Transnasal Esophagogastroduodenoscopy for Evaluation of Upper Gastrointestinal Non-Neoplastic Disorders in Patients With Fresh Hypopharyngeal Cancer

Objectives/Hypothesis: Upper gastrointestinal (UGI) tract non-neoplastic disorders are detrimental to cancer treatment. This study is to evaluate the feasibility of transnasal esophagogastroduodenoscopy in the diagnosis of UGI disorders at the same time as the diagnosis of hypopharyngeal cancer and to provide the prevalence of UGI disorders in patients with fresh hypopharyngeal cancer. Study Design: A prospective cases series study. Methods: Patients with newly diagnosed hypopharyngeal cancer between 2007 and 2010 were enrolled. An endoscope (GIF-XP260N; Olympus Optical, Tokyo, Japan) without conscious sedation was transnasally used to evaluate from the pharynx to duodenum. Results: One hundred two patients were evaluated. Sixty-five patients had at least one UGI disorder: gastric/duodenal ulcers in 32; active Helicobacter pylori infection in 36; and erosive esophagitis in 20 patients, including Los Angeles classification grade A in eight patients, grade B in 10, grade C in one, and grade D in one. Of the abovementioned disorders, 45 patients had only one, 17 patients had two, and three patients had all of the above disorders. Neither age, sex, location, nor T classification of the hypopharyngeal tumor was associated with the presence of UGI disorders. Conclusions: Transnasal esophagogastroduodenoscopy can be a single procedure to diagnose hypopharyngeal cancer and UGI disorders at one session. Approximately ? of the patients with fresh hypopharyngeal cancer had either erosive esophagitis, active H. pylori infection, or gastric/duodenal ulcers.