Screening and surveillance of esophageal cancer by magnifying endoscopy with narrow band imaging improves the survival of hypopharyngeal cancer patients

Abstract

IntroductionPatients with head and neck cancer may develop a second primary neoplasm (SPN) of the esophagus due to field cancerization. This study investigated the impacts of esophageal cancer screening using magnifying endoscopy with narrow-band imaging (ME-NBI) on the outcomes of hypopharyngeal cancer patients.MethodsPatients with hypopharyngeal cancer diagnosed from 2008 to 2021 in a tertiary hospital were reviewed retrospectively. Screening and surveillance using ME-NBI examination of the esophagus were divided into three patterns: (1) ME-NBI never performed or more than 6 months after diagnosis of index primary hypopharyngeal cancer, (2) ME-NBI within 6 months only, and (3) ME-NBI within 6 months and regular surveillance.ResultsA total of 261 were reviewed and 21 (8%) patients were in stage I, 20 (8%) in stage II, 27 (10%) in stage III, 116 (44%) in stage IVA, 65 (25%) in stage IVB, and 12 (5%) in stage IVC. Sixty-seven (26%) patients had SPN (50 esophagus, 10 oral cavity, 3 oropharynx, 2 nasopharynx, 1 larynx and 1 lung). Among esophageal SPN, 35 (70%) and 15 (30%) patients developed synchronous and metachronous neoplasia, respectively. In multivariate Cox regression analysis, advanced stages III and IV (compared with stages I and II, HR: 1.86, 1.18-2.95, p=0.008), ME-NBI examination of the esophagus received within 6 months and regular surveillance (HR: 0.53, 0.36-0.78, p=0.001) were independent factors affecting the overall survival of patients with hypopharyngeal cancer.DiscussionOur findings demonstrated that screening and surveillance of esophageal SPN by ME-NBI improves the survival of patients with hypopharyngeal cancer.

The usefulness of narrow-band Imaging (NBI) in nasopharyngeal lesions—Validation of the Ni NBI classification dedicated for vascular pattern in the nasopharynx

“…Yet another issue is that the diagnostic accuracy of NBI has been found to be similar in different upper airway and upper digestive tract locations, assessment types, endoscope systems, as well as in the use of high-definition visualization [ 19 , 20 ]. Thus, NBI may represent a vital additional tool for differentiating between benign and malignant lesions in the nasopharynx [ 19 ].…”

“…The recommendations for the diagnosis, treatment, and follow-up of NPT in the regions where NPC is endemic, include the use of plasma EBV DNA with a primer/probe assay targeting the BamHI-W region of the EBV genome, performed in duplicate and coupled with endoscopic examination and MRI. This study demonstrated a sensitivity and specificity in screening NPC of 97.1% and 98.6%, respectively [ 20 ]. The recommended endoscopic methods in the abovementioned areas include WLI and NBI [ 21 ].…”