Method
A retrospective review of electronic medical records was conducted on
consecutive patients with newly diagnosed and untreated HNSCCsin a
tertiary referral center. In our center, newly diagnosed HNSCC patients
were screened with oesophagoscopy and bronchoscopy at the time of
diagnosisand therefore all patients were included in the study.The
endoscopic procedure was done in outpatient setting under local
anesthesia and using trans-nasal flexible endoscopy. With the
trans-nasal flexible endoscopy, the nasopharyngeal, oropharyngeal,
laryngeal, and pharyngeal areas will be inspected, following by
oesophagoscopy (for oesophagus down to oesophageal gastric junction) and
bronchoscopy (for tracheobronchial tract).
Synchronousmalignancies were defined as malignancies that were detected
during the initial workup upon the diagnosis of the primary malignancy
at other sites in the upper aerodigestive tract.Exclusion criteria
included HNSCC arising fromnon-aerodigestive tract region in head and
neck region (ear, skin, salivary glands, lacrimal glands), tumorswith
non-squamous cell carcinomas histology, patient with history of
nasopharyngeal carcinomas, patients with previous history of irradiation
and patients of non-East Asian ethnicity. Information regarding
patient’s demographics, subsites and staging of primary and
synchronousmalignancies, pickup rate by other means of investigations
like PET-CT (Positron emission tomography- computed tomography scan),
survival statistics (disease free survival and overall survival) will be
recorded and studied. Staging of primary and synchronousmalignancies was
done in accordance to the eighth edition of the AJCC Cancer Staging
Manual (TNM classification from the American Joint Committee on Cancer
[AJCC]).
All data was input into Excel spreadsheets (Microsoft Excel for Mac 2013
version 15; Microsoft Corporation, Redmond, Washington). Data analysis
was done with SPSS version 24.0 software (IBM, Armonk, New York).
Differences in means for normally distributed variables was assessed
with 2-tailed unpaired t test. Differences in means for non-normally
distributed variables was assessed with Mann-Whitney U test. P value was
set at <0.05 to be statistically significant.