Pretreatment elevated mean corpuscular volume as an indicator for high risk esophageal second primary cancer in patients with head and neck cancer |
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| Institution: | 1. Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan;2. Swallowing Center, the University of Tokyo Hospital, Tokyo, Japan;3. Faculty of Engineering Systems Innovation, the University of Tokyo, Tokyo, Japan;4. Department of Computational Diagnostic Radiology and Preventive Medicine, the University of Tokyo Hospital, Tokyo, Japan;5. AIC Yaesu Clinic, Tokyo, Japan;1. Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan;2. Department of Otorhinolaryngology, Koshigaya Municipal Hospital, 10-32, Higashikoshigaya, Koshigaya-shi, Saitama, 343-8577 Japan;3. Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan;1. Division of Otolaryngology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan;2. Department of Otolaryngology, Yamagata City Hospital Saiseikan, Yamagata, Japan;3. Division of Anatomy and Cell Biology, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan;4. Division of Pathology, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyaginoku, Sendai 983-8512, Japan;1. Department of Otolaryngology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey;2. Department of Radiology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey;3. Department of Pathology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey;1. Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;2. Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan;3. Kobe City Medical Center General Hospital, Department of Pathology, Kobe, Japan;4. Institute of Liver Studies, King''s College Hospital & King''s College London, London, UK |
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| Abstract: | ObjectiveEsophageal cancer is the most common second primary cancer (SPC) in patients with head and neck cancer (HNC). Esophageal SPC has a negative impact on survival. Elevated mean corpuscular volume (MCV) is an accepted predictor of esophageal cancer risk. The aim of this study was to elucidate the usefulness of elevated MCV as an indicator of a high risk for esophageal SPC.MethodsWe retrospectively reviewed the medical records of patients with oropharyngeal, hypopharyngeal, and laryngeal squamous cell carcinoma who underwent chemoradiotherapy between 2003 and 2012. We excluded patients younger than 20 years or who had received treatment for esophageal cancer and who had a histologically unproven lesion. Patients were divided into two groups according to their MCV. The cut-off for MCV was defined by receiver operating characteristics curve analysis. The primary endpoint was the cumulative incidence of esophageal SPC.ResultsA total of 295 patients were included. The median follow-up period for surviving patients was 7.4 years and the optimal cut-off point was 99.0 fL. One hundred ninety-five patients (66%) had an MCV < 99.0 fL and 100 (34%) had an MCV ≥ 99.0 fL. The 5-year cumulative incidence in patients with an MCV < 99.0 fL and ≥ 99.0 fL was 8.7% and 27%, respectively. In the multivariate analysis, an MCV ≥ 99.0 fL (HR=2.2; 95%CI, 1.1-4.2) was an independent risk factor.ConclusionMCV ≥ 99.0 fL was found to be a risk factor for esophageal SPC. We, therefore, recommend that patients with an MCV ≥ 99.0 fL should undergo intensive monitoring. |
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