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Value of oesophagoscopy and bronchoscopy in diagnosis of synchronous malignancies in patients with head and neck squamous cell carcinomas: a 10-year single center experience in Chinese population.
  • Shi Yeung Ho,
  • Raymond Tsang
Shi Yeung Ho
Queen Mary Hospital
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Raymond Tsang
University of Hong Kong
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Abstract

Title Value of oesophagoscopy and bronchoscopy in diagnosis of synchronous malignancies in patients with head and neck squamous cell carcinomas: a 10-year single center experience in Chinese population. Objectives Routine screening of patients with head and neck squamous cell carcinomas (HNSCCs) for synchronous malignancies using oesophagoscopy and bronchoscopy had been controversial. The aim of this study is therefore to find out the rate of synchronous malignancies in patients with primary HNSCCs, the risk factors for its occurrence and the effectiveness of oesophagoscopy and bronchoscopy in a single center with Chinese population. Method A retrospective review of medical records was conducted from July 2008 to June 2018 in a tertiary referral center in Hong Kong. All patients with newly diagnosed HNSCCs were screened with oesophagoscopy and bronchoscopy at the time of diagnosis and therefore all patients were included in the study. The incidence of synchronous malignancies along the aerodigestive tract and the yield of oesophagoscopy and bronchoscopy were studied. Result Of the 702 patients included in the study, the overall rate of synchronous malignancies was 8.3% (58/702), with the rate of synchronous esophageal and lung malignancies being 5.8% (41/702) and 0.85% (6/702) respectively. 14 out of the 41 esophageal malignancies were only detectable with esophagoscopy. Only one of the synchronous lung malignancies was detectable by bronchoscopy. Risk factors for synchronous malignancies include male gender, smokers, drinkers and primary hypopharyngeal cancer. Conclusion Oesophagoscopy is essential for detecting synchronous esophageal malignancies in patients with HNSCC especially in male patients, smokers, drinkers and primary hypopharyngeal cancer patients. Bronchoscopy had a low yield for synchronous lung malignancies and can be potentially replaced by imaging techniques.