Tu1192 Clinical Significance of Detecting Early Esophageal Cancer in Patients With Head and Neck Cancer

Abstract

Aims: The efficacy of endoscopic screening for esophageal cancer (EC) in patients with head and neck cancer (HNC) remains controversial and its impact on the patient prognosis has not been adequately discussed. We have attempted to provide clinical data regarding the usefulness of endoscopic screening for early EC in patient with HNC. Materials and Methods: We retrospectively reviewed a total of 714 HNCs (oral cavity in 236, pharynx in 224, and larynx in 254 patients) which were pathologically confirmed as squamous cell carcinoma. Results: Of the 714 patients, 590 (82.6%) were males; median age was 59.6 years. Thirtysix ECs were detected in 36 (5%) patients (28 synchronous and 8 metachronous). The median interval time between the diagnosis of HNC and EC was 7.78 months (range: 0-72 months). Among the 36 ECs, the early and advanced EC numbered 17 (47.2%) and 18 (52.8%), respectively. The three-year overall survival rates in patients with HNC only and in HNC combined with EC, were 71.2% and 48.2%, respectively (P <0.001). In 36 patients with EC, the three-year overall survival rates with early and advanced EC were 77.7% and 21.7%, respectively (P =0.01). On multivariate analysis, the location of HNC (pharynx) was associated with the development of second primary EC (Odds ratio 3.916, P = 0.018). Conclusions: This study showed a high incidence of EC in HNC patients. In our study patients with HNC, early EC was associated with a good prognosis compared with that seen in advanced EC. Therefore, endoscopic screening to detect early EC in HNC is necessary.