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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(07): E900-E910
DOI: 10.1055/a-1147-8977
Original article

Does a history of head and neck cancer affect outcome of endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma?

Renata Nobre Moura
1   Department of Gastroenterology, Cancer Institute, Hospital das Clinicas of University of Sao Paulo, Sao Paulo, Brazil
,
Vitor Nunes Arantes
2   Alfa Institute of Gastroenterology, Hospital de Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
Tarso Magno Leite Ribeiro
2   Alfa Institute of Gastroenterology, Hospital de Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
Roberto Gardone Guimarães
2   Alfa Institute of Gastroenterology, Hospital de Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil
,
Joel Fernandez de Oliveira
1   Department of Gastroenterology, Cancer Institute, Hospital das Clinicas of University of Sao Paulo, Sao Paulo, Brazil
,
Marco Aurélio Vamondes Kulcsar
1   Department of Gastroenterology, Cancer Institute, Hospital das Clinicas of University of Sao Paulo, Sao Paulo, Brazil
,
Rubens Antonio Aissar Sallum
1   Department of Gastroenterology, Cancer Institute, Hospital das Clinicas of University of Sao Paulo, Sao Paulo, Brazil
,
Ulysses Ribeiro-Junior
1   Department of Gastroenterology, Cancer Institute, Hospital das Clinicas of University of Sao Paulo, Sao Paulo, Brazil
,
Fauze Maluf-Filho
1   Department of Gastroenterology, Cancer Institute, Hospital das Clinicas of University of Sao Paulo, Sao Paulo, Brazil
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Abstract

Background and study aims Esophageal squamous cell carcinoma (ESCC) is the most common secondary tumor in patients with head and neck squamous cell cancer (HNSCC). Currently, endoscopic submucosal dissection (ESD) is the preferred approach to manage superficial ESCC, however, it remains to be elucidated whether patients with HNSCC and early ESCC managed by ESD have different outcomes.

Patients and methods We retrospectively analyzed esophageal ESD for early ESCC from September 2009 to September 2017 and the following variables: demographics, tumor and specimen size, Paris classification, location, en bloc and R0 resection rates, overall survival (OS) and adverse events (AEs). To reduce selection bias, propensity score matching was applied to compare the results.

Results Eighty-nine ESDs were performed in 81 consecutive patients (47 with HNSCC and 34 without HNSCC). Patients with HNSCC who developed superficial ESCC were found to be younger and to refer a more frequent history of alcohol ingestion and smoking. There was no difference in lesion size, number of lesions, procedure time, en bloc resection rate, R0 resection rate, local recurrence and adverse event rate between the two groups. The histological depth of invasion for patients with HNSCC was significantly shallower before (P = 0.016) and after (P = 0.047) matching. The overall survival rate was similar in both groups.

Conclusions Patients with HNSCC have earlier detection of ESCC, probably due to endoscopic screening. Previous history of chemoradiation and surgery for HNSCC does not affect procedure time, AEs and OS.



Publication History

Received: 03 September 2019

Accepted: 17 February 2020

Article published online:
16 June 2020

© 2020. Owner and Copyright ©

© Georg Thieme Verlag KG
Stuttgart · New York

 

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