Endoscopy 2021; 53(S 01): S104
DOI: 10.1055/s-0041-1724524
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Screening for Synchronous Esophageal Second Primary Tumors in Patients With Head and Neck Cancer

SEM van de Ven
1   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
W de Graaf
1   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
O Bugter
2   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Otorhinolaryngology and Head and Neck Surgery, Rotterdam, Netherlands
,
MCW Spaander
1   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
S Nikkessen
1   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
PJF de Jonge
1   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
JA Hardillo
2   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Otorhinolaryngology and Head and Neck Surgery, Rotterdam, Netherlands
,
A Sewnaik
2   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Otorhinolaryngology and Head and Neck Surgery, Rotterdam, Netherlands
,
DA Monserez
2   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Otorhinolaryngology and Head and Neck Surgery, Rotterdam, Netherlands
,
H Mast
3   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Oral and Maxillofacial Surgery, Rotterdam, Netherlands
,
S Keereweer
2   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Otorhinolaryngology and Head and Neck Surgery, Rotterdam, Netherlands
,
MJ Bruno
1   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
RJ Baatenburg de Jong
2   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Otorhinolaryngology and Head and Neck Surgery, Rotterdam, Netherlands
,
AD Koch
1   Erasmus MC Cancer Institute, University Medical Center Rotterdam, Gastroenterology and Hepatology, Rotterdam, Netherlands
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Aims Patients with head and neck squamous cell carcinoma (HNSCC) have an increased risk of developing esophageal second primary tumors (SPTs). We aimed to determine the incidence, stage and outcome of synchronous esophageal SPTs in patients with HNSCC in a Western population.

Methods We performed a prospective, observational, cohort study. Patients diagnosed with HNSCC in the oropharynx, hypopharynx, any other sub-location in combination with alcohol abuse, or patients with two synchronous HNSCCs, between February 2019 and February 2020, were included. Screening esophagogastroduodenoscopy (EGD) was performed in all patients during the work-up for HNSCC. In general, EGD was performed with white light high resolution endoscopy, narrow-band imaging and Lugol chromoendoscopy by an experienced interventional endoscopist within two weeks after HNSCC diagnosis. Esophageal SPT was defined as presence of esophageal squamous cell carcinoma (ESCC) or high grade dysplasia (HGD).

Results Eighty-five patients were included. The majority of HNSCC was located in the hypopharynx (33 %) or oropharynx (29 %). A lesion suspected for esophageal SPT was detected in 24 of 85 patients, which was pathologically confirmed in 5 patients (1 ESCC, 4 HGD). The radiotherapy field was extended to the esophagus in 2 of 5 patients, HGD was treated with endoscopic resection in 3 of 5 patients. None of the esophageal SPTs were detected on MRI and/or CT-scan prior to EGD. Of the remaining 19 patients, 3 had low grade dysplasia on histology whereas the other 16 patients had benign lesions.

Conclusions Incidence of synchronous esophageal SPT was 5.9 % in our cohort of HNSCC patients. All SPTs were diagnosed at an early stage and treated with curative intent. We believe that screening for synchronous esophageal SPTs in patients with HNSCC is promising and should be first considered in high-risk patients.

Citation: van de Ven SEM, de Graaf W, Bugter O et al. eP23 SCREENING FOR SYNCHRONOUS ESOPHAGEAL SECOND PRIMARY TUMORS IN PATIENTS WITH HEAD AND NECK CANCER. Endoscopy 2021; 53: S104.



Publication History

Article published online:
19 March 2021

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