Role of Routine Panendoscopy in Cancer of the Upper Aerodigestive Tract

Stoeckli, Sandro J.; R, Zimmermann; Schmid, Stephan

doi:10.1067/mhn.2001.112311

Cited by 52 publications

(43 citation statements)

References 34 publications

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“…In a previous panendoscopy study at our institution most of the synchronous second primaries were found in the upper aerodigestive tract (60%) [6]. In the present study, the minority (27%) of the aerodigestive tract cancers were in the upper part.…”

Section: Discussionsupporting

confidence: 48%

“…For the highest-risk subgroups metachronous SCC occur in about 4% of patients per year [5]. Panendoscopy studies have shown the prevalence of synchronous primary SCC to range from 1.4 to 17% [6]. At our institution a prevalence of second primary tumours detected with panendoscopy of 16.2% has been found, with 6.4% being synchronous and 9.8% being metachronous [6].…”

Section: Introductionmentioning

confidence: 63%

“…Panendoscopy studies have shown the prevalence of synchronous primary SCC to range from 1.4 to 17% [6]. At our institution a prevalence of second primary tumours detected with panendoscopy of 16.2% has been found, with 6.4% being synchronous and 9.8% being metachronous [6]. 18 F-Fluoro-deoxy-glucose positron emission tomography (FDG-PET/CT) is increasingly used for staging of HNSCC with a considerable impact on treatment decisions [7][8][9].…”

Section: Introductionmentioning

confidence: 97%

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Head and neck squamous cell carcinoma (HNSCC) – detection of synchronous primaries with 18F-FDG-PET/CT

Strobel

Haerle

Stoeckli

et al. 2009

Eur J Nucl Med Mol Imaging

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118

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Purpose The aim of the study was to evaluate 18 F-FDG-PET/CT for the detection of synchronous primaries at initial staging of patients with head and neck squamous cell carcinoma (HNSCC). Methods FDG-PET/CT images acquired between March 2001 and October 2007 in 589 consecutive patients (147 women, 442 men; mean age 61.5 years, age range 32-97 years) with proven HNSCC were reviewed for the presence of synchronous primaries. Cytology, histology and/or clinical and imaging follow-up served as reference standard.Results FDG-PET/CT showed 69 suspected synchronous primaries in 62 patients of which 56 were finally confirmed in 44 patients. Of the 56 second cancers, 46 (82%) were found in the aerodigestive tract in the following locations: lung (26, 46%), head and neck (15, 17%), oesophagus (5, 9%). Ten second cancers (18%) were located outside the aerodigestive tract (colon, five; stomach, lymphoma, breast, thymus and kidney, one each). Six patients had three synchronous primaries and three patients had four synchronous cancers. Nine synchronous cancers were not detected by PET/CT (four head and neck, two lung, two oesophageal, one gastric). False-positive PET/CT findings were mainly related to benign FDG uptake in the intestine due to benign or precancerous polyps or physiological FDG uptake in other head and neck regions. Overall the prevalence of synchronous second primaries according to the reference standard was 9.5%, of which 84% were detected with FDG-PET/CT. In 80% of the patients, therapy was changed because of the detection of a synchronous primary. Conclusion FDG-PET/CT detects a considerable number of synchronous primaries (8.0% prevalence) at initial staging of patients with HNSCC. Synchronous cancers were predominantly located in the aerodigestive tract, primarily in the lung, head and neck and oesophagus. Detection of second primaries has an important impact on therapy. PET/ CT should be performed before panendoscopy.

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Section: Discussionsupporting

confidence: 48%

Section: Introductionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 97%

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Head and neck squamous cell carcinoma (HNSCC) – detection of synchronous primaries with 18F-FDG-PET/CT

Strobel

Haerle

Stoeckli

et al. 2009

Eur J Nucl Med Mol Imaging

Self Cite

118

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“…Only one of the four simultaneous tumours was diagnosed at EUAP with the remainder being evident on either physical examination or plain radiography. Stoeckli et al, 4 in an evaluation of 358 patients presenting with previously untreated SCC of the upper aerodigestive tract, demonstrated an incidence of second primary tumours of 6.4% whereas Hujala et al 5 found eight patients with simultaneous second primaries in a review of 203 consecutively treated patients (3.9%). All of these studies included multiple primary sites.…”

