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TumorDiagnostik & Therapie 2008; 29(1): 35-39
DOI: 10.1055/s-2008-1027213
Thieme Onkologie aktuell

© Karl Demeter Verlag im Georg Thieme Verlag KG Stuttgart · New York

Koinzidenz von Plattenepithelkarzinomen der Speiseröhre und Kopf-Hals-Karzinomen: Risiko und Früherkennung[1]

Coincidental Squamous Cell Cancers of the Esophagus and Head and Neck: Risk and SurveillanceJ. Steinberg1 , C. Schwertner1 , E. M. de Villiers2 , P. Mir-Salim3 , R. Kiesslich4 , U. Stoelzel5 , H. Scherübl1
  • 1Klinik für Innere Medizin, Gastroenterologie und Gastrointestinale Onkologie, Vivantes Klinikum Am Urban, Berlin
  • 2Institut für Tumorvirologie, DKFZ Heidelberg
  • 3HNO Klinik, Vivantes Klinikum im Friedrichshain, Berlin
  • 4Medizinische Klinik I-Gastroenterologie, Universitätsklinikum Mainz
  • 5Klinik für Gastroenterologie und Infektiologie, Klinikum Chemnitz
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Publication History

Publication Date:
18 February 2008 (online)

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Zusammenfassung

Patienten mit Kopf-Hals-Karzinomen tragen ein Risiko von 5 - 14 %, an einem Plattenepithelzweitkarzinom der Speiseröhre zu erkranken. Tritt bei diesen Patienten ein symptomatisches Ösophaguszweitkarzinom auf, wird die dann meist ungünstige Prognose durch das Ösophaguskarzinom bestimmt. Prospektive Studien aus Japan, Brasilien, Taiwan, Frankreich aber auch aus Deutschland zeigen, dass durch endoskopische Vorsorgeuntersuchungen mit hochauflösenden Videoendoskopen nicht nur eine Früherkennung der Ösophaguszweitneoplasien, sondern auch eine frühe kurative Therapie möglich ist. Dies unterstreicht die Bedeutung einer Screeningösophagoskopie bei Erstdiagnose des Kopf-Hals-Karzinoms als auch der Surveillance. Umgekehrt sollen Patienten mit behandelten Plattenepithelösophaguskarzinomen regelmäßig pharyngolaryngoskopiert werden, da das Risiko von Zweitneoplasien in diesem Bereich 9,3 - 11,4 % beträgt. Patienten mit einer sog. field cancerisation des Atemwegs- und oberen Verdauungsapparates bedürfen somit der interdisziplinären Betreuung und Überwachung.

Abstract

Patients suffering from head and neck cancer (HNC) have or will develop a second esophageal squamous cell cancer (ESCC) in 5 - 14 %. When a second esophageal neoplasm occurs in a HNC patient, the prognosis is generally determined by the ESCC, and unfortunately it is poor. Prospective clinical studies in Japan, Brazil, Taiwan, France and Germany have shown that screening or surveillance using Lugol chromoesophagoscopy enables early detection of second esophageal neoplasias. Such a surveillance results in a survival benefit for HNC patients. Vice versa, ESCC patients also have a risk of 9.3 - 11.4 % for a head and neck cancer. Periodic otolaryngeal examination and pharyngoscopy is recommended for curatively treated ESCC patients. Patients with a so-called field cancerisation of the airways and upper digestive tract thus require an interdisciplinary management and monitoring.

