Abrasive Esophageal Cytology for the Oncological Follow‐Up of Patients With Head and Neck Cancer

Pellanda, Antonio; Grosjean, Pierre; Leoni, Sandra; Mihaescu, Anca; Monnier, Philippe; Pelletier, Philippe

doi:10.1097/00005537-199910000-00028

Cited by 14 publications

(6 citation statements)

References 23 publications

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“…The high incidence of second primary cancers warrants a close follow-up with abrasive pharyngoesophageal cytology that allows diagnosis at an early stage in most cases. 22 The possibility of repeating the resection over time offers an important advantage in patients with metachronous second primary cancers. Also, avoiding radiotherapy in early stages of the disease allows this therapeutic modality to be reserved for more advanced metachronous cancers in the future, should it be needed.…”

Section: Commentmentioning

confidence: 99%

Transoral Laser Surgery for Pharyngeal and Pharyngolaryngeal Carcinomas

Kutter¹,

Lang²,

Monnier³

et al. 2007

Arch Otolaryngol Head Neck Surg

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To assess early oncological and functional outcomes after transoral laser surgery in patients with pharyngeal or pharyngolaryngeal squamous cell carcinoma. Design: Inception cohort, with a median follow-up of 24 months. Setting: Tertiary university center. Patients: Fifty-five consecutive patients with pharyngeal or pharyngolaryngeal squamous cell carcinoma (T1, 24 patients; T2, 28 patients; and T3, 3 patients) were included. Patients had to be eligible for open functional surgery, and exposure in suspension micropharyngoscopy had to be possible. Interventions: The pharynx and larynx were exposed with a bivalved laryngopharyngoscope, and the resection of the tumor was performed with a carbon dioxide laser coupled to a microscope. Neck dissection was performed in 43 patients. It was not attempted in the other 12 patients for the following reasons: N0 neck and severe comorbidities (n = 6), microinvasive cancer (n=3), patient's refusal (n=1), inoperable N3 disease (n=1), and rapid local recurrence (n = 1). Eighteen patients (33%) received adjuvant radiotherapy: 12 for neck disease and 6 for positive resection margins. Main Outcome Measures: Local control and overall survival at the median follow-up visit. Evaluation of complications, pain, and rehabilitation of swallowing capacity. Results: At a median follow-up of 24 months, the local control rate was 90%, and the overall survival rate was 78%. There were 16 early postoperative complications: recurrent aspiration pneumonia (n = 7); laryngeal obstruction, which required tracheotomy (n=3); severe postoperative hemorrhage (n=2); and cervical emphysema, which resolved spontaneously (n=4). Feeding tubes were necessary in 37 patients. They were removed after a median period of 7 days. The median pain score was 4 of 10 during the first postoperative week and 0 of 10 after 4 weeks. The median hospital stay was 13 days (15 days for patients with neck dissection). Conclusions: Transoral laser surgery for pharyngeal and pharyngolaryngeal squamous cell carcinoma is a safe and acceptable therapeutic modality in selected cases. Good local control and avoidance of tracheotomy can be expected in most cases. Oral food intake is immediate, but feeding tubes are required to avoid weight loss during the postoperative period. Frequent early problems include transient postoperative bronchoinhalations and pain.

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Section: Commentmentioning

confidence: 99%

Transoral Laser Surgery for Pharyngeal and Pharyngolaryngeal Carcinomas

Kutter¹,

Lang²,

Monnier³

et al. 2007

Arch Otolaryngol Head Neck Surg

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“…The OPB has indeed proved very sensitive for the detection of new primary lesions. In the study by Pellanda et al (1999), none of the 254 patients with negative OPB cytology developed an oesophageal tumour. Among the 25 asymptomatic patients with positive OPB cytology, a premalignant or early oesophageal tumour was detected in 20 cases.…”

Section: Discussionmentioning

confidence: 96%

Cytology vs molecular analysis for the detection of head and neck squamous cell carcinoma in oesopharyngeal brush samples: a prospective study in 56 patients

