Impact of preceding treatment for head and neck squamous cell carcinoma on synchronous superficial esophageal squamous cell carcinoma

Tomoya Ueda; Ryu Ishihara; Yasuhiro Tani; Yoshiaki Ando; Gentaro Tanabe; Yuta Fujimoto; Noriaki Ito; Nobutoshi Tsukuda; Kazuki Matsuyama; Muneshin Morita; Minoru Kato; Shunsuke Yoshii; Satoki Shichijo; Takashi Kanesaka; Sachiko Yamamoto; Koji Higashino; Noriya Uedo; Tomoki Michida; Takashi Fujii

doi:10.1007/s00535-024-02201-z

Impact of preceding treatment for head and neck squamous cell carcinoma on synchronous superficial esophageal squamous cell carcinoma

J Gastroenterol. 2024 Dec 11. doi: 10.1007/s00535-024-02201-z. Online ahead of print.

Authors

Tomoya Ueda¹, Ryu Ishihara², Yasuhiro Tani¹, Yoshiaki Ando¹, Gentaro Tanabe¹, Yuta Fujimoto¹, Noriaki Ito¹, Nobutoshi Tsukuda¹, Kazuki Matsuyama¹, Muneshin Morita¹, Minoru Kato¹, Shunsuke Yoshii¹, Satoki Shichijo¹, Takashi Kanesaka¹, Sachiko Yamamoto¹, Koji Higashino¹, Noriya Uedo¹, Tomoki Michida¹, Takashi Fujii³

Affiliations

¹ Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan.
² Department of Gastrointestinal Oncology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka, 541-8567, Japan. ryu1486@gmail.com.
³ Department of Head and Neck Surgery, Osaka International Cancer Institute, Osaka, Japan.

PMID: 39661111
DOI: 10.1007/s00535-024-02201-z

Abstract

Background: Patients with esophageal squamous cell carcinoma (ESCC) frequently develop synchronous head and neck squamous cell carcinoma (HNSCC). With advances in endoscopic technology and widespread screening of synchronous cancers, the detection of synchronous HNSCC and superficial ESCC (SESCC) is increasing. We aimed to evaluate the impact of preceding HNSCC treatment on synchronous SESCC.

Methods: This single-center retrospective study enrolled patients with synchronous HNSCC and SESCC who were treated between January 2010 and December 2023. Tumor size and depth of SESCC before and after HNSCC treatment were evaluated. The factors associated with SESCC progression were investigated.

Results: Of the 299 patients with synchronous HNSCC and SESCC, 134 who underwent preceding HNSCC treatment with follow-up esophagogastroduodenoscopy (EGD) for SESCC were evaluated. Chemoradiotherapy was the most common treatment for HNSCC (56.0%), followed by surgery (17.2%), radiotherapy (14.9%), local resection (7.5%), and chemotherapy (4.5%). The tumor size of SESCC increased after HNSCC treatment in 18 patients (13.4%). Multivariate analysis revealed that an EGD interval of ≥ 120 days was significantly associated with increased tumor size in SESCC (odds ratio, 6.64; 95% confidence interval, 1.91-23.1). Tumor regrowth was observed in 70.6% of SESCCs that shrank with HNSCC treatment, mostly within six months. Tumor depth aggravation was rare (2.2%), but progression to advanced ESCC was observed in two patients.

Conclusions: Timely endoscopic follow-up, preferably within 120 days, is crucial for managing synchronous SESCC after HNSCC treatment to prevent tumor progression. Tumor regrowth should be monitored when SESCC shrinks with HNSCC treatment.

Keywords: Digestive system endoscopy; Disease progression; Esophageal squamous cell carcinoma; Head and neck squamous cell carcinoma; Synchronous neoplasms.