Section: Discussionmentioning

confidence: 99%

“…2 There is, however, increasing evidence that the incidence of simultaneous malignancies may be in the low single figures. [3][4][5] The routine use of EUAP as a diagnostic and screening tool for the primary assessment of patients with head and neck cancer continues to be controversial. A number of retrospective and prospective studies have variably supported its usefulness.…”

Section: Discussionmentioning

confidence: 99%

The Use of Examination Under Anaesthesia and Panendoscopy in Patients Presenting with Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Kerawala

Bisase

Lee

2009

annals

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INTRODUCTION Although examination under anaesthesia and panendoscopy (EUAP) has traditionally been used in the assessment of patients presenting with oral cavity and oropharyngeal squamous cell carcinoma (SCC), the era of modern medicine with its advanced imaging techniques has meant that the indications for this technique have potentially reduced. SUBJECTS AND METHODS In an attempt to quantify the current use of EUAP in the UK, a structured telephone questionnaire was undertaken of 50 maxillofacial units. Information was gathered regarding whether the technique was adopted on a routine or selective basis. Likewise perceived disadvantages were sought. RESULTS Twenty-two units (44%) carried out EUAP on all patients presenting with oral cavity and oropharyngeal SCC. Of the remaining 28 units, all employed EUAP on a selective basis, the most commonly for the assessment of the primary tumour. The most common perceived disadvantage of carrying out EUAP routinely was its potential to increase the waiting time to definitive treatment. CONCLUSIONS These results suggest a gradual move towards the selective use of EUAP in patients presenting with oral cavity and oropharyngeal SCC. KERAWALA BISASE LEE EUAP IN ORAL CAVITY AND OROPHARYNGEAL SQUAMOUS CELL CARCINOMA PATIENTSAnn R Coll Surg Engl 2009; 91: 609-612 610 on a selective basis. For the purposes of the study 'panendoscopy' was defined as the endoscopy of the nasal cavity, nasopharynx, oropharynx, larynx and upper oesophagus, with or without bronchoscopy. The indications for EUAP were obtained in terms of index tumour assessment, detection of simultaneous disease in the asymptomatic individual and its use as a 'test anaesthetic'. In units with a selective approach, further information regarding that process was elicited, e.g. did a patient's exposure to risk factors influence its use? Finally, the perceived advantages of EUAP were obtained where relevant. ResultsRepresentatives from 50 maxillofacial units were questioned. Of these, 22 (44%) employed EUAP on all patients. Of the remaining 28 units, the most common indication for EUAP was the assessment of the index tumour (Fig. 1). Around one in four units still felt that the use of EUAP as a 'test anaesthetic' was justified.For those units adopting a selective approach, the most commonly perceived disadvantage of routine EUAP was a potential increase in waiting time to definitive treatment (Fig. 2). One-third of units also expressed concern regarding the cost implications of a second anaesthetic. DiscussionEUAP was introduced in the management of head and neck malignancy in the late 1970s and is still used in many units throughout the world on a routine basis. It requires little in the way of equipment and remains less expensive than some of the alternative modes of staging patients such as computed tomography (CT), magnetic resonance imaging (MRI) and positron imaging tomography. The morbidity and mortality is low.1 In this day and age, it may still be the most sensitive way of detecting superficial mucosal ...

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Rigid Esophagoscopy for Head and Neck Cancer Staging and the Incidence of Synchronous Esophageal Malignant Neoplasms

McGarey

O’Rourke

Owen

et al. 2016

JAMA Otolaryngol Head Neck Surg

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Rigid esophagoscopy is safe, but the utility is low for cancer staging and for detection of nonmalignant esophageal disease. Review of the literature and analysis of a large national cancer data set indicate that the incidence of synchronous esophageal malignant neoplasms in patients with HNSCC is low and has been decreasing during the past 3 decades. Thus, screening esophagoscopy should be limited to patients with HNSCC who are at high risk for synchronous esophageal malignant neoplasms.

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Role of Routine Panendoscopy in Cancer of the Upper Aerodigestive Tract

Cited by 52 publications

References 34 publications

Head and neck squamous cell carcinoma (HNSCC) – detection of synchronous primaries with 18F-FDG-PET/CT

Head and neck squamous cell carcinoma (HNSCC) – detection of synchronous primaries with 18F-FDG-PET/CT

The Use of Examination Under Anaesthesia and Panendoscopy in Patients Presenting with Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

Rigid Esophagoscopy for Head and Neck Cancer Staging and the Incidence of Synchronous Esophageal Malignant Neoplasms

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