Tu1588 Safety and Feasibility of Endoscopic Submucosal Fine Needle Injection of Gold Fiducial Markers for Esophageal Cancer
2015
Tu1586 Routine Endoscopic Screening for Synchronous Esophageal Neoplasm in Patients With Head and Neck Squamous Cell Carcinoma: a Prospective Study Eun Jeong Gong*, Do Hoon Kim, Ji Yong Ahn, Kwi-Sook Choi, Kee Wook Jung, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea (the Republic of) Background: Early detection of synchronous esophageal squamous cell neoplasm (ESCN) in head and neck squamous cell carcinoma (HNSCC) patients can significantly affect their prognosis. We prospectively investigated the efficacy of routine endoscopic screening for synchronous ESCN by analyzing its incidence, risk factors, and patient survival. Methods: Subjects who were diagnosed as HNSCC from May 2010 to January 2014 were eligible. All patients underwent conventional white light endoscopic examinations with narrow band imaging and Lugol chromoendoscopy. Results: Among 458 subjects screened, 28 synchronous ESCN, including 18 dysplasias and 10 squamous cell carcinomas, were detected in 24 patients (5.2%). The incidence of ESCN was greatest in patients with hypopharyngeal cancer (20.9%), followed by laryngeal cancer (3.8%), oropharyngeal cancer (2.8%), and oral cavity cancer (0.9%). Among 40 patients with pyriform sinus involvement, ESCNwas detected in 19 patients (47.5%), and pyriform sinus involvement was independent risk factor for developing synchronous ESCN by multivariate analysis (odds ratio 171.2, p!0.001). Most patients with synchronous ESCN (22/24, 91.7%) were early stage, and 16 patients (66.7%) received treatment with curative intent. During the follow-up period (median, 24 months), the 3-year overall survival rates for patients with HNSCC was 77.0%. The survival 3-year overall survival rate was significantly lower in patients with ESCN than in patients without ESCN (54.2 vs. 78.3%, pZ0.0013). Conclusions: Routine endoscopic screening for detecting synchronous ESCN should be recommended for patients with HNSCC, especially those with pyriform sinus involvement. The early detection of ESCN may improve prognosis of patients with HNSCC.
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