Esophageal pathology in patients after treatment for head and neck cancer

Author:

Farwell D. Gregory1,Rees Catherine J.2,Mouadeb Debbie A.1,Allen Jacqueline1,Chen Allen M.3,Enepekides Danny J.4,Belafsky Peter C.1

Affiliation:

1. From the Department of Otolaryngology-Head and Neck Surgery, University of California Davis School of Medicine Sacramento, CA

2. Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, NC

3. Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CA

4. Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Medical Center, Toronto, Ontario, Canada.

Abstract

OBJECTIVE: To determine the prevalence of esophageal pathology following treatment for primary head and neck cancer (HNCA). STUDY DESIGN: Case series with planned data collection. SETTING: Academic medical practice. SUBJECTS AND METHODS: 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. RESULTS: 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. CONCLUSION: Esophageal pathology is extremely common in patients treated for HNCA. These findings support routine esophageal screening after HNCA treatment. © 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.

Publisher

SAGE Publications

Subject

Otorhinolaryngology,Surgery

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