- 作者：Wen-Lun Wang ; Cheng-Ping Wang ; Hsiu-Po Wang ; Ching-Tai Lee ; Chi-Yang Chang ; Chi-Ming Tai ; Cheng-Hao Tseng ; Tzer-Zen Hwang ; Chih-Chun Wang ; Jo-Lin Lo ; Ping-Huei Tseng ; Han-Mo Chiu ; Jang-Ming Lee ; Jenq-Yuh Ko ; Pei-Jen Lou ; Ming-Shiang Wu ; Yi-Chia Lee ; Jaw-Town Lin
- 关键词：Hypopharyngeal cancer ; Synchronous neoplasms ; Esophageal cancer ; Survival ; Image-enhanced endoscopy
- 刊名：Oral Oncology
- 出版年：2013
- 出版时间：August, 2013
- 年：2013
- 卷：49
- 期：8
- 页码：808-813
- 全文大小：959 K
Summary
Background
Synchronous esophageal cancers can suppress the survival of patients with hypopharyngeal cancers. Esophageal screening with the image-enhanced endoscopy may identify more synchronous cancers while there is no evidence to support its benefit on survival.Methods
A total of 281 and 320 patients were diagnosed with hypopharyngeal cancer before and after the policy of routine esophageal screening. Primary outcome measures were overall survival.
Results
Among those who received screening, 49 patients (49/180, 27.2 % ) had synchronous esophageal cancers; treatment planning was changed in 42 (23.3 % ). Before and after the policy, percentages of stage I-II synchronous cancers were 20 % (3/15) and 53.1 % (26/49), respectively. Adjunctive therapies for synchronous cancers have led to a better survival after the policy than before (P = 0.002). The Cox regression model quantified a survival benefit of 29 % (95 % CI: 11-43 % ) when adjusting for TNM stage of hypopharyngeal cancer. In post-policy period, the survival was better for those who chose screening than those who did not (HR: 0.57, 95 % CI: 0.41-0.79). Among those without screening, there was no difference between the pre- and post-policy periods (HR: 0.96, 95 % CI: 0.74-1.26).
Conclusions
Patients with hypopharyngeal cancers may benefit from the esophageal screening with image-enhanced endoscopy through the better detection of early-stage synchronous cancers.