Screening Endoscopy Should Be Considered in Patients With Head and Neck Cancer to Identify a Second Primary Esophageal Tumor
Prateek Sharma, MD, FASGE, reviewing Overwater A, et al. Am J Gastroenterol 2022 Feb 25.
Individuals diagnosed with head and neck squamous cell carcinoma (HNSCC) are known to have an increased risk of developing a second primary tumor in the esophagus. This single-center study from the Netherlands identified patients diagnosed with HNSCC to determine the incidence, risk factors, and survival of those found to have a second primary esophageal tumor.
Of the 1708 patients (66.2% male; mean age, 64.4 [11.5] years) with pathology-confirmed HNSCC, 484 (28.3%) underwent an endoscopy after diagnosis, and 47 were found to have a second primary esophageal tumor (SCC, 43; adenocarcinoma, 4). The cumulative incidence of being diagnosed with a second primary esophageal tumor was 2.9% at 10 years. The median time from HNSCC to esophageal tumor diagnosis was 18 months, and 32% (n=15) were identified within 6 months from the original HNSCC diagnosis. The features that significantly increased the risk for a second primary esophageal tumor were HNSCC location (in the oral cavity, hypopharynx, or oropharynx) and consumption of more than 2 standard drinks of alcohol per day. The overall survival was decreased when patients were found to have a second primary esophageal tumor (hazard ratio, 3.36; 95% confidence interval, 2.16-5.22) compared with those without an esophageal tumor.
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.
Overwater A, Rueb K, Elias SG, de Bree R, Weusten BLAM. Esophageal second primary tumors in patients with head and neck squamous cell carcinoma: incidence, risk factors and overall survival. Am J Gastroenterol 2022 Feb 25. (Epub ahead of print) (https://doi.org/10.14309/ajg.0000000000001711)