Second primary cancers (SPC) in the respiratory and gastrointestinal tracts, such as the lungs and the esophagus, had been frequent in patients with HNC. In Taiwan, HNC accounts for approximately 10% of all cancers, with a 7.3-fold higher incidence in men than in women, and about 8.2% of all cancer-related death in both sexes. Head and neck cancers (HNC) account for approximately 3.7% of all cancers and 2.4% of all cancer-related deaths in both sexes in the United States. In addition to PET/CT scan, narrow-band imaging endoscopy should be considered in head and neck patients at high risk for developing second primary esophageal cancer. PET/CT scan was inferior to narrow-band imaging endoscopy in detecting second primary esophageal cancer in head and neck cancer patients. Hypopharyngeal or laryngeal location of the primary head and neck cancer was the only risk factor for developing second primary esophageal cancer. The respective sensitivity, specificity, and area under the curve for detecting suspicious esophageal lesions were 33.33, 97.73%, and 0.655 for PET/CT scan, and 100.0, 84.85%, and 0.924 for narrow-band imaging endoscopy. The final pathologic diagnoses were esophageal squamous cell carcinoma in 10 and high-grade dysplasia in 5.

ResultsĪ total of 147 subjects were included in the analysis suspicious esophageal lesions were identified by PET/CT scan in 8 (5.44%) and by narrow-band imaging in 35 (23.81%). Descriptive statistics, receiver operating characteristic curve analysis, logistic regression analysis, independent Student’s t-test, and Kaplan–Meier survival analysis were conducted with MedCalc Statistical Software. Methodsįrom November 2015 to November 2018, all head and neck cancer patients who underwent both PET/CT scan and narrow-band imaging endoscopy at Changhua Christian Hospital were retrospectively enrolled.

We aimed to compare PET/CT scan and narrow-band imaging endoscopy for the detection of esophageal cancer in head and neck cancer patients. Narrow-band imaging endoscopy is an accurate and convenient technique for esophageal examination. Although Positron emission tomography (PET)/computed tomography (CT) scan is commonly conducted in head and neck patients, its ability to detect early esophageal cancer is limited. Second primary cancer of the esophagus is frequent in head and neck patients, especially in high-risk populations, and has a great impact on the prognosis.

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