|Title:||The benefit of pretreatment esophageal screening with image-enhanced endoscopy on the survival of patients with hypopharyngeal cancer||Authors:||Wang W.-L.
|Issue Date:||2013||Journal Volume:||49||Journal Issue:||8||Start page/Pages:||808-813||Source:||Oral Oncology||Abstract:||
Background Synchronous esophageal cancers can suppress the survival of patients with hypopharyngeal cancers. Esophageal screening with the image-enhanced endoscopy may identify more synchronous cancers while there is no evidence to support its benefit on survival. Methods A total of 281 and 320 patients were diagnosed with hypopharyngeal cancer before and after the policy of routine esophageal screening. Primary outcome measures were overall survival. Results Among those who received screening, 49 patients (49/180, 27.2%) had synchronous esophageal cancers; treatment planning was changed in 42 (23.3%). Before and after the policy, percentages of stage I-II synchronous cancers were 20% (3/15) and 53.1% (26/49), respectively. Adjunctive therapies for synchronous cancers have led to a better survival after the policy than before (P = 0.002). The Cox regression model quantified a survival benefit of 29% (95% CI: 11-43%) when adjusting for TNM stage of hypopharyngeal cancer. In post-policy period, the survival was better for those who chose screening than those who did not (HR: 0.57, 95% CI: 0.41-0.79). Among those without screening, there was no difference between the pre- and post-policy periods (HR: 0.96, 95% CI: 0.74-1.26). Conclusions Patients with hypopharyngeal cancers may benefit from the esophageal screening with image-enhanced endoscopy through the better detection of early-stage synchronous cancers. ? 2013 Elsevier Ltd. All rights reserved.
|ISSN:||1368-8375||DOI:||10.1016/j.oraloncology.2013.04.009||SDG/Keyword:||adult; aged; article; cancer palliative therapy; cancer screening; cancer staging; cancer survival; cancer therapy; esophagoscopy; esophagus cancer; female; follow up; health care policy; health care quality; histology; human; hypopharynx cancer; image enhancement; major clinical study; male; outcome assessment; overall survival; priority journal; squamous cell carcinoma; treatment planning; Esophageal cancer; Hypopharyngeal cancer; Image-enhanced endoscopy; Survival; Synchronous neoplasms; Adult; Aged; Aged, 80 and over; Endoscopy; Esophageal Neoplasms; Female; Humans; Hypopharyngeal Neoplasms; Image Enhancement; Male; Middle Aged; Survival Analysis
|Appears in Collections:||醫學系|
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