Schlüsselwörter

Ösophaguskarzinom - Ösophagus

Key words

oesophageal carcinoma - oesophagus

1 Wir danken der Deutschen Krebshilfe für die Projektförderung.

Literatur

  • 1 Cooper J, Pajak T, Rubin P. et al . Second malignancies in patients who have head and neck cancer: Incidence, effect on survival and implications based on the RTOG experience.  Int J Radiation Oncology Biol Phys. 1989;  17 449-456
    Google Scholar
  • 2 Scherübl H. Sigmund Freuds Krankheit.  Dt Ärzteblatt. 2006;  103 A-1913-1914
    Google Scholar
  • 3 Dubuc J, Legoux J, Winnock M. et al . Endoscopic screening for esophageal squamous-cell carcinoma in high-risk patients: a prospective study conducted in 62 French endoscopy centers.  Endoscopy. 2006;  38 690-695
    Google Scholar
  • 4 Horiuchi M, Makuuchi H, Machimura T. et al . Survival benefit of screening for early oesophageal carcinoma in head and neck cancer patients.  Dig Endosc. 1998;  10 110-115
    Google Scholar
  • 5 Makuuchi H, Machimura T, Shimada H. et al . Endoscopic screening for oesophageal cancer in 788 patients with head and neck cancers.  Tokai Exp Clin Med. 1996;  21 139-145
    Google Scholar
  • 6 Möschler O, Spahn T, Middelberg-Bisping C. et al . Chromooendoscopy is a valuable tool for screening of high-risk patients with head and neck cancer for early detection of esophageal cancer.  Digestion. 2006;  73 160-166
    Google Scholar
  • 7 Muto M, Hironika S, Natanabe M. et al . Association of multiple Lugol-voiding lesions with synchronous and metachronous esophageal squamous cell carcinoma in patients with head and neck cancer.  Gastrointest Endosc. 2002;  56 517-521
    Google Scholar
  • 8 Petit T, Georges C, Jung G. et al . Systematic esophageal endoscopy screening in patients previously treated for head and neck squamous-cell carcinoma.  Ann Oncology. 2001;  12 643-646
    Google Scholar
  • 9 Scherübl H, Lampe von B, Faiss S. et al . Screening for oesophageal neoplasia in patients with head and neck cancer.  Brit J Cancer. 2002;  86 239-243
    Google Scholar
  • 10 Shiozaki H, Tahara H, Kobayashi K. et al . Endoscopic screening of early oesophageal cancer with the Lugol dye method in patients with head and neck cancers.  Cancer. 1990;  66 2068-2071
    Google Scholar
  • 11 Tincani A, Brandalise N, Altemani A. et al . Diagnosis of superficial oesophageal cancer and dysplasia using endoscopic screening with a 2% Lugol dye solution in patients with head and neck cancer.  Head Neck. 2000;  22 170-174
    Google Scholar
  • 12 Lee. et al .Narrow band imaging endoscopy for early detection of second esophageal neoplasias in head and neck cancer patients. Orlando, USA; GI ASCO 2007
    Google Scholar
  • 13 Leon X, Quer M, Diez S. et al . Second neoplasm in patients with head and neck cancer.  Head Neck. 1999;  21 204-210
    Google Scholar
  • 14 Lin K, Patel S, Chu P. et al . Second primary malignancy of the aerodigestive tract in patients treated for cancer of the oral cavity and larynx.  Head Neck. 2005;  27 1042-1048
    Google Scholar
  • 15 Ban S, Toyonaga A, Harada H. et al . Iodine staining for early endoscopic detection of esophageal cancer in alcoholics.  Endoscopy. 1998;  30 253-257
    Google Scholar
  • 16 Meyer V, Burtin P, Bour B. et al . Endoscopic detection of early oesophageal cancer in a high-risk population: does Lugol staining improve videoendoscopy?.  Gastrointest Endosc. 1997;  45 480-484
    Google Scholar
  • 17 Boffetta P, Hashibe M. Alcohol and cancer.  Lancet Oncology. 2006;  7 149-156
    Google Scholar
  • 18 Yokoyama A, Muramatsu T, Ohmori T. et al . Alcohol-related cancers and aldehyde dehydrogenase-2 in Japanese alcoholics.  Carcinogenesis. 1998;  19 1383-1387
    Google Scholar
  • 19 Vakevainen S, Tillonen J, Salaspuro M. 4-Methylpyrazole decreases salivary acetaldehyde levels in aldh2-deficient subjects but not in subjects with normal aldh2.  Alcohol Clin Exp Res. 2001;  25 829-834
    Google Scholar
  • 20 Visapaa J, Gotte K, Benesova M. et al . Increased cancer risk in heavy drinkers with the alcohol dehydrogenase 1C*1 allele, possibly due to salivary acetaldehyde.  Gut. 2004;  53 871-876
    Google Scholar
  • 21 Homann N, Stickel F, Konig I. et al . Alcohol dehydrogenase 1C*1 allele is a genetic marker for alcohol-associated cancer in heavy drinkers.  Int J Cancer. 2006;  118 1998-2002
