Abstract
Patients with esophageal cancer often have multiple cancers, head and neck cancer being the most common associated cancers. We have performed otolaryngological examinations and pharyngolaryngoscopy screening in all patients with esophageal cancer prior to treatment since May 1995, when the department of otolaryngology was established in our institution. These patients also underwent examinations at discharge and every 6 months during the follow-up period.
Hypopharyngeal cancers were revealed in 60 of 1,563 esophageal cancer patients seen between May 1995 and September 2003. The TNM stages of their hypopharyngeal cancers were as follows: stage I:37, stage II:16, stage III:4, stage IV:3. Nineteen patients (stage I:16, stage II:3) were able to undergo endoscopic mucosal resection (EMR) for hypopharyngeal cancer. Three patients underwent chemotherapy after EMR because malignant tumor cells were positive at the stump or in close vicinity to the resected mucosal margin. There were no deaths related to EMR. Three patients died of other carcinomas and one died of other disease, but no patient undergoing EMR died of hypopharyngeal carcinoma.
These findings suggest that periodical examinations and pharyngolaryngoscopy screening after treatment of esophageal cancer can detect early hypopharyngeal cancers treatable with EMR, and may yield preservation of the larynx. Further investigation is necessary concerning the indications and curability of the treatment.
