Consider Endoscopic Upper GI Screening in Patients With Head and Neck Squamous Cell Cancer
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Consider Endoscopic Upper GI Screening in Patients With Head and Neck Squamous Cell Cancer

Prateek Sharma, MD, FASGE, reviewing van Tilburg L, et al. Endoscopy 2023 Jun 16.

It is known that some patients with head and neck squamous cell carcinoma (HNSCC) can develop a second primary tumor (SPT). Timely detection of SPTs in an early stage through endoscopic screening could significantly enhance survival rates.

A prospective endoscopic screening study from the Netherlands included 202 patients with curably treated HNSCC diagnosed between January 2017 and July 2021. After their diagnosis, patients underwent synchronous (<6 months) or metachronous (≥6 months) screening, performed with flexible transnasal endoscopy and positron emission tomography and computed tomography scans or a magnetic resonance imaging scan. The primary outcome was the prevalence of SPTs, defined as the presence of esophageal high-grade dysplasia or squamous cell carcinoma.

During synchronous and metachronous screenings, a total of 11 SPTs were detected in 10 patients, resulting in a prevalence of 5.0% (95% confidence interval, 2.4%-8.9%). Most SPTs were diagnosed in an early stage (90%) and treated with curative intent through endoscopic resection (80%). Routine imaging for HNSCC before the endoscopic screening did not detect any SPTs.

Prateek Sharma, MD, FASGE

COMMENT

Endoscopic screening in patients with HNSCC detected SPTs in 5% of cases. Endoscopic screening should be considered for a specific group of patients with HNSCC at a higher risk of developing SPTs.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

van Tilburg L, van de Ven SEM, de Jonge PJF, et al. Endoscopic screening of the upper gastrointestinal tract for second primary tumors in patients with head and neck cancer in a Western country. Endoscopy 2023 Jun 16. (Epub ahead of print) (https://doi.org/10.1055/a-2111-5935)

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