    Google Scholar
  • 22 Salaspuro V, Hietala J, Marvola M. et al . Eliminating carcinogenic acetaldehyde by cysteine from saliva during smoking.  Cancer Epidemiol Biomarkers Prev. 2006;  15 146-149
    Google Scholar
  • 23 De Villiers E M, Gunst K, Stein H. et al . Esophageal squamous cell cancer in patients with head and neck cancer: Prevalence of human papillomavirus DNA sequences.  Int J Cancer. 2004;  109 253-258
    Google Scholar
  • 24 Shimada H, Makuuchi H. Endoscopic treatment of esophageal cancer.  Kyobu Geka. 2006;  59 768-775
    Google Scholar
  • 25 Scherübl H, Scherer H, Hoffmeister B. Second esophageal cancers in head and neck cancer patients.  N Engl J Med. 2002;  346 1416-1417
    Google Scholar
  • 26 Scherübl H. Pesquisa de neoplasias esofágicas secundarias en los pacientes con cáncer de cabeza y cuello.  2005;  , www.trabajosdistinguidos.com/oncologia/indiceonco165.php
    Google Scholar
  • 27 Inoue H, Sasajima K, Kaga M. et al . Endoscopic in vivo evaluation of tissue atypia in the esophagus using newly designed integrated endocytoscope: a pilot trial.  Endoscopy. 2006;  38 891-895
    Google Scholar
  • 28 Watanabe A, Tsujie H, Taniguchi M. et al . Laryngoscopic detection of pharyngeal carcinoma in situ with narrowband imaging.  Laryngoscope. 2006;  116 650-654
    Google Scholar
  • 29 Hoffmann A, Goetz M, Vieth M. et al . Confocal laser endomicroscopy: technical status and current indications.  Endoscopy. 2006;  38 1275-1283
    Google Scholar
  • 30 Murakami S, Hashimoto T, Noguchi T. et al . The utility of endoscopic screening for patients with esophageal or head and neck cancer.  Dis Esophagus. 1999;  12 186-190
    Google Scholar
  • 31 Wang G, Abnet C, Shen Q. et al . Histological precursors of oesophageal squamous cell carcinoma: results from a 13 year prospective follow up study in a high risk population.  Gut. 2005;  54 187-192
    Google Scholar
  • 32 Maaser K, Däubler P, Barthel B. et al . Esophageal squamous cell neoplasia in head and neck cancer patients. Upregulation of COX-2 during carcinogenesis.  Brit J Cancer. 2003;  88 1217-1222
    Google Scholar
  • 33 Scherübl H, Sutter A. et al . NSAIDs and esophageal cancer.  Gastroenterology. 2003;  125 1875-1876
    Google Scholar
  • 34 Limburg P, Wei W, Ahnen D. et al . Randomized, placebo-controlled, esophageal squamous cell cancer chemoprevention trial of selenomethionine and celecoxib.  Gastroenterology. 2005;  129 863-873
    Google Scholar
  • 35 Sutter A, Höpfner M, Huether A. et al . Targeting the epidermal growth factor receptor by erlotinib (Tarceva) for the treatment of esophageal cancer.  Int J Cancer. 2006;  118 1814-1822
    Google Scholar
  • 36 Makuuchi H. Endoscopic mucosal resection for early oesophageal cancer. Indications and techniques.  Dig Endosc. 1996;  8 175-179
    Google Scholar
  • 37 Savary J, Grosjean P, Monnier P. et al . Photodynamic therapy of early squamous cell carcinomas of the esophagus: A review of 31 cases.  Endoscopy. 1998;  30 258-265
    Google Scholar
  • 38 Matsubara T, Yamada K, Nakagawa A. Risk of second primary malignany after esophagectomy for squamous cell carcinoma of the thoracic esophagus.  J Clin Oncology. 2003;  21 4336-4341
    Google Scholar
  • 39 Watanabe A, Hosokawa M, Taniguchi M. et al . Periodic pharyngolaryngoscopy detects early head and neck cancer and improves survival in esophageal cancer.  Ann Thorac Surg. 2003;  76 1699-1705
    Google Scholar
  • 40 Watanabe A, Hosokawa M, Taniguchi M. et al . Head and neck cancer associated with esophageal cancer.  Auris Nasus Larynx. 2007;  34 207-211
    Google Scholar
  • 41 Bareiß D, Stabenow R, Müller R. et al . Aktuelle Epidemiologie des Ösophagus- und des Kardiakarzinoms in Deutschland.  Dtsch Med Wochenschr. 2002;  127 1367-1374
    Google Scholar

1 Wir danken der Deutschen Krebshilfe für die Projektförderung.

Prof. Dr. Hans Scherübl

Klinik für Innere Medizin-Gastroenterologie und Gastrointestinale Onkologie, Vivantes Klinikum Am Urban

Dieffenbachstr. 1

10967 Berlin

Phone: ++49/30/69 72 52 01

Fax: ++49/30/69 72 52 05

Email: hans.scheruebl@vivantes.de

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