et al. 2003

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Oesopharyngeal brush (OPB) sampling with cytological analysis can yield exfoliated cells from asymptomatic tumours of the upper aero-digestive tract and the oesophagus. In this study, we compared cytological evaluation and molecular analysis for the detection of exfoliated cancer cells sampled with an OPB. A total of 56 patients with a known unique head and neck squamous cell carcinoma (HNSCC) and five healthy controls were enrolled prospectively. Exfoliated cells from these 61 patients were collected with an OPB before initial endoscopy. p53 mutations and UT 5085 microsatellite instability (MI) were analysed in the HNSCC tumour, lymphocytes and the corresponding OPB DNA samples. p53 mutations and UT5085 MI were detected in 31 out of 56 and 14 out of 56 HNSCC, respectively, but not in any of the five controls. Direct sequencing of p53 was able to detect mutations in OPB DNA in only two out of 29 patients harbouring a p53-mutated primary tumour. Microsatellite instability was detected in OPB DNA of 11 out of 13 informative (bandshift detected in tumour) patients, whereas cytological analysis detected abnormal cells in only six of the same 13 patients (P ¼ 0.03). In informative patients, all positive OPB samples at cytological analysis were also positive at molecular analysis of UT5085, and both analyses confirmed the two negative samples. Molecular analysis of OPB from eight uninformative patients and from five healthy controls were all negative. OPB sampling with MI-based molecular analysis could be efficient for early detection of recurrent HNSCC. This result prompts us to use other microsatellite markers in order to maximise the percentage of informative patients.

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“…Screening mit nichtendoskopischer Abrasiv-Zytologie (Cytosponge etc.) in Kombination mit Biomarkern Die Anwendung nichtendoskopischer Abrasiv-Zytologie ist ein in Asien und Europa seit langem praktiziertes Verfahren im Screening auf Plattenepithelkarzinome des Ösophagus [50][51][52][53]. Die Verwendung der Abrasiv-Zytologie als Screening-Verfahren auf BE und EAC ist dagegen eine relativ neue Methode (▶ Abb.…”

Section: Erweiterte Auswertung Von Biopsien Auf Biomarker Für Intraepunclassified

Barrett-Screening: rationale, aktuelle Konzepte und Perspektiven

et al. 2020

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ZusammenfassungDer Barrett-Ösophagus (BE) stellt den wichtigsten Risikofaktor für das ösophageale Adenokarzinom dar. Derzeit ist kein hinreichend effizientes Screening-Programm verfügbar, um in der Gesamtpopulation Patienten mit einem hohen Risiko für ein ösophageales Adenokarzinom auf dem Boden eines Barrett-Ösophagus zu identifizieren. Das aktuelle endoskopische Screening zielt auf symptomatische Refluxpatienten, aus denen sich aber nur ein Teil der Risikopatienten rekrutiert. Derzeit werden verschiedene neue Verfahren untersucht, die die Effektivität des Screenings deutlich erhöhen könnten.Selektive Literaturrecherche in MEDLINE/PubMed unter Berücksichtigung deutscher und internationaler Leitlinien.Alternative Screening-Verfahren könnten 2-stufig angelegt sein: Zunächst die Identifikation von Personen „at risk“ über eine Erfassung geeigneter biologischer Marker, dann deren gezielte endoskopisch-bioptische Abklärung, Risikostratifikation, Überwachung (Surveillance) und ggf. Therapie. Neue diagnostische Methoden wie der Cytosponge® in Kombination mit einer Auswertung von Markern für Barrett-Schleimhaut könnten einen wesentlichen Fortschritt darstellen.Barrett-Karzinome zeigen nach wie vor eine zunehmende Inzidenz und eine (trotz therapeutischer Fortschritte) ungünstige Prognose, wobei aber Patienten mit Barrett-Frühkarzinomen eine gute Prognose hinsichtlich Langzeitüberleben aufweisen. Eine verbesserte Früherkennung ist dringend wünschenswert, da bisher die meisten Patienten erst im fortgeschrittenen Stadium endoskopisch diagnostiziert werden, was eine kurative Therapie erschwert. Nur eine effiziente frühzeitige Identifizierung von Risikopatienten mit Barrett-Ösophagus durch ein praktikables Screening-Programm auf Populationsebene wird zur Verbesserung der Prognose beitragen können.

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Abrasive Esophageal Cytology for the Oncological Follow‐Up of Patients With Head and Neck Cancer

Abstract: For patients with head and neck cancer, abrasive sponge cytology is useful for detecting esophageal cancer at an early stage. In addition, it may reveal unsuspected second primaries or recurrences in the head and neck region.

Cited by 14 publications

References 23 publications

Transoral Laser Surgery for Pharyngeal and Pharyngolaryngeal Carcinomas

Transoral Laser Surgery for Pharyngeal and Pharyngolaryngeal Carcinomas

Cytology vs molecular analysis for the detection of head and neck squamous cell carcinoma in oesopharyngeal brush samples: a prospective study in 56 patients

Barrett-Screening: rationale, aktuelle Konzepte und Perspektiven

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