Clinical impact of surveillance for head and neck cancer in patients with esophageal squamous cell carcinoma

Abstract

AIMTo evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).METHODSSince 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.RESULTSA total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.CONCLUSIONSurveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.

Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer

“…Regarding surveillance methods, many studies reported on the use of endoscopy for head and neck cancer, and the cumulative incidence of head and neck cancer was 3.2–12.1% . Katada et al .…”

Skill‐up study of systemic endoscopic examination technique using narrow band imaging of the head and neck region of patients with esophageal squamous cell carcinoma: Prospective multicenter study

“…Our previous study showed that HNSCC detection rate without or with surveillance for HN region by NBI was 0.3% and 3.9%, respectively. 7 The sample size for this trial was sufficient to show an improved detection rate by 4% or more following the training program. Therefore, we assumed the histologically confirmed HNSCC detection rate before and after the training program to be 1% and 5%, respectively.…”

“…Almost all superficial HNSCC detected using NBI can be cured with favorable prognoses following endoscopic resection or partial resection . Morimoto et al . reported that head and neck surveillance using NBI increased the superficial HNSCC detection rate in patients with ESCC, and that this reduced the serious event rates associated with advanced metachronous HNSCC, including laryngeal function loss and death.…”

“…Almost all superficial HNSCC detected using NBI can be cured with favorable prognoses following endoscopic resection or partial resection. 5,6 Morimoto et al 7 reported that head and neck surveillance using NBI increased the superficial HNSCC detection rate in patients with ESCC, and that this reduced the serious event rates associated with advanced metachronous HNSCC, including laryngeal function loss and death. However, expert endoscopic techniques are necessary to survey the head and neck region for the presence of superficial cancers; therefore, training in endoscopic techniques that can detect superficial HNSCC is essential if they are to become more widely used, even among beginner endoscopists.…”

Pharyngeal observation via transoral endoscopy using a lip cover‐type mouthpiece

“…These anatomically adjacent sites in the hypopharynx constitute a closed space, which disturbs us to notice subtle changes in the mucosa during endoscopic observation. Consequently, cancers in this area are detected as advanced cancers requiring invasive treatment, such as surgical resection or chemoradiotherapy, which might not be curative . Therefore, appropriate observation of blind areas, including the postcricoid area and the posterior hypopharyngeal wall, is essential for early cancer detection.…”