Esophageal pathology in patients after treatment for head and neck cancer

To determine the prevalence of esophageal pathology following treatment for primary head and neck cancer (HNCA). Case series with planned data collection. Academic medical practice. Subjects comprised HNCA survivors. Esophagoscopy was prospectively performed on 100 patients at least three months aft...

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Bibliographic Details
Published in:Otolaryngology-head and neck surgery 2010-09, Vol.143 (3), p.375-378
Main Authors: Farwell, D. Gregory, Rees, Catherine J., Mouadeb, Debbie A., Allen, Jacqueline, Chen, Allen M., Enepekides, Danny J., Belafsky, Peter C.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cohort Studies
Esophageal Diseases - epidemiology
Esophageal Diseases - pathology
Esophageal Diseases - therapy
Esophagoscopy
Esophagus - pathology
Female
Head and Neck Neoplasms - complications
Head and Neck Neoplasms - pathology
Head and Neck Neoplasms - therapy
Humans
Male
Middle Aged
Neoplasm Staging
Prevalence
Proton Pump Inhibitors - therapeutic use
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Summary:To determine the prevalence of esophageal pathology following treatment for primary head and neck cancer (HNCA). Case series with planned data collection. Academic medical practice. Subjects comprised HNCA survivors. Esophagoscopy was prospectively performed on 100 patients at least three months after treatment for HNCA. Patient demographics including cancer stage, cancer treatment, use of reflux medications, symptoms surveys, and esophageal findings were prospectively determined. The mean age of the cohort was 64 (± 10) years; 75 percent were male. The mean time between the end of treatment and endoscopy was 40 (± 51) months. Eighty-one percent of HNCA was advanced stage (3 or 4). The distribution of site of the primary HNCA was as follows: oropharynx (38%), larynx (33%), oral cavity (17%), unknown primary (10%), hypopharynx (1%), and nasopharynx (1%). Treatment modalities included surgery alone (15%), surgery with radiation (34%), radiation alone (6%), chemoradiation alone (24%), and chemoradiation with surgery (20%). The findings on esophagoscopy included peptic esophagitis (63%), stricture (23%), candidiasis (9%), Barrett metaplasia (8%), gastritis (4%), and carcinoma (4%). Only 13 percent had a normal esophagoscopy. Esophageal pathology is extremely common in patients treated for HNCA. These findings support routine esophageal screening after HNCA treatment.
ISSN:0194-5998
1097-6817
DOI:10.1016/j.otohns.2010.05.006