Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.1051
Peer-review started: September 16, 2016
First decision: October 28, 2016
Revised: November 24, 2016
Accepted: January 18, 2017
Article in press: January 18, 2017
Published online: February 14, 2017
To evaluate the clinical impact of surveillance for head and neck (HN) region with narrow band imaging (NBI) in patients with esophageal squamous cell carcinoma (ESCC).
Since 2006, we introduced the surveillance for HN region using NBI for all patients with ESCC before treatment, and each follow-up. The patients with newly diagnosed stage I to III ESCC were enrolled and classified into two groups as follows: Group A (no surveillance for HN region); between 1992 and 2000), and Group B (surveillance for HN region with NBI; between 2006 and 2008). We comparatively evaluated the detection rate of superficial head and neck squamous cell carcinoma (HNSCC), and the serious events due to metachronous advanced HNSCC during the follow-up.
A total 561 patients (group A: 254, group B: 307) were enrolled. Synchronous superficial HNSCC was detected in 1 patient (0.3%) in group A, and in 12 (3.9%) in group B (P = 0.008). During the follow up period, metachronous HNSCC were detected in 10 patients (3.9%) in group A and in 30 patients (9.8%) in group B (P = 0.008). All metachronous lesions in group B were early stage, and 26 patients underwent local resection, however, 6 of 10 patients (60%) in group A lost their laryngeal function and died with metachronous HNSCC.
Surveillance for the HN region by using NBI endoscopy increase the detection rate of early HNSCC in patients with ESCC, and led to decrease serious events related to advanced metachronous HNSCC.
Core tip: This is a retrospective study to evaluate the clinical impact of intensive surveillance for head and neck (HN) region by using narrow band imaging (NBI) endoscopy in patients with esophageal squamous cell carcinoma. The detection rate of superficial head and neck squamous cell carcinoma (HNSCC) which could be easily treated with endoscopic resection was dramatically increased after introduction of surveillance for HN region with NBI, and the serious events (loss of laryngeal function, death) due to metachronous advanced HNSCC were led to decrease when comparing with historical control. Surveillance for HN region with NBI might have a clinical impact at the point of reduction of head and neck cancer death in esophageal cancer survivor.