The incidence and diagnosis of secondary esophageal carcinoma in the head and neck cancer patient.

The historical development of additional primary neoplasms of the esophagus is traced. To determine the incidence and time of appearance of these esophageal malignancies, a retrospective study of 790 head and neck cancer patients was conducted. In addition, a prospective study of 268 head and neck cancer patients was undertaken to determine the optimum diagnostic approach for esophageal neoplasms. All patients in the prospective study had a pharyngoesophagogram plus esophagoscopy as part of the initial diagnostic evaluation. The false negative rate of the pharyngoesophagogram was 72.2% in patients with esophageal pathology. In patients with esophageal malignancies it was 80%. Esophagoscopy should be a part of the initial evaluation of every patient with an upper aerodigestive tract primary malignancy.