Clinical impact of surveillance for head and neck cancer in patients with esophageal squamous cell carcinoma

Table 1 Characteristics of patients with esophageal squamous cell carcinoma n (%)

	Group A (n = 254)	Group B (n = 307)	P value
Sex
Male	214 (84)	260 (85)	0.907
Female	40 (16)	47 (15)
Age (yr), median (range)	64 (39-81)	66 (41-86)	< 0.001
Baseline clinical TNM-stage
I	119 (47)	155 (50)	0.39
II	66 (26)	88 (29)	0.50
III	69 (27)	64 (21)	0.09
Treatment for primary ESCC
Surgery	84 (33)	124 (40)	0.079
Endoscopic resection	77 (30)	113 (37)	0.010
Chemoradiotherapy	93 (37)	70 (23)	0.001
Follow-up period
Median months (range)	60 (13-145)	67 (12-107)	0.150

ESCC: Esophageal squamous cell carcinoma.

Table 2 Synchronous superficial head and neck squamous cell carcinoma lesions n (%)

	Group A (n = 254)	Group B (n = 307)	P value
Synchronous HNSCC
No. of patients	1 (0.3)	12 (3.9)	0.008
No. of lesions	1	14	0.010
Location of cancer
Oropharynx	0	5
Hypopharynx	1	8
Larynx	0	1
Treatment for synchronous HNSCC
ER or surgical local resection	0	7 (58)
TPLE	0	1 (8)
Radiation and/or chemotherapy	1 (100)	0
No treatment	0	4 (33)
Death due to synchronous HNSCC	0	0

ER: Endoscopic resection; TPLE: Total pharyngo-laryngo-esophagectomy; HNSCC: Head and neck squamous cell carcinoma.

Table 3 Characteristics of metachronous head and neck squamous cell carcinoma n (%)

	Group A (n = 254)	Group B (n = 307)	P value
Metachronous HNSCC
No. of patients	10 (3.9)	30 (9.8)	0.008
No. of lesions per patients			0.404
1	9	22
≥ 2	1	8
Total number of cancers	11	53	0.007
Location of cancer
Oropharynx	3	13
Hypopharynx	7	34
Larynx	1	6
Clinical stage			< 0.001
I/II	4 (36)	53 (100)
III/IV	7 (64)	0
Interval between ESCC and HNSCC
Median months (range)	56 (7-80)	31 (7-107)	0.130

HNSCC: Head and neck squamous cell carcinoma.

Table 4 Clinical course of patients with metachronous head and neck squamous cell carcinoma n (%)

	Group A, patients (n = 10)	Group B, patients (n = 30)	P value
Metachronous HNSCC	11 lesions	53 lesions	< 0.001
I/II	4 (36)	53 (100)
III/IV	7 (64)	0 (0)
Treatment
Local resection	2 (18)	49 (92)	< 0.001
Endoscopic resection	0	44
Surgical local resection	2	5
TPLE	3 (27)	0 (0)	0.001
Radiotherapy alone and/or chemotherapy	4 (36)	2 (4)	0.006
No treatment	2 (18)	2 (4)	0.133
Laryngeal function			< 0.001
Maintained	4 (40)	30 (100)
Lost	6 (60)	0
Outcome			0.001
Alive	3 (30)	26 (87)
Death	7 (70)	4 (13)
Death with metachronous HNSCC	6 (60)	0 (0)	< 0.001

HNSCC: Head and neck squamous cell carcinoma; TPLE: Total pharyngo-laryngo-esophagectomy.

Table 5 Clinical outcome of all patients with esophageal squamous cell carcinoma n (%)

	Group A (n = 254)	Group B (n = 307)	P value
Occurrence of advanced metachronous HNSCC	7 (2.8)	0	0.003
Loss of laryngeal function	6 (2.4)	0	0.008
Outcome			< 0.001
Alive	172 (68)	254 (83)
Dead	82 (32)	53 (17)
ESCC	43 (17)	41 (13)	0.284
HNSCC	6 (2.4)	0	0.018
Other cancer	6 (2.4)	4 (1.3)	0.360
Gastric cancer	3 (1.2)	0	0.092
Lung cancer	0	2 (0.7)	0.0503
Lymphoma	1 (0.4)	1 (0.3)	> 0.999
HCC	1 (0.4)	1 (0.3)	> 0.999
Prostate cancer	1 (0.4)	0	0.452
Other/unknown	27 (11)	8 (2.6)	< 0.0001
Radiation pneumonia	8 (8.1)	1 (0.3)	0.013
Heart failure	6 (2.4)	1 (0.3)	0.050

HNSCC: Head and neck squamous cell carcinoma; ESCC: Esophageal squamous cell carcinoma; HCC: Hepatocellular carcinoma.