Vol 13: Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case-control study.Report as inadecuate



 Vol 13: Risk factors for second primary neoplasia of esophagus in newly diagnosed head and neck cancer patients: a case-control study.


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This article is from BMC Gastroenterology, volume 13.AbstractBackground: The prevalence of esophageal neoplasia in head and neck H&N cancer patients is not low; however, routine esophageal surveillance is not included in staging of newly-diagnosed H&N cancers. We aimed to investigate the risk factors for synchronous esophageal neoplasia and the impact of endoscopy on management of H&N cancer patients. Methods: A total of 129 newly diagnosed H&N cancer patients who underwent endoscopy with white-light imaging, narrow-band imaging NBI with magnifying endoscopy ME, and chromoendoscopy with 1.5% Lugol’s solution, before definite treatment were enrolled prospectively. Results: 60 esophageal lesions were biopsied from 53 41.1% patients, including 11 low-grade, 14 high-grade intraepithelial neoplasia and 12 invasive carcinoma in 30 23.3% patients. Alcohol consumption odds ratio OR 5.90, 95% confidence interval CI 1.23-26.44, advanced stage stage III and IV of index H&N cancers OR 2.98, 95% CI 1.11-7.99, and lower body mass index BMI every 1-kg-m2 increment with OR 0.87, 95% CI 0.76-0.99 were independent risk factors for synchronous esophageal neoplasia. NBI with ME was the ideal screening tool sensitivity, specificity, and accuracy of 97.3%, 94.1%, and 96.3%, respectively, for detection of dysplastic and cancerous esophageal lesions. The treatment strategy was modified after endoscopy in 20 15.5% patients. The number needed to screen was 6.45 95% CI 4.60-10.90. Conclusions: NBI-ME surveillance of esophagus should be done in newly-diagnosed H&N cancer patients, especially those with alcohol drinking, lower BMI, and advanced stage of primary tumor.



Author: Chung, Chen-Shuan; Liao, Li-Jen; Lo, Wu-Chia; Chou, Yueh-Hung; Chang, Yi-Chen; Lin, Yu-Chin; Hsu, Wei-Fan; Shueng, Pei-Wei; Lee, Tzong-Hsi

Source: https://archive.org/







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