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Routine image-enhanced endoscopic surveillance for metachronous esophageal squamous cell neoplasms in head and neck cancer patients

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Abstract

Background

Esophageal squamous cell neoplasms (ESCNs) are common second primary tumors in patients with head and neck cancer. Image-enhanced endoscopy (IEE) with Lugol chromoendoscopy or magnifying narrow-band imaging both increase the detection of early ESCNs. No evidence-based ESCN surveillance program for head and neck cancer patients without a history of synchronous ESCNs exists. We aimed to evaluate the performance of an IEE surveillance program with magnifying narrow-band imaging endoscopy and Lugol chromoendoscopy.

Methods

From April 2016, we routinely used IEE with magnifying narrow-band imaging and Lugol chromoendoscopy to evaluate patients with head and neck cancer history. All patients who were negative for ESCNs at the first surveillance endoscopy and received at least 2 IEEs through December 2019 were included. Demographic profiles, clinical data, cancer characteristics, IEE results and pathology reports were analyzed.

Results

A total of 178 patients were included. Only 4 patients (2.2%) developed metachronous ESCNs during follow-up, all of whom received curative resection treatment. The interval for the development of metachronous ESCNs was 477 to 717 days. In multivariate Firth logistic regression and Kaplan‒Meier survival curve analysis, Lugol’s voiding lesion type C had an increased risk of esophageal cancer development (adjusted odds ratio = 15.71; 95% confidence interval, 1.33–185.87, p = 0.029). Eight patients died during the study period, and none of them had metachronous ESCNs.

Conclusions

IEE with magnifying narrow-band imaging and Lugol chromoendoscopy is an effective surveillance program in head and neck cancer patients without a history of ESCNs. Annual surveillance can timely detect early ESCNs with low ESCN-related mortality.

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Data availability

The data are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

The study was supported by grants from the Ministry of Science and Technology, Taiwan (MOST 110-2628-B-075-009) and Taipei Veterans General Hospital (V112C-088). The funding sources had no role in any process of our study.

Funding

The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Endoscopy Center For Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan

    Yong-Cheng Ye, Yen-Po Wang, Tien-En Chang, Pei-Shan Wu, I-Fang Hsin, Ping-Hsien Chen, Ming-Chih Hou & Ching-Liang Lu

  2. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Yong-Cheng Ye, Yen-Po Wang, Tien-En Chang, Pei-Shan Wu, Ming-Chih Hou & Ching-Liang Lu

  3. Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Yen-Po Wang & Ching-Liang Lu

  4. Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Yong-Cheng Ye, Yen-Po Wang, Tien-En Chang, Pei-Shan Wu, Shyh-Kuan Tai, Pen-Yuan Chu, Ming-Chih Hou & Ching-Liang Lu

  5. Division of Gastroenterology, Department of Medicine, West Garden Hospital, Taipei, Taiwan

    Ping-Hsien Chen

  6. Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan

    Shyh-Kuan Tai & Pen-Yuan Chu

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  1. Yong-Cheng Ye
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Contributions

Concept and design: YC YE, YP WANG, IF HSIN, PH CHEN, SK TAI, PY CHU, MC HOU, CL LU. Acquisition, analysis, or interpretation of data: YC YE, YP WANG, IF HSIN, PH CHEN, SK TAI, PY CHU, PS WU, TE CHANG. Drafting of the manuscript: YC YE, YP WANG, PS WU, TE CHANG, MC HOU, CL LU. Critical revision of the manuscript for important intellectual content: YP WANG, TE CHANG, SK TAI, PY CHU, MC HOU, CL LU. Statistical analysis: YC YE, YP WANG, IF HSIN, PH CHEN. Obtained funding: YP WANG. Administrative, technical, or material support: YP WANG, IF HSIN, PH CHEN. Supervision: YP WANG.

Corresponding author

Correspondence to Yen-Po Wang.

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Ethical Statement

This research study was conducted retrospectively from data obtained for clinical purposes. This study was approved by the Taipei Veterans General Hospital Institutional Review Board (IRB, 2022-12-005BC).

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Ye, YC., Wang, YP., Chang, TE. et al. Routine image-enhanced endoscopic surveillance for metachronous esophageal squamous cell neoplasms in head and neck cancer patients. Esophagus 21, 131–140 (2024). https://doi.org/10.1007/s10388-023-01039-3

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  • DOI: https://doi.org/10.1007/s10388-023-01039-3

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