Hypopharyngeal cancer associated with synchronous oesophageal cancer: risk factors and benefits of image-enhanced endoscopic screening

J Laryngol Otol. 2018 Feb;132(2):154-161. doi: 10.1017/S0022215117002493. Epub 2017 Dec 14.

Abstract

Objectives: To explore the risk factors associated with the occurrence of synchronous oesophageal cancer in patients with hypopharyngeal cancer, and to investigate the roles of image-enhanced endoscopic screening in the prediction and diagnosis of early oesophageal cancer.

Methods: The clinical characteristics of patients with hypopharyngeal cancer (n = 160) were analysed. All patients underwent laryngoscopic and gastroscopic examination using image-enhanced endoscopic techniques before treatment.

Results: Of 160 hypopharyngeal cancer patients, 43 (27 per cent) had synchronous oesophageal cancer. Heavy drinking (odds ratio = 4.787, p = 0.029) and local invasion of three or more anatomical sites (odds ratio = 14.391, p = 0.000) were independent risk factors for synchronous oesophageal cancer. Narrow-band imaging laryngoscopy could detect more invaded anatomical sites than ordinary white light endoscopy (t = 8.532, p = 0.000). More early oesophageal cancer cases were detected with Lugol chromoendoscopy than with non-Lugol iodine staining examination (χ2 = 4.925, p = 0.026).

Conclusion: Synchronous oesophageal cancer is common in patients with hypopharyngeal cancer. The heavy drinking patients with hypopharyngeal cancer should undergo intensive monitoring. Image-enhanced endoscopic screening is helpful in the prediction and early detection of second primary oesophageal cancer.

Keywords: Chromoendoscopy; Endoscopic Screening; Esophageal Cancer; Hypopharyngeal Cancer; Narrow Band Imaging; Second Primary Cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / diagnostic imaging*
  • Esophageal Neoplasms / diagnostic imaging*
  • Esophagoscopy* / methods
  • Female
  • Humans
  • Hypopharyngeal Neoplasms / diagnostic imaging*
  • Image Enhancement / methods
  • Laryngoscopy* / methods
  • Male
  • Middle Aged
  • Narrow Band Imaging / methods
  • Neoplasms, Multiple Primary / diagnostic imaging*
  • Retrospective Studies
  • Risk Factors