Primary lung cancer after treatment of head and neck cancer without lymph node metastasis: Is there a role for autofluorescence bronchoscopy?

Risk of lung cancer in patients with preinvasive bronchial lesions followed by autofluorescence bronchoscopy and chest computed tomography

“…In support of the field cancerisation theory [18][19][20], we found that patients with new SD detected during follow-up were at higher risk for CIS and LC. Also, most (17/20) of the detected LC developed at sites different from the follow-up sites.…”

Diagnostic value of autofluorescence bronchoscopy in lung cancer

“…Some of the fluorophores are collagen, elastine, tryptophane, flavins, nicotinamide adenine dinucleotide hydrogen (NADH) and porphyrin The intensity of the autofluorescence emission generated by the fluorophores depends on their concentration, their maximal absorption, scattering, and on the characteristics of the light source. It is believed that the concentration of the fluorophores in the pathologically changed bronchial mucosa is significantly higher than in normal bronchial mucosa 12–19 . In an AFI examination normal mucosa appears green, while pathologically altered mucosa is magenta or red‐brown.…”

“…The significant value of AFB in the detection of premalignant lesions is validated through a large number of published clinical evaluations. Accurate detection of these lesions, visual classification, and histological confirmation are improved with the use of AFB in comparison to white light bronchoscopy 12–19 . However, there are still many ongoing trials aimed at evaluating the efficiency of AFB in the detection of pre‐malignant bronchial lesions.…”

Second primary lung cancer or double cancer of the aerodigestive tract?

“…In the December 2008 issue of Lung Cancer Lee et al [1] reported on second primary lung cancer (SPLC) in patients with curatively treated head and neck cancer (HNC) without lymph node metastases. In 51 patients, referred to the pulmonary department for radiological abnormalities and/or symptoms of lung cancer between 1995 and 2005, and prospectively followed until December 2006, the authors detected 42 cases of SPLC.…”

“…The diagnosis of double cancer of the aerodigestive tract substantially influences the treatment modality, especially avoiding mutilating surgery. The prognosis of such patients mostly depends on lung cancer: Lee et al [1] reported all 12 deaths due to lung cancer in 34 patients with HNC and SPLC. Between 1968 and 1983, 99 patients were treated for double primary cancer of the aerodigestive tract at the Institute of Oncology Ljubljana (Slovenia) [6].…”