The benefit of pretreatment esophageal screening with image-enhanced endoscopy on the survival of patients with hypopharyngeal cancer

Quantification of tumor infiltrating Foxp3+ regulatory T cells enables the identification of high-risk patients for developing synchronous cancers over upper aerodigestive tract

“…This study consecutively recruited 300 patients who underwent meticulous endoscopic screening of the upper aero-digestive tract with image-enhanced endoscopy, including narrow-band imaging (NBI) and Lugol chromoendoscopy [8][9][10], from January 2008 to January 2011. Of these patients, 100 had ESCC only, 150 had HNSCC only, and 50 had synchronous SCC simultaneously in both esophagus and the head neck regions.…”

“…Based on the well-established concept of field cancerization [4], the patients with ESCC or HNSCC may develop synchronous multifocal squamous cancers over the UADT [5][6][7][8][9][10]. The repetitive exposures to the common carcinogens are proposed to lead into genetic alterations in multi-focal locations of the UADT fields and ultimately develop with synchronous SCC with worse survival [5][6][7].…”

Image‐enhanced endoscopy for detection of second primary neoplasm in patients with esophageal and head and neck cancer: A systematic review and meta‐analysis

“…Cancers of the esophagus and the head and neck regions are common leading malignancies worldwide, especially in areas where the consumption of carcinogens, such as alcohol, cigarettes, and betel nuts, is prevalent . Because the mucosa of the esophagus and the head and neck regions are always chronically exposed to the accumulation of carcinogens, synchronous or metachronous tumorigenesis in these areas is not uncommon in what is known as “field cancerization.” Although there have been improvements in multidisciplinary treatment strategy, the outcomes of these malignancies are still poor because diagnosis occurs in later symptomatic stages, especially for those with synchronous or metachronous second primary neoplasms . Therefore, the early diagnosis and treatment of a second primary neoplasm is of paramount importance to improving overall outcomes …”

“…With the use of these image‐enhanced endoscopy screening methods in high‐risk populations, a substantial proportion of second primary neoplasms could be identified at early stages before symptoms appear . In addition, the detection of synchronous lesions not only modifies the treatment planning, but also leads to better survival of those with index primary tumors …”

Human papillomavirus infection on initiating synchronous esophageal neoplasia in patients with head and neck cancer

“…Based on field cancerization theory, patients with HNSCCs, especially those with oropharyngeal and hypopharyngeal cancers, frequently developed synchronous esophageal cancers . A strategy to meticulously screen the upper aerodigestive tract, including head and neck mucosa and esophagus, with image‐enhanced endoscopy has been initiated since 2008 at E‐DA Hospital (Kaohsiung, Taiwan), as previously described . This study consecutively recruited 50 patients who had synchronous SCCs simultaneously in both the head neck regions and esophagus (synchronous group) from January 2008 to January 2011.…”