Screening for head and neck second primary tumors in patients with esophageal squamous cell cancer: A systematic review and meta‐analysis

Abstract

Background Esophageal squamous cell carcinomas (ESCCs) are often accompanied by head and neck second primary tumors (HNSPTs). The prognosis of patients with an additional HNSPT is worse compared with patients with only ESCC. Therefore, early detection of HNSPTs may improve the overall outcome of patients with ESCC. The purpose of this study was to investigate the yield of endoscopic screening for HNSPTs in patients with primary ESCC. Methods We conducted a systematic literature search of all available databases. Studies were included if ESCC patients were endoscopically screened for HNSPT. The primary outcome was the pooled prevalence of HNSPTs. Results Twelve studies, all performed in Japan, were included in this systematic review with a total of 6483 patients. The pooled prevalence of HNSPTs was 6.7% (95% confidence interval: 4.9–8.4). The overall heterogeneity was high across the studies ( I2 = 89.0%, p < 0.001). Most HNSPTs were low stage (85.3%) and located in the hypopharynx (60.3%). The proportion of synchronous (48.2%) and metachronous (51.8%) HNSPTs was comparable. Conclusion Based on our results, HNSPT screening could be considered in patients with primary ESCC. All studies were performed in Japan; it is therefore not clear whether this consideration applies to the Western world.

UEGWeek: The modern School of Athens

“…In a retrospective cohort study in collaboration with the Netherlands Cancer Registry, including more than 9000 patients with primary esophageal squamous cell carcinoma, a significantly increased risk of both synchronous and metachronous multiple primary tumors was found, with half of them located in the head and neck region 19 . This was further confirmed in a systematic review and meta‐analysis by the same group 20 …”

“…Among the almost 6000 abstracts submitted to 2019 and 2020 UEGWeek editions, 32 were then accepted as full‐text publication to UEG Journal 1–31 . Here we will summarize these “hot” papers (see also Figure 3).…”

Comprehensive Analysis of Multiple Primary Cancers in Patients With Esophageal Squamous Cell Carcinoma Undergoing Esophagectomy

“…Thus, attention should be paid to cancer incidence in these organs. 23 Saito et al 24 recommended routine endoscopic pharyngeal cancer surveillance using narrow-band imaging (NBI) in patients with esophageal cancer. A prospective observational study suggested that routine endo-scopic screening for esophageal cancer using NBI was also important in patients with head and neck SCC.…”

Current Trends in Endoscopic Diagnosis and Treatment of Early Esophageal Cancer

“…As for Barrett’s esophagus, there is no established population-based screening for esophageal squamous cell cancer. However, endoscopic screening should be considered in the presence of risk factors, e.g., after diagnosis of head and neck cancer, in cases of long standing achalasia, or for persons with heavy smoking and drinking [ 40 ]. Vice versa, there is an increased risk for head and neck cancer in patients treated for superficial esophageal squamous cell cancer [ 41 ].…”