Introduction
Synchronous malignancies occurring along the upper aerodigestive tract
was originally discovered by Billroth1 and
Slaughter2, with the latter proposing the theory of
‘field cancerization’. The theory of ‘field cancerization’ suggested
that with exposure to tobacco and alcohol, synchronous multifocal
malignancies can occur in oesophagus and lung for patients with primary
head and neck squamous cell carcinomas (HNSCCs). The rate of occurrence
of such synchronousmalignancies can be as high as
23%3-6 and their overall survival can be 50% worse
when compared with first primaries. Oesophagoscopy and bronchoscopy had
beenthe procedure of choice for screening synchronous malignancies along
the upper aerodigestive tract7-9. Debates however
existed on whether the routine use of them were warranted as there were
concerns over risks and cost of procedure and increasing waiting time
before start of treatment10-13. The aim of this study
is therefore to find out the rate of such synchronousmalignancies 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.