Usefulness of Endoscopic Screening for Synchronous Cancer in HNSCC as Initial Baseline Study

Abstract

Objectives: Determine the usefulness of endoscopic screening methods for detecting synchronous malignancies in patients with head and neck carcinoma. Methods: We retrospectively reviewed the medical records of patients who were diagnosed with head and neck mucosal squamous cell carcinoma (oral cavity, oropharynx, nasopharynx, larynx, hypopharynx) between January 2003 and July 2013 in the Department of Otorhinolaryngology, Head and Neck Surgery, Yonsei University Wonju Christian Hospital. Results: Among 285 patients who underwent esophagogastroduodenoscopy and bronchoscopy as initial baseline study, 23 synchronous cancers were diagnosed. Esophageal cancer and lung cancer were diagnosed as the most synchronous cancers (10 lesions each), followed by gastric cancer (2 lesions), and colon cancer (1 lesion). Among these 23 patients, positron emission tomography (PET) or PET/computed tomography (CT) was performed in 14 patients. Of these 14 patients, PET or PET/CT detected 7 of the synchronous cancers. Conclusions: As to their ability in detecting synchronous cancer in head and neck carcinoma, PET or PET/CT showed unsatisfactory detection rate. PET and PET/CT have limitations in the detection of superficial lesions. As initial baseline modality, PET or PET/CT needs supplementary endoscopic studies for the detection of superficial lesions.