The Justifications and Controversies of Panendoscopy – A Review

Levine, Brett R.

doi:10.1177/014556139207100802

Cited by 19 publications

(12 citation statements)

References 30 publications

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“…Levine and Nielsen reported that the approximate cost of performing a panendoscopy with biopsy as a day-surgery procedure without an overnight hospital stay is approximately $2,000, plus or minus about $500. 14 In our study, we found that the total cost was roughly $3,100.…”

Section: Discussionmentioning

confidence: 58%

Utility of Panendoscopy for the Detection of Unknown Primary Head and Neck Cancer in Patients with a Negative PET/CT Scan

Pattani¹,

Goodier

Lilien

et al. 2011

Ear Nose Throat J

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We conducted a retrospective review of the records of 23 patients who had been diagnosed with regionally metastatic head and neck squamous cell carcinoma from an unknown primary tumor. Our goal was to assess the utility of panendoscopy in locating the primary tumor in those patients whose positron-emission tomography/computed tomography (PET/CT) fi ndings were negative. Overall, we found that PET/CT had correctly identifi ed the unknown primary in 12 of the 23 patients (52%); panendoscopy confi rmed this fi nding in all 12. Of the remaining 11 patients, however, panendoscopy located the primary tumor in only 1 (9%). In this era of cost containment and ongoing advances in imaging and transnasal esophagoscopy, it is important to revisit the workup of an unknown primary in patients with a negative PET/CT scan. Th ere are various advantages and disadvantages to performing panendoscopy with biopsy in patients with an unknown primary and a negative PET/CT scan, but our results and the fi ndings of others indicate that it will detect the primary in only about 10% of these cases. We recommend careful selection of patients who are to undergo panendoscopy for the routine workup of an unknown primary.

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Section: Discussionmentioning

confidence: 58%

Utility of Panendoscopy for the Detection of Unknown Primary Head and Neck Cancer in Patients with a Negative PET/CT Scan

Pattani¹,

Goodier

Lilien

et al. 2011

Ear Nose Throat J

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“…Studies have shown that rigid endoscopy is superior to barium swallow as the principle means of diagnosing UADT malignancy 17–21 . There are also concerns about radiation exposure with barium swallows being equivalent to 75 Chest X‐rays 22…”

Section: Discussionmentioning

confidence: 99%

“…17 Studies have shown that rigid endoscopy is superior to barium swallow as the principle means of diagnosing UADT malignancy. [17][18][19][20][21] There are also concerns about radiation exposure with barium swallows being equivalent to 75 Chest X-rays. 22 Using TNFLO, the authors have been able to discharge the majority of patients with globus (89.1%) and 47.8% of those with dysphagia after the initial visit to the department.…”

Section: Diagnosticsmentioning

confidence: 99%

How we do it: The role of trans‐nasal flexible laryngo‐oesophagoscopy (TNFLO) in ENT: one year's experience in a head and neck orientated practice in the UK

Price

Sharma

Snelling

et al. 2005

Clinical Otolaryngology

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KEYPOINTS: Transnasal flexible laryngo-oesophagoscopy (TNFLO) is a safe and well-tolerated procedure that may be performed in a procedure room in the outpatient or day-case/main theatre setting. It requires a local anaesthetic and no sedation. It may be used to histologically diagnose or exclude pathology from the nose to the gastro-oesophageal junction. It provides a "one stop" diagnosis service, reducing diagnostic delays, the need for endoscopy under general anaesthesia, barium swallows and follow-up outpatient appointments. Therapeutic procedures such as vocal cord medialization, endolaryngeal laser surgery, insertion of speech prostheses and foreign body removal may be performed without general anaesthesia.

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“…The concept of field cancerization is the basis for most of our diagnostic and follow up protocols for HNSCC patients. This includes routine panendoscopy and PET-CT scanning in many centers for detection of second primary tumours in this musocal field [12,13]. …”

Section: Introductionmentioning

confidence: 99%

HPV Status and second primary tumours in Oropharyngeal Squamous Cell Carcinoma

Biron

Puttagunta

et al. 2013

Journal of Otolaryngology - Head & Neck Surgery

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IntroductionsThe incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCCs) is rising in developed nations. Studies have shown that these virally mediated tumours are epidemiologically, clinically, and biologically different than other head and neck squamous cell carcinomas and traditional concepts of field cancerization may not apply to HPV-related oropharyngeal cancer.ObjectiveThe purpose of this study was to evaluate the rate of second primary tumors and the diagnostic yield of field cancerization work up in the upper aerodigestive tract in patients with HPV-related and HPV-unrelated oropharyngeal squamous cell carcinoma.DesignRetrospective review.SettingTertiary cancer care centers in Alberta.MethodsRetrospective review of 406 patients diagnosed with OPSCC in Alberta between 2005 and 2009. HPV-status of tumours was determined by tissue microarray using immunohistochemistry staining for p16.Main outcome measuresPrimary outcome: incidence of upper aerodigestive tract second primary tumours in p16-positive versus p16-negative OPSCC. Secondary outcomes: diagnostic yield of traditional field cancerization work-up in p16-positive versus negative patients.ResultsThe overall rate of SPTs was 7.4% (30/406). The incidence rate of SPTs was significantly lower in p16-positive patients (0.7 per 100 patient-yrs vs. 8.5 in p16-negative, p < 0.0001). Field cancerization work-up for synchronous lesions in the upper aerodigestive tract, including panendoscopy and whole-body PET-CT, had decreased diagnostic yield in p16-positive patients (2.8% vs. 10.2% in HPV-negative patients, p=0.02).ConclusionsPatients with HPV-related OPSCC, who are non-smokers have decreased risk of developing second primary tumours in the upper aerodigestive tract and have low yield on field cancerization work-up. This study provides further evidence that virally mediated OPSCC are distinct and may benefit from alternate diagnostic pathways.

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The Justifications and Controversies of Panendoscopy – A Review

Cited by 19 publications

References 30 publications

Utility of Panendoscopy for the Detection of Unknown Primary Head and Neck Cancer in Patients with a Negative PET/CT Scan

Utility of Panendoscopy for the Detection of Unknown Primary Head and Neck Cancer in Patients with a Negative PET/CT Scan

How we do it: The role of trans‐nasal flexible laryngo‐oesophagoscopy (TNFLO) in ENT: one year's experience in a head and neck orientated practice in the UK

HPV Status and second primary tumours in Oropharyngeal Squamous Cell Carcinoma

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