Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2021; 13(10): 491-501
Published online Oct 16, 2021. doi: 10.4253/wjge.v13.i10.491
Clinical impact of gastrointestinal endoscopy on the early detection of pharyngeal squamous cell carcinoma: A retrospective cohort study
Hideaki Miyamoto, Hideaki Naoe, Jun Morinaga, Kensuke Sakisaka, Sayoko Tayama, Kenshi Matsuno, Ryosuke Gushima, Masakuni Tateyama, Takashi Shono, Masanori Imuta, Satoru Miyamaru, Daizo Murakami, Yorihisa Orita, Yasuhito Tanaka
Hideaki Miyamoto, Hideaki Naoe, Kensuke Sakisaka, Sayoko Tayama, Kenshi Matsuno, Ryosuke Gushima, Masakuni Tateyama, Yasuhito Tanaka, Department of Gastroenterology and Hepatology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
Jun Morinaga, Department of Clinical Investigation, Kumamoto University Hospital, Kumamoto 860-8556, Japan
Takashi Shono, Department of Gastroenterology, Kumamoto Chuo Hospital, Kumamoto 860-8556, Japan
Masanori Imuta, Department of Radiology, Kumamoto University Hospital, Kumamoto 860-8556, Japan
Satoru Miyamaru, Daizo Murakami, Yorihisa Orita, Department of Otolaryngology-Head and Neck Surgery, Kumamoto University Hospital, Kumamoto 860-8556, Japan
Author contributions: Miyamoto H, Naoe H, Morinaga J, Shono T and Tanaka Y were involved in the analysis and interpretation of data and drafting the manuscript; Sakisaka K, Tayama S, Matsuno K and Gushima R participated in the study coordination and acquisition of data; Tateyama M, Imuta I, Miyamaru S, Murakami D, and Orita Y critically revised the manuscript for important intellectual content; Tanaka Y approved the final version of the article for publication; All authors approved the final version.
Institutional review board statement: This study has been ethically approved by the Kumamoto University Ethics Committee (Approval No. 1851).
Conflict-of-interest statement: The authors declare no conflicts of interest associated with this manuscript.
Data sharing statement: All data relevant to the study are included in the article. No additional data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yasuhito Tanaka, MD, Professor, Department of Gastroenterology and Hepatology, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan. ytanaka@kumamoto-u.ac.jp
Received: March 6, 2021
Peer-review started: March 6, 2021
First decision: July 3, 2021
Revised: July 26, 2021
Accepted: September 16, 2021
Article in press: September 16, 2021
Published online: October 16, 2021
ARTICLE HIGHLIGHTS
Research background

Recently, many pharyngeal cancers have been discovered by gastroenterologists, with the growing availability of image enhanced endoscopy in gastrointestinal endoscopy. However, few studies have shown how much gastroenterologists contribute to the detection and treatment of pharyngeal cancer. In particular, the details of the lesions detected by the gastrointestinal endoscopy are unknown.

Research motivation

To highlight that gastrointestinal endoscopists should take a more active role both in the detection and treatment of pharyngeal cancer.

Research objectives

To clarify the importance of gastrointestinal endoscopy in detection and treatment of pharyngeal cancer.

Research methods

In this retrospective cohort study, the authors assessed the clinical records of consecutive 522 patients with oropharyngeal or hypopharyngeal cancer in our hospital between January 2011 and December 2018. The lesions were classified into two groups: Group GE (detected by gastrointestinal endoscopy) and Group non-GE (detected by means other than gastrointestinal endoscopy), and the clinical characteristics were compared between the two groups.

Research results

Of total 522 lesions, 164 (31.4%) in Group GE had a higher proportion of asymptomatic cases (61.6% vs 7.3%, P < 0.001), cTis-1 cases (32.9% vs 12.0%, P < 0.001), cases with no lymph node metastasis (69.5% vs 19.0%, P < 0.001) and cases treated by endoscopic laryngo-pharyngeal surgery/endoscopic submucosal dissection (21.3% vs 0.6%, P < 0.001) than Group non-GE, leading to a better prognosis.

Research conclusions

To the best of our knowledge, this is the first study to explore the detection modality of oropharyngeal and hypopharyngeal squamous cell carcinomas (SCC) in a large number of cases. Gastrointestinal endoscopy plays an important role in the early detection and improving the prognosis of pharyngeal SCCs.

Research perspectives

In the future, a multicenter prospective study should be designed in a set up where equal accessibility to gastrointestinal endoscopy and otolaryngology services is available.