The role of esophagoscopy and imaging in the detection of second esophageal primary carcinomas in mucosal head and neck malignancy

Abstract

ObjectiveEsophagoscopy and/or barium swallow are routinely performed in the evaluation of patients with mucosal head and neck malignancies. Whether this intervention is efficient or cost-effective is questioned in our multidisciplinary head and neck tumor clinic. Our study objective is to find the yield provided by esophagoscopy and barium swallow, and the incidence of second primary cancers. Study DesignRetrospective case series. MethodsA retrospective chart review was done on patients treated at our institution for squamous cell carcinomas of the head and neck over a period of 8 years. The records of five hundred and ninety-four patients were analyzed to determine the method by which the cancer was diagnosed, the association with a particular region of the primary cancer, and the incidence of risk-increasing behavior. ResultsFive patients (0.84%) were found to have a second neoplasm of the esophagus. Of these, three patients (0.5%) had metachronous and two (0.34%) had a synchronous lesion. Three were diagnosed with barium swallow and two during routine endoscopy. The primary tumors were of the oral cavity in three patients and of the glottis and/or hypopharynx in two patients. All patients had a history of tobacco or alcohol abuse. ConclusionThe incidence of a second cancer of the esophagus in head and neck cancer patients was low. Esophagoscopy and barium swallow are safe and reliable methods to detect an esophageal lesion.