Esophageal pathology in patients after treatment for head and neck cancer |
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Authors: | D Gregory Farwell Catherine J Rees Debbie A Mouadeb Jacqueline Allen Allen M Chen Danny J Enepekides Peter C Belafsky |
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Institution: | a Department of Otolaryngology-Head and Neck Surgery, University of California Davis School of Medicine, Sacramento, CA b Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, NC c Department of Radiation Oncology, University of California Davis School of Medicine, Sacramento, CA d Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Medical Center, Toronto, Ontario, Canada |
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Abstract: | ObjectiveTo determine the prevalence of esophageal pathology following treatment for primary head and neck cancer (HNCA).Study DesignCase series with planned data collection.SettingAcademic medical practice.Subjects and MethodsSubjects 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.ResultsThe 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.ConclusionEsophageal pathology is extremely common in patients treated for HNCA. These findings support routine esophageal screening after HNCA treatment. |
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