Endoscopic Diagnosis and Treatment of Primary Esophageal Cancer Associated with Head and Neck Cancer

Eiji Ako, Yoshito Yamashita, Masaichi Ohira, Naoshi Kubo, Kazuya Muguruma, Tetsuji Sawada, Makoto Kusuki*, Hiroyoshi Iguchi*, Hideo Yamane* and Kosei Hirakawa

Department of Surgical Oncology and Department of Otolaryngology*, Osaka City University Graduate School of Medicine

Introduction: Esophageal cancer is frequently accompanied by other primary cancer, especially head and neck cancer (HNC). We endoscopically diagnosed and treated primary esophageal cancer associated with head and neck cancer. Materials and Methods: From 2000 to October, 2004, we conducted upper gastrointestinal (UGI) endoscopy with iodine staining in 150 patients with HNC. Results: Single unstained lesions were seen in 23 cases, including 5 cancers, multiple unstained lesions were seen in 38 cases, including 9 cancers. Of the 14 patients with multiple primary cancer of HNC and esophageal cancer, 13 with early esophageal cancer, 11 patients had stage IV HNC. The sake and Brinkman index in patients with multiple primary cancer did not have a difference in comparison with nonmultiple primary cancer patients significantly. Four with simultaneous esophageal cancer and HNC were treated for both by chemoradiotherapy (CRT). Among 10 already undergoing CRT for HNC, 7 with controlled HNC had operation or endoscopic mucosal resection (EMR) based on treatment planned for esophageal cancer. Conclusions: It is important to diagnose esophageal cancer by UGI endoscopy as early as possible in patients with HNC. To treat esophageal cancer discovered in this screening, therapy depends on treatment timing and HNC progression.

Key words
esophageal cancer, head and neck cancer, multiple primary cancer, upper gastrointestinal endoscopy

Reprint requests
Yoshito Yamashita Department of Surgical Oncology, Osaka City University Graduate School of Medicine
1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585 JAPAN

Accepted
April 27, 2005

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