Abstract
Due to advanced disease at the time of diagnosis the prognosis of oesophageal cancer is generally poor. As mass screening for oesophageal cancer is neither feasible nor reasonable, high-risk groups should be identified and surveilled. The aim of this study was to define the risk of oesophageal cancer in patients with (previous) head and neck cancer. A total of 148 patients with (previous) head and neck cancer were prospectively screened for oesophageal cancer by video-oesophagoscopy and random oesophageal biopsies. Even in a macroscopically normal looking oesophagus, four biopsy specimens were taken every 3 cm throughout the entire length of the squamous oesophagus. Low- or high-grade squamous cell dysplasia was detected histologically in 10 of the 148 patients (6.8%). All but one dysplasias were diagnosed synchronously with the head and neck cancers. In addition, oesophageal squamous cell carcinoma was diagnosed in 11 of the 148 patients (7.4%). Most invasive cancers (63.6%) occurred metachronously. The risk of squamous cell neoplasia of the oesophagus is high in patients with (previous) head and neck cancer. Surveillance is recommended in this high-risk group.
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Acknowledgements
We thank the nurses of the Central Endoscopy Unit, University Hospital Benjamin Franklin, FU Berlin, for their excellent support of this study. We are indebted to CM deVilliers, C Ell, M Hollstein, H Makuuchi, T Ponchon and M Stolte for reading the manuscript and helpful suggestions.
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Scherübl, H., Lampe, B., Faiss, S. et al. Screening for oesophageal neoplasia in patients with head and neck cancer. Br J Cancer 86, 239–243 (2002). https://doi.org/10.1038/sj.bjc.6600018
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DOI: https://doi.org/10.1038/sj.bjc.6600018
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