Endoscopic screening of early esophageal cancer with the Lugol dye method in patients with head and neck cancers

Abstract

The poor prognosis for esophageal cancer could be improved if lesions were detected at an early stage. To detect early esophageal cancer, endoscopic screening of the esophagus with the Lugol dye method was performed in patients with head and neck cancers who were asymptomatic but regarded as being at high risk for synchronous or metachronous esophageal cancer. Of 178 patients screened, 9 had esophageal cancer (5.1%). Eight of these patients (89%) were at early stages with no lymph node metastasis. Most of the lesions (9 of 13 lesions) were not detectable by barium studies or ordinary endoscopic study. The epidemiologic statistical analysis of the patients confirmed that they had a significantly high observed and expected number (O/E) ratio (39.7; P less than 0.001). These results demonstrate the value of endoscopic screening of the esophagus with the Lugol dye method in patients with head and neck cancers and imply that endoscopic screening with the Lugol dye method may be useful for detecting early esophageal cancer in individuals at risk for other causes.

Screening for oesophageal neoplasia in patients with head and neck cancer

“…Various alternative screening strategies have been described. These include brush-capsule cytology (LeoniParvex et al, 2000), biannual oesophageal endoscopy without Lugol staining (Petit et al, 2001), Lugol chromoendoscopy with (Fagundes et al, 1999) or without random biopsies (Shiozaki et al, 1990;Makuuchi et al, 1996), (auto)fluorescence endoscopy (Haringsma et al, 2001) or tri-modal spectroscopy (Georgakoudi et al, 2001). These different strategies have, however, not yet been compared in controlled clinical trials.…”

“…Altogether 13 head and neck cancers had occurred in the 10 patients with oesophageal dysplasia (mean 1.3 HNC per patient). All patients found to suffer from dysplasias or early oesophageal cancer were further examined by chromoendoscopy with Lugol dye solution (Shiozaki et al, 1990;Endo et al, 1986;Sugimachi et al, 1988) and by endoscopic ultrasound (Ziegler et al, 1991). Lugol chromoendoscopy identified all but one dysplastic lesions and proved very helpful in assessing the mucosal extension of early neoplastic lesions ( Figure 1); additional neoplastic foci were not detected by Lugol staining.…”

“…Patients who survived HNC are known to develop a second neoplasm with a risk of 3 -7% per year (Cooper et al, 1989;Sturgis and Miller, 1995). Prospective studies in Japan and recently in Brazil detected oesophageal squamous cell neoplasia in 5.1 -11.8% of HNC patients (Shiozaki et al, 1990;Makuuchi et al, 1996;Tincani et al, 2000). General surveillance of HNC patients is not yet recommended in Western countries, mainly due to a lack of adequate data from this part of the world (Agrawal and Wenig, 1998;Deleyiannis and Weymuller, 1998).…”

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

“…[12][13][14][15] Furthermore, there are few studies assessing the value of colonoscopy for the preoperative work-up in HNSCC patients. 5,6 We hypothesized that colorectal tumor prevalence may be higher in HNSCC patients than in the control group because of shared risk factors, such as smoking, alcohol consumption, and old age, for both HNSCC and colorectal cancer.…”

Valor preditivo da expressão dos anticorpos Antifator VIII no carcinoma epidermóide do esôfago

“…Por ser neoplasia muito agressiva, com características de invasão precoce na submucosa e ocorrência de metástases, tem sobrevida em cinco anos de 10 a 20%, a despeito do tratamento instituído 4 . Quando se consegue tratar doentes com diagnóstico precoce, a sobrevida, em cinco anos, pode chegar até 100% .…”