. Grossman TW. The incidence and diagnosis of secondary esophageal carcinoma in the head and neck cancer patient. Laryngoscope. 1989; 99:1052–1056.

24. Lim H, Kim do H, Jung HY, et al. Clinical significance of early detection of esophageal cancer in patients with head and neck cancer. Gut Liver. 2015; 9:159–165.

25. Miyazaki T, Tanaka N, Sano A, et al. Clinical significance of total colonoscopy for screening of colon lesions in patients with esophageal cancer. Anticancer Res. 2013; 33:5113